Helping community leaders plan for mass violence

By Diane Alexander, Victoria Shelton, and Tara Hughes

Jun 27, 2022

This podcast series was recorded in April 2022. ICF has been providing immediate assistance to communities after a mass violence incident (MVI) for over 30 years. In this podcast we share guidance and advice on how communities can create a plan to respond to MVIs and identify and develop strategies to address the short- and long-term needs of the people they serve.

Editor’s Note: The following content deals with the sensitive topic of mass violence. Some listeners may find it distressing.

We invite you to listen to the first episode in a new series talking about sensitive topics that affect us all to some degree—large-scale violence and domestic terror. Mass violence incidents that occur in our communities in places such as schools, churches and other locations have both immediate and long-term impacts on victims, their families, and the immediate community. These incidents often shake our sense of safety to the core and reverberate across communities near, far, and the world at large. Joining this conversation with senior manager in the Office for Victims of Crime, Training and Technical Assistance Center (OVC TTAC) Diane Alexander are victim support services experts Victoria Shelton (OVC TTAC) and Tara Hughes, director of Improving Community Preparedness to Assist Victims of Mass Violence and Domestic Terrorism (ICP TTA). Together, they discuss the critical importance of preparing and pro-actively planning for best ways to support victims and communities when incidents of mass violence occur. Communities can’t assume that these type of acts will never happen in their town or city; they must prepare for when they will.

Topics covered in this episode include:

How are mass violence and domestic terrorism defined?
What are some of the negative ramifications of not preparing for a incident of mass violence in your community?
How mass violence response planning is different from planning for other “big things”
The three things that affect a mass violence response plan
Robust victim assistance and first-responder care services and psychological first-aid measures

Transcript:

Diane: Good day and welcome to our podcast on mass violence planning. My name is Diane Alexander and I am the senior manager in Victim Services at ICF. I currently focus my work on managing support to communities that have experienced a mass violence incident and helping communities plan for how they will respond to a mass violence incident.

Joining me today are Victoria Shelton and Tara Hughes.

Victoria is currently a Project Manager in ICF with the Office for Victims of Crime, Training and Technical Assistance Center (OVC TTAC). In her role, she supports consultants responding to communities impacted by incidents of mass violence.

Prior to joining ICF, Victoria worked in a state victim service program where she collaborated with other stakeholders in developing and implementing victim assistance protocols for incidents of mass violence and terrorism within the Pennsylvania State Emergency Management Plan. As the primary point of contact for the state's victim services crisis intervention team, Victoria assessed crisis response needs of communities impacted by mass violence and criminal activities, developed intervention plans with community leaders, and monitored deployment activities of the state crisis intervention team.

Tara is a subject matter expert in mass violence response, working directly with victims and families to ensure comprehensive care. Currently, she is the project director of the Improving Community Preparedness to Assist Victims of Mass Violence and Domestic Terrorism: Training and Technical Assistance project, and she oversees work with communities to plan for mass violence response. She has extensive experience working in mass violence casualty incidents, with a focus on the violence that affects large numbers of people and whole communities.

Tara has responded to many different incidents, including the crash of Colgan Air Flight 3407; the Haitian earthquake; the Newtown, Connecticut, Sandy Hook School shooting; the Boston Marathon bombing; Orlando Pulse Nightclub shooting; and the Route 91 Harvest Festival shooting in Las Vegas. Her current work in long-term recovery included the Pittsburgh Synagogue shooting, Virginia Beach municipal workplace shooting, and the Gilroy California, Garlic Festival.

Today, we are going to talk about the importance of planning for a mass violence incident. We've seen an increase in the number of mass violence incidents over the last several years. And while there were fewer incidents during the pandemic—primarily due to the lockdown of communities—it didn't take long after the lockdown ended for incidents of mass violence to return to our communities. We know that each incident will reveal the negative ramifications of not planning. Primary among those issues is the confusion and possible delay in establishing services to victims. And we know that the greatest benefit to planning is that it will minimize the chaos of the incident for everyone. Through the planning process, partnerships are established with key stakeholders and that reduces the chaos in the initial response and may increase collaboration to address other community issues as time goes on.

