MUSC-based town hall on school shootings attracts international audience

May 31, 2023
A woman hugs someone whose back is to the camera. A pink balloon floats beside them with the words Uvalde Strong on it.
The school shooting at Robb Elementary in Uvalde, Texas, took place a little over a year before a national discussion about mass violence. Its commemoration on May 24, 2023 was part of the backdrop for the town hall. Photo by Eric Gay

In a year with 27 school shootings so far, the virtual National Town Hall webinar on mass violence couldn’t have been timelier. The National Mass Violence Victimization Resource Center, or NMVVRC, which is based at the Medical University of South Carolina, hosted the event. 


The town hall’s emphasis was on school shootings: how experts can prepare for them and help in the aftermath. Those experts turned out in force for the online event.


“We had over 400 participants registered for today's town hall, representing 44 states, including D.C., as well as seven countries besides the United States,” said moderator Alyssa Rheingold, Ph.D. She directs the Preparedness, Response and Recovery Division of the NMVVRC.

“The top professionals joining us today are victim service professionals and mental behavioral health professionals as well as a number of others to welcome of note.”

It was a reminder that there is now a whole field dedicated to studying school shootings and other mass violence incidents and taking a scientific, compassionate approach to helping survivors and others affected by the violence. 


The NMVVRC launched in 2017 in partnership with the U.S. Department of Justice. MUSC had previous experience with the department’s Office of Victims of Crime through its work helping people affected by the 2015 racially motivated attack on Mother Emanuel AME Church in Charleston. 


The quarterly town hall, the NMVVRC’s sixth, focused on how schools and communities can meet the mental health and other needs of students and others affected by school shootings. It looked at the different roles experts can play, how a child’s age affects the reaction to mass violence, strategies for promoting resilience in the aftermath of a school shooting and more. 


A group of people gathered in front of two white crosses. You can see a sign that says Covenant Presbyterian Church in the background. 
Fitzgerald Moore leads a group in prayer at a memorial at the entrance to The Covenant School in Nashville, Tennessee, where three 9-year-olds and three adults were killed in March 2023. The NMVVRC helped in the shooting's aftermath. (AP Photo/Wade Payne)

Speakers included Melissa Brymer, Ph.D., director of Terrorism and Disaster Programs at the UCLA-Duke National Center for Child Traumatic Stress. She helped in the aftermath of the 2012 Sandy Hook Elementary School shooting in Newtown, Connecticut, which killed 28 people. She talked about the need to tailor assistance to each incident and avoid taking a cookie-cutter approach.


“One of the things that we take into account is, first and foremost, understand the event. Thinking about the factors related to that community,” she said. 


“Have they had other adverse events? So when I responded to Sandy Hook, we had to think about and keep in mind that many residents of Newtown had two months prior been impacted by Super Storm Sandy.”


That meant they were already dealing with some challenges. Brymer said mental health experts also need to look not only at people directly affected by the event but also their loved ones and others who were traumatized. And structuring experts’ response is essential. 


“When there are large events like Uvalde, Sandy Hook and others, the number of offerings that come into the school district can be daunting and so overwhelming that there needs to be a group that helps organize those offerings, helps to evaluate those that want to give support.”


Another speaker at the town hall also had direct experience with the aftermath of a school shooting. Crisis responder Debra Howard-Burton leads the organization SOAR, which stands for Serving Others Achieving Results. Howard-Burton, who has a doctorate in theology and is also a retired law enforcement officer who served as a victim advocate, responded to the 2018 mass shooting at Marjory Stoneman Douglas High School in Parkland, Florida. 


“This was the first time something of this magnitude hit home for me. And so I'm going to give you some of the lessons learned: good, bad and indifferent,” Howard-Burton said.


One of those lessons: It’s important to understand a community, she said, describing the demographics of Parkland and the campus of the high school. “It's a 45-acre campus. So when I get ready to show the dynamics of the school and the blueprint, you'll understand this is a big campus. It had 13 buildings.”


She showed a map of the high school and the nearby hotel where survivors were reunified with their families. But high school students weren’t the only ones who were worried and scared. “When everybody went on lockdown, not only did they go for the high school, but they also did at the middle school, which is a mile and half away.”


