Facing the first holiday season without a loved one can trigger feelings of acute pain and loss – emotions that increase tenfold for those grieving especially sudden, needless deaths, like the 58 people lost in the Las Vegas shooting; the 26 lives taken in Sutherland Springs, Texas; and the five dead near Corning, California, part of the more than 13,000 deaths attributed to gun violence in 2017.
The enormity of these tragedies is daunting and yet the numbers don’t reflect the more far-reaching stories of near-fatal incidents ranging from muggings to mass shootings – for example, the approximately 22,500 concert-goers who survived the Las Vegas massacre and those who survived the shootings in Texas and California. Both the wounded and physically unscathed often struggle with post-traumatic stress, depression, insomnia, a desire to self-medicate and thoughts of self-harm – reactions to having feared for their lives and sometimes having witnessed horrific events.
These walking wounded return to their families, friends and communities changed. Alternating between feelings of guilt and gratitude for being alive, they can’t necessarily put on a happy face for the various joyful gatherings that dominate the season. When they smile, they can be masking significant turmoil within.
As a mental health attorney who works closely with families coping with loved ones’ emotional distress, as well as serious mental health and substance abuse issues, I can affirm that the volume of calls I receive increases dramatically between Thanksgiving and New Year’s. I hear the pain of those touched by tragedy and the pain of their parents, children, spouses and friends who are gravely concerned and don’t know how to help.
Everyone experiences tragedy differently. While one person might be capable of “shaking it off,” another could experience it as a breaking point, especially if s/he already struggles with mental health issues. To provide help is to first understand this individuality, to be ready to listen and empathize, and to remember it’s not about us, but them.
The second is to understand that the most compassionate, devoted loved ones are not necessarily the best mental health advocates, as the latter role often requires pushing those struggling out of toxic routines and toward healthier behaviors: getting out of bed, taking prescribed medication, ceasing the use of drugs and alcohol, etc. The care and patience of this work takes a considerable emotional toll, with loved ones fearful they may or may not be doing the “right thing,” and stretched in their efforts to care for other family members and/or succeed at work.
Third, families must seek out the assistance of local mental health resources, shedding any stigma of what it means to ask for help, encouraging their loved ones to participate in the process. Individuals in emotional crisis often do best when paired with others in their communities who have shared tragic experiences. Such “clubs,” to which no one would ever want to belong, can provide tremendous aid and support to those newly experiencing traumatic events. Preferences based on age, gender and sexual orientation can also help determine the professional(s) most able to offer help.
Because of our ill-funded system, professional mental healthcare can be extremely expensive, especially if optimal care encompasses residential treatment. Program costs necessitate that families carefully vet in-patient and/or out-patient facilities, speaking with as many local experts as possible, checking credentials online, speaking with current/former patients and their families, and making use of walk-through opportunities and other visits or orientations.
Above all else, families must be watchful for suicidal thoughts and ideation. National suicide prevention lifelines provide 24/7 free and confidential support for people in distress, as well prevention resources for families. Therapists, psychiatrists and other related clinicians can make treatment recommendations specific to such crises. Attorneys like myself are available to provide help navigating the complex, often daunting mental healthcare system. In serious situations, we help clinicians and families understand exceptions to HIPAA to address otherwise private medical information concerns; gather evidence of symptoms that meet the legal standards for involuntary hospital commitments; facilitate legal entry for in-home assessments; and counsel/navigate issues of guardianship.
There is no shame in those who fled a deadly scene seeking help and relying on their loved ones and communities. The shame is in not identifying them, reaching out to them, offering them information and expertise as the gateway into conversations and improvement in their mental healthcare as well as the mental healthcare of all who need it. The staggering number of tragic events makes clear the enormity of the task, but all who are now part of this unwanted club deserve timely, high-quality, well-coordinated mental healthcare. Providing such support free of judgement reflects the true spirit of the holiday season.