mental health

Las Vegas Mass Shooting Survivors Continue to Struggle with Major Depression, PTSD

People physically injured in the shooting or who received low social support in the years after the incident had a higher risk of developing the mental health conditions. 

Four years after a gunman killed 60 people (58 died in the immediate aftermath and two later died from sustained injuries) and physically injured 867 more during the October 2017 Route 91 Harvest Music Festival  in Las Vegas, witnesses and survivors of the tragic incident still struggled with their mental health, according to a study led by the School of Public Health and the Medical University of South Carolina (MUSC).

Published in JAMA Network Open, the study found that nearly half of the Las Vegas concertgoers surveyed in 2021 reported that they had experienced major depressive episodes within the past year. More than 63 percent said they had experienced posttraumatic stress disorder (PTSD) during the same time period.

The findings underscore the critical need for sustained mental health support for people who experience a mass violence incident. As the gun violence crisis continues to affect every corner of America—with mass shootings still on the rise and total gun deaths nearly quadrupling since 2014—the number of people who need these services will continue to grow.

“Our findings reveal the long-lasting impact of gun violence on witnesses and survivors, with many still grappling with severe mental health issues years after the Las Vegas shooting,” says study lead and corresponding author Mohammed Abba-Aji, research fellow in the Department of Epidemiology. “This underscores the unique and ongoing challenge America faces with gun violence and its aftermath. This crisis calls for a national response to not only address but also to prevent the enduring trauma inflicted on our communities.”

Abba-Aji and Dean Kilpatrick, Distinguished University Professor at MUSC, worked with colleagues to gather survey data on mental health outcomes among witnesses and survivors of the Las Vegas shooting, selected from a list of people who were eligible to receive services from the Vegas Strong Resiliency Center, funded by the US Department of Justice Office for Victims of Crime (OVC). That resiliency center has since been renamed the Resiliency & Justice Center and designated as Nevada’s statewide victim assistance center to support all survivors of crime, emergency responders and those impacted by mass violence incidents such as Route 91 and the recent shooting at the University of Nevada, Las Vegas on December 6, 2023. For the study, witnesses were defined as those who were present at the scene and/or sustained physical injuries, and survivors included family members or friends of people who were physically injured or killed.

Among the 177 witnesses and survivors who responded to the survey, 58 reported that they were physically injured during the shooting, and 49.7 percent of respondents said they had received little social support from family and friends during the six months prior to the survey. Those who were physically injured had a 30-percent higher risk of experiencing a major depressive episode or PTSD, compared to concertgoers who were not injured. Similarly, those who received inadequate social support had roughly a 50-percent higher risk of experiencing a major depressive episode or PTSD compared to those who received adequate social support.

“The fact that such a high percentage of these mass violence victims still had PTSD and depression four years later is disturbing and demonstrates a continuing need for effective, trauma-informed mental health services,” says Kilpatrick, principal investigator on the project. “There is also a need for larger studies with longer follow-up of these survivors to see if these problems persist.”

Other studies have documented the development of these mental health conditions following other mass violence incidents, but the prevalence of both major depression and PTSD prevalence appeared substantially higher among the Vegas shooting witnesses and survivors than among other victims of mass shootings.

“Our study adds to the evidence around the devastating societal impact of mass shootings and the need to advocate for policies to prevent them,” says study coauthor Salma Abdalla, assistant professor of global health. “Moreover, the findings underline the necessity for ongoing mental healthcare, especially among people who experience physical injuries and lack of social support. The results highlight the urgent need for our health systems to prioritize long-term care strategies for trauma survivors, ensuring they receive the necessary support to navigate their recovery journeys.”

Study coauthor Angie Moreland is also the codirector of the OVC-funded National Mass Violence Center (NMVC) at MUSC, which offers resources for victims and survivors, community leaders, and clinicians to guide MVI preparedness, response, and resiliency efforts. Moreland says there are a variety of long-term support strategies that communities affected by mass violent events can implement to identify and treat mental health concerns as they arise. “The results of this study highlight the importance of work we are doing at NMVC to help communities prepare for mass violence incidents, and make sure victims and survivors have access to first rate information and services when mass violence happens.”

At SPH, the study was coauthored by Sandro Galea, dean and Robert A. Knox Professor.