Lauren Reese always said that she didn’t want her children to go to Columbine High School in Littleton, Colorado, where she was once a student.
Twenty years ago, on April 20, 1999, Reese was calling her mom at a payphone in the hallway of Columbine High School. She remembers every detail of that moment: The 35¢ in her pocket, that she was covered in clay because she had just finished a ceramics class, that she was telling her mom about where she would be playing lacrosse that afternoon. As she was talking she heard shots fired and someone running. Then she saw an arm coming from around the corner holding a sawed-off shotgun.
When she saw Dylan Klebold, one of the gunmen, she dropped the phone and ran. Hiding in the girls bathroom, she heard shots, screaming, and the fire alarm. She stepped into the hallway and heard her mother screaming from the dangling payphone receiver. She picked up the phone and told her mother that someone had brought a gun to school. Her mother told her to run.
For years after that day, throughout her late teens and early twenties, Reese says she often felt angry and cold and withdrawn. She developed an eating disorder and also cut herself.
Fifteen people died including the shooters, and 21 were injured that day at Columbine High School. The hundreds of survivors have had to wrestle with the long-term effects of being there that day. There is no way to predict who will be most affected by a traumatic event like witnessing gun violence, and it’s difficult to calculate how many people like Reese are still dealing with lasting emotional scars. But a number of witnesses continue to battle depression and post traumatic stress disorder and may be vulnerable to other mental health issues. Coordinating care long after an incident is quite difficult and varies wildly from location to location.
Reese didn’t immediately seek counseling. Instead, she says, her mom helped her talk through some of her feelings, and she says she eventually stopped some of her destructive behaviors. Still, there were lingering symptoms, especially when she would drink. “I didn’t live the best life I could have, because I didn’t understand that something was wrong,” she says.
She was finally confronted by her depression after the arrival of her second son in 2012. The sales job she worked only offered six weeks of maternity leave. Exhausted, she remembers staring at her computer screen like a zombie at work every day. “I couldn’t even function,” she says. At home, it was the same. She didn’t want to do anything. Reese was also constantly worried that she was going to hurt her son.
“I remember always being afraid to walk on cement floors because I thought I would drop my second child,” she said. She had repeated visions of his head cracking open. “That’s when I went to the doctor because I was like, is it normal for me to think this?” Her gynecologist said it was likely postpartum depression and she should go see a counselor.
Postpartum depression occurs in 15% of births, according to the National Institutes of Health, but mothers with a history of childhood-related PTSD or depression are more likely to experience postpartum depression four to six months after birth, a 2015 study shows. Untreated trauma can leave a person vulnerable to other issues.
And handling symptoms of depression or post-traumatic stress disorder without the help of a professional can actually make symptoms worse. “Cognitive processing of the incident and acceptance have been associated with lower levels of symptoms, whereas ruminative and avoidant coping styles have been found to increase risk,” reports a study on mental health outcomes from mass shootings.
In the aftermath of the shooting in 1999, Reese remembers sitting in a church in a circle with 200 of her peers listening to a counselor, but she doesn’t remember follow-up or further counseling. When Columbine students were relocated to another school, she remembers grief counselors being available. “I remember having a couple of sessions with one woman, and I just talked about my story, but I don’t think I had healed or or gotten any tips on how to deal with what I was feeling,” she recalls. The only comfort she remembers finding was in a blanket she received from Project Linus.
Two decades later much has changed. More than 226,000 students have been exposed to gun violence at school since Columbine, according to the Washington Post. After the shooting at Marjory Stoneman Douglas High School last year, the Parkland, Florida, region was flooded with support. The state of Florida received $1 million in Project SERV funding from the Department of Education to help cover the costs of services needed following a violent or traumatic event. The county brought in 34 portable buildings to be used as classrooms and support additional mental health staff. There were therapy dogs and therapeutic activities built into the student curriculum.
On the whole, efforts to build out mental health networks are more aggressive than they were 20 years ago. Before the shooting at Parkland, the Medical University of South Carolina in collaboration with the National Child Traumatic Stress Network had conducted trainings on trauma-focused cognitive behavioral therapy for 250 professionals in the Broward County area. Those organizations came back to refresh area professionals after the shooting in 2018. There is now a plan with the Office of Victims of Crime as well as the National Mass Violence Victimization Center (funded through a grant to MUSC) to continue support to the area through 2020.
