For mass shooting survivors, scars can last a lifetime

Mia Tretta was shot in the abdomen by a .44-caliber ghost gun as she walked with her best friend at Saugus High School. It was Nov. 14, 2019.

She survived. He did not.

Tretta was hospitalized for days, but pushed through the pain and returned to school on Dec. 2. “Myself and most people in my community were still in shock,” she reflected recently in an interview with Education Week. “I think because, initially, I was so in shock, a lot of people assumed I was fine.”

She was not fine. The survivors of gun violence rarely are.

In January alone, more than 20 people have been killed in horrific mass shootings in California – including 11 in Monterey Park – but more survived and will live the rest of their lives with the trauma. It leaves physical and emotional scars, and imposes raw economic costs, for all of us.

For every person shot and killed by a gun in the U.S., two more are wounded, says a study in the Western Journal of Emergency Medicine.

In California, that translates to about 3,160 dead from gun violence each year, while more than twice as many — more than 6,800 — are injured, according to data from the U.S. Centers for Disease Control.

Survivors face bills for hospital care, long-term care, medications, therapy. Gun violence costs some $23 billion a year in California, largely borne by insurers, with $1 billion or so paid by taxpayers, according to an analysis of CDC and Healthcare Cost and Utilization Project data by Ted R. Miller of the Pacific Institute for Research and Evaluation.

Some rebound comparably quickly. Others need care for years, and sometimes lifetimes. What should the survivors of these recent massacres expect now?

Denial, shock, anger

In the aftermath of a shooting, survivors typically go through three stages of healing, according to a research bulletin from the Substance Abuse and Mental Health Services Administration.

Denial, shock and disbelief are common in the first, acute phase. Victims need mental health resources, information and “psychological first aid,” which can help normalize overwhelming feelings of fear, anxiety and helplessness.

Once the initial shock wears off, survivors enter an intermediate phase, often characterized by fear, anger, anxiety, difficulty paying attention, depression and disturbed sleep. It’s critical for communities to offer long-term support at this time, SAMHSA said.

And several months after the crisis, survivors enter the long-term phase. Many adjust to their new reality, with decreasingly frequent episodes of fear and anxiety. Most survivors, particularly children, won’t need continuous mental health support any longer, and many say they’ve grown from the experience, emerging with greater self-worth and sense of purpose.

But for others, this is when the big problems start. Some have guilt for surviving the attack, while friends or loved ones perished. Post-traumatic stress disorder, flashbacks, debilitating anxiety, “psychic numbing” and self-medication with alcohol or drugs can solidify into serious, long-term issues, according to the American Psychological Association.

 

School shootings in particular can have long-term ramifications. The National Bureau of Economic Research found that they increased absenteeism, reduced high school and college graduation rates and decreased retention of teachers. The effects persisted into surviving students’ mid-20s, and they had lower employment rates and earnings than their peers.

What’s critical, research suggests, is that victims feel connected to their communities and have ongoing support.

In a way, we’re all survivors of these tragedies, several researchers suggest. A third of adults have said they now avoid certain places and events as a result of mass shootings. The never-ending backdrop of violence erodes our sense of well-being and safety, elevating fear and anxiety for us all.

Paying for it

Half of victims are ill-equipped to handle the financial burden suddenly thrust upon them.

Johns Hopkins University found that more than half of survivors in its study sample were uninsured or self-paying, which means they either bore the burden of the medical charges, or the charges weren’t paid and added to the uncompensated care provided by hospitals and health care systems.

Enter now California’s Victim Compensation Board, a public “payor of last resort.”

After all other avenues have been exhausted — insurers, litigation, etc. — California’s VCB will cover up to $70,000 worth of expenses per victim.

In the last fiscal year, it received 39,015 applications for help, and paid $40.3 million in compensation, according to its latest report.

The biggest spending was on funeral and burial expenses, which cost $13.5 million.

The next biggest spending was mental health, at $10 million.

Requests for help after mass shootings continue for years.

On Oct. 1, 2017, more than 600 people were injured in a shooting at the Route 91 Harvest Festival in Las Vegas. Thirty-five of the 58 people killed were from California. As of the end of June, California’s victims board had issued $6.3 million to 1,725 claimants, an average of $3,652 per claimant.

On July 28, 2019, four people were killed and 17 were wounded at the Gilroy Garlic Festival. As of the end of June, the victims board had issued $248,140 to 121 claimants, an average of $2,051 per claimant.

On April 3, 2022, six people were killed and 12 were injured in a shooting in downtown Sacramento. As of the end of June, the victims board had issued a total of $29,404 to five claimants, an average of $5,881 per claimant.

Immigration status is not a factor in whether a victim or family member qualifies for compensation, said spokeswoman Heather Jones. Covered services include home or vehicle modifications for victims who became disabled, medical, dental and mental health treatment costs and income loss compensation, in addition to funeral and burial expenses.

Victims and their families have seven years from the date of the event to apply for compensation. Some won’t realize, or acknowledge, that they need help for a long time.

The board can be reached by phone at 1-800-777-9229, by email at info@victims.ca.gov and via its website, victims.ca.gov.

Moving on

California has some of the nation’s toughest gun laws and lowest gun death rates. Mass shootings comprise just a tiny fraction of the gun violence in this and every other state — some 1% — but the trauma makes them loom much larger in our collective consciousness.

Moving on – for victims like former White House Press Secretary James Brady, former U.S. Rep. Gabby Giffords, the kids at Parkland, the parents at Sandy Hook and young Mia Tretta herself – means throwing themselves into righteous action.

“Nothing has relieved the pain in my heart like working to prevent more senseless shootings,” Tretta said in April in Washington D.C., as President Joe Biden looked on.

Tretta and her mom joined forces with Everytown for Gun Safety, Moms Demand Action and Students Demand Action, aiming to transform pain into progress, she said. Though it has been difficult to make major changes in federal gun policy, Tretta claimed a victory that day in April, after Biden announced that so-called ghost guns would be treated like the deadly firearms they are.

“For me, I think activism really helps,” she said. “It’s been fighting for change and gun sense candidates. I am fighting to make sure this doesn’t happen again.”

She takes every opportunity to remind people about her friend, Dominic Blackwell, who died that day. Her Twitter account is a megaphone.

“Kids like me who were SHOT shouldn’t have to be the ones convincing YOU to want change,” she tweeted after the Monterey Park shootings. “Kids like me should heal, but we can’t cause every day more people DIE. My love to the new community of survivors and victims.”