By Christopher Ryan

Survivors, witnesses, loved ones, and other members of the Las Vegas community are already bravely navigating a plethora of evolving challenges to recover from the tragic mass shooting on October 1. Facilitating the recovery will be a major challenge for emergency managers, but they can craft useful strategies by reviewing available evidence from similar tragedies in recent history. Reports from the Washington, DC sniper shootings (2002); London attacks (2005); Virginia Tech shootings (2007); Santa Monica shootings (2013), and; Boston Marathon bombings (2015) provide a compelling body of evidence about lessons learned and best practices in recovering from a terror attack with mass causalities. Considered together, the reports contain three key themes that emergency managers should use as a basic starting point for developing expectations and guiding recovery in Las Vegas: 1) Those effected need practical logistical support, especially in the short-term; 2) Resources for mental health recovery must be widely available, and; 3) Support must include indirect victims and be accessible to the whole community.

• Those effected need practical logistical support, especially in the short-term

Survivors of the Las Vegas shootings and their loved ones are likely to need help managing a web of unexpected logistical challenges, and lessons learned from several recent terror attacks provide emergency managers with a basic guide for helping provide practical logistical support. A key best practice from the Virginia Tech recovery was that all victims and victims’ families should have access to a designated advocate that can represent them and help simplify the complex processes of learning about their rights and ensuring that they can access all available resources. Similarly, an official report from the 2005 bombings in London stated that “many individuals were overwhelmed with administrative demands as a result of their bereavement or incapacity, just when they were least able to cope with them,” and that “advice on finance and benefits, travel, employment, housing etc. [sic] may be the most urgent need for many of those involved.” A Boston Marathon report identified Family Assistance Center-provided logistical support as a best practice, including “emergency funds for travel and food while supporting hospitalized family members,” as well as help obtaining disability placards. As the early part of the recovery phase continues, emergency managers in Las Vegas should be prepared to continue providing logistical support for victims and families on a potentially large scale.

• Resources for mental health recovery must be widely available

Community psychological recovery is likely to be enormous in scale and indefinite in duration, but evidence from recent attacks can help guide emergency managers in providing the mental health support. The U.S. Department of Veterans Affairs’ National Center for Post-Traumatic Stress Disorder reports that approximately one out of every three mass shooting survivors will develop an acute stress disorder. With about 22,000 concertgoers present when the shooting started, recovery officials in Las Vegas may need to assist several thousand people. Reports from the Boston Marathon bombings, DC sniper shootings, London bombings, and Virginia Tech shootings all emphasized the need for a formal community mental health coordination planning or training initiative, and the Santa Monica report recommended that mental health support partners should be included in the Incident Command System.  Boston and Santa Monica both identified their use of walk-in community mental health support centers as a best practice. London’s 7^th July Assistance Centre [sic] (7JAC) observed that after four to six months, requests for assistance generally shifted from logistical issues to concerns about mental health, and noted that attack-related news items, anniversaries, and investigative developments often triggered spikes in requests for mental health support. Recovery support personnel in Las Vegas should continue working closely with mental health professionals to develop or update mental health coordination plans as needed, be prepared to provide some form of support to thousands, and begin to anticipate and plan for surges in mental health support needs at key points in the future.

• Support must include secondary victims and be accessible to the Whole Community

Recovery efforts and resources naturally focus on the primary victims and survivors of mass attacks, but evidence from other attacks suggests that the Las Vegas community and beyond are likely to have many other victims that require support too, including first responders, healthcare practitioners, loved ones, and those with preexisting mental health problems. The Boston Marathon report stated:

“mental health needs of some healthcare and human services providers who supported individuals impacted by the bombings were not adequately addressed… Many of these individuals had first line interactions with survivors, their families, and others who were greatly impacted by the incident, and committed long hours over many days to provide support services… [but] some departments did little more than refer staff to an Employee Assistance Program.”

The DC report also emphasized the need for “post-traumatic stress counseling for victims’ families and community members as well as law enforcement employees and their families.” The Virginia Tech report asserted that “short- and long-term counseling should be made available to first responders, students, staff, faculty members, university leaders, and the staff of The Inn at Virginia Tech,” which hosted the family assistance center. London’s 7JAC also emphasized the need to make sure support services possess sufficient geographic reach, as survivors from outside of London “felt particularly isolated and excluded from the psychological and other support services that were available.” The 7JAC report also noted that trauma in a community can disproportionately affect people that were already suffering from mental health problems by exacerbating existing issues.  Recovery authorities in Las Vegas should be prepared to provide support broadly to the whole community, including first responders, employees, other secondary victims, and those with special needs.

No two terror attacks are fully congruent, but emergency managers can develop useful strategies for facilitating recovery from the Las Vegas shooting by reviewing available evidence from similar tragedies in recent history. By understanding that those effected need practical logistical support, especially in the short-term; noting that resources for mental health recovery must be widely available; and appreciating that support must include secondary victims and be accessible to the whole community, emergency managers in Las Vegas can begin addressing key challenges they are likely to face and ultimately guide a successful recovery.