Today, we're going to touch on key elements of planning and provide you with resources for your planning efforts. Let's start with Victoria. Victoria, why don't you get us started by telling us about the Office for Victims of Crime, and then talk a little bit about how we define victims and OVC's missions to care for them?

The Office for Victims of Crime supports healing and promotes justice

Victoria: Thanks, Diane. When we're talking about the Office for Victims of Crime, which we refer to as OVC, their mission is broadly to enhance the nation's capacity to assist crime victims and to provide leadership in changing attitudes, policies, and practices in ways that promote justice and healing for all victims.

What that essentially means is that OVC is really looking for ways to enhance victims' rights and services for all victims across the United States. They are located within the Department of Justice. They are the agency actually charged with administering the Crime Victims Fund, which is very important because it's that fund that supports funding in both victim compensation and victim assistance programs in every US state and territory. It also supports training, technical assistance, and other programs to help improve service to support victims of crimes wherever they occur in the United States.

It's important to note that the funds are also distributed to federal agencies that provide services to victims. What comes to mind, the FBI Victim Assistance, and those victim advocates who work in U.S. Attorney's Offices. Some of the money goes to support model practices. But most of the Crime Victims Fund money gets funneled to states. And that is what then, in turn, distributes grants to local victim services programs that provide direct services and support to victims of crime.

I think it's really helpful today for our conversation—the context for listeners to know—that OVC also provides grants that support preparedness, response and recovery. It's really focused on assisting victims impacted by incidents of mass violence. And that's part of the work that Diane does and part of the work that Tara does.

When we're chatting about victims—technically, the definition of a victim refers to someone who's been injured by criminal acts of perpetrators, but in a broader sense, and doing the work of victim assistance—we tend to think of it as someone who's experienced either mental, physical, financial, social, emotional, or spiritual harm as a result of a crime committed on them or their property. When we're talking about victimization, it's important to remember that family members, significant others, and community members may be impacted indirectly, and we refer to those folks as “secondary victims.”

If we think about the impact of a crime as a pebble dropped into a pond, there are always a number of other people who are affected by that ripple effect. I think it's helpful to think about primary victims and secondary victims to include those family members, significant others, community members, and other people that may just be indirectly impacted by a crime—which includes incidents of mass violence, of course.

How do we define mass violence and domestic terrorism?

Diane: Thanks for that overview, Victoria, and that visual. I think that's really helpful for folks to be able to picture what we were talking about with victims. So, knowing that there are lots of crimes that impact victims, can you define what we mean by mass violence and domestic terrorism?

OVC has a definition for terrorism and mass violence, and that definition is an intentional, violent, criminal act that results in physical, emotional, or psychological injury to a sufficiently large number of people, significantly increasing the burden of victim assistance and compensation for the responding jurisdiction.

Victoria: I wish I could, Diane. There's not really a universal definition of mass violence, but there are a number of definitions, which sometimes can be part of the challenge when we talk about mass violence and responding to mass violence.

The FBI does not technically have a definition of mass violence, but we often see the term "mass murder" as being defined generally as multiple homicide incidents in which three or more victims are murdered within one event and in one or more locations in close geographical proximity. There are some caveats to that definition: It doesn't include situations where perpetrators may kill family members or situations where a homicide occurs as part of another crime.

You can see, there's not really one neat, tidy definition of mass violence. And then we start talking about more popular definitions and recognizing that mass violence at a community level also has an impact. That community-level violence can leave a large number of people injured or dead, it may occur across a community, and those incidents may not be related. I'm primarily referring to gun violence experienced by communities. Unfortunately, we often see in the media shootings that occur at house parties where a large number of people are injured and are killed by that sort of violence. Each of those incidences obviously leaves behind lots of victims and survivors.

What we're seeing is that over time, this is really changing the focus and the expectation of both the response and the services that are available, because what will often happen is that perhaps a community that's impacted by a more traditional mass violence incident will have an influx of services and resources. And those community-level incidents, perhaps, don't have the same level of resources and support. And community violence, just like mass violence, is unpredictable and can disturb that sense of order that we live with in our world.

It's really important to know that you don't have to have casualties for an incident to traumatize a community; it’s really about the impact of that event on a community.

I think it's really important to know that you don't have to have casualties for an incident to traumatize a community; it’s really about the impact of that event on a community. And then the definition of mass violence is further complicated by what the media refers to. So that makes it difficult for tracking. Makes it difficult to really identify and provide continuity in terms of research and that sort of follow up. The one thing that is probably consistent from community to community, unfortunately, is that school shootings are still school shootings regardless of where they're occurring. So that is, unfortunately, one consistent factor.

Diane: Thanks, Victoria. I think you already addressed frequency in your comments. We might come back to that if there's something more to talk about there.

Tara, let's bring you in here. Tell us, why do we need to plan specifically for a mass violence response, and how is a mass violence response different than another response?

Mass violence response planning is different than planning for other “big things”

Tara: Thank you for bringing me in. And Victoria, thank you for setting the stage so beautifully for this conversation.

So, how is mass violence different, and why do we need to have a specific plan? It's a great question. It's one that's asked by many, many communities because most communities have all-hazard plans or they have plans to work with, sort of, the normal “big things” that happen in communities.

Size and scope are important to remember in terms of why these incidents tax a community.

But why do we need to plan for something bigger than that? I think the biggest thing is that it's bigger. I know I've used that word a few times, but size and scope are really important to remember in terms of why these incidents tax a community.

Part of what we're looking at is, yes, the impact on victims, the impact on the community. But we're also looking at the impact on services and what services need to continue to happen at the same time as you are managing a very large incident that happened in your community. So, size and scope are going to be major driving factors in how you need to plan and what you need to think about differently. We'll get into more of those specifics as we go on. And definitely, in our second episode , we will get into more of those specifics about what are the key things to think about in terms of specifics to planning. But size and scope, in general, are two really big things to remember.

The other thing to remember is that criminal intent is behind mass violence and domestic terrorism. And it is not the case if it's a hurricane or a tornado or flooding or something like that—which may also have a large number of deaths and other casualties, injuries, and things like that related to it—but the intention of harm lays a groundwork during an event of mass violence or domestic terrorism that shakes an entire community. That community, by the way, can be the community of Newtown, Connecticut, but also, that shooting that killed 20 children, impacted the community of the world at large—in many ways. So, when you think about that intention of harm, it really impacts across the board. And there are different things that need to happen, not just for direct, or primary, and secondary victims who you're dealing with on the ground, but the community at large that you are dealing with, too.

When we look at the norms that we all function under every day—we do things like get in our cars, drive on roads, go to the grocery store, send our children to school, go to work, take walks outside, all of those things—those are the norms of a society and the norms of people functioning together. When you have intentional harm that brings about mass violence—domestic terrorism of some dimension—that foundation gets rocked. And because of that, the ripple effect that Victoria was talking about really intensifies. Instead of a pebble going into a pond, sometimes it's (more) like a huge rock going into a pond or a huge pillar of stone going into a pond. The ripple effects continue and can be very, very big as they move away from that immediate impact.

Planning helps communities prepare to respond and decrease fears

Tara: It impacts how people choose to do things, like send their children to school or (if they) are able to go to the grocery store without fearing that they're going to get shot while at the grocery store, those kinds of things. The foundations of everything get rocked. That means people behave differently and we need plans to help them figure out how to behave closer to that norm that they used to have.

So planning—even if you're planning for something that you hope never happens—is going to positively impact how you manage all of these different kinds of things.

Part of the long-term planning that we do is helping communities get back to a sense where the level of fear is decreased. It's very hard to do if you haven't thought about it before an event. So planning—even if you're planning for something that you hope never happens—is going to positively impact how you manage all of these different kinds of things.

There is a criminal component to this, too. Many plans that are written by emergency managers don't take into account criminal intent, criminal justice, and things that have to happen. Everything from finding a perpetrator to arresting them and what that means for victims. Before sentencing, are there hearings they have to go to, arraignments? What is that like for the people who are directly impacted by it?

