Healing a Community: Lessons for Recovery after a Large-Scale Trauma

INTRODUCTION

When I began my licensed therapy practice back in 1991, I never imagined that I would someday live in a world where mass shootings occur dozens of times each year. In 2015, The Washington Post reported that during President Obama’s second term, no single Sunday-to-Saturday calendar week passed without a mass-shooting incident. And since then, the violence has proliferated at airports, schools, and malls, not only in the US but around the world. What’s more, natural disasters such as hurricanes, mudslides, and wildfires significantly affect communities well after the initial incident, causing mental health problems for large portions of the impacted populations.

Despite their best intentions, most clinicians are not adequately trained to work with people suffering from complicated grief and complex trauma, the psychological phenomena that often result from these tragedies. Most therapists have not practiced in situations in which hundreds of people are affected at the same time, so why would they have sought such knowledge? Yet in the world we now inhabit, the need to prepare for those circumstances is great. The unfortunate lesson I learned in Newtown, Connecticut following the Sandy Hook School (SHS) shooting is that every community needs to create a mental health recovery plan so that its leaders, therapists, and families know what to do if a large-scale tragedy occurs.

NEWTOWN’S STORY

Newtown was, and is, quintessential New England. It’s lined with residential neighborhoods, multiple churches and other houses of worship, boutique shops, restaurants, and picturesque Colonial houses and buildings. There is a huge flagpole in the middle of a roundabout on Main Street. Located in Fairfield County, Connecticut, Newtown stands apart in its quiet charm from what is otherwise known as the Gold Coast of Connecticut. Surrounded by farms and rolling hills, Newtown was founded in 1705 and incorporated in 1711. Today, it’s the fifth largest town in Connecticut, covering sixty square miles. For its 28,000 residents, Newtown provides a safe haven to raise a family away from the hustle of New York City, Hartford, and Boston. Violent crime was virtually unheard of in its quaint environs until December 14, 2012, when Newtown changed forever.

That morning, at approximately 9:35a.m., twenty-year-old resident Adam Lanza entered his neighborhood Sandy Hook Elementary School after shooting and killing his mother in their home. Armed with a high-caliber rifle, he shot his way through the locked glass front doors of what was his former grade school. The principal raced into the hallway, the public address system in the front office still turned on for the morning announcements. Lanza immediately shot and killed the principal and a school psychologist, and injured another educational professional, all of whom had run to the school entryway upon hearing the initial gunfire. Heroically, they had tried to stop the shooter before he could harm others. But in less than five minutes, Lanza gained access to two first grade classrooms off the school’s main corridor, where he killed twenty students, two teachers, and two teacher’s aides in quick succession, firing 156 shots from one rifle and two more from a pistol. Lanza killed himself then, just as emergency responders were arriving to the scene.

The school was evacuated immediately after the shooting. Teachers and staff raced surviving children to a nearby firehouse. As reports of the shooting spread through town, frantic parents descended on the site. By nightfall the firehouse had become a gathering place for the entire community, including parents and family members who had lost loved ones.

This heartbreaking tragedy remains one of the country’s most devastating massacres. At the time it occurred, it was the second-deadliest mass shooting in modern US history, a statistic that has since been surpassed. More than six years later, the names Newtown and Sandy Hook continue to spark horrific memories for countless Americans. In a tearful statement delivered on the night of the shooting, President Obama said, Our hearts are broken today—for the parents and grandparents, sisters and brothers of these little children, and for the families of the adults who were lost. Our hearts are broken for the parents of the survivors as well, for as blessed as they are to have their children home tonight, they know that their children’s innocence has been torn away from them too early, and there are no words that will ease their pain.

CHAOS AND DISAGREEMENT IN THE IMMEDIATE AFTERMATH

The Sandy Hook neighborhood, as well as the greater Newtown community, was inextricably altered by the event. The recovery effort began immediately. It still continues today. And one of many important lessons to come out of the process was that even the best-intentioned remedies, when put in place without a clear, long-term plan, can have devastating effects.

The local and national response to the shooting was overwhelming. Without underlying town-wide disaster plans, Newtown officials quickly developed collaborative partnerships to address the Sandy Hook School community and Newtown residents’ needs. The town was flooded with donations, money, volunteers, and well-meaning providers. But while some added value, others actually hindered the response. For instance, the Reed Intermediate School was transformed into a mental health triage and crisis intervention center staffed by Newtown Youth & Family Services, clinicians from the Red Cross, behavioral healthcare providers from the immediate community and the rest of the country, and the Department of Mental Health and Addiction Services (DMHAS). This influx of support was appreciated, yet chaotic and ultimately ineffective. There was no organization, and even experts were not always clear on their roles. Communication among the groups was often splintered or fragmented, credentials were not always vetted, and in a short period of time this level of support began to deteriorate.

