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Nearly three years on, El Paso is still processing the trauma of a mass shooting

AYESHA RASCOE, HOST:

Whenever there's a shooting in the United States, processing trauma extends far beyond the week it happened into the months and years after. One of the communities still reckoning with the mental health impacts of a shooting is El Paso, Texas, where a gunman killed 23 and wounded dozens in August of 2019. We now turn to Celeste Nevarez. She's the chief of clinical services at Emergence Health Network and has led their counseling response to the El Paso shooting. Thanks for joining us.

CELESTE NEVAREZ: Thank you so much for having me. It's an honor to be here.

RASCOE: Your health network immediately sprang into action following the shooting in El Paso. Can you talk to me about some of those early mental health needs that were there?

NEVAREZ: Within hours, we were called to action as far as mental health necessity, because things like death notifications were being delivered. And that is a heart-wrenching moment. And so to have clinicians on site in order to provide that emotional support and that immediate processing during that shock was just a deep honor to be part of that with them, to hold their hand through this journey. But it was also so toll-taking. You know, I just can't believe that we were there with that. We've never had that kind of experience.

RASCOE: You've now been talking about mental health issues, you know, arising from the shooting for almost three years. Can you give us some sense of how people's trauma changes from those early days and weeks to years later when the media may not be talking about it, but the wounds and the mental wounds are still there?

NEVAREZ: Yeah. Yeah. And the fact that grief and trauma - healing is not necessarily linear. You know, there's no timeline. There's nothing that says by three months, you should feel this way. By six months, you should feel that way. Over the course of the last three years, you know, the initial shock for some people was devastating, while others maybe suppressed those emotions and went straight into action, so maybe had a delayed response. You know, we had folks coming in a year later that were now ready to process these emotions and now feeling them at a more intense level because it's just been, you know, action, go, go, go, serve, serve, serve. Like, I don't have time to even think about these emotions.

RASCOE: So now with what happened in Uvalde, is that affecting people in El Paso?

NEVAREZ: It absolutely is. And it's heartbreaking in that it's reigniting some of these emotions. We've seen an increase in calls of the community that we serve, specifically with our August 3 families and survivors, saying, I need to come in for a session. This is bringing up some very familiar emotions. And also our workforce - you know, our team of clinicians and caseworkers and psychiatrists that were, again, quick to be, on that day, helping, serving, are also remembering what it's like to feel that sense of helplessness. How do I help? What can I do? I've gotten phone calls from friends and family saying, this just - it feels like this is happening all over again, and I'm crying, or I'm having trouble sleeping, and we feel connected to them. And it's just - it's heartbreaking.

RASCOE: El Paso's population is over 80% Hispanic or Latino. Uvalde is also over 80% Latino or Hispanic. Are there culturally specific needs that you saw in El Paso that might be relevant in Uvalde?

NEVAREZ: I think being able to offer therapy or clinical support in the native language that people speak in. You know, when we're emotionally distressed, we go to our native tongue, whatever that may be. And so if that is Spanish for that community, as it was for ours, we want to make sure we're able to provide those services in Spanish and comfortable - and also just the linguistic slang. And I smile when I say that, but there are just certain words that are specific to a region. And so being able to understand that and connect on that cultural, emotional level, spiritual level, I think is so important.

RASCOE: So one thing, you know, when you're talking about a community, part of it can be that, certain communities, there is a stigma about going to therapy. Can you talk about the stigma that can be around that?

NEVAREZ: Absolutely. There's stigma around mental health nationwide. So I understand that that's present. But specifically in El Paso, being a Latino community, therapy is quote-unquote "not for us." There's nothing about that. Just pray it away, or you'll be fine. Go to church. You'll be OK. There's also this machismo culture that's like, we're tough. We don't need that. That's not for us. And so we had to remind folks, like, yes, you are tough. You are the toughest people. You just endured a huge trauma. And this is a sign of strength in reaching out for help, not a sign of weakness. And so being culturally competent in the services we provide, in our approach, even, our outreach approach - it wasn't just, here, call 915 (vocalizing). It was, you can do this. We are together in this. This makes us stronger together. We are El Paso strong. And when people came in - so meeting people where they're at, welcoming families together, if that was more comfortable for them, and that cultural component really played a huge role in all of what we did.

RASCOE: Is there anything you'd like to say to the people in Uvalde?

NEVAREZ: Yes, that my heart is with you. Our heart is with you. And to those therapists and clinicians, take some time to take care of yourself. I know the work is there. The work will be there. This is a long marathon, not a sprint.

RASCOE: Celeste Nevarez, chief of clinical services at Emergence Health Network, thank you so much.

NEVAREZ: Thank you.

(SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.