The criminal intent adds something to this, as does that criminality, in terms of giving us access to certain services. Victoria talked some about this with the Crime Victims Fund funding victim advocacy and victim compensation in states. Those are things that are available due to the criminal nature of mass violence and domestic terrorism, and they are something that needs to be incorporated into emergency management plans. The relationships need to be there, prior to something happening, so that you don't have silos of people working tactically in operations to stabilize the incident itself, and then a different silo that's dealing with the victims or the people who are directly impacted. Those (services) need to be interwoven so that they are responsive to what they need to be responsive to.

Plan for first-responder services to be more robust than typical care

Tara: I think the other thing we need to look at is the scope of services that are needed for first responders. We know that communities plan for responders having some challenges with larger critical incidents—they may have peer teams, they may have teams that help people process incidents after they happen, and they may have all of those things in place. What we have seen with mass violence situations is those services need to be more robust than your everyday services.

We had—in Las Vegas, in particular—many, many, many calls going to the lead of the peer team in Las Vegas. She was very overwhelmed. She was very, very overwhelmed. Normally, (the peer team lead) has a couple of teams that can function at the same time, but she was being asked to potentially run debriefings for 10-12 groups a day, plus their families. So we look at that and the need for that really robust response is something you need to pre-plan. And you need to think about how do we do that and what kind of mutual aid can we use between our city and other cities, that may be close by, that can support us in those kinds of things?

The other thing to know about in terms of the responder piece is that the responders are often not always on duty when they're responding to mass violence. These incidents are so big that they draw people in. So people will self-deploy from home sometimes. Sometimes they are in attendance at the festival or the concert or the Christmas parade, as in Waukesha, Wisconsin. So their interaction is not always in their primary role as a first responder. They may be in proximity to their families and being shot at. They may be in proximity to their families and giving care to others who have been shot or who have other types of injuries.

All of that first responder care is something that we want to try to help communities develop well ahead of time so that they have the robust response that they would need from that.

Diane: Thanks, Tara. That's a great overview.

I want to bring Victoria back in here now and ask both of you to touch on—with everything that we've just discussed as kind of our foundation—what does that mean for what is needed in response to mass violence?

Prediction, preparation, and planning are needed to address mass violence

Victoria: Thanks, Diane. I'll lead here. I'd just like to circle back to something that Tara said as she was talking. It reminded me to remind all our listeners here to keep in mind that when we're talking about responders and we're talking about folks in the community responding, we are often talking about working with people who are experiencing trauma, too.

Planning can really be helpful, and practice can really be helpful, so those roles, expectations, and responses are kind of thought through beforehand. It might help with the responders who are perhaps experiencing their own trauma because their families are being impacted. These sorts of incidents are not just happening to a community, and then everybody from the outside is coming in to help. Often, it's the people from the community (who are) responding to the community. So I think that's a really important point that we keep front and center as well.

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When we are working with communities who have been affected by mass violence, quite often, what we hear is that they didn't expect it to happen here.

I think prediction, preparation, and planning. Tara talked beautifully about the importance of planning. I know Diane, Tara, and perhaps some of our listeners can relate to when we are working with communities who have been affected by mass violence, quite often, what we hear is that they didn't expect it to happen here . But we know, it's not a matter of if, it's a matter of when. Planning is really a critical part of that preparation and predicting for people what they may have to do in the aftermath of a mass violence incidence.

I think that when we talk about victim care, and we're talking about both direct and indirect victims, when we think about victim assistance, we have to think about what is in place now. And as we're thinking about planning and preparing to respond to mass violence, we have to recognize that those agencies are already very, very busy, and some of them may already have waiting lists. So they're going to be quickly overwhelmed by trying to provide ongoing support to a community impacted by mass violence. And victims of other crimes—the crimes that happened the day before and the crimes that happened the day after the mass violence incidents—are still going to need support and services and assistance.

We need to plan to support those victims, the victims that are impacted by the mass violence event, the secondary victims, thinking back to that ripple effect we mentioned earlier. And I have such a visual now from what Tara said about dropping a huge boulder into that pond.

Victim compensation are state programs that reimburse eligible victims for out-of-pocket expenses related to their victimization—but it's really important to know that eligibility varies greatly from state to state.

