The psychological effects of public space shootings extend beyond physical harm because they create a broad psychological impact on everyone present at the scene. People who witnessed the shooting directly, and those who escaped by chance, along with emergency responders and personnel who cleaned up the area, family members of victims, and people who watched repeated disturbing media coverage, will develop post-traumatic stress symptoms.

But the main concern for clinicians and school administrators, and community leaders after the Sept. 10, 2025, university killing of Charlie Kirk isn’t whether trauma will appear, because it will, but how to minimize PTSD development while supporting long-term recovery.

Who is at risk?

The extent of trauma exposure determines PTSD risk levels because it depends on how close people were to the event and how intense and significant the experience was for them. Someone doesn’t need to be at an event to suffer, and I would suspect that some are still suffering the effects of viewing the events in Ohio, where students were killed by National Guardsmen.

A survey of 10,000 U.S. adults indicated that 7% of participants had experienced a mass shooting firsthand and 2% had suffered physical injuries during such incidents. The research, however, suggests that younger people face greater danger than older individuals and that exposure rates differ between male and female participants and even between different racial groups.

The numbers would seem to advise that individuals should receive screening tests following major public violence incidents. How we would do that and how far-reaching it would need to be is the question. Barring such monitoring means that people will suffer with the disorder in silence because they will not be in the pool being assessed for it. In fact, they may not even know that they are experiencing vicarious PTSD.

It’s not a question of being at the spot of the trauma. The study and conclusions underscore the danger of viewing violent events through the media multiple times, which can lead to stress symptoms. Experts are expressing a concern that gun-violence exposure affects two-thirds of U.S. adults through direct contact and media exposure, while demonstrating significant racial and gender differences. They believe that research is proving that media violence exposure can cause psychological damage to students who frequently watch violent video clips.

Even the professionals who help others should expect to develop secondary traumatic stress, too, according to clinicians. The 2025 research study about therapists working through mass violence events showed that their burnout and distress levels rose because of their work with grieving clients, which created an impact that weakened the essential recovery workforce.

What should the immediate response look like?

The initial response period focuses on establishing safety while providing stabilization, practical help, and emotional connection rather than forcing people to deal with the traumatic event. The National Child Traumatic Stress Network (NCTSN) and National Center for PTSD provide field guides that support Psychological First Aid (PFA) as the evidence-based approach for handling disasters and violent situations. The PFA-Schools model from the National Child Traumatic Stress Network (NCTSN) helps schools to provide the Psychological First Aid program to their students and staff members who experienced the event directly or are mourning its loss.

Multiple guidelines and summarized reviews demonstrate that mandatory psychological debriefing for unscreened groups should be avoided because it produces no PTSD prevention and potentially creates additional symptoms in some individuals. The evidence shows that this approach fails to stop PTSD development and actually may create additional symptoms in particular cases. The recommended approach involves a stepped care model, which involves normalizing typical responses while conducting ongoing screenings to direct affected individuals to trauma-focused treatment when their symptoms persist and cause impairment.

A 2025 SAMHSA roadmap provides universities with operational trauma-sensitive approaches to handle mass violence through memorial services and anniversary management, spiritual leader support, and mental health emergency response planning. The combination of academic requirements, public service obligations, and ceremonial activities in universities makes this approach particularly important for their settings.

Screening, timing, and differential trajectories

Not everyone who experiences traumatic events will develop PTSD. Most individuals go through short-term stress reactions that resolve within a few weeks. The first step in evidence-based treatment involves specific screening tests conducted at two to four weeks and again at six to eight weeks for those with high levels of exposure, using the PTSD Checklist for DSM-5 for self-assessment and the Clinician-Administered PTSD Scale for diagnostic interviews. These tools are standard in clinical practice because they have strong psychometric properties and include updated guidelines for healthcare providers.

The assessment process should focus closely on students and staff members who have experienced past trauma, lack social support, and face ongoing threats at the exact location. It should also consider those showing functional problems such as classroom panic, sleep disturbances, and campus avoidance. Supervisors of providers, too, need to monitor their workloads and offer structured supervision to prevent secondary traumatic stress from developing in their staff members.

The 2025 American Psychological Association (APA) guideline identifies individual trauma-focused psychotherapies as the first-line treatments for patients. The recommended first-line treatments for adults with PTSD symptoms include Prolonged Exposure (PE) and Cognitive Processing Therapy (CPT), and Eye-Movement Desensitization and Reprocessing (EMDR). The most successful protocol is highly dependent on the individual’s needs and ability to respond. There is no one-size-fits-all here, as in anything else.

The primary treatment for early intervention may not be medication, but it serves as a secondary option. Clinical practice guidelines support using specific SSRIs/SNRIs for PTSD patients who can’t access psychotherapy or refuse it, or who need additional treatment. Still, there is no solid evidence for using these medications as a preventive measure after trauma, and propranolol has not been viewed as standard prevention.

The most effective school-based interventions for children and adolescents who attend college part-time (dual-enrollment students and teen attendees) involve family-inclusive CBT approaches. Debriefing of young people is strictly prohibited under current guidelines.

Communal grief and polarization

The act of public assassination creates dual effects on trauma responses because it combines moral harm with political affiliation. The clinical presentation of patients includes anger, cynicism, and withdrawal behavior when they experience hostile online interactions. Research on collective and occupational trauma shows that structured peer support, together with clear institutional values and guided meaning-making processes, helps reduce distress among professionals who work with trauma victims. Universities should implement transparent safety updates, low-stimulation memorial areas, and voluntary small-group support sessions with trained facilitators, rather than conducting large-scale “processing” events.

There are steps outlining practical actions that universities and mental health professionals should take. What are the researchers and the professionals recommending? Here is a preliminary list:

1) Map exposure tiers. The assessment process should identify three groups of people: those who experienced the event directly, those who witnessed it from a distance, and first responders, family members, friends, and staff members who faced high exposure. The outreach process should use specific approaches instead of sending general invitations to all people.

2) Establish PFA (psychological first aid) services, which should become available within 24 to 72 hours after the event. The program should provide quiet spaces, assistance with transportation and housing adjustments, and educational materials about typical reactions and resources.

3) Screen and proceed. The PCL-5 screening tool should be administered to exposed groups between 2 and 4 weeks after the event, followed by referrals to PE, CPT, or EMDR therapy with trained therapists for those experiencing persistent impairment. The CAPS-5 functions as a diagnostic tool for both standard and complex cases.

4) The practice of mandatory debriefing sessions should be avoided, and the organization should replace single-session “venting” events with brief skills-based support sessions. These programs teach breathing techniques, sleep hygiene, and grounding methods, and establish clear paths to therapy access.

5) Support the helpers. The organization should establish monitoring systems that provide clinicians and staff members with supervision to prevent secondary traumatic stress and burnout.

6) Plan for anniversaries. The team should prepare for increased symptoms during the first month and first year after the event by scheduling communication plans, memorial services, and clinical support services.

The treatment of survivors who witness public killings requires more than one established protocol to reduce their suffering. The past ten years of PTSD research give universities, clinicians, and communities clear guidance: first, stabilize patients; then, conduct careful screening; and finally, apply trauma-focused treatment when necessary, while avoiding ineffective methods. Combining disciplined compassion with evidence-based practices helps survivors heal, supports helpers in maintaining their endurance, and allows communities to remember without being overwhelmed by it.

We are living in a world that is transformed from that of our parents, and we must adapt to this change. It is unlikely that there will be a cessation of community violence, given the widespread rhetoric that appears to underpin much of it. What can we do? Provide fact over fiction, utilize our critical thinking skills, and maintain our sense of hopefulness.