Four years after her daughter watched a friend get shot in a Marjory Stoneman Douglas High School classroom, Nicole Cook is angry that another community faces the same magnitude of mental health recovery without a roadmap.
“There still is no trauma research on something like this,” Cook says. “No guidelines for what to say or what should happen. No evidence-based manual. No protocol. By now, we know it’s going to happen again, and so there should be.”
In the aftermath of the Marjory Stoneman Douglas High School shootings that took the lives of 17, Parkland found itself in the same mental health crisis as Uvalde today. Parkland’s experiences offer the Texas community lessons for the difficult years ahead.
When the unthinkable happens, students are harmed in their classrooms surrounded by peers, the trauma that follows unfolds in an increasingly predictable and torturous way.
First comes the overwhelming anger and shock.
This draws therapists, grief counselors and school psychologists who jettison into the community with good intentions, but often are untrained and unable to keep up with the anxiety and post-traumatic stress of parents, family members and victims.
Aftershock sets in next, bringing suicide attempts and self-injury, substance abuse, crippling fear and deep depression.
Eventually comes the realization that the work to cope never really ends and communities don’t have the scope of mental health resources and insurance access to address the enormity of challenges.
“There are no community trauma resources to deal with persistent long-term grief and PTSD,” said Cook, a former Parkland resident who says her two teenage daughters are still struggling. “We didn’t think Sandy Hook and Columbine could happen over and over. Now we have a need in society for people who are specifically trained in the science of helping children, adults and families who are victims of mass shootings. Ongoing trauma services need to be available and accessible, and they are not.”
First response
Within weeks of the Parkland shooting, therapists and support organizations flooded the city including grief counselors from Newtown where Sandy Hook Elementary School is located. But many of the therapists lacked the trauma expertise to provide the specialized counseling students needed. As a result, some of the initial mental health services offered in Parkland turned out to be the most damaging, experts say.
“Some of the crisis clinicians who met with people after the event were not trained in trauma work,” said Dr. Steven Ronik, chief executive officer of Henderson Behavioral Health. They tried to use psychotherapy, to dig deeper and offer insight, he said. “But what these people really needed was to be listened to and supported.”
Ronik said it took more work to undo the damage and coax survivors back into therapy.
Along with counseling, some students and parents used activism as an outlet. Others turned to meditation and mind-body workshops.
“We had rage and grief and we were all trying to get it out of our system,” said Diane Wolk Rodgers, a retired Marjory Stoneman Douglas teacher who used mindfulness techniques to cope.
But it was in the next stage where Parkland families visibly struggled.
A year later
Experts who assisted in Parkland provided crisis support but did not prepare school counselors or parents for the long-term effects of trauma.
“There was not enough ongoing education on signs to watch for and how to access ongoing mental health resources,” said Dr. Jessica Ruiz, a clinical psychologist with Goodman Jewish Family Services in Broward County. “The one-year anniversary started to trigger people and we started seeing more severe presentations — hospitalizations, suicide attempts, substance use problems, poor academic performance. We saw that survivors were struggling and that the community would be impacted for a long time.”
Just after the first anniversary of the shootings, two teenage survivors took their own lives.
Community leaders moved swiftly. Parkland opened Eagles Haven wellness center, a place where someone in stress can take group yoga, meditation or art therapy classes. “It is designed to create a safe space for people who might need additional services,” said Rebecca Jarquin, program director for Eagles Haven. There are no therapists at the center, but Jarquin says Eagles Haven has navigators who can connect people to crisis care.
Jarquin says some students will never agree to get mental health counseling, so wellness therapies are at least one tool to help.
But even with this resource, Parkland families say they need more — and Uvalde families will, too.
They want continuous, long-term mental health support from experts with training in trauma.
“Long after a tragedy, the trauma continues to take its toll,” Jarquin said. “The impact is so wide-reaching and the mental health needs just don’t go away. There is no magic fix.”
Mental health needs funding
Florida, like Texas, has been slow to invest in mental health resources. However, in the last two years, Gov. Ron DeSantis has allocated additional public funds for youth mental health and recently signed a bill with funding to train school personnel in mental health awareness.
Stacey Udine, executive director of Parkland Cares, said her organization has raised and given out $1 million in private funding for mental health counseling in the local community, and still there are more services needed. Udine said she will advise Uvalde leaders to raise mental health services funds for both immediate and long-term needs.
“A lot of people need help and don’t realize they need help until years later,” Udine said. “Four years later, the funding needs to be there because there’s a ripple effect. The parent or the grandparent who lives with the child needs help, too.”
As a parent of a survivor, Cook says Parkland has lacked a key component for healing: trauma specialists who do outreach and conduct ongoing check-ins with families. “Trauma stays in your brain and can come out years later,” Cook said. “Ongoing trauma services need to be available and accessible and parents need to be contacted and taught what to look out for.”
Cook’s daughter, Eden Hebron, 19, has been in and out of treatment centers after she witnessed a gunman kill three fellow students and injure five others in her Parkland classroom. At times over the last four years, Cook said she feared their teenage daughter would harm herself. At one point, Eden attended a residential mental health center in California.
Cook said the onus has been on her family to navigate trauma treatment — and pay for it. “Insurance for behavioral health is difficult to access and when you do, there are wait lists,” she said. “We should have a better paradigm by now.”
Hayley Betancourt, a freshman at the time of the Parkland shooting, just returned to home from her first year of college. Betancourt lost eight friends in the tragedy and has suffered from survivor’s guilt in the years that have followed.
In the months after the shooting, Betancourt tried to find a support system in family and friends. Eventually, she recognized the need for formal mental health counseling and says a trauma therapist in her high school got her through to graduation.
But at a Florida university, miles from home, the 19-year-old again felt overwhelming fear for her safety and sought mental health services. Campus counselors turned her away, politely informing her they didn’t feel equipped to treat a mass-shooting survivor. She now considers getting through her first school year of college one of her biggest accomplishments.
“I have learned there is no way to heal from this,” she said. “I just have to deal with it day by day.”
A critical intervention
By now, the students who attended MSD at the time of the shootings are no longer in high school.
Their mental health recovery is ongoing and some are experiencing relapses after hearing about the Uvalde school shooting. The students mostly are turning to each other for support, and revisiting their professional therapists.
Wolk Rogers, a former AP world history teacher at Stoneman Douglas who retired in 2020, said she continues to see the toll that post-traumatic stress has on her co-workers and students and wishes she could offer Uvalde families proven ways to cope. “It’s really sad we don’t have research by now to know what are the best mental health treatments for these kids,“ she said.
Lori Alhadeff, a Broward County School Board member whose 14-year-old daughter Alyssa was killed in the Parkland shooting, notes trauma manifests differently in each person. But she said one collective lesson Parkland can offer Uvalde four years later is this: There is no timeframe for healing. “The entire community continues to need ongoing mental health support, education and resources.”