Victim compensation is a really important part of planning and preparation. Generally speaking, if folks are not familiar with victim compensation, these are state programs that reimburse eligible victims for out-of-pocket expenses related to their victimization—but it's important to know that eligibility varies greatly from state to state. For instance, in some states, victims who do not have physical injuries may not be eligible for any type of crime victim compensation. While in other states, they might be eligible for things like counseling and other supportive services. And for those compensation programs to be really thinking proactively as part of the planning process about how to make the process of even applying for crime victim compensation more streamlined, more accessible, and easier after an incident of mass violence is helpful.

The other thing that we need to think about as part of the planning and the preparation is the idea that there are many pathways to services. There's this no wrong-door approach to finding services and support, and recognize that services and support may look different as well. Some victims and survivors may want to join a more traditional kind of support group approach, but others may prefer yoga or more informal get-togethers. It's about offering as many open doors as possible for finding services and support.

I think it's really important here to talk, too, about how we recognize that recovery is not linear. Planning those pathways may have to change over time, evolve a little bit. What works at one point in time may need to be changed at a later point. And it can really help planning efforts to know this and anticipate this.

Tara, over to you.

Predicting reactions to traumatic events can help people understand their reactions are normal

Tara: Sure, thank you, Victoria. I would add to that, that understanding the fact that you will have, or communities will have reactions for an extended period of time. This is huge. These events of mass violence are huge. The services need to be there for an extended period of time, which sometimes is taxing on a community in and of itself, but also a lot of those services are those non-traditional services, as Victoria said, that give people information. And so we're really looking at a lot of people who are impacted, or very intensely impacted, but are not necessarily in need of mental health or substance abuse treatment at any moment; they may really just need support and information.

Part of what happens a lot in the immediate aftermath, but also in the long-term aftermath, is what’s called psychological first-aid. It really looks at helping to predict what people can expect from themselves and those around them when something like this happens. Psych first-aid is not something that is done only by licensed providers: Psych first-aid—everyone listening to this can provide psych first-aid. And frankly, you probably already do it to many of the people who you love and care about because it's really about helping them to figure out how they can best respond to their internal reactions.

Part of what we need to do is help not to pathologize all of these things that are happening, but to support people through what we're really considering predictable reactions. So when Victoria talks about “no wrong door” and how things have to change over time, it’s absolutely true. The information changes a little bit over time, but it needs to be available all along the way. Helping to figure out how to set up systems ahead of time will really help a community, and individuals within that community, get this information as quickly as possible.

We have the ability, many of us do, to go on Google and find information about what are the predictable reactions. That's all well and good, but trying to figure out how to put that into a way to get it into community messaging, to get it out to people so that we can say to them: "You know what? We get it…we get that you're having a hard time sleeping," or “…that you don't have as much patience with your children." All of those kinds of things. We can normalize that.

Planning gives us the ability to be able to think ahead of time: What are we going to need? And we know what's going to be needed. So preload that, find a place to put that in your community, and get it into the hands of the right people to get it out there. Again, the more we put out the information, the more people can start to predict their own reactions.

If I think I'm not broken by this, but that I'm just having what is a predictable reaction, then that changes how I manage moving forward. It changes for me. It changes for my family. It changes for responders, for providers. It changes for a lot of people.

What we know is, from a mental health standpoint, the more we can predict how we are going to react and we can normalize, “yes, that's happening to a lot of people out here,” the less we are going to think that we are broken. That means that I can function better. I may be having a really hard time, but if I think I'm not broken by this, but that I'm just having what is a predictable reaction, then that changes how I manage moving forward. It changes for me. It changes for my family. It changes for responders, for providers. It changes for a lot of people.

So looking at community messaging and interventions centered around this predictability, and helping communities and individuals understand that, is really the bulk of a lot of what we do in the aftermath of these events. And a lot of that can be pre-planned.

Diane, I'm going to hand it back to you to start to talk about some of the challenges that we see in these responses, and then you can throw it back to me when you're done.

Diane: OK, great. I think maybe you talked a little bit about the challenges and the response is really only the beginning of the challenges. When there is a criminal case, we've got a lot of points within the criminal justice system where victims and survivors will need support and services. So, as we've talked about these challenges and keeping them in mind, let's talk about the essential role of planning.

