Aug. 25 (UPI) -- One-third of staff at social services agencies working in Pittsburgh in the aftermath of the mass shooting at the Tree of Life synagogue reported suffering from mental health issues a year later, according to a study published Tuesday by JAMA Network Open.
The study, researchers said, shows the continued effects of shooting events among people who are not witnesses or survivors of an attack, but have worked with them.
Among more than 150 social workers surveyed a year later -- 11 people were killed in the Oct. 27, 2018, shooting -- 24% indicated they misused alcohol and 20% said they had symptoms of post-traumatic stress disorder, the data showed.
In addition, 19% reported having symptoms of generalized anxiety disorder, while 10% said they were clinically depressed.
Eleven percent said they had had thoughts of suicide in the year since the incident.
"There are devastating ripple effects for communities that suffer a mass casualty event," study co-author Rafael Engel told UPI.
"We tend to focus on the immediate period after a mass-shooting and, unfortunately, the individuals who work at agencies in the communities where mass-shootings occur are often overlooked," said Engel, an associate professor at the University of Pittsburgh's School of Social Work.
Because they work in the city, Engel and his colleagues said they saw "first-hand the emotional consequences" for the staff of social service and educational institutions within the community where the Tree of Life synagogue is situated.
They received a number of comments from survey respondents who "thanked us for simply asking how they were faring after the massacre," Engel said.
For this study, researchers surveyed 156 staff members at eight social services agencies and educational institutions in the area around the synagogue. The survey was conducted via email 11 months after the mass shooting, which has been described as the deadliest antisemitic attack on U.S. soil.
In addition to the mental health effects, roughly 30% of respondents reported experiencing feelings of burnout due to exhaustion and being "overwhelmed by the amount of work," among other factors.
About 40% of those surveyed had worked directly with survivors of the shooting and the families of victims, while another 40% worked as administrators in community organizations that served them, the researchers said.
Social service organizations form the "backbone" of many communities, particularly in times of crisis and it's imperative that these organizations "adequately address the mental health and well-being of staff," Engel said.
"For all the right reasons the federal government and the local community focus on the well-being of the families of those murdered, the witnesses and the survivors," he said.
"One of our key findings was that these longer-term challenges are not just limited to those who provide direct assistance, but cut across staff at all levels of the organization."