Where can you feel safe?

With the news still fresh about a Texas church shooting that killed 4 percent of the town’s population and left 26 people dead, Dean Kilpatrick and his team at the National Crime Victims Research & Treatment Center are rolling up their sleeves.

It’s not to parachute in to save the day, says Kilpatrick, Ph.D., the director of the center that is part of the Medical University of South Carolina’s Department of Psychiatry and Behavioral Sciences. It’s to gear up for the long haul.

The center has received the “all clear” on an $18 million grant it received from the Office for Victims of Crime (OVC) to establish a Mass Violence and Victimization Resource Center.

“One of the ironies and the tragedies of this is when these things happen, there’s a lot of focus on it. A lot of people swoop in. People know more what to do, so we’ve gotten better at that. There’s a lot of attention, but then they go away, and the people are left. And they’re still having problems,” he says.

A case in point is the mass shooting in Las Vegas. Law enforcement did an amazing job in responding, but there are reports that survivors are running into jurisdictional issues in tapping into support services now that they are back in their home states. There also is a shortage of mental health providers in Nevada, he says.

The OVC wants the center’s team to go in and assess where the gaps in resources and services are and how to close them. One of the areas that has been identified involves hospitality industry workers, who witnessed the event, he says. “Our focus is going in later to make sure these people don’t get forgotten as the weeks, months and maybe even years roll by.”

For example, counselors reached out to survivors and family members affected by the Emanuel AME Church shootings in Charleston in June 2015 after the Texas shooting, since it also involved a church. “It’s a trigger that can exacerbate pre-existing fears and concerns.”

Each mass casualty incident poses different challenges in how to best reach out to survivors who need help, he says. In Las Vegas, an estimated 75 to 80 percent of the people affected by the mass shooting don't live in Nevada.

“When you’ve seen one of these, you’ve seen one of them. How they each differ highlights the complexity of it.”

The center will be studying those differences as it sets up its “many moving parts.” In addition to tapping into the resources of current faculty and staff at MUSC, the center will be partnering with 11 external groups, consulting with 26 subject matter experts and hiring 19 new staff members to manage various aspects of the grant.

“We’re helping build infrastructure and helping the OVC to figure out what areas need additional resources and training. We may provide some direct services, but our main role is to identify gaps and figure out how to fill those gaps.”

One primary goal will be to develop high quality, online resources. Benjamin Saunders, Ph.D., associate director of the NCVRTC, says over the next three years the mass casualty center will develop resources that can be used by everyone from survivors to first responders.

“We’re looking forward to this. We can develop good resources that can be spread widely and utilized by victims. Of course in Las Vegas, everyone knows about the 58 people killed. But there were literally thousands and thousands of victims at the scene and there are the family members of those at the scene,” he says. “We’re looking at how can we use technology and other kinds of channels and mechanisms to speed up the process of recovery and aid states, cities and towns where this is happening.”

The center also will be working to raise stress resiliency in the general public as these incidents create a collective stress, says Kilpatrick. “The extent you have this happening may diminish the focus on one as it moves onto another, but it’s a cumulative effect in terms of stress. It’s not that you get immune to these things, but rather more sensitized.”

According to the American Psychological Association’s report, "Stress in America: The State of Our Nation,” almost 60 percent of Americans consider this the lowest point in U.S. history they can remember — a figure spanning every generation, including those who lived through World War II and Vietnam, the Cuban Missile Crisis and the Sept. 11 terrorist attacks.

The most common issues causing stress when thinking about the nation are health care (43 percent), the economy (35 percent), trust in government (32 percent), hate crimes (31 percent) and crime (31 percent), wars or conflicts with other countries (30 percent), and terrorist attacks in the United States (30 percent).

Kilpatrick notes that while some people go into denial and want to tune it out, that’s not the typical reaction. “We are taking it for granted now that it is a part of life. There may be some who just don’t flat out want to think about it. Denial is sort of an issue. There are some of those people, but most people do care about it. It’s just they don’t know what to do.”

Part of the stress is that people no longer feel safe. Kilpatrick poses the question: “Where could you go that you would feel safe now?” He ticks off incidents that have happened in malls, concerts, churches and even elementary schools. Saunders says another problem about high-visibility traumatic events is they seem more threatening than they actually are.

“It’s normal to be nervous. Now we get more details right away. It’s instantly on your Twitter feed in a matter of seconds,” Saunders says. But that feeling needs to be put in perspective. “Most people are terrified of things that rarely happen and have no appreciation of things that they are really most at risk of. You’re much likelier to die in a car wreck.”

Kilpatrick agrees. “If you wanted to be totally safe you could go live in a bank vault, but your life would suck, and you’d probably die of boredom.”

The issues that may be causing a rise in these incidents do need to be addressed, but the problem can’t be laid at the feet of those with mental health issues, he says. “It’s insulting to say it’s a mental health issue. The vast majority of people with mental health issues do not shoot anybody or blow something up. They represent a minority of the cases.”

Kilpatrick’s best advice: “Live your life. What terrorists are trying to get us to do is to change our lifestyles and our behaviors. They want us to overreact to situations and intimidate and push some political agenda,” he says.

“Go on with your life, build good networks with your friends and neighbors. Social support is one of the most protective things we have. Obsessing about your own problems is often not helpful. It’s important to get out of your own head and focus on helping others. That’s what makes it better.”

When asked how he deals with the stress of being constantly focused on these mass casualty events, Kilpatrick says it’s not as bad as it might seem.

“What happens to people is depressing. Why it’s not depressing to us at the center is that people often have gotten nothing and no help. They’ve gotten no appreciation for what they’ve gone through. We can’t undo what happened, but we can do our part to make things better, and we will make things better in many ways.”