Center for the Study of Traumatic Stress
CSTS | Department of Psychiatry | Uniformed Services University | 4301 Jones Bridge Road, Bethesda, MD 20814-4799 | www.CSTSonline.org

Criminal Mass Casualty Trials:
Enhancing the Psychological Healthof Victims and Witnesses
stresses are likely to be exacerbatedCriminal trials are an integral
when the events precipitating apart of the US criminal justice
Behavioral health professionals,
trial involve numerous deaths
system. They involve multiple
prosecution teams, and victim services
and/or widespread injury, areparties participating in many diverseproviders and advocates are anespecially symbolic or meaningfulroles. The goal at trial is to ensure(such as the deaths of children
just outcomes for all involved. The
important part of managing theor first responders), or whereparticipation in trials by victims andstressofvictims
andwitnesses.
trials are likely to generate intense
witnesses is an integral part of theseand prolonged public exposure
processes. While the testimony ofand attention. Behavioral healthvictims and witnesses is often central
professionals, prosecution teams, and victim services
to achieving just outcomes, few victims and witnesses
providers and advocates are an important part of managing
have experience with these proceedings. They may havethe stress of victims and witnesses.
a very limited understanding of the process and players.
The information presented below broadly defines theVictims may have very unrealistic expectations of whatterm, ‘victim’, and may include family members of deceased
trials will be like or how the outcome may affect them.
victims, injured survivors, first responders, and witnesses toFor these reasons, victims and witnesses may experiencean incident.
significant stress before, during, and after trials. TheseBefore the Trial■ Provide information on mental health services, including
informal support services (e.g., Victim Advocates,Chaplains, and peer support).
■ Inform and assure access to victim assistance staff invarious agencies (see Resources section).
■ Establish a mechanism to identify and respond to unmet
needs that may have resulted from the incident.
■ Provide victims with spiritual/religious support whenapplicable. Often, it is through the lens of these beliefs
that victims begin to find understanding and meaning inwhat they have experienced. The faith community of thevictim’s choosing can be a frequent source of support tovictims in all phases of recovery.
■ Screen and evaluate spontaneous offers to assist andsupport victims. Focus on appropriateness of the offers
and the group offering in order to reduce potential forexploitation.

■ Educate victims on dealing with the media. Assist, if

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■

■

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needed/requested, in shielding victims from unwanted
media attention.
Coordinate access to prosecutorial staff who canprovide case status, explain processes and legal terms
and their implications.
Anticipate logistical concerns that may impact trial
participation (e.g., transportation, lodging, child care,access to closed circuit television).
Help victims identify their expectations of the trial andits various results. Educate to ensure these expectations
are realistic. Help prepare victims for undesired
outcomes (such as a not-guilty verdict, a plea bargain,or dropped charges).
Prepare victims for information they may hear/
see at the trial that may be inconsistent with theirunderstanding of what occurred (e.g., witness may learn
that a deceased victim suffered before death when they
believed that person died instantly).
Continued

■ Prepare victims for the reality that victim impact

statements may have little or no bearing on sentencing.
Preparation of victim impact statements, while often
therapeutic, can also be enormously stressful.

During the Trial■ Organize and coordinate medical and mental healthservices for victims. This includes support immediately
available to victims during the trial in case it is needed.
■ Prosecutors should keep victims updated on trial
activity and progress throughout the trial period.
■ Dispel misunderstandings about the justice system andprovide realistic expectations (e.g., the relationshipbetween victim and prosecutor is not the same as
relationship between defendant and defense attorney).
■ Inform victims and families that unless they are
actually testifying, the only real input they might havein the judicial process will be in the form of a victim
impact statement.
Following the Trial■ Assure access to medical and mental health services forvictims and their families.
■ Educate victims in understanding post trial legal
processes (e.g., sentencing phase, associated civil trials,
a reduced sentence, probation and parole, and releasedates).

■ Know the psychosocial aspects of restitution to victims,

where applicable (e.g., concerns about timing, nature,and fairness of funds for victims).
■ Include victims in planning memorials, anniversary
events, and remembrances. Symbols and rituals are often
comforting to victims. They cross boundaries of culture,
language, profession, and class.
■ Facilitate opportunities for victims to gather in groupsettings for mutual support if they wish.
Special Issues for First Responders to Criminal EventsFirst responders to criminal events often experience
exposure to events quite differently than most victims.
They may simultaneously be witnesses and victims. Their
exposure is the result of specific responsibilities andoccupational roles during and following events. They may,
but not always, have the benefit of specialized training andmore experience with trials.
At the same time, stigma concerning mental health andthe psychological response to traumatic events is often highin first responders. Sometimes, this stigma is intensified
by concerns about “fitness for duty” assessments that may
affect a first responder’s ability to continue doing their job.
This assessment may directly impact a first responder’sincome, employment, and workplace support and status.
Attending to these concerns of stigma and practical
impact are important to assure care and support for firstresponders.

Resources
1. Responding to Terrorism Victims: Oklahoma City and Beyond, Office forVictims of Crime, Office of Justice Programs, USDoJ, NCJ 183949, 2000.
2. Office for Victims of Crime — Directory of Crime Victims Services 		http://ovc.ncjrs.gov/findvictimservices/
3. National Organization for Victim Assistance (NOVA): 			
http://www.trynova.org/victiminfo/
4. National Center for Victims of Crime 					http://www.ncvc.org/ncvc/main.aspx?dbID=DB_ HelpfulContacts859

Center for the Study of Traumatic Stress
Department of Psychiatry
Uniformed Services University
4301 Jones Bridge Road, Bethesda, MD 20814-4799
www.CSTSonline.org