Dean Kilpatrick woke at 4 a.m. Oct. 2 out of the blue and tuned into the news to hear the sounds of an automatic weapon firing upon a crowd of country music fans in Las Vegas.
There was no chance for sleep at that point as the director of the National Crime Victims Research & Treatment Center (NCVRTC) in the Department of Psychiatry and Behavioral Sciences at the Medical University of South Carolina hurried into work. With the ink still drying on an $18 million grant recently awarded to the center from the Office for Victims of Crime (OVC), his mind raced with how to accelerate plans to get the grant finalized.
That way his team could start its task of developing a Mass Violence and Victimization Resource Center, a center designed to help people just like the ones he was watching on TV who were frantically trying to flee the scene.
"It's tragic. It's un-American that people who are enjoying a country music concert get attacked by a man with an automatic weapon and that so many people are killed and injured and scared to death."
His next thought: "This is something we need to get moving with," he said about the proposed new resource center. His team will be responsible for developing a way to bring fast and comprehensive services to help those affected by a mass casualty event. "Our job is not to figure out who is doing this but to figure out how to help those affected by it -- the survivors, victims' families and first responders. We need to be able to respond quickly. This is about trying to really help the nation do a better job when these things happen."
MUSC's NCVRTC is celebrating its 40th anniversary and takes pride in its extensive research into effective ways to help those affected by trauma and crime. It's one reason Kilpatrick said his center landed the grant. Mass casualty incidents inflict a type of suffering that cuts deep and those affected by it often need specialized support and mental health treatment, he said.
"There is something about an event where someone's trying to inflict harm that is extremely disturbing and hard to cope with. Social support after such an event is important, particularly for that subset of people who are likelier to develop mental health issues. They can have problems for years after the event."
And, they can fall through the cracks of a system overwhelmed by an unprecedented level of violence, he said. An FBI study of active shooter incidents in the U.S. between 2000 and 2013 described 160 incidents in 40 states resulting in more than 1,000 casualties.
"This kind of thing is just unimaginable, although there's a lot of data that we're going to start having to imagine it. We can't undo it. We just need to do everything we can to work collaboratively to be better prepared."
The new center will draw on research already done, including three former mass violence incidents extensively studied by the NCVRTC: the 1992 Los Angeles Civil Disturbances; the 1988 Pan Am Flight 103 terrorist bombing; and the 9/11 World Trade Center terrorist attack.
Some of the key findings were:
- - Certain factors, such as direct exposure and close relationships to victims, increased the risk for mental health issues
- Many individuals who were not direct victims developed mental health problems
- Many of those affected still had mental health problems months or years after the event
- Exposure to the incident increased fear of crime and impacted lifestyles and behavior among community members
The NCVRTC also is drawing on experience from a grant it received to help the survivors and family members affected by the Emanuel AME Church shootings in Charleston in June 2015. Counselors at the center learned how important it was to build key relationships with relevant local agencies and community leaders to collaboratively provide outreach. The NCVRTC partnered with numerous organizations after the Emanuel shootings to provide more effective outreach. It was an approach that got good feedback from survivors and church members as well as OVC officials, he said.
"We have somewhat of a different approach in that we don't just parachute in someplace, but we try to identify key stakeholders in terms of mass violence response and then work with the groups and organizations that really serve those stakeholders."
MUSC will be partnering with many organizations and experts to establish the new center. Its academic partners include the Boston University School of Public Health and the University of California, Los Angeles. Several professional organizations will be involved, such as the United States Conference of Mayors and National Association of Attorneys General, as well as other major national nongovernmental organizations.
One key part of the center will focus on technology.
All cases are different. Take the Boston Marathon terror attack and now the shooting in Las Vegas. Kilpatrick said victims and their families come from states across the nation, so the challenge is how to deliver services to people in all 50 states in cases when people return home and find they're suffering from anxiety, depression or post-traumatic stress disorder.
As part of the OVC's grant awarded to MUSC after the Mother Emanuel shooting, the staff developed an app for mobile devices that provided psychoeducation and coping instruction to community members affected by the tragedy. That tool received positive feedback and that's one reason the grant includes plans to develop more mobile apps as self-help tools, including a kid-friendly one, and an interactive website.
Technology also will be used to broaden the scope of training and evidence-based services, he said, and expand access to services. The center will figure out ways to reach these people so they have access to counselors who have specialized training in trauma. The services could be offered either in person or via tele-mental health, an area MUSC research has found to be an effective way to deliver counseling, he said.
Community outreach and feedback will continue to be part of the center's mission. The center will be working with Abt Associates, a survey research firm, to conduct hundreds of surveys with victims and service providers involved in these events to find out what is working well and what services still are needed. The way the grant is designed ensures that important research data is being combined with real-world experiences of trauma survivors and service providers to develop better ways to respond and recover from these horrific incidents, he said.
Another part of the grant's scope includes handling incidents of criminal negligence that harm or kill people, such as an oil spill. The new center, which will be based at MUSC, has a broad scope with a massive public impact. That's why it strikes both terror and excitement in him as the same time, he said.
"We're most excited about how we think this project has a chance to change and improve the services that families, victims and first responders can have available to them."
He's terrified because so much rides on doing it well. "It's a big task," he said, adding that there's no more gratifying feeling than to have a trauma survivor be thankful about how they've been helped. "This means a lot of hard work and our commitment to get the job done. It's a lot of pressure, but we all know we have to do something about this. We have to help these people. At the end of the day, we'll be happy if what's available to those touched by these tragedies is a lot better than it is now."