You may recall that I mentioned when we first started the podcast today that the greatest benefit to planning is that it will minimize the chaos of an incident for everyone. And as Victoria just said, it isn't a matter of if, it's a matter of when a mass violence incident will happen in a community. And that is something I have heard more often than I can count when I've talked to leaders who are interested in creating their plan. They realize that there is almost no place to hide, that it is a matter of when it will happen in their community and they want to be prepared.

Tara, do you want to take us through some of the issues about how the challenges can be ameliorated with planning?

Specificity increases response plan effectiveness while increasing community confidence

Tara: Sure. Part of what we need to remember—and really I'm speaking to the leaders who are listening to this call and leaders of emergency management, law enforcement, fire, EMS, dispatch, hospitals, the medical examiner, coroners—that part of what happens to a community very quickly after something like this happens, is that discussions start about the effectiveness of the response and the confidence that the community has that the next response is going to be effective, or if they're going to be able to do it well.

What we start to see is that one of the challenges is after an event like this is people starting to leave communities, that means that homeowners start to leave; they decide this is not a safe community, we want to move somewhere else. We see students being pulled from schools. And sometimes, those students are being taken out and put into private or charter schools within the same community. And sometimes we're seeing them being taken out and families are moving to get to what they're hoping are safer schools. We see businesses either not coming, or leaving communities. And when we talk to all of these—the homeowners, the parents, the business owner—about what they are calculating to figure out if they're staying or going—a lot of it comes back to: “We don't have confidence in the response that happened.” Or, “We don't have confidence that the next one will be any different.”

Part of what we've seen over time is that pre-planning gives two answers to that challenge in particular. One is that the more you plan and the more you think about the specifics that need to happen moving forward after a mass violence event, and the more concrete and effective that plan is going to be. The difference between, oh, “we'll have to take care of victims,” and, “in order to take care of victims, we need to engage victim advocates and victim compensation and behavioral health folks and spiritual care folks,” is the difference between sort of having a general plan and having a very specific plan. That kind of specificity increases effectiveness and therefore increases confidence in the people in the community who are there in that response and what is coming later.

You also have people who now have talked to each other ahead of time. We've said this a bunch of times—all three of us so far—about relationships and the relationships that are needed to really be effective in these responses. Those relationships only happen if you do this planning. As I said before, in a normal everyday world in a community, the fire chief is not necessarily talking to the victim advocates. Or they're not necessarily talking to the mental health or spiritual care folks who might come in to support people. So when something happens and everyone's attempting to meet each other at that moment and work together, that becomes really challenging.

What planning does for you is it front-loads all of those relationships. So now you have people who know each other. And even if personnel change, there's now a history of planning together and working together, and that really leads to a more effective and a more confidence-building response. That really will leave—everybody again, homeowners, businesses, students in your schools, teachers in your schools, even responders themselves.

What we know is after many mass violence events, we have responders leaving their departments sometimes, and sometimes leaving the field altogether. Front-loading information for them, planning ahead of time, and having all supports pre-existing for an event like this, really can help to solidify who you have in your community, get people to stay there, and continue to work together—as opposed to just starting to work together at that moment of crisis, which is always a challenge.

Reviewing and exercising response plans helps build and strengthen the relationships of everyone who will be a part of a response

Victoria: Tara, can I piggyback on something that you just said about relationships?

Tara: Sure.

Victoria: It was making me think about my time as a young advocate, joining a tabletop exercise in my community and feeling like I had been dropped into another planet. It was very different from my experience of working as a victim advocate—different language, different roles. And I'm so glad, thinking back, that I had an opportunity, as you said, to forge those relationships, figure out my role, figure out the language that was used before we had to be on-site together. I had an arena to practice, so to speak, and it was really, really valuable for me.

Tara: You talking made me think about when we showed up, and we were going to talk more about the Boston Marathon in a minute, but when we showed up in Boston, we—being a number of different agencies who needed to respond—we had challenges. We're going to get into that in a minute.

But one of the things that we didn't have at that moment was a challenge in our relationships with each other. So we are talking about victim advocates. We're talking about the FBI Victim Service Division. We're talking about the American Red Cross, some mental health people, the uniform public health folks. We had all just come off forging those relationships in Newtown at the Sandy Hook shooting response.

