Nationwide Efforts Address Trauma, Support Recovery in Las Vegas Aftermath Mental Health Weekly October 9, 2017 Last week's tragic event in Las Vegas brought shock and horror to the nation as nearly 60 people were killed and hundreds more injured following a mass shooting during a concert on Oct. 1. As lawmakers consider gun control measures, officials are still grappling to understand the motive behind the attack by the alleged gunman, 64-year-old Stephen Paddock. Meanwhile, the investigation, say lawmakers, will take time. And so willtherecoveryforthepeople dealing with the trauma. Nation- al and state officials, mental health groups, counselors, psychologists and others are continuing to mobilize efforts to address the needs of people impacted by what is called the worst mass shooting ever in this country. Many are prepared to address the trauma they say may linger in the aftermath of this tragedy. The Substance Abuse and Mental Health Services Administration immediately released its Disaster Distress Helpline to provide immediate counseling 24 hours a day, seven days a week to help people to cope with this tragedy. The helpline will connect callers to trained professionals from the closest crisis counseling center in its network of centers. The American Psychological Association released a list of its providers available to talk about gun violence and help children and adults with managing distress in the aftermath of a shooting. Give an Hour, an organization with a network of nearly 7,000 mental health providers, is also supporting Las Vegas's recovery efforts. "In response to the horrific attack on innocent people in Las Vegas, our organization and our providers are offering care and support to those affected by this trauma," Barbara Van Dahlen, Ph.D., president and founder, said in a statement. "Some Give an Hour providers may join efforts on the ground - others in our vast network will offer phone support to the thousands who need their compassion, expertise and assistance." NAMI Southern Nevada Nicole McGee, executive director of the National Alliance on Mental Illness-Southern Nevada, told MHW that the organization is continuing with its existing support services, educational classes and community presentations as well as providing referrals to their community partners that address additional needs. "We are available by phone and email and have a website that lists resources, including a 24-hour crisis line," she said. McGee said that NAMI Southern Nevada had not received any calls in the immediate days following the tragedy that have been identified as seeking support as a direct result of the tragedy. "We know that trauma support can be needed long after the fact, so we anticipate that we will be providing assistance in the future," she said. Ironically, McGee was already in Las Vegas prior to the shooting for a mental health presentation. "Weeks ago, it was planned for NAMI Southern Nevada to have an information table in the student union at the University of Nevada, Las Vegas to commemorate Mental Illness Awareness Week (Oct. 1-8)," she said. "The goal was to get students familiar with NAMI and the supports we provide and gauge the interest of possibly starting a NAMI campus club." McGee added, "I knew it was important that I set up a NAMI table not only for the above-mentioned reasons but to act as resources for students seeking information on coping with the aftermath of a tragic event." NAMISouthernNevadais equipped with outside community resources and will refer anyone in need to the appropriate provider, she said. "As it directly relates to this, we are not presently working with police or first responders but plan to reschedule a Crisis Intervention Team informational [session] that was originally set for Oct. 3 but was cancelled due to the tragedy," McGee said. "NAMI Southern Nevada certainly understands there will be long-term repercussions," she said. "We will be here to accommodate and assist in healing our community with our large system and team." Defining, Addressing the Needs A spokesperson from the Nevada Department of Health and Human Services Division of Public and Behavioral Health said the department is working with local authorities to define the needs of Las Vegas citizens and are utilizing resources to address the needs as they arise. "We have a Family Assistance Center at the Convention Center that has been set up to address the needs of those dealing with missing persons, support service and the need for re- sources, including behavioral health needs," Martha Framsted told MHW. Framsted added that through the Nevada Emergency Operations Center process, the department is defining the needs of the citizens in Las Vegas impacted by the tragic events that occurred on Oct. 1 and making resources available. "As the division includes both public and behavioral health, we are uniquely positioned to address both areas," said Framsted. "We have been working with the local officials to address the needs and are temporarily expanding our state-operated civil mental health hospital's capacity to reduce the burden on the ERs with the influx of medical patients. We are also staffing the Family Assistance Center." There are a number of resources available for assisting in relief efforts, she noted. Large health care systems exist in the Las Vegas area and officials have been able to rely on their internal resources to ad- dress the emergency medical needs at the time of the incident, said Framsted. "There have been reports of these centers calling upon the majority of their staff to respond to this mass-casualty event and thank- fully they have performed above and beyond to meet the needs of the community," she said. Framsted added, "In addition to the local resources through the Southern Nevada hospitals, there has been an outpouring of support from volunteers from all walks of life who want to support these efforts in any way that is needed. We are managing these offers and will call upon them if needed." Along with the governor's proclamation as of Oct. 2, 2017, the resources for medical response have been expanded to allow for additional medical providers to work in Nevada if they are licensed and out of state, said Framsted. "This does not seem to be the need at this time," she said. "We have approximately 50 patients sent to a hospital in another state so that they can be treated in the most efficient and effective manner and will ease the burden on the Las Vegas-area hospitals. Other states have called to offer their support, unsolicited, to our agency." Outpouring of Support Framsted pointed to an outpouring of support from national partners, including those the department works with on a regular basis. "Many groups have also expressed concern and recommendations as we move from crisis to recovery as the day's progress," she said. "Communication with Governor Brian Sandoval has proven to aid in the response as the needs are revealed. " The needs of children during this time are also being supported. There are a number of resources available on the division's webpage, DPBH.nv.gov,shenoted,and through the Division of Child and Family Services, along with local efforts through community providers. "At the Assistance Center, the Children's Mobile Crisis services are available for children and their families impacted," she said. For consumers already suffering from mental health disorders, ongoing support and services have not ceased during this time, said Framsted. "The state-operated services remain constant, and local community providers are also stepping up and doing what is needed to address the identified needs," she said. "We will address these needs ongoing, as it will be a long time before Nevada can put this incident in our past," said Framsted. "We will continue to assess the needs; how- ever, we have no plans to discontinue our involvement until it is clear that the needs no longer exist." *