title: Framework of the outreach after a school shooting and the students perceptions of the provided support.
abstract: BACKGROUND
  A large number of bereaved family members, surviving students, and their relatives as well as school staff and the wider community were in need of psychosocial support as a result of a school shooting in Kauhajoki, Finland, 2008. A multilevel outreach project provided psychosocial care to the trauma-affected families, students, schools staff, and wider community for 2 years and 4 months.
  
  
  OBJECTIVE
  This article is twofold. First, it presents the theoretical rationale behind the psychosocial support and describes the multimodal elements of the services. Second, it analyzes the trauma-exposed students' help-seeking behavior and perceptions of the usefulness of the support they were offered in different phases of recovery.
  
  
  METHODS
  Information of students' help-seeking and perceptions of support is based on a follow-up data from 4 months (T1, N=236), 16 months (T2, N=180), and 28 months (T3, N=137) after the shootings. Mean age of students was 24.9 (SD=10.2; 95% women). Their perceptions of the offered psychosocial support were collected with structured and open questions constructed for the study.
  
  
  RESULTS
  The results confirmed the importance of enhancing the natural networks after a major trauma and offering additional professional support for those in greatest need. The students' perceptions of the provided care confirmed that the model of the acute and long-term outreach can be used after major tragedies in diverse situations and in other countries as well.
authors.affiliation: Hospital District of South Ostrobothnia, Seinäjoki, Finland ; Department of Psychology, School of Social Sciences and Humanities, University of Tampere, Tampere, Finland.
authors.forename: Tuija
authors.initials: T
authors.lastname: Turunen
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland ; Department of Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Henna
authors.initials: H
authors.lastname: Haravuori
authors.affiliation: Hospital District of South Ostrobothnia, Seinäjoki, Finland.
authors.forename: Jaakko J
authors.initials: JJ
authors.lastname: Pihlajamäki
authors.affiliation: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, Helsinki, Finland ; Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland.
authors.forename: Mauri
authors.initials: M
authors.lastname: Marttunen
authors.affiliation: Department of Psychology, School of Social Sciences and Humanities, University of Tampere, Tampere, Finland.
authors.forename: Raija-Leena
authors.initials: RL
authors.lastname: Punamäki
keywords: School shooting; bereaved families; psychosocial support; trauma; youth