However, a year after the Stoneman Douglas shooting, where 17 people were killed and 17 were injured, some students feel they haven’t been adequately supported. In March, following two student suicides, the outrage flowed on Twitter. “These kids need more. Not ‘trauma specialists’ trained in 3 days. Not a hug from the suck ass principal. Not painted rocks or cards. We need real help. Real specialists. Real empaths. No more half-assed effort for full blown trauma and depression. This is what it does,” wrote Victoria Gonzalez, a Marjory Stoneman Douglas student.
When it comes down to it our trauma was quickly swept aside because they wanted everything to return to normal, we literally went back a week after it happened
— lex (@witchyactivist) March 24, 2019
Not only students have spoken out. Teachers have raised concerns too. Kimberly Krawczyk, a math teacher at Marjory Stoneman Douglas, penned an essay calling out the quality of care the teachers and students were connected with. She said counselors were cycled in and out, so that students never saw the same person twice. “The Broward school district’s employee assistance never called me or other teachers in Building 12, where the shooting occurred, to offer us mental health services. When I called them, they told me they didn’t have any appointments. But the district did find the time to shepherd us into photo shoots to show the country that we were #MSDStrong,” she wrote.
Care also has to go beyond the school systems to the wider community to ensure that family and loved ones of victims who were harmed in an attack are also connected with care. In March, Jeremy Richman, who lost his 6-year-old daughter in the 2012 shooting at Sandy Hook Elementary School in Connecticut, committed suicide.
“What we’re seeing over time is that there are individuals that are still needing support,” says Melissa Brymer, director of terrorism and disaster programs at the UCLA-Duke National Center for Child Traumatic Stress. She says support for long-term care is increasing. The Victims of Crimes office in each state does provide long-term services for counseling, for example, though there is a window for signing up that differs in each state (in Florida, victims have one year to sign up; in New Jersey it is three years). Community wellness centers, like the recently opened Eagles Haven in Parkland, Florida, can also provide care years after an event. However, resources may be harder to find if a person relocates.
“Sometimes we’re hearing that kids were insulated while they were still in the school or in the community where the incident took place, and that they could talk to their peer groups about their shared experience, but when they go to a new community, they feel more isolated from that experience,” says Brymer. “So how do we make sure that we use outreach or different technologies such as internet-based services or smart apps so that there are ways that we can form connections?”
There are several other factors that complicate care. Funding to address more immediate concerns eventually dries up. Sometimes trained therapists burn out. Quality of care varies and is hard to control. Teachers and other caregivers in charge of connecting students with services may also be grappling with their own post-trauma feelings.
While the overall number of gun-related deaths and injuries over the last 20 years is comparable to two decades prior, the number of mass shootings (defined as four or more casualties) is certainly on the rise. According to the Gun Violence Archive, there have been 80 mass shootings so far this year, and 340 mass shootings last year. The years since Columbine has have also seen a significant uptick in high-profile tragedies outside of school shootings: 58 people killed at an outdoor music festival in Las Vegas in 2017, 49 people killed in the Pulse Nightclub shooting in Orlando in 2015, and 9 people killed at a black church in Charleston, South Carolina, in 2015, to name just a few. As thousands of Americans are living with the lasting trauma of being witness to or otherwise impacted by gun violence, Brymer says some states are beginning to think about how to build out regional support systems for trauma victims, so that treatment is more readily available broadly.
Back in Littleton, Colorado, where Lauren Reese still lives, she wonders what life would have been like if she had gotten counseling when she was still in high school. “If I had gone to counseling from day one after Columbine and got the tools not to be angry and knew I had to take care of myself and eat and knew I couldn’t cut myself, maybe it’d be 100% different,” she says.
With her own children, Reese says she now has a framework for how she could spare them from some of the worst symptoms she experienced. She’s cultivating a close relationship with her sons, just like her mom did with her. And if disaster were to strike, or if her sons were to start exhibiting the familiar signs of depression, she says she would take action immediately. “I feel like right off the bat I’d call my [doctor],” she says, in order to get some recommendations for therapists. “I would never turn my back on them.”
She’s sitting in the bedroom of her Colorado home, which she built with her mom. She says it is a perfect house. It has warm southwestern colors and big windows. Reese says she has learned that winter and darkness are not good for her. The house is always bright and sunny. This is her happy place.
If you’re thinking about suicide, are concerned about someone you know, or need emotional support, you can call the National Suicide Prevention Lifeline network 24 hours a day in the U.S. at 1-800-273-8255.