Step 6: Harm / Impact

What It Is

Harm (or Impact) is the actual injury, loss, or damage that results when vulnerabilities, risks, exposures, and triggers culminate in a crisis.

Harm can be physical (injury, illness, death),
psychological (trauma, depression, anxiety),
social (loss of trust, broken relationships, stigma), or
systemic (community disruption, inequitable outcomes, financial collapse).

Harm is not always immediate — some forms are acute and visible, while others are hidden or cumulative over time.

Relationship to the Pathway of Harm

Harm is the consequence stage of the pathway — where theory becomes reality.
It represents both the end of one cycle and the beginning of the aftermath, shaping future vulnerabilities.
In A.V.E.R.T., harm is understood not only as an outcome to reduce, but also as a signal — pointing backward to missed opportunities and forward to recovery needs.

What We Train Individuals to Do

A.V.E.R.T. does not train people to “measure harm” in a clinical sense — instead, we focus on:

Recognizing harm when it has occurred, including less visible forms (emotional, social, systemic).
Responding without blame — centering support, not judgment.
Providing immediate stabilizing help — first aid, active listening, accompaniment, calling resources.
Documenting or sharing appropriately so others can follow up.
Understanding harm as preventable — learning to trace harm back along the pathway to address vulnerabilities and risks earlier next time.

What We Hope Others (Clinicians, Leaders, Systems) Will Do

Clinicians: Treat the physical or psychological injuries of harm while also addressing underlying causes.
Public Health & Leaders: Collect data on patterns of harm (e.g., overdose clusters, violence hotspots) and intervene at a community scale.
Systems: Shift from reactive-only models to preventive strategies, ensuring that harms don’t repeatedly occur in the same populations.

Examples of Harm / Impact

Individual: A person overdoses and sustains long-term brain damage.
Youth: A bullied student attempts suicide, leading to hospitalization and lasting trauma.
Community/System: A flood devastates a low-income neighborhood, displacing hundreds and entrenching long-term poverty.

Illustrative Statistics

Suicide is the second leading cause of death among youth ages 10–14 in the U.S.
Nearly 1 in 4 adults report experiencing at least one adverse mental health symptom during a public health emergency (like COVID-19).
Communities with repeated exposures to violence show higher intergenerational trauma and 2–3x greater rates of chronic illness.

Takeaway/Summary

Harm is the visible and invisible damage that occurs when the pathway is not interrupted in time. In A.V.E.R.T., recognizing harm is not the end point — it is a call to action: to treat, to heal, and to learn how to intervene earlier in the pathway next time.