At the end of the day on May 24, more than 400 children walked away from Robb Elementary in Uvalde, Texas as survivors. That single day of grade school will follow them for years, a formative trauma that increases their risks of experiencing depression, missing school days and even earning less money over their lifetimes. Research shows that violence in the classroom harms kids regardless of whether it physically injures them. 

There were also more than 50 million children enrolled at other K-12 schools in the United States that day. Whether they were across town or across the country, many of those children will also have memories of May 24, 2022; sirens, blaring news reports, or the hushed, tense whispers of adults. They know something awful happened to kids just like them. Next year, they’ll do active shooter drills in their own schools and remember that this will be real someday for someone, even if it’s never real for them.

Is that, also, a kind of trauma? 

There is precious little known about how the impacts of school shootings ripple out to children in the rest of the community, state and nation. But there’s plenty of research that suggests the trauma of violence in general probably doesn’t stop at the specific location where it happened. And that, experts told me, means we need to be thinking differently about the damage violence can cause and who is at risk. 

Despite the high-profile nature of school shootings, and mass shootings more broadly, the mental health impacts of these kinds of events have not been widely studied. Five years ago, Dr. Sandro Galea, an epidemiologist at the Boston University School of Public Health, co-published a review of research on how mass shootings impact mental health. The 49 peer-reviewed papers he analyzed were mostly focused on what happened to direct survivors — people who were at the site of a mass shooting but left alive. There were only a few that addressed indirect exposure. 

These studies found evidence of trauma even for those who were not in the room or building where a mass shooting happened, though impacts were larger the closer people were to the actual incident. Other factors — such as media exposure, or the amount of time someone spent discussing the shooting with family and friends — also seemed to affect who came away with symptoms of trauma and how severe they were. But the amount of research on this subject was very small and incomplete, and it’s hard to say much with certainty. 

And according to Gaelea that is still true today. “The issue of mental health in community members who are not directly affected… most people in the mental health space think it’s a real issue but there actually has been very little research on it,” he told me. 

More broadly, there’s lots of evidence that, in certain situations, people can have their mental health impacted by traumatic events even if they weren’t personally in physical danger. “We’ve known for 20 years that watching media images of people suffering can, in and of itself, be a trigger for common mood anxiety disorders, things like depression and post-traumatic stress,” Galea said. 

Evidence suggests there are multiple kinds of indirect trauma, said Jennifer Carlson, a professor of sociology, government and public policy at the University of Arizona. Vicarious trauma, she said, is what happens when people like social workers are deeply exposed to the trauma of their clients and feel helpless to prevent those people from experiencing traumatic events. Community trauma, meanwhile, happens when whole populations are collectively traumatized by something that affects everyone on a cultural level, even if some individuals don’t experience it personally. The traumatic impact of the Holocaust on the Jewish community is a good example of this, as is the collective trauma expressed by Black Americans in the wake of the George Floyd murder. 

This knowledge has implications for how we think about the trauma of school shootings, even if we don’t know exactly how school shootings are affecting the mental health of kids nationwide. People who aren’t affected physically by a disaster are often reminded that they have a low risk of experiencing something like that themselves. There are tens of millions of kids enrolled in school every year, but only a little over a hundred a year — if that — become direct victims of a school shooting. The risk is low. 

But that’s the wrong way to think about risk when we know a traumatic event will happen. The number of school shootings every year that involve active shooters are very small — averaging 5 per year between 2021 and 2011, according to the Naval Postgraduate School’s K-12 School Shooting Database. But you have to go back to 1981 to find a year without at least one. School shootings are almost guaranteed to happen every year — we just don’t know to whom, Carlson said. 

And that means the risk of harm isn’t just about the physical likelihood of being shot, it’s also about anticipating a trauma that will happen to someone — maybe even you — and feeling powerless to stop it and at the mercy of chance. “I am a sociologist of crime,” Carlson said. “I’m very much on board with [the idea that] people overestimate their likelihood of victimization.” But this is different, she said. The likelihood of anticipatory trauma can be high even if the risk of injury and death is low. 

Given that, it’s useless to tell people not to be afraid of something like gun violence. It isn’t just about the personal risk of getting shot, Galea said. In 2016, he published an analysis that found the chances of an American knowing a gun violence victim at some point in their lifetime are nearly 100 percent. There’s a greater social burden than the statistics of direct risk can show.