That meant some middle schoolers, staff and loved ones were scared and worried, too.


Howard-Burton realized crisis experts had to cast a wide net. “So crisis intervention, whoever needed it, we gave what information we had. It does not matter if it was the teacher, the custodian, the cafeteria worker, whoever needed it at that time. We gave out information and referrals, and we helped everybody. They wanted to ask, ‘Who is in charge?’ ‘Can you tell me everything?’ ‘What is going on with the investigation?’ ‘Why can't I get my book bag?’ ‘Where's my child's laptop?’ ‘Why can't I get my iPhone?’ ‘What are you doing with this?’ ‘Can I get this back?’”


She also was involved in informing families of the loss of loved ones. “Most of the time we did it with a detective, or we did it with another victim advocate.” And all of this was in the context of information coming out, not only through official statements but also through other channels. “Information was given out on social media before even law enforcement advocates knew because the students knew and they were sending pictures.” 


The students themselves came from a variety of backgrounds. “We had a lot of people from South America, so we had to deal with a lot of things from immigration. There was a Jewish community. So we understand that some of the people who were deceased were Jewish and made sure their faith and their religion weren’t compromised.”

School nurses, including Shernette Tolley, left, listen to a discussion about bleeding control. 
School shootings have become such a fact of life that in 2018, MUSC began training school nurses such as Shernette Tolley, left, to stop severe bleeding.

“When you have a mass tragedy like that, you never know what's going to happen. You just take the knowledge that you had and put it into a working wheel, make sure it works. It's going right. It's fluid. And when it's finished, you sit down and look at what worked and what didn’t.”

The other two speakers featured were Angela Moreland, Ph.D., associate director of the NMVVVRC and a clinical psychologist within MUSC’s Department of Psychiatry and Behavioral Sciences, and Jason Dewar, a professional school counselor/victim advocate and Office of Victims Crime consultant. They focused on the emotional and psychological impact of mass violence on young people and families and what Dewar called the PREPaRE Model developed by the National Association of School Psychologists.

Moreland described the toll mass violence can take on children. “Some of the main things that we tend to see are fear and anxiety, sadness, depression, anger, decreased perceived safety –feeling unsafe in spaces where they typically felt safe prior to the event. And then PTSD symptoms.”

She explained that really young kids tend to stick closer than usual to parents, sometimes wanting to sleep with them. They can have tantrums and a hard time keeping emotions in check. 

Kids who are a little older may show other symptoms. “It's much more intrusive thoughts and withdrawn and aggressive behavior. So that's where some of that disruptiveness may come in. And poor concentration and distractibility.”

Adolescents, defined by the World Health Organization as ages 10 to 19, may be more secretive about their reactions. “So, embarrassed by responses to trauma reminders. They don't want, necessarily, people to know they're not doing OK, or they're having a hard time. They may think they're unique in this experience. So that kind of typical teenager spotlight, where it's only me, I'm the only one that feels this.”

But most can recover over time, Moreland said. “If people have family support and peer support and school support, they're more likely to be OK and to be more resilient than those that don't.”

Dewar shared a quote from a friend: “The only thing harder than explaining why you should prepare for a tragic event is explaining why you did not.”

It was the perfect beginning for his emphasis on the PREPaRE Model. P stands for prevent and prepare for crises. R is reaffirm physical health and welfare and perceptions of safety and security. E is evaluate psychological trauma risk. P stands for provide crisis interventions. A is for and. R is for respond to mental health needs. And E is examine the effectiveness of crisis preparedness. 

“It can be a complex process, especially when we're responding to a larger-scale event with mass casualties. But doing it means that we've got to plan, and we have to be prepared. It's important that we are providing professional development to our mental health professionals with trainings like PREPaRE, Psychological First Aid or some of the other things that we've talked about in this training. It's recommended that our community partners, such as mental health centers, victim advocates, are identified and partnered with prior to crisis,” Dewar said.

The full presentation, which contains many more details, will become available on the NMVVRC’s website. As Rheingold noted in her closing remarks, “We packed a lot in 90 minutes.” You can also find recordings and resources of the prior five virtual mass violence town halls here.

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