Survivor perspectives on research priorities for assessing mental health outcomes after school shootings: a qualitative study.

Background: Firearm violence is a major public health problem and the leading cause of death among children and youth aged one to nineteen in the United States (US). School shootings, though a relatively rare form of firearm violence in the US, have been occurring with increasing frequency, exposing more than 380,000 students to such events since 1999. This study engaged school shooting survivors to identify key research areas regarding their mental health, aiming to enhance the relevance and impact of future research for this community.

Methods: Participants for individual and group interviews were recruited from survivor support groups and through snowball sampling between May and August 2024. The interview guide, based on a recent scoping review highlighting gaps in research on the mental health impacts of school shootings, facilitated discussions on participants' experiences, needs, and research priorities. Interviews were recorded, transcribed verbatim, and analyzed using thematic analysis. Thirteen individuals participated (median age: 40 years; range: 18-47), including 11 former student survivors, one parent of a survivor, and one sibling of a victim. These participants represented ten school shootings from 1997 to 2022 across eight US states including Colorado, Florida, Kentucky, Maryland, Michigan, Oregon, Tennessee, and Washington. Eight participants experienced a mass school shooting (four or more fatalities excluding the perpetrator).

Results: The study identified three key research priorities: (1) understanding the long-term mental health impacts of school shootings across the life course, (2) expanding research to include broader outcomes beyond traditional mental health metrics, and (3) diversifying research approaches, study designs, and study populations to better capture the varied experiences of survivors.

Conclusion: There is a need for researchers to explore a wider range of outcomes, communities, and timeframes when studying the mental health impacts of school shootings. Such investigations are essential for understanding the complex and unique aspects of recovery and resilience among survivors. Centering survivor perspectives enhances our understanding of ongoing challenges facing survivors of school shootings, which should be prioritized in designing and evaluating interventions and policies.