 Joining us now to talk about your health is Kay Connors, social worker with the University of Maryland Children's Hospital. Kay, thanks so much for joining us. Thank you so much for having me. Just about a week ago, we had this horrible shooting in South Baltimore, 30 people. Something like half of them were minors, were young people. Talk about the psychological impact on them and on their peers in that community. Yes, unfortunately, Baltimore and most recently, also Salisbury community have been impacted by these mass violent events. And so as the survivors of those events are recovering from their physical wounds, the stress and the psychological wounds are really what linger for quite a long time. When does the focus turn to that? I mean, the hospital's in closest proximity to this parent's shootout, 30 people, were immediately overwhelmed. And the first responders within the hospital, the doctors, the nurses, the other staff members spring into action. Your colleagues did a terrific job. When does the focus turn from stop the bleeding, priority one, to the psychological side? It really starts right away. And I really appreciate you bringing up the first responders and the medical teams because they've also been through so much with COVID and having to then respond to these kinds of events that often feel senseless and it's hard to make meaning of these difficult things. So I think psychological first aid really focuses on getting in touch with your own feelings, normalizing that stress and anger and fear are really the first wave of the response and allowing yourself to talk about that, to think about it, to do some things that are gonna help you pause and reset and even nurture yourself. And sometimes when people have lived through really difficult things, they don't feel like they deserve a break or time to take care of themselves. But that's really an important part of psychological first aid that for everyone needs to start that night or the next day. You used to be referred to as being shell shocked a generation or two ago. Now PTSD, how do you define that? What is it? Post-traumatic stress disorder is a clinical diagnosis. About 20% of adults and about 20 or more, 20 to 30% of teenagers and children will actually experience full blown PTSD. Most of us will experience some kind of range of traumatic reactions and responses to difficult things. But PTSD, we look for that at about a month after the event. If you're still feeling very frightened, having difficulty sleeping, having nightmares, having flashbacks or a very sudden reminders or reactions to memories of what happened or also having very big emotional responses that get in the way of you doing your everyday life, going to school, being in relationships, things like that, that's when it's time to really reach out to your primary care doctor or even seek mental health treatment. So what is this concept of psychological first aid and when do you apply that? It really starts right away. We learned many years ago that something called psychological debriefing, getting people to talk about events right after they happened was really more harmful than helpful. Interesting. So in these 20 years, particularly after 9-11, we really learned that giving people comfort and aid, helping with problems in daily living, but also providing comfort, but also psychological comfort. If people wanna talk about it, being able to listen, but not asking a lot of details, helping particularly teenagers in this incident that we're talking about today and their parents, giving them information about what this shell shock or traumatic stress response is gonna be, that it's gonna be normal, and you wanna keep tabs on it until things settle back down and you return to your normal routines. Yeah, I was wondering if the timing was bad from the standpoint of a young person because school's out, summer vacation, but maybe if school's coming back in in a month and a half or whatever, that timing might be okay for school counselors to get involved? Yeah, I think school counselors will be a really important resource because the effects of this incident will still be felt in August and September when kids return to school. I think school counselors are really experts in building on kids' strengths and their resilience, and for many kids, school is a safe space. Even though we hear a lot about some bad things that happen in school for many kids, it is a place of refuge and a place where they feel competent. Yeah, I wish that was always the case, that it was a safe space. What should parents know? What should parents, in that community and maybe beyond that community, because if you watch the news, you couldn't help but be exposed to this story or you mentioned Salisbury or DC or Philadelphia or Lord knows how many. Yeah, parents really play the key role and I think psychological first aid really focuses on helping parents be that safe space for their children and their teenagers by giving them information and resources. First, starting with themselves and focusing on parents' self-care and not being too hard on themselves, giving them a chance to know that it's okay to have these strong feelings and particularly worries about their children. And that's parents' main job is to protect their kids. Absolutely, nonstop and forever. Is there a predictable timetable for when somebody in the community, somebody in your colleagues in the hospital might find themselves being affected by this? Is it hours, days, months? When might somebody feel that percolating? Definitely after a month, if some of the intensity has not lessened and if people are having difficulty returning to their normal routines, that's a sign of you might wanna reach out for more help. Another thing is people that have already experienced stressful or traumatic events. And for many of our youth and families and communities, that's- Not the first time. Yeah, this is not the first time and we're really just coming off the stress of COVID. So I think it's really gonna take some time and I think normalizing that it takes some time to cope with this mass violence. Do you see that in your patients that this is a community, it's a country, there's a planet that is still a little bit on edge from the pandemic and then we just pile stuff on it? Yeah, I really do. And this incident and the incident in Salisbury really speaks to the concerns about gun violence as well. That's in 2022 it was the number one reason why youth died. So not cancer and other things like automobile accidents but it was gun violence. So parents are very worried. Social media doesn't seem to be a help to anybody. I mean, is it probably not a place the young people should turn for assistance in dealing with the situation like this? Yeah, thank you for bringing up that point. It's really an important time to take a step back from social media, put yourself on a little social media diet where you're only watching a little bit because the more you see repeated images and hear stories, the more difficult your stress response is gonna be. I just have half a minute but I'