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Violence, destruction, and death that is deliberately and malevolently caused by another human is horrific and tragic.

Victims, responders, the community, and sometimes the entire country experience the impact of mass criminal victimization, along with varying degrees of outrage, sadness, and feelings of vulnerability. The following principles guide mental health providers, as well as other responders and human service workers assisting survivors: 

• No one who witnesses the consequences of mass criminal violence is unaffected by it. Many groups may be emotionally affected, including emergency responders, government officials, media personnel, disaster workers, the community, those who view extensive media coverage, and mental health providers. A range of psychological support and educational interventions are important components of the overall response; 
• Most people pull together and function following a mass tragedy, but their effectiveness is diminished and they may have brief periods of being emotionally overwhelmed. Because of the magnitude and severity of psychological impacts inherent in mass violent criminal victimization, a wide range of intense emotional, physical, and behavioral responses are expected. However, human resilience and kindness predominate;
• Most survivors respond to active, genuine interest and concern. However, some will reject services of all kinds. Respectful human kindness is the basis for intervention. This includes supporting survivors' choices to not receive outside assistance, and understanding that, for some, choices may change over time; 
• Mental health assistance is practical, flexible, and empowering. It reflects survivors' needs to pace their exposure to harsh realities resulting from the event. First and foremost, providers must do no harm when intervening. Mental health providers must sensitively determine each survivor's needs and coping style, quickly establish rapport and connection, and offer support and assistance appropriate for that individual. Some survivors manage their intense reactions through protective denial and distancing, so that they may gradually come to realize the magnitude of the tragedy and their losses.

Helpful Resources:

• National Mental Health Information Center 
  Toll-Free: 1-800-789-2647 (English and Espaņol) 
  TDD: 1-866-889-2647 
  Web Site: www.mentalhealth.samhsa.gov
• National Clearinghouse for Alcohol and Drug Information 
  Toll-Free: 1-800-729-6686 (English and Espaņol) 
  TDD: 1-800-487-4889 
  Web Site: www.ncadi.samhsa.gov
• National Suicide Prevention Lifeline 
  Toll-Free: 1-800-273-TALK (8255) 
  TTY: 1-800-799-4TTY (4889) 
  Web Site: www.suicidepreventionlifeline.org
• Office for Victims of Crime 
  Toll-Free: 1-800-851-3420 
  TTY: 1-877-712-9279 
  Web Site: www.ojp.usdoj.gov/ovc/ovcres/welcome.html
• For information provided in Spanish, please click here:
  http://mentalhealth.samhsa.gov/publications/allpubs/
  KEN-01-0099/

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