ArticleJMIR public health and surveillance2023
The Use of Crisis Services Following the Mass School Shooting in Uvalde, Texas: Quasi-Experimental Event Study.
Article in JMIR public health and surveillance, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Associations between media gun violence exposure (GVE) and mental health: a national cross-sectional study.BMC public health · 2026Article
- Silent echoes: understanding and predicting the widespread mental health impact of mass shootings.Frontiers in public health · 2026Article
- Survivor perspectives on research priorities for assessing mental health outcomes after school shootings: a qualitative study.Injury epidemiology · 2025Article
- Response From Crisis Text Line to "Commentary on 'Protecting User Privacy and Rights in Academic Data-Sharing Partnerships: Principles From a Pilot Program at Crisis Text Line'".Journal of medical Internet research · 2025Article
- Exploring whether mental health crisis text conversations that include discussion of firearms differ from those without firearms.Preventive medicine · 2023Article
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Authors and funding
6 authors.
Funding
Abstract
backgroundMass shootings result in widespread psychological trauma for survivors and members of the affected community. However, less is known about the broader effects of indirect exposure (eg, media) to mass shootings. Crisis lines offer a unique opportunity to examine real-time data on the widespread psychological effects of mass shootings.
objectiveCrisis Text Line is a not-for-profit company that provides 24/7 confidential SMS text message-based mental health support and crisis intervention service. This study examines changes in the volume and composition of firearm-related conversations at Crisis Text Line before and after the mass school shooting at Robb Elementary School on May 24, 2022, in Uvalde, Texas.
methodsA quasi-experimental event study design was used to compare the actual volume of firearm-related conversations received by Crisis Text Line post shooting to forecasted firearm conversation volume under the counterfactual scenario that a shooting had not occurred. Conversations related to firearms were identified among all conversations using keyword searches. Firearm conversation volume was predicted using a seasonal autoregressive integrated moving average model trained on the 3 months of data leading up to the shooting. Additionally, proportions of issue tags (topics coded post conversation by volunteer crisis counselors at Crisis Text Line after the exchange) were compared in the 4 days before (n=251) and after (n=417) the shooting to assess changes in conversation characteristics. The 4-day window was chosen to reflect the number of days conversation volume remained above forecasted levels.
resultsThere was a significant increase in the number of conversations mentioning firearms following the shooting, with the largest spike (compared to forecasted numbers) occurring the day after the shooting (n=159) on May 25, 2022. By May 28, the volume reverted to within the 95% CI of the forecasted volume (n=77). Within firearm conversations, "grief" issue tags showed a significant increase in proportion in the week following the shooting, while "isolation/loneliness," "relationships," and "suicide" issue tags showed a significant decrease in proportions the week following the shooting.
conclusionsThe results suggest that the Uvalde school shooting may have contributed to an increase in demand for crisis services, above what would be expected given historical trends. Additionally, we found that these firearm-related crises conversations immediately post event are more likely to be related to grief and less likely to be related to suicide, loneliness, and relationships. Our findings provide some of the first data showing the real-time repercussions for the broader population exposed to school shooting events. This work adds to a growing evidence base documenting and measuring the rippling effects of mass shootings outside of those directly impacted.
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