The Role of Institutional Responses In Caregivers’ Mental Health and Recovery Following a Mass School Shooting

Background: Since the Columbine High School massacre, there have been more than 435 school shootings, exposing approximately 398,000 students to gun violence in schools. Research has documented high rates of posttraumatic stress and lower educational attainment among exposed students, and lasting adverse consequences for communities. However, far less is known about caregivers' experiences following these events, despite their central role in recovery across families, schools, and communities. Findings suggest that institutional responses influence caregiver health and recovery, contributing to or prolonging distress and worsening symptoms. This study sought to understand how institutional responses shaped caregiver health and healing following a mass school shooting. Methods: This study used semi-structured interviews with 27 caregivers whose child had been present during a mass school shooting. Participants were recruited using purposive and snowball sampling. Interviews explored caregiver experiences during and following the event. Data were analyzed using reflexive thematic analysis through an iterative process of code identification and refinement. Results: Caregivers described significant mental and physical health impacts following the shooting. Across interviews, caregivers emphasized that institutional responses in the aftermath played a central role in these symptoms- often causing and prolonging stress, and complicating healing. More specifically, institutional responses, including unclear guidance, limited transparency, and inconsistent communication, influenced caregivers' understanding of the event and how they navigated the immediate and longer-term aftermath, exacerbating mental and physical health symptoms, reducing education access, and increasing distress. When institutional supports were provided, they were frequently perceived as misaligned with caregiver and family needs, and at times, as not prioritizing students and families. This, in turn, limited caregivers’ capacity to support healing across individual, family, and community levels. Institutional responses also shaped perceptions of safety. Many caregivers described persistent fear and uncertainty about returning their children to school, which were directly related to institutional responses, with concerns about safety, trust, and communication influencing family decision-making and complicating reengagement in school environments. These findings suggest that institutional responses may inadvertently create and/or compound harm, shape access to resources and the school environment, following mass school shootings, which directly impacts caregivers and, in turn, extends to families and community recovery. Conclusion: Caregivers are central in recovery following mass school violence, supporting not only their children but families, the school, and the community while experiencing significant and persistent health impacts. Findings suggest that institutional responses are not peripheral to recovery but may shape healing across individual health, family functioning, community well-being, and education systems. These findings underscore the critical importance of trauma-informed, coordinated institutional responses that are responsive to the specific needs of caregivers and families. Social workers are uniquely positioned to play a central role across prevention, emergency response, intervention, long-term recovery, and policy advocacy. Strengthening communication, aligning supports with identified needs, and ensuring that institutional responses do not inadvertently cause further harm are essential to improving outcomes for caregivers. Continued research must center the voices of affected individuals to inform interventions, resource allocation, and policy change that support healing and strengthen recovery.