The tendency is for people to come together quickly after a tragedy to offer their assistance. Yet with no designated liaison or gatekeeper, communication can break down and result in a fractured system rather than a cohesive network. People don’t know who is in charge or where to go for help. Questions about trust, overlap, and service duplication surface. This breeds a culture of informal dialogue and assumptions about who is eligible for assistance and which groups have the greatest need. Providers may feel minimized or excluded from the recovery network. Competition and distrust can ensue.

There was also the question of what to do with the building. Sandy Hook closed immediately after the shooting, and the surviving children were temporarily enrolled at a school in a neighboring town. Then, six months later, Newtown voted to have the Sandy Hook School building torn down and replaced with a new one on the same footprint. Yet once construction began, there was tremendous emotional upheaval. The idea of a schoolhouse sitting at the same location became a trigger for Sandy Hook School personnel as well as some parents and students. Residents would drive to the construction site and sit in their cars and cry. Teachers questioned whether they could return to the location. Nearly four years after the massacre, when the project was finished, everything about the new building showed careful planning and tremendous sensitivity. The design also included state-of-the-art security systems. But many teachers and families still had a hard time driving to the site of such a horrific chain of events.

MONEY TO ADDRESS RECOVERY NEEDS

In January 2013, just a month after the shooting, the federal Office of Victim Services and the Department of Justice suggested that Newtown file a proposal to access federal financial aid to support their recovery. A community needs assessment was completed later that year; it stated that the mental and physical health needs for the community would be long term, given the age of the victims and the horror of the circumstances. The community applied for the Department of Justice grant, which would become the first of its kind to address the mental health needs of an entire community. The application included proposals from organizations for continued programming funds.

Eighteen months later, the town government of Newtown received $7 million from the federal government to address consequence management related to the tragedy. A large portion of the grant went to boost other organizations’ infrastructure and capacity, including that of mental health services providers and those offering wellness opportunities. Individual organizations approved in this grant had already provided some services and were now submitting invoices for their work, along with future programming ideas and strategies to assist the community. For instance, the Visiting Nurse Association wished to continue providing grief support services. The Resiliency Center of Newtown offered creative and alternative treatments such as art and music therapy. Newtown Youth and Family Services provided counseling and youth bureau programming. Each group was compensated for its important work. Yet in the eighteen months it took for the grant to be processed and money to be dispersed, local mental health providers doing the best they could to support the town’s needs were consistently overwhelmed.

Newtown officials didn’t have a support structure in place to adequately meet the community’s needs. And why would they? A tragedy like this had never occurred before. New systems and procedures would be needed to address ongoing mental health issues in the community.

MY ROLE

On the day of the shooting, I watched the news unfold just like millions of other people. The difference was that Newtown was only thirty minutes from my home. At the time, I was working as the behavioral health director for Catholic Charities of Fairfield, Connecticut, a nonprofit organization that also served the Newtown area. As soon as we heard about the shooting, we began to strategize about ways our organization could provide support.

The next day, as I was preparing to go to my psychotherapy office, I received a call from a psychiatrist who worked closely with me at Catholic Charities. She had a personal request: a close friend who had lost a son in the shooting needed help. The family had four other children, and the two youngest, one a twin of the son who was killed, hadn’t yet been told that their brother was not coming home. The parents needed guidance and assistance in breaking the news. I asked for a few minutes to cancel appointments with clients; then I would go to their house to provide whatever assistance I could.

I spent the next four hours working with the family in the most intimate way, not to make sense of what was happening, but simply to provide guidance on necessary and immediate steps to communicate the enormity of the loss to their children. This was the ultimate example of the clinical practice of holding space in a safe way while allowing the emotions of life to flow. The afternoon culminated with the family sitting together in their grief while the children were told that their brother had been killed at school.

Three months later, I saw these same parents at a recovery event in a neighboring state. The three day event had a lot of participant interaction. I did not want to trigger their pain, and did not know if they would be uncomfortable with my presence. That time I spent in their living room was heart wrenching and had created an indelible image in my mind of raw, inconsolable pain. Yet I put my reservations aside and decided to walk over to say hello. As I approached them, I extended my hand and said something like, It’s good to see you here. To my surprise, they looked at me in complete confusion. They had no idea who I was.

This is what trauma looks like and how deeply it affects the brain. Post-traumatic stress often results in cognitive and behavioral changes and deficits. Emotional flooding transfers into a breakdown in cognitive processing, including absent or diminished recall of the event and the most painful experiences connected to it. These parents were in the throes of trauma. In Newtown, most of the community had some variation of post-traumatic stress. And to make things more complicated, what one person may process as a life-altering interaction may be processed by another trauma victim as a numbing experience of which they have only foggy or minimal recall.

Over the next year and a half I went about my work at Catholic Charities and provided support to the Sandy Hook community whenever I could. This meant employing counselors for their Catholic school, securing grant money to provide clinical coverage to families and individuals affected by the tragedy at a nearby mental health center, and deploying therapists to offer support at events when asked.