We didn't know each other there, or many of us didn't know each other there, but when we left Newtown, that was a core that had done this work together, had figured it out very quickly with each other. And when we arrived in Boston, we sort of were so far ahead of where we had been in Newtown because we all knew each other. And we all knew how each other was going to work and what needed to happen and how we were going to connect to each other, and it made such a difference in that unit in Boston.

Diane: OK, so can I piggyback off of both of you? A couple of thoughts: One is, and Victoria touched on this earlier, about exercising. And Victoria, you just shared what it was like to be dropped into an exercise not really knowing anybody. That is a really critical part of the planning. You can't just create a plan and put it on a shelf. And a lot of folks out there listening who are emergency managers or first responders, you understand the need to plan and exercise those plans.

So, just reiterating that for everybody out there: You can create a plan, but then you need to review it regularly and exercise it. And that helps to build those relationships that we've been talking about.

The other thing I wanted to touch on is that we've been talking about first responders. And Tara, you mentioned Las Vegas. I just want to say, we need to broaden who we think of as first responders, because some of our consultants who were out there learned that the nurses that were on duty at many of the hospitals there left their profession after that evening. And that was even with them planning and having a plan in place. So, really being able to think about the worst-case scenario that you can and try and make sure you have services in place for keeping those very valued employees in their positions so they can continue helping folks.

The only other thing I wanted to touch on was something that Tara said was that we have first responders leaving. After the Virginia Tech shooting in 2007—and they just had their 15-year commemoration—there's been a complete turnover in the university security force there. And that is just not recent; it happened over a few years after the incident. So, by not taking care of your first responders, you lose a lot of talent and expertise in your departments.

Any more piggybacking before we go on?

Tara: One more piggyback. I'm going to grow in there that we're going to talk about resources and some of them will be listed. But in terms of resources, my program, the ICP TTA Program, has a guide for exercising that will give you scenario extensions for existing exercises that include the victim services pieces so that you can have it sort of seamlessly go from the exercise you are already planning and add on some victim services components. We have in there the objectives and inject and all of those kinds of things. So there are resources out there in terms of planning and exercising to get you through that point so that you can do that with understanding what the key challenges are going to be because the injects in that guide really highlight the key challenges that we see when we go out.

Diane: Thanks for plugging the resources, Tara. On the page where you have found this podcast, we will have a list of different resources that you can reach out to and explore.

I'd like to thank Victoria and Tara for sharing their insights with us today. I wanted to give you a little bit of a teaser for our next podcast. We're going to start kind of delving into real-life examples. Tara mentioned the Boston Marathon. Do you want to talk a little bit more about what our listeners will hear in our next podcast?

Tara: Sure, absolutely. In Boston, when the marathon happens, there is an extensive plan and extensive exercising actually about tactically what is going to happen during the marathon. It's everything from something happening on the route, but also if there happens to be a house fire at the same time. There's a lot of planning that goes into all of that, and that planning has existed for a long time. There are 10 plus hospitals in the Boston area. There's planning among them, if there are issues, and what the hospitals are going to do in response.

What we found after the Boston Marathon bombing was that all of that planning actually worked pretty well. What didn't enter into any of that planning was anything about victim assistance and victim services or taking care of families and taking care of the people who were impacted and maybe didn't have a physical injury, but had an emotional injury.

So, looking at what was attempted immediately by the people who were already in charge, and then knowing what really needed to happen and how that all worked, is actually how we're going to start the next podcast.

What that really meant was the uniqueness of the services that were needed were not understood by the city. Who should be involved was not understood, or the extent of services that were needed at that moment. Again, we're going to talk more about that and what that took to get all of that going. And, eventually, it was successful, but it really was a sort of Herculean effort to get it off the ground.

That's where we're going to start the next podcast. I'll hand it back to Diane.

Diane: Thanks, Tara. That's a great teaser. I'd like to thank Tara and Victoria again for sharing their knowledge, thoughts, and experiences with us. I hope everyone will join us for our next podcast. Have a great day.