Mental Health Service Utilization Following Mass Shootings

Mental health service utilization following a campus mass shooting: The role of preshooting emotion dysregulation and posttraumatic cognitions.

“…However, age and preshooting emotion dysregulation interacted to predict an increased likelihood of psychotherapy utilization, suggesting that older women with greater preshooting emotion dysregulation were more likely to utilize psychotherapy services. This aligns with the broader MHU literature that shows the effect of age on MHU varies by context (Smith et al, 2017). However, the effect of age in the current study was found only for psychotherapy, not medication use.…”

“…Nonetheless, our results may not generalize to men or individuals who identify as male, and our college sample limits the extent to which our results apply to older or community samples. For instance, following disaster, women utilize more MH services than men, and previous MHU work has utilized older samples and those with wider age ranges than ours (Smith et al, 2017). Additionally, younger individuals and MENTAL HEALTH SERVICE UTILIZATION AFTER SHOOTING 157 women both show a preference for psychotherapy over medication (McHugh et al, 2013).…”

“…This would explain the observed interaction because depressive rumination entails abstract thoughts about a depressed mood's meaning, causes, and consequences that stymy problem-solving behaviors (e.g., MHU; Kennair et al, 2017). Communities affected by mass shootings may potentially mitigate this deterring effect by promoting messages that normalize the experience of depression and other mental health difficulties, as strength-based campaigns that emphasize only resilience may alienate those who are struggling (e.g., "BOSTON STRONG;" Smith et al, 2017).…”

“…Much of the research on MHU comes from the disaster literature and has largely relied upon Anderson's (1995) behavioral model as a framework to understand three classes of factors that affect health care utilization: predisposing factors (e.g., age, gender), enabling/disabling factors (e.g., stigma, financial constraints), and perceived or evaluated need (e.g., emotional distress; see also Rodriguez & Kohn, 2008). Although the relevancy of these factors varies and appears dependent on the sample, need has been identified as the strongest predictor of MHU (Anderson, 1995;Smith et al, 2017). For example, across the MHU postdisaster and posttrauma literature, variables such as severity of distress, psychopathological symptoms (e.g., depression, PTSD), and exposure are consistent predictors of increased MHU (e.g., Gavrilovic et al, 2005;Smith et al, 2017;Kantor et al, 2017).…”

Protective Factors, Coping Appraisals, and Social Barriers Predict Mental Health Following Community Violence: A Prospective Test of Social Cognitive Theory

“…Approaches to building CSE among victims can be considered through the notions that social support from others with like experiences can maximize the positive benefits of social transactions (Thoits, 2011;Smith, Donlon et al, 2015), and that vicariously observing like-experienced others who are coping well can be a powerful CSE shaping strategy (Bandura, 1997). Our findings also have implications for public health messaging approaches that may boost individual and community adaptation (see Smith, Donlon, Wusik, & Jones, 2016;Jones, Donlon, Burns, Schwartz-Goel, & Law, 2012). For example, universities can tailor public messages to reduce perceptions of social support barriers and bolster CSE appraisals, by doing such things as setting the norm that we are a "community of care," "there are people here to listen," and/or focusing on positive acts of humanity (brave first responders) to positively influence community grieving and recovery.…”