Orlando, Fla. — Signs of community recovery will not easily be identified in the aftermath of the Pulse nightclub shooting in downtown Orlando, according to community leaders. Dollars, metrics and opened streets are unlikely to encapsulate the full story. That’s because much of the damage, they say, has taken place below the skin.
Mental health and spiritual counseling have emerged as some of the primary community needs in the days following the June 12 shooting that killed 49 and injured dozens more. Victims, families, community members and even service providers themselves have all been hit by the emotional toll of the attack. Unlike physical injuries, there is little telling the degree in which emotional wounds are healed or can be reopened.
Dr. David Baker-Hargrove co-founded and serves as president of Two Spirit Health Services, a nonprofit that provides socially competent mental health and medical care to members of Orlando’s LGBTQ community – many of them uninsured or underinsured. When Baker-Hargrove was first contacted by The Center, Orlando’s primary LGBTQ community center on the morning on June 12 he assumed that the incident was small in scope. Once details rolled in, he jumped into mental health disaster response.
Baker-Hargrove, stationed on Thursday evening at the First Unitarian Church of Orlando, said that he had yet to visit his office in the days following the attack — working in the field to help coordinate resources and send therapists where they are needed in what he described as a very informal process. That informal process has also made estimating the number of individuals assisted difficult.
“We continue to identify where to go to meet our community where they are at and just be a presence for people in need and that’s been extremely effective,” Baker-Hargrove said. Counselors have been stationed at a variety of points throughout the city including the Dr. Phillips Center for the Performing Arts, where the community vigil was held and memorial remains, and local gay bars.
Common emotions among the community include shock, anger, fear and guilt, Baker-Hargrove said. There are powerful stories from individuals who had just left Pulse before the shooting or had chosen not to go, in at least one case, literally by the flip of a coin. Some anger also comes from the perception that elected officials, and entities that have not previously supported the LGBTQ community, are capitalizing on the tragedy with public appearances, Baker-Hargrove said.
Cultural competence among those providing assistance is another issue. “There are nuances to our community in terms of gay men and their relationships with each other and gay women – which is two completely different cultural ideologies. Gay men and gay women, they could not be more different. Night and day. You have to understand that,” Baker-Hargrove said. Members of the transgender community are particularly maligned and discriminated against, sometimes unintentionally, in healthcare, he added.
Baker-Hargrove predicted that those in need of mental health services would trickle in slowly as individuals wrap their minds around the shooting and how it might have impacted them personally. In response, he floated the idea of a voucher system to help those in need. Under the program, which he saw in practice while he worked the response to the Sept. 11 terror attacks, grant dollars would be dedicated to vouchers. Those in need would take a numbered voucher and bring it to the therapist of their choice. Afterward, the therapist would fill it out, mail it in and be reimbursed through the grant system.
The tight-knit nature of the Orlando LGBTQ community has meant that the entire community is facing secondary trauma as a result, he said. Pulse being the target of the attack has hit hard given its place in the heart of downtown and as an epicenter of the LGBTQ youth of the community. “It’s a very welcoming, very non-threatening place,” Baker-Hargrove said of Pulse. “People come and go as they please. There’s a sense that is that even possible – that I can even come and go as I please or are we all sitting ducks?”
Michael Slaymaker, volunteer board president for the Orlando Youth Alliance (OYA) — a community gay-straight alliance — confirmed that Pulse has served as a right of passage for the young LGBTQ community. Serving about 60 young people per week and 1,500 in its 25-year history, OYA offers three support groups per week that serve as a place for those ages 13 to 24 to coalesce on topics ranging from suicide prevention to bullying to coming out.
Mental health counselors have been in attendance at the first few meetings since the attack, Slaymaker said, as survivors’ guilt becomes a reality for members. Making sure that young people take advantage of the opportunity to hash out issues and feelings is the next step.
“I know kids that weren’t there that needed to be,” Slaymaker said of OYA’s meeting the Tuesday following the shooting. “We need to reach out to each individually telling them that they need to come in. Bring them in. Some might not be seeking counseling or support and that’s dangerous.”
In addition to the youth who he works directly with, Slaymaker said that some parents of victims have found out that they have both lost a child and that that child was gay at the same time. Support will be needed for those victims. Parents, Family and Friends of Lesbians and Gays (PFLAG) is one resource for those facing such issues.
Mental health counseling is one of the primary ways that the American Red Cross – Central Florida Region has stepped in to respond, according to Josh Lockwood, CEO of the Red Cross’ Greater New York Region. Lockwood flew to Orlando less than 24 hours after the shooting and has offered support to the local team.
“One thing that we know, the mental health needs of the community will evolve and can even grow at different points in time,” Lockwood said. “The one week anniversary, the one month anniversary – there can be trigger points along the way.” Experience about coping, coping mechanisms and talking to children about the incident are proficiencies Red Cross has brought to the table, he added.
The massiveness of the attack and the fact that so many of the victims were very young adds further complexity to recovery, according to Lockwood, which will not come with any quick or easy solution. Unanticipated needs will emerge in the coming months and signs of progress will be more individualized and family-focused than community-wide.
Red Cross has been stationed at the family assistance center (FAC) at Camping World Stadium, formerly known as the Citrus Bowl. Leaders from a variety of religions have been on hand to provide spiritual support and counselors have worked with survivors, family members, community members and law enforcement, Lockwood said. Support for counselors and caregivers also surfaced as a need.
“When we have mental health counselors in the family assistance center, it’s hard to imagine a more charged, just really tragic environment where people are learning that someone close to them has passed,” Lockwood said. “For our mental health counselors, we want to make sure that they can reflect and take a step back.”
Compassion fatigue is an issue currently facing first and second responders. Major Ted Morris of The Salvation Army – Orlando Area Command has helped provide meals to first responders three times per day since the afternoon following the shooting. An opportunity to talk things out has at times been more important than the meal itself, he said.
Orlando’s 2-1-1 system has, similarly, fielded calls from service providers needing assistance themselves. Caree Jewell, who heads the system, cited a minister exhausted from planning a vigil as an example of community members overwhelmed by the need to respond. Call staff members have been supported by an onsite senior crisis specialist.
Orlando Regional Medical Center (ORMC), a nonprofit community hospital located just a few blocks north of Pulse, took in 44 victims from the shooting. Counseling and support has been extended, not only to those who were in the hospital that morning, but those who weren’t and are struggling because they wish they were, according to ORMC President Mark A. Jones.
“We’re working very hard and making sure that our chaplains, our spiritual care team, the counselors that we have here, the additional support that we’re going to provide is directed at our team,” Jones said. “We’ve done that already over the course of the last several days. That will continue, I’m sure, for quite some time.”