Amy Forsyth-Stephens, MSW, Executive Director

1. Tragedy at Virginia Tech: A Rural Health Outreach Program’s Role in Immediate and Long-Term Disaster Recovery Amy Forsyth-Stephens, MSW, Executive Director Mental Health Association of the New River Valley, Inc. Presented at: Health Resources and Services Administration All-Programs Meeting August 27, 2007 Washington, D.C.

2. April 16, 2007 • A violent day - extremely windy, unseasonably cold, a grey Monday, and Income Tax Day

3. One day changes everything

4. The nation had experienced an “earthquake to our souls” and Blacksburg, Virginia was at the epicenter.

5. 4-16-07 was a pure mental health disaster • Health and safety needs put to rest quickly • Mental health impact extreme, due to various unique factors

6. Largely rural community, which means… • Volunteer fire and rescue • Everyday people experiencing the unthinkable • Close knit community—people’s stories traveled quickly

7. Also adding to the psychological impact: • The extremely violent nature of the incident. • Cho’s pre-planning and precise execution of the killings. • Cho was a community and campus member- this was not inflicted from the “outside.”

8. Extreme re-traumatization caused by Cho’s manifesto two days later.

10. Overview of the Mental Health Association of the New River Valley

12. Largest MHA Chapter in Virginia • Located blocks from VT campus • Leader in pre- and post-booking jail diversion programs • Operate a free, mental health clinic for the low- income uninsured

13. Rural Health Outreach Program: • ARMS Reach: Access to Rural Mental Health Services

14. ARMS Breaking Down Barriers • Transportation • Stigma • Cost • Cultural factors

15. A pilot site for a 2003 NMHA project: Blueprint for Responding to Public Mental Health Needs in Times of Crisis • Conducted extensive local disaster mental health planning in 2003-04 • Executed drills, signed MOAs, established roles and protocols

16. Response Phases

17. Phase I: Immediate (first 4 days) • Phase II: Through student re-entry to campus on Monday and Tuesday, April 23-24th • Phase III: Through VT graduation, May 12th • Phase IV: Up to one-year anniversary

18. Phase I • On site at Inn at Virginia Tech (disaster headquarters) • Families gathered, responders deployed and decompressed • Coordination with other providers • Cook Counseling Center of VT • Red Cross • Public MH agency (New River Valley Community Services)

19. We divided up the immediate work

20. Convocation on April 17th • An uplifting, healing event on TV • President chanting “Let’s Go Hokies” • In stands, many had difficulty: • Uncontrollable sobbing • Heart palpitations • Shortness of breath • Freezing up, numb • Fainting

21. CHAT • Our Mental Health Association created the Center for Community Healing After Tragedy (CHAT) • High Impact Groups identified and listed on “master plan”

22. Tier One Groups • Victim’s families • Injured individuals and their families • Front line responders in Norris and AJ • Highly affected VT Departments, faculty and staff

23. Tier Two Groups • Second line responders not in Norris Hall or AJ dorm (perimeter workers) • Survivors and witnesses • VT building facilities workers • Postal workers • Roommates and floor mates of Cho and victims • Resident Advisors

24. Tier Two Groups, cont. • Cho’s instructors • High profile VT administrators • Responders’ families—spouses and children • Family liaisons assigned to victims’ families by VT • Korean community, on campus and community-at-large, including school children

25. Tier Three Groups • VT student body at large • VT faculty at large • VT staff at large (those with and without benefits) • Hospital staff (4 hospitals involved) • Funeral home staff • Medical Examiner Office staff

26. Tier Three Groups, cont. • Red Cross workers • Clean-up crews at AJ and Norris • Archivists • Staff at the Inn at Virginia Tech • Non-dominant populations, on and off campus • Front line mental health responders • Mental health and legal professionals involved in Cho’s past

27. Tier Four Groups • Marching Virginians • Corps of Cadets • GLBTQ community • Local media people • Campus chaplains • Community Clergy • Fragile Elderly • Those with existing PTSD or past gun violence • Current mental health consumers • School teachers and guidance counselors • Private schools and home-schoolers

28. Tier Five Groups • VT alumni • Employers and landlords of victims • Blacksburg “townies” who resent students • People with ties to Blacksburg

29. PHASE II • Assisted with one of the nation’s largest deployments of mental health professionals in history • Headquartered at VT’s Lane Stadium press box • Local mental health professionals enlisted to help

30. Lane Stadium Press Box

31. Began Holding “Grief Gatherings”

32. Mental Health Command Center Moved to Local CSB Facility • Operates crisis hotline, and received many distress calls; deployed DMH responders (“hotshots”) • DMH responders were deployed to all natural gatherings of mourners or those involved in the tragedy • DMH responders deployed to drill field 24/7

33. PHASE III • VT Graduation Weekend, May 11-12th • 28 different events • Victims’ families housed together • Students, families, alumni returning for the first time after the shooting • Media returns!

34. Phase IV Mental Health Community moves from Honeymoon Phase to Disillusionment Phase: • Facing the task ahead. • Tendency to retreat into silos. • Budget implications and anxieties sink in.

35. “Helping Us Help You” Event Held June 11, 2007 Purpose: To identify community mental health priorities now and in the future Outcomes: Specific interventions created by and for the local community

36. Money Issues • So much giving, so little money. • Battles begin between the funds. • Territoriality regarding grants.

37. “Recovery is not a sprint, it’s a marathon.”

38. We will continue to invent the future through our blood and tears and through all our sadness.... We will prevail.... -- Nikki Giovanni, University Distinguished Professor, poet, activist

39. Images of Healing

45. Squires Student Center