Center uses expertise after tragedy strikes

The National Crime Victims Research and Treatment Center at the Medical University of South Carolina, almost 40 years old, is taking on one of its greatest challenges as it leads the way in using a Department of Justice grant to help members of the Charleston community affected by the Mother Emanuel church shootings of June 17, 2015. Dean Kilpatrick, Ph.D., directs the center. Here, he discusses what went into securing the grant, the work it will fund and how the center’s remarkable history will aid its efforts.

What inspired the application for this grant, and how will it work?

My colleagues and I at the National Crime Victims Research and Treatment Center, the MUSC President's Office and the College of Nursing are thrilled that our grant application was funded because it will permit MUSC and our eight partner agencies to provide vitally needed services to victims and survivors of the Mother Emanuel AME church massacre. 

The activities supported by this grant will require an enormous amount of work on our part and a great deal of collaboration and coordination with our partner agencies, so we recognize that we have a big challenge ahead of us to make sure that the victims, survivors and Emanuel AME church members get the services they so richly deserve. 

This is an unusual grant mechanism in that you cannot just submit an application; the Office for Victims of Crime (OVC) must invite you to submit an application. 

The NCVC got involved in negotiating with OVC about submitting a grant application for three reasons. First, we knew from previous experience with large-scale mass murders and terrorist attacks such as the Pan Am flight 103 terrorist bombing and the 9/11 terrorist attacks that victims and survivors would have a variety of mental health and other needs that would persist long after the initial incident. 

Second, several NCVC faculty members, staff members, postdoctoral fellows and psychology interns volunteered immediately to assist victims, survivors and church members. This provided us with first-hand knowledge of how extensive the needs were and how long the recovery process was likely to take. 

Third, we had good working relationships with many local, state and national criminal justice, mental health and victim assistance agencies before this tragedy, and we worked collaboratively with them in the aftermath of responding to this tragedy. 

When we were approached by several of these agencies about taking the lead in seeking OVC funding to address this problem, we knew the assistance was needed, and we were honored to negotiate with OVC on behalf of the victims, survivors and our partner agencies.

Can you describe the role of the resiliency center funded by the grant?

Some people may be unfamiliar with the term resiliency. It has been defined as the ability to recover quickly from misfortune without being overwhelmed or acting in dysfunctional or harmful ways. We know giving people accurate information about traumatic events and their impact can increase resiliency. We also know that social support is a huge factor in increasing resiliency. 

This grant will support several community resiliency-building events designed to promote healing by giving victims an opportunity to commemorate their loss with others. It will also show that the community at large has not forgotten about the tragedy and remains committed to addressing the continuing needs of victims. 

The grant will also support a resiliency center housed in a building near the Emanuel AME church. It will serve as a hub to connect those impacted by the Emanuel AME church massacre with a wide variety of services designed to assist them in their recovery and to provide a gathering place that facilitates their connection to each other. 

The center will include therapy and group support rooms as well as a small technology assistance program that will help victims, survivors and members of the congregation access online materials developed for this project. MUSC will enter into a contract with the Emanuel AME church to support the development and maintenance of the resiliency center.

What experience has the NCVC drawn upon in helping people affected by the Mother Emanuel murders?

For nearly four decades, the NCVC has been at the forefront of research, teaching and clinical service delivery with respect to understanding and addressing the mental health impact of violent crime and other traumatic events. Particularly relevant in our ability to respond to this situation is work that we have done concerning the mental health impact of homicide on the family and friends of victims. 

We conducted the first national study of homicide in the late 1980s and found that it increased risk of mental health problems, including post-traumatic stress disorder and depression. We also found that many friends and family members had unmet mental health needs years after the homicide. 

Partly as result of that study, we established a homicide support group for family members and friends of homicide victims that has been provided in conjunction with the Charleston County Sheriff's Office for over a decade. This experience gave us considerable insight into the needs of the survivors of the Emanuel AME church massacre. 

We have also conducted research of the impact of several large-scale traumatic events,including the 1992 Los Angeles riots, the Pan Am flight 103 terrorist bombing and the 9/11 terrorist attacks. These experiences provided us with valuable information about the types of services that victims, survivors and members of the congregation were likely to need in the aftermath of this tragedy. 

We also have pioneered the development of web-based psycho-educational materials that are designed to provide individuals with accurate information about the mental health impact of traumatic events and ways to facilitate recovery. 

Finally, we have developed a number of specialized, evidence-based mental health treatments for trauma-related mental health problems. We have an active mental health clinic for trauma-related mental health problems and provide training for mental health professionals concerning how to deliver these mental health services.

Can you provide a little more detail about those treatments?

As I noted previously, many individuals are resilient following exposure to traumatic events, but we know that some will develop trauma-related mental health problems and can benefit from specialized mental health treatment. Mental health problems are not limited to post-traumatic stress disorder, but it is clear that post-traumatic stress disorder (PTSD) is one of the major problems that can occur following traumatic events. 

There have been a number of well-designed, randomized clinical trials that have studied the safety and effectiveness of several treatments for PTSD and related disorders. In general, they’ve shown that trauma-related psychotherapeutic treatments are more effective than generic psychotherapy or medications. 

The most effective treatments differ somewhat in the way they approach addressing the impact of the traumatic events, but they all include providing information about the types of problems that generally occur following exposure to traumatic events as well as why and how the problems develop. They also involve engaging patients in a variety of strategies to replace potentially maladaptive ways of responding to traumatic events with more constructive ones.

How do you approach the aftermath of such a horrific event and prepare for the future?

Unfortunately, this type of mass shooting has become much more common than it used to be. In recent years, mass shootings have occurred at Virginia Tech, Fort Hood in Texas, a theater in Aurora, Colorado, the Sandy Hook Elementary School in Connecticut and a community center in San Bernardino, California. A major terrorist bombing occurred during the Boston Marathon. 

Charleston had already experienced many traumatic events, some of which, such as the Civil War, occurred before we were born, but others, including Hurricane Hugo and the Sofa Super Store fire, happened within recent memory. We can no longer maintain the fiction that it can't happen here, because it already has happened here. 

The first step in preparing our community to deal with future events is to recognize that it can happen here and force ourselves to prepare for this eventuality. This is not a comfortable or easy thing to do because it forces us to confront the fact that life is fragile and terrible things can happen. 

The second step in building an effective community response and recovery plan is establishing good collaborative working relationships between relevant agencies before the next tragedy happens and developing a plan. Many of the agencies responding to this tragedy, including the NCVC, had been working together for years before this tragedy occurred. This history facilitated the collaboration and trust that enabled our community to respond so effectively.

How have church members’ reactions to the shootings affected the community?

The family members’ responses demonstrated such amazing grace that they set a high bar for the rest of us. The Emanuel AME church has always been a leader in the African-American community, and this tragedy gave those of us who are not African-Americans an opportunity to see what it looks like when people exhibit such strength and faith. 

I think most people were extremely moved by their example and inspired to try to live up to the example they set. I also think the city of Charleston has been blessed with exceptional political and community leaders who established an environment that fosters strong community response and support when something like this happens. 

Many people in our community over many years have spent a lot of time and effort trying to promote better understanding and address inequities, and I think that groundwork helped us during this tragedy. 

What is important now is that we all do everything we can to nourish the spirit of unity and commitment, because this tragedy is not over. There will be many rough spots ahead, and we need to remember the amazing example that has been set and live up to it in our actions.