During the first few hours after the school shooting in Connecticut there were vague and conflicting reports. The shooter was still being misidentified as the first rumblings of mental health issues began to surface. Amateurs and professionals began to pontificate on the need for meaningful support for first responders, victim’s families and witnesses. We have become much more comfortable in acknowledging the profound psychological impact of trauma. We can look at a (massively media covered) tragedy and think; “ah yes, this will have an impact.” What we have a bit more trouble discerning is mental health challenges that may not stem from widely covered events. We are also a bit challenged in trying to foresee lasting effects.

Our first thought when hearing about murdered children is about their parents. If we’ve been lucky, it is beyond our first hand comprehension. It is simply unfathomable to lose a child let alone in such a horrific manner. The parents’ lives, now unrecognizable to themselves, are forever marked by this loss. Our minds grasp for any detail that we can construe as offering comfort. Are there surviving siblings, someone to motivate the parent to go on? And then we remember that while it is a gift to survive it is a burden as well. The siblings, no matter their age, will forever be survivors. They will feel that label and internalize it in varied ways. Even siblings not yet born will wear that identity. It could color (and potentially burden) their entire lives.

Similar survivor issues may well develop in adults and children who could have been included in the count. It is tempting to not give survivor mental health issues the attention they warrant. These people still have their lives after all. But if we’ve learned anything from this (and other) barbaric acts it is that mental health care cannot be ignored. Many will need and should have access to a lifetime of mental health support. In the coming days we will learn more about the perpetrator and the details leading up to the massacre. We will demand serious and desperately needed real gun control. We will light candles and say prayers. And we must, if we hope to ever live in a humane world, give mental health care the respect and importance it deserves.