Providing Multi-Tiered Mental Health Support After a School Tragedy
For schools that choose to bring in community mental health professionals following a tragedy, there are two critical factors that must be considered.
We all grieve differently. Some immediately take the necessary steps to confront their grief and try to heal. For others, it may take years, if ever, for them to accept and confront their grief. Since there is not a “one-size-fits-all” approach to grieving, schools must provide different levels of support — both long-term and short-term — for students and staff affected by a loss or school tragedy.
Dr. Melissa Reeves, a certified school psychologist, licensed professional counselor and a past-president of the National Association of School Psychologists (NASP), presented at the National Summit on School Safety earlier this year about the importance of mental health support following a school tragedy.
Campus Safety had the privilege of speaking with Dr. Reeves at the event, which took place in the days following the losses of Jeremy Richman, the father of Sandy Hook victim Avielle Richman, and 19-year-old Marjory Stoneman Douglas graduate Sydney Aiello. Both died by suicide.
Discussions of “survivor’s guilt” soon flooded the media following those tragic losses. While survivor’s guilt is extremely common for those directly affected by a tragedy, it’s just one small component of what survivors work through in the recovery process, says Reeves.
“I think what compounds survivor’s guilt for many of them is when people make comments or innuendos like, ‘You’re lucky that you’re one of them who survived.’ Well, there’s nothing lucky about going through a traumatic experience like that,” she says. “They struggle with the would of, could of, should of. It’s hard for those thoughts not to happen on a regular basis, especially if they don’t have access or just aren’t in the position to do some of the post-trauma therapy work that is really needed to help work through some of those emotions and thoughts and be able to have some control over the frequency of those.”
It is essential that following any sort of tragedy — whether it be a school shooting, a natural disaster, or a student or teacher death — schools must put proper supports in place to ensure survivors’ emotional needs are being met.
Reeves co-authored NASP’s PREPaRE Training Curriculum, which teaches school districts (specifically school mental health providers and other mental health providers who support schools) how to approach crisis response.
Since trauma affects each individual differently, schools must provide multi-tiered intervention supports through what Reeves calls “psychological triage.”
“[Psychological triage is] looking at the level of impact and then providing supports based upon demonstrated needs,” she describes. “Some individuals need social support and that is sufficient. Others are going to need more psycho-education. ‘Help me understand some of the emotions I am going through and identify coping strategies and supports.’ Others, particularly those who were more directly witnessed or experienced the event, may need to actually process through and share their trauma story. So in the immediate aftermath, we want to make sure those supports are there.”
It is also vital to be aware that adverse childhood experiences greatly affect how students react to trauma. Schools must ensure that all students’ needs, particularly those who have had known difficulties in their childhood, are being met.
Schools are typically good at immediately rushing in with supports, Reeves says, but as time goes on, those initial supports start to fade and many schools do not have a system in place for identifying delayed reactions while still being able to implement necessary supports for those students or staff.
“Some may do very well in the first couple of months because they dive back into their routine, especially our high-achieving students. ‘I’m going to get back to studying. I’m going to work on my grades. I’ve got this.’ The delayed trauma reactions kick in two months, four months, six months, sometimes even a year or two later, and we don’t do a good job of continuing support in the long term.”
Bringing in Community Mental Health Professionals for Supplemental Support
Following a tragedy, many school districts have limited resources and must rely on outside resources to provide support. Although Reeves does recommend bringing in community mental health professionals, she hesitates because it is critically important to screen community mental health professionals in advance to ensure they have the necessary credentials and experience working with children and youth. Perhaps even more important, these outside professionals should not replace school professionals.
“And if we screen them in advanced and they also were trained in a school model, they come in and should work alongside school professionals,” she emphasizes. “And that was the pause because what we’ve seen happen is that when school districts bring in outside mental health providers, the training and approaches they use are not always appropriate for the developmental ages, the types of students we work with, and so forth.”
In fact, Reeves says there have been instances where outside support has been counterproductive.
The other issue Reeves has seen in communities that have experienced significant trauma is that grant money is often used to help provide some of the therapeutic interventions in the aftermath.
“The problem with how that is often structured is that they pay people to come in from the outside, they work with the student population, but because of HIPAA privacy laws, they’re not allowed to share the work they are doing or to potentially even collaborate with the school professionals. There’s this disjointed system of the school professionals not being aware of what those community mental health professionals are providing,” she says. “Then the funds run out and the community mental health providers leave, the school mental health professionals are there for the long-term recovery and supports, but they don’t have any of the critical information on what work they did, what worked for this particular student, what they need to do to continue the progress that has been made.”
Reeves urges schools to break down those confidentiality barriers and work as a cohesive team. She also has advice for any of us who might be a support system for someone grieving.
“The most empowering thing is to give them permission to live, to be happy, and to not feel guilty about that.”
If you or someone you know is grieving and needs support, here are some resources: