Six months after the tragic shootings in Newtown, Conn., a ceremony was held at Edmond Town Hall last month honoring the 20 children and six adults killed at Sandy Hook Elementary School. Above are two of the families who attended. Newtown held a moment of silence for the victims of the massacre.
AP Photo/Jessica Hill
The horrific mass shooting that took the lives of 20 young students and six educators at Sandy Hook Elementary School in Newtown, Conn., December 14, 2012, has produced an extended response from the state’s mental health community.
In the days following the tragedy, several mental health and social service organizations collaborated on offering drop-in help at a town middle school, a service that continued until April 10 (Psychiatric News, February 1).
The Connecticut Psychiatric Society (CPS) arranged for 150 volunteers to counsel Newtown residents during that time, said CPS President Carolyn Drazinic, M.D.
Eventually, the Newtown Health District established a coordinating council for mental health that included several area medical and mental health personnel.
Over the last six months, psychiatrists and others have worked to help Newtown recover and prevent future incidents by advocating for mental health concerns at the state and federal levels, providing direct mental health services, or helping the townspeople cope with their losses.
One unexpected consequence arose well beyond Newtown after the tragedy, said Harold Schwartz, M.D., psychiatrist-in-chief at the Institute of Living and vice president of behavioral health at Hartford Hospital.
“After the shooting, we had a crush of children and adolescents brought into the emergency department by families who feared they could become seriously dangerous,” he told Psychiatric News.
On the legislative front, new mental health legislation enacted so far in Connecticut is a mixed bag, said Schwartz, who is also legislative chair of the CPS. On the positive side, steps were taken to increase access to early treatment for young people, expand training in mental health first aid, and develop school-based mental health programs.
“But I’m disappointed in proposals requiring that all voluntarily hospitalized psychiatric patients be reported to the state and are thus prevented from obtaining gun permits,” said Schwartz. Under existing law, patients involuntarily committed by the courts are added to the registry and the federal gun-purchase database, but those hospitalized under a physician’s emergency certificate are not.
“That is ironic,” said Schwartz. “Putting patients on a registry would have little value for public safety but would discourage patients from coming in for treatment.”
The CPS was also instrumental in passage of a draft statement in the APA Assembly in May calling for improved firearms safety, restriction of access to guns by people considered dangerous (whether mentally ill or not), research on violence, and improved mental health services and access to care. The APA Board of Trustees is scheduled to discuss the Assembly’s proposal at its meeting this month.
Meanwhile, numerous mental health agencies, hospitals, and university psychiatry departments are caring for Newtown residents or training those who help them.
“We’re working on building capacity in the community by increasing the skills in trauma care among local mental health providers so they can offer their expertise to the primary care community,” Charles Herrick, M.D., chief of psychiatry at Danbury Hospital, told Psychiatric News.
After the acute phase, it was important to help local clinicians learn how to screen for reactions to trauma, psychologist Stephen Marans, Ph.D., of the Yale Child Study Center, said in an interview.
Marans and Yale colleague Steven Southwick, M.D., a posttraumatic stress disorder specialist at the West Haven Veterans Affairs Medical Center, started a program that has trained about 40 mental health care providers in trauma-focused cognitive-behavioral therapy.
The Yale team has also been directly involved at Sandy Hook Elementary School, said Marans. “We’ve offered in-classroom assistance and consulted with families, teachers, and administrators about how to reestablish order and predictability in children’s lives.”
“There can be a disruption of baseline capacity for regulation of feelings, thought, and behavior,” Marans noted. For instance, some first graders may show increased anxiety and greater startle response.
“We’ve suggested techniques to calm the class if there is a loud noise,” he said. They conduct screenings of children with traumatic symptoms, discuss those findings with parents, and refer some children for trauma-focused treatments.
“We also see children helping each other to better understand what’s going on in their own bodies,” he said. “But returning to routine is easier said than done. There are a lot of evidence-based mental health treatments for people who have experienced trauma, but there is also a gap in the number of clinicians with training in those treatments.”
In a separate program, psychiatrist John Woodall, M.D., a resident of Newtown, works with older children. Woodall developed the Unity Project 13 years ago, based on his work for the U.S. Department of State training mental health personnel for work in postconflict Bosnia and Uganda.
“We need to switch from the traditional mental health model to a resilience response, a model that mobilizes communities and increases capacity,” Woodall said. “So we work on mental health goals, not mental illness symptoms.”
The Unity Project was working with high-school students in Newtown even before the tragedy. At the request of local educators after the shooting, Woodall spun off an organization called Peacebuilders for youth aged 11 to 14.
“Rather than succumbing to despair, fear, or blame, adolescents in the program have responded to the tragedy with compassion and a desire to improve the world now,” said Woodall.
The broader Newtown community is trying to heal as well. The town has hired child and adolescent psychiatrist Jill Barron, M.D., of Yale School of Medicine to prepare a mental health needs assessment, which will soon be completed.
“The vast majority in the area are normal people who have experienced an overwhelming tragedy,” said Herrick. “They are not mentally ill but still need some help.”
There is nothing good about the deaths of children and their teachers, but perhaps something positive can grow in Newtown, said Woodall. “The town has responded really well. People are finding some higher meaning. The best thing for the children is that in 20 years they’ll be involved some way in public service and won’t see themselves as survivors or psychological casualties.” ■