Sonja Miller was in a meeting when she heard the news. Her phone buzzed with text messages, phone calls and emails. Shots had been fired at Reynolds High School.
Miller, the supervisor of Multnomah County’s school-based mental health consultants, knew she needed to respond to the aftermath. And as her original meeting continued, she anxiously followed the developments. Within an hour, her supervisors instructed her to head to the scene. Her task? Erect a “community support center.”
Driving to the school was nerve-wracking. As she listened to breaking news developments over the radio, she prepared for the worst.
“I remember thinking, “Some families are going to be in some real pain today,’”Miller said. “Somebody is going to lose their children today, and that is the saddest thing in the world.”
Making children feel special and loved
Thirty years ago, Miller never would have thought she’d be en route to the scene of a disaster. Back then, she was just graduating from college with a degree in business finance and real estate. She was on track for a career as an appraiser.
But when she wasn’t appraising property, she devoted much of her time to young people.
Miller always loved volunteering with children. Youth groups. Girl Scouts. Summer camps. When people suggested she take on that service as a vocation, she started to agree. Five years into her stint as a property appraiser, she went back to school, earned her master’s in counseling psychology and changed directions.
“I went from making better money to making no money,” she joked. “But something that has always guided me is that every kid needs some adult that thinks they’re the most special person in the world. And some kids don’t have that.”
With that mindset, Miller started working in mental health. As years went by, she amassed an impressive résumé working with children in need of mental health support. In 2013, she was chosen as supervisor for Multnomah County’s school-based mental health after decades in the field.
But on that Tuesday morning—June 10, 2014—she faced her biggest challenge yet.
Miller arrived on the Reynolds High School campus within 30 minutes of being told to report. Following her was a team of behavioral health specialists: Stephen Dunlevy and Jasmin Harshman--both school-based mental health consultants--and Dr. Leigh Hedrick, a child psychiatrist.
That’s when the adrenaline kicked in. All around Miller saw emergency vehicles from every agency in the metro area. She had to identify herself at every checkpoint, until she was finally given permission to enter the incident command center assembled in the football field.
The command center was full of local law enforcement officials with pre-established roles. The concept is based on the “incident command structure” and is the standard way for first responders to organize themselves in a crisis.
Miller began working with local law enforcement leaders on the scene. Their first goal was to provide support for anyone who visited the community support center.
To Miller’s relief, a strike team of behavioral health professionals had already been dispatched.
She coordinated with school-based counselors, Red Cross responders, local and federal victim assistance programs, and volunteers from the Trauma Intervention Program, a national nonprofit that provides mental health support during emergency situations.
The trauma specialists started out by greeting people as they came in to the community support center. Next, they checked to see if the visitors needed anything to eat or drink. They listened to their stories and assessed their coping skills and support systems. They also linked students with the county’s 24-hour crisis hotline in case things got worse.
Heeseung Kang supervises the county’s crisis hotline. On that Tuesday, her team fielded 20 percent more calls than usual. She says those phone calls make a difference in the long run.
“It’s really important to have a service open 24/7,” Kang says. “We can provide direct crisis counseling over the phone as well as provide referrals for long-term care.”
Miller was pleased with how things went. But to her, the shooting revealed something else: the behavioral health response to crises needs to be more organized.
“What it brought home for me is that we need to outline a couple scenarios in terms of where behavioral health really needs to respond,” she says.
Behavioral health response critical in disasters
Alice Busch is an emergency manager for the Office of Emergency Management. With more than 20 years experience in the fire service, she’s accustomed to the incident command structure of outlining duties and roles for a disaster response.
The problem? At this moment, behavioral health specialists aren’t part of that system. That means people like Miller must make decisions in real-time during traumatic events. It’s an issue that Busch has known for years—around the state, behavioral health hasn’t been integrated into disaster planning and response as well as it should.
Right now, Busch is the lead planner in charge of developing a “Mass Care and Shelter” plan for the county. She says one of her priorities is incorporating a task force of behavioral health professionals into the fold.
“We’re long overdue for behavioral health,” she says. “I think one of the challenges for those of us who have grown up with the incident command structure is it’s pretty rigid.”
In order to incorporate behavioral health into the structure, she thinks the heads of all the emergency response agencies must get in the same room. Behavioral health responders also need to be trained in the incident command structure.
In the minds of many behavioral health experts, having a presence at traumatic incidents—just like EMTs and law enforcement—isn’t just a good idea. It’s imperative.
Donna Schuurman, chief executive officer of the Dougy Center, is one of those experts.
The Dougy Center is an internationally-renowned organization that provides support to grieving families. Its grief support model has been replicated more than 500 times across the globe. And in Schuurman’s 23-year-career, she’s spent countless hours with families affected by traumatic events including work with families and first responders of the Sandy Hook Elementary School shooting.
Schuurman says the lingering mental health effects of a school shooting can be just as severe as some of the physical injuries. Following an incident like Reynolds, witnesses might become hypersensitive to certain sights and sounds. Their eating and sleeping habits change. Sometimes, they even experience post-traumatic stress symptoms.
“The biggest danger is that healing from traumatic losses is much longer than people are often afforded services for,” says Schuurman.
Now that the event has passed, county behavioral health specialists have been pursuing ways to improve awareness about mental health crises.
The county’s Mental Health and Addiction Services division has begun rolling out a plan to promote mental health first aid training to the community. The division has also reached out to the Reynolds School District to provide Applied Suicide Intervention Skills Training. The goal is to educate students and faculty about the warning signs of mental health crises and the services that are available.
But the long-term behavioral health response looks much different from the services needed for the immediate aftermath. For instance, the expertise of a counselor differs from that of an emergency behavioral health specialist. In a disaster, it’s critical the right people with the right training are dispatched.
That’s why Schuurman says communication about the response makes all the difference.
“I think it would be a really great idea to have a task force of people from specific behavioral health agencies to work together,” she says. “Because the middle of an emergency is not the best time to be making all those kinds of decisions.”
Busch says the planning process, if inclusive, pays dividends. She says it’s important for disaster response experts to get to know each other and learn about their capabilities and limitations. According to her, people don’t pull plans off the shelf. They do as they have trained and practiced.
The idea of planning hits a bit closer to home for Miller. It’s part of her personality. She’s recently been organizing disaster preparedness plans with her neighbors. She even has an earthquake kit at home.
Having a plan, according to Miller, makes it easier for responders to focus on the real task: saving lives.
“In the event of a huge disaster," she says, "the sooner you can get people up and functioning then you reduce the number of victims you have to care for.”
“That’s what emergency preparedness is all about," she adds. "So being ready to respond quickly, have the right kind of response there, and giving out messages that the feelings are normal, that helps people to get functioning much quicker.”
If you or someone you know is in need of immediate crisis counseling, please contact Multnomah County’s 24/7 crisis hotline at 503-988-4888
