Mass shootings like the one that killed 18 in Lewiston last month haunt survivors, witnesses, and those who lost loved ones long after the last bullet is fired and the funerals end, but emerging research suggests Lewiston also has a long road to recovery ahead.

Researchers compare the impact of the Oct. 25 slayings of 18 people at Just-In-Time Recreation and Schemengees Bar & Grille to an earthquake. At its epicenter are the injured and those who lost loved ones. Those who were there will feel shockwaves. But tremors may ripple out across the community.

And the aftershocks could be felt for months to years to come.

Buffalo, New York, Mayor Byron Brown said the May 2022 shooting at a Tops supermarket that killed 10 people in that city would have a long-lasting and negative impact far beyond those who knew and loved the victims. He testified in front of Congress last year that the shooting would affect an entire generation of children.

“Our family members, friends, and neighbors were simply going about their business grocery shopping when without warning they were interrupted by deadly gunfire,” Brown told the U.S. House Financial Services Committee. “It was a moment that changed our community forever.”

The FBI defines a mass shooting as an incident in which four or more people are killed within 24 hours, excluding the shooter. Using that definition, 815 people have been killed and 1,257 injured in 88 U.S. mass shootings in the last 20 years, according to a Violence Prevention Project Research Center database.

In 2023 alone, mass shootings had already claimed the lives of 42 people and wounded 34 others before last month’s horrific shooting deaths in a Lewiston bowling alley and bar added 18 more names to the list of this year’s fatalities.

While no two shootings or communities are the same, researchers say those who live in the same town, city or county may experience increased rates of depression, post-traumatic stress disorder substance use, and declining employment, wages, and housing prices.

Hamline University criminology professor Jillian Peterson, who co-founded a nonprofit research center dedicated to reducing violence in society, just finished writing a chapter about the mental health impact of mass shootings on the community for the American Psychological Association.

In communities where a mass shooting occurs, U.S. Department of Veterans Affairs studies have found that 5% to 10% of people who are not direct victims develop PTSD, she said. Schools, organizations, workplaces, and businesses have been described as “co-victims” because of psychological impacts.

“Mass shootings result in social disruption, creating fear and confusion,” said Peterson, who pointed to research that showed people perceive mass shootings as more traumatic than nearly any other cause of death. “Because they are seemingly random and unpredictable, these events cause helplessness.”

Those mental health impacts may be felt beyond community borders, especially if the shooting garners national headlines. About 80% of U.S. adults report feeling stressed about mass shootings, according to the Substance Abuse and Mental Health Services Administration.

Fear of America’s ever-expanding catalogue of mass shootings can cause people to steer clear of large public venues, such as shopping malls, movie theaters, and big community events, according to the APA. School shootings create an especially deep-seated community fear, she said.

The community impact of a mass shooting is significant and long-lasting, according to Abel Brodeur, an assistant economics professor at the University of Ottawa who studies the costs of gun violence. He spoke at the “Hearts and Prayers Are Not Enough” congressional hearing last year, along with Brown.

“Mass shootings decrease medical health in the short run and the long run,” Brodeur said. “We find that respondents in these communities increasingly report that they cannot do their normal activities like working, like taking care of their children.”

Brodeur reported that his 2022 study of mass shootings between 2000 and 2013 – when at least 300 lives were lost – showed that communities reported a 2% decline in employment, a 2.5% decline in earnings, and a 3% decline in property values.

Consumers in counties with mass shootings are 5.2% more likely to say their finances are worse now than before the tragedy, Brodeur reports, and 4.9% more likely to say local business conditions are worse now than beforehand.

Research shows that economic consequences are tougher for hospitality and manufacturing towns.

Although survivors and communities may learn to recover from a mass shooting in their own ways, on their own timetables, the way the disaster unfolds can be generally broken down into six phases, according to the Substance Abuse and Mental Health Services Administration – from pre-disaster to impact, heroics to a “honeymoon” period, and disillusionment to reconstruction.

The agency maps out a general psychological response to each phase in its training manual for mental health and human services workers tasked with responding to major disasters.

For a mass shooting, the pre-disaster period is usually not defined until after the tragedy has unfolded. Those who knew the gunman might wrestle with how any warning signs were missed or mismanaged. Many shootings are over within five minutes, but in Lewiston, the impact phase was prolonged by a multiday manhunt and community lockdown.

The manual stresses that the impact phase can feel different for people involved in the shooting and those trying to find loved ones where it took place, who may be panicked, anxious, confused, and in a state of disbelief until they are reunited or receive word of their loved one’s status.

The immediate aftermath, or the heroic phase, is when the gunman is caught or killed. In most cases, this is when police evacuate the scene, first responders offer medical care to victims, and families start to receive police notifications about loved ones.

Lewiston has now entered what the SAMHSA manual indelicately calls the honeymoon period. That is when a community pulls together, organizes vigils and memorials, unites over their shared experiences of the tragedy, and funerals begin to be held.

This is when individuals and the community may feel most optimistic about the possibility of rebuilding, possibly as a result of offers of assistance that pour in from outside the area and the formal government assistance, such as crisis counseling and funeral assistance, that is made available.

With other mass shootings, this stage can last up to a few months before survivors report feeling newly discouraged. The SAMHSA found that as assistance begins to fade over time, survivors may feel abandoned, resentful, and isolated as they struggle to rebuild while others return to business as usual.

Financial losses, changing financial dynamics, and bureaucratic delays can increase stress and pressure, prompting some to withdraw or turn to drugs and alcohol to help work through their grief. This can go on for years, sometimes prolonged by anniversaries and other mass shootings.

The final reconstruction phase might start around the one-year mark and can continue for years. Survivors are often still stricken with grief, and media accounts of other shootings may rekindle the old trauma, but some might start to develop healthy coping strategies.

Michael Rocque, associate professor of sociology at Bates College in Lewiston, who has studied mass shootings, said when a tragedy occurs, the community goes through a process of recovering from trauma.

“There’s more and more research being done that shows that there are negative effects to being in the vicinity or associated with a place of a mass shooting,” Rocque said. Mass shootings in schools, for instance, often lead to negative effects on grades, increased use of antidepressants, and more students suffering from PTSD.

At Bates, Rocque said, he noticed that even when classes resumed, some students had a more difficult time focusing on schoolwork. The extended manhunt, with a large police presence and helicopters overhead, made people feel ill at ease.

Rocque said the school tried to be as flexible as possible with students.

“This is a traumatic event that happened to the entire community,” Rocque said. “But we are seeing people coming together, with the Lewiston Strong T-shirts and gatherings. People want to come together to heal together.”

Researchers like Jaclyn Schildkraut, executive director of the Regional Gun Violence Research Consortium at Rockefeller Institute of Government, caution that every mass shooting is different, as is every community where they occur.

What Aurora, Colorado, has experienced – the good and bad – in the 11 years since a man shot 12 to death and injured 70 at a crowded movie theater can’t even be linked to what happened there, much less predict what lies in Lewiston’s future, she said.

“Despite all the shootings, there’s no playbook because every community is different,” Schildkraut said. “The public, even the survivors, would like there to be one, to know what to do, but part of the process is just getting through it. There’s no one right way.”

For example, the Parkland, Florida, community took some comfort in political activism after a former student killed 17 and wounded 17 others at Marjory Stoneman Douglas High School in 2018, Schildkraut said.

Some of these tragedies are hopelessly intertwined with the place where they occurred – Columbine and Littleton, Sandy Hook and Newtown, Pulse, and Orlando – while others appear to have faded from the national conversation about gun violence.

A gunman killed 14 people at a Binghamton, New York, civic center in 2009 – yet Binghamton, which isn’t that much bigger than Lewiston, is better known for its sauced, grilled meat sandwich known as a spiedie than for being the home of a mass shooting.

While some communities struggle to move past a mass shooting, Binghamton officials and survivors expressed frustration that the country appeared to have forgotten about them during local memorials held a decade after the tragedy.

While they represent a tiny fraction of total U.S. gun deaths, mass shootings trigger an outsized amount of anxiety and public outrage. Yet we have limited research on health impacts, said Dean Sandro Galea of Boston University’s School of Public Health.

That is because of a 1996 law that discouraged federal funding of the study of how gun violence impacts health out of fear that it would promote gun control. Congress relaxed the law in 2018 and earmarked $25 million for school-focused health research in 2019.

“We should see more research into this topic now, but it takes a while,” Galea said. “It will come too late to help Lewiston now, but it’s not going away. Based on what we do know, Lewiston is going to need help for years to come.”

Staff Writer Joe Lawlor contributed to this story.

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