The suicides of three people connected to school shootings in the last week is bringing renewed attention to the long-term effects of such trauma—from survivor’s guilt to post-traumatic stress disorder.
There is scant research on whether living through or losing someone in a massacre increases the risk of suicidal ideation, and experts agree that suicide is a complex phenomenon in which genetics and neurobiology also play a role.
Tens of thousands of students have survived school shootings at this point—with varying degrees of proximity to the violence and ties to the victims—and reports of suicide among them are scattered.
But at the same time, scientists have found links between PTSD and suicide, particularly when there is underlying depression. And studies have shown that survivors of mass shootings are at higher risk for PTSD and other mental issues—although how much higher varies from study to study.
According to the National Center for PTSD, 28 percent of people who witnessed a mass shooting develop the disorder, with another third developing an acute stress disorder.
Sydney Aiello, who survived the deadly rampage at Marjory Stoneman Douglas High School in Parkland, Florida, but took her own life on March 17, had been diagnosed with PTSD, according to her family, who said she was also suffering from “survivor’s guilt.”
It’s not clear what kind of issues a Parkland sophomore might have been facing before he took his own life a few days after Aiello’s suicide. And little information has emerged about the death of Jeremy Richman, the father of a first-grader slain at Sandy Hook Elementary in Newtown, Connecticut, who was found dead Monday of an apparent suicide.
Amy Nitza, the director of the Institute for Disaster Mental Health at SUNY New Paltz, said that kind of guilt is a “typical reaction” but does not, in isolation, lead to suicide.
“Survivor’s guilt is not a diagnosis,” Nitza said. “It’s not in the extreme category, either. It’s not like PTSD.”
It can, however, be very unsettling.
Patrick Korellis survived a shooting at Northern Illinois University in 2008. Because he was sitting at the end of the row of seats, he managed to make a run for the door as shotgun pellets hit his head and arm. He was bleeding heavily when he arrived at the ER, but he survived—while five classmates died.
At a memorial service, the parents of a victim asked Korellis how their daughter, who was sitting in the middle of his row, died. Was she hiding under the desk? Was she trapped?
“I told them, yes, she was trapped under there,” Korellis told The Daily Beast. “I knew she was trapped, too. Why didn’t I grab her, try and save her? But the parents said, ‘No, don’t ever think that.’”
Korellis credits a strong survivor support network with keeping him from becoming suicidal, because when he was feeling really down, “he always had someone to talk to.”
Nitza, who recently published a book of case studies on mental health after disasters, said that the health of survivors is difficult to study because gathering data following trauma is ethically problematic.
However, there have been other cases of suicide after mass shootings. Roy McClellan survived the Las Vegas shooting; within two months, he killed himself. A year after the Columbine massacre, student Greg Barnes took his life. In Chardon, Ohio, six students attempted suicide after a 2012 shooting that left three schoolmates dead. A year and a half after Columbine, the mother of a student who was severely wounded was dead by her own hand.
Here’s what experts do know: Survivors of these horrific events need a strong support system. A study from Northern Illinois University found that survivors who were satisfied with their social support were more likely to recover from acute stress symptoms and persistent PTSD.
Melissa Brymer, director of terrorism and disaster programs at the UCLA-Duke National Center for Child Traumatic Stress, said access to services is also key.
During screenings, she asks students how often they’re thinking of the traumatic event, if they’re avoiding situations that remind them of it, if they’re depressed or suicidal, or if anyone in their peer group is struggling as well.
“Any kids who show signs of PTSD, we make sure they get help,” Brymer said.
Aiello was away from home at college when she died, which can heighten suicide risk. Brymer said her program trains trusted figures in college students’ lives, such as resident assistants and graduate assistants, to look for warning signs.
“They need to know there’s someone who cares and that there’s help available if they need it,” Brymer said. “We want the kids to know they have options.”
Brymer added that anniversaries are also high-risk times for survivors. The deaths of the Parkland students come just a month after the anniversary of the shooting and just before the anniversary of the March For Our Lives led by Parkland students.
Some of the Parkland survivors took to social media after the two suicides to complain they did not get enough services. Kyra Parrow wrote on Twitter that “after experiencing the deadliest high school mass shooting in American history” she was forced to return to the campus two weeks later.
“I remember at one point I couldn’t [bear] to write my paper. I went to my teacher—she proceeds to tell me to put my grief in a box to complete it.”
Students, she wrote, were “expected to brush aside our grief and deep mental wounds. The passing of two survivors by suicide is a awake up call of yet again, another failure by America.”
Two months after surviving the NIU shooting, Korellis met with survivors of the Virginia Tech shooting. He said talking with them helped him.
He said they discussed their common experience such as being triggered by certain sights or smells that remind them of the shooting, bad dreams, and trouble going into classrooms and lecture halls.
“I asked them, ‘Is it ever gonna get easier?’” he recalled. “They … said it gets a little easier each day.” He noted, “Even your closest family and friends won’t really understand what you’re going through like other survivors.”
Korelis now manages the NIU Facebook group for survivors of the shooting, their families, and victim families. It has about 70 members. He’s also active in a Facebook group for those affected by all mass shootings, which has about 900 members and cited groups such as The Rebels Project and Everytown Survivor Network.
“People post a lot saying they’re having a tough day, and there’s always reponses, people reaching out,” he said. “It’s sad but the group is always growing from victims of new shootings, so there’s no lack of support.”
Rhonda Hart, who lost her daughter, Kimberly, in a school shooting in Santa Fe, Texas, just three months after Parkland, said it can be hard to find the right person to talk to. In addition to therapy, she calls or texts suicide hotlines sometimes. She’s not part of any survivor networks.
“I’ve called the hotline just to talk, because I’m having a really bad day,” she said. “I just wanted someone to say, ‘It’s OK.’”
Korellis believes if he could have talked to the Parkland students, perhaps they would have lived.
“I wish I could have helped those kids before they committed suicide, I wish they’d reached out to us or someone,” he said. “We all have survivor's guilt. We’re all in this together trying to get through.”
If you or a loved one are struggling with suicidal thoughts, please reach out to the National Suicide Prevention Lifeline at 1-800-273-TALK (8255).