CREATING A RECOVERY AND RESILIENCY TEAM

Once the DOJ grant was received, it was used to create the Newtown Recovery and Resiliency Team (NRRT). A colleague pushed me to apply for a Community Outreach Liaison position posted through the Town of Newtown. This person would be the de facto director of the NRRT. The job description was brief, and the listed expectations both vague and wide-ranging:

•  Conduct long-term strategic planning, assessment, facilitations, coordination, training, vetting, and advocacy at a high level in the community

•  Serve as the pivotal position in the community for residents, providers, funders, and municipal and community leaders to learn about available resources. This role will be the central position in Newtown responsible for monitoring and supporting the response efforts

•  Help link service providers with available funds to stimulate community networking and build capacity to achieve identified core community objectives

•  Facilitate discussion among all groups that have raised money in response to the tragedy to ensure each group shares its scope and mission in order to eliminate duplication and identify gaps

•  Anticipate and respond to ever-changing community issues

This sounded interesting to me, but I was concerned the goals were too open-ended. How could anyone anticipate the ever-changing needs of a community in crisis? It wasn’t until later on that I realized this disconnect was due to the fact that the grant was not written through a clinical lens, with guidelines to inform expectations and outcomes.

The lack of clarity in the description made me reluctant to apply, but something compelled me to send my resume in anyway, on the day before the posted deadline. I was called in for several interviews then and, to my surprise, was offered the position. Over the next few days, I searched for information on stepping into the realm of community recovery following a mass tragedy that is not due to a natural disaster. But there was little in the way of literature to provide guidance. I accepted the position even though I was uneasy. I knew I didn’t have the specific expertise, but I could use my skillset as a clinician and nonprofit leader to assess and build recovery efforts. I accepted the challenge with the understanding that I had a year and a half to create meaningful results. The grant term was for just eighteen months.

Operating under a $400,000 budget, my team was tasked to create infrastructure, services, and best practices to meet the mental health needs of a highly-impacted community. Interestingly, the grant award was earmarked for recovery programming for the entire town, but no one seemed to recognize the immense emotional and organizational collateral damage to the broader community that we would have to navigate, address, and resolve. The grant offered only a basic outline for the work. The 2013 Needs Assessment—a survey on the emotional state of the town in the shooting’s aftermath—was helpful. It identified who might be impacted and how to categorize their needs. But it did not provide a guide for the recovery process. My first task was to start at the beginning—get a comprehensive grasp of the community’s current needs. It had been more than a year since the last town-wide assessment. From there, I could make better decisions about allocating time and resources.

I brought together a talented team of professionals and embarked on the project with aid from outside experts and dedicated community supporters. It was truly a collaborative effort as we navigated the turbulent waters of forging a model for healing a community. I strongly believe that the programs I set up and the lessons I learned can be applied to any community that faces these challenges.

Unfortunately for Newtown, the DOJ grant lacked a framework emphasizing trauma-informed care or clinical best practices. While restoring wellness and resiliency encompasses many realms of treatment and community effort, understanding complicated grief and trauma is vital to every healing service. Because this was not a focus before the NRRT was in place, it was an uphill battle to explain the importance and justify the cost of having trained, qualified professionals deliver programming. It also became important to spend time educating the public, town leaders, and local clinicians on trauma-informed approaches to care. The team constantly had to learn on the job, and at the same time set a precedent for the clinical response to community recovery.

In addition to bringing in outside experts on community recovery, trauma, and grief work, we partnered with the Newtown/Sandy Hook Community Foundation to provide assistance and funding. The foundation was born out of the tragedy; it managed most of the donations that flooded in and provided financial support for much of the individual clinical and wellness treatments, as well as grants for programming that enhanced recovery.

While our team developed an array of recovery programming, we also supported efforts by local foundations, organizations, and faith-based institutions to educate and assist the community, and included these programs in our resource repertoire. Finally, we were tasked to continue work previously assumed by the State Office of Victim Services, which encompassed assessments to reimburse individuals impacted by the tragedy in need of financial assistance. While this part of the job was not anticipated, it was a natural fit for our comprehensive case management.

My team had to formulate a plan for parents, students, and first responders. Not only was every subsection of the community in a different stage with different needs, but every individual within each subgroup was also in a different stage with different needs. Trauma-related wounds are easy to reopen. A triggering event, such as news of another incident, the anniversary of the tragedy, back-to-school season, or a lockdown drill, would often require the therapeutic process to start anew even if the individual was making significant progress.

Newtown’s recovery was further complicated by a number of issues. The maze of finding and connecting its most vulnerable population—the children—to mental health resources daunted the families and their medical providers. They also had to navigate the immediate presence of media, the young age of victims, the rural location of the town, the violent nature of the crime, the tragedy having occurred at their school, an overwhelming influx of donated goods, and political issues that fractured groups. Challenges to a traumatized community are on a continuum of evolving needs impacted by culture, other world events, community resources, finances, geographic location, local leadership, media attention, socioeconomic status, the number and age of victims, the site of the actual tragedy, the trauma having been inflicted by a person, and the background and motive of the perpetrator.

The NRRT inherited a community generously supported by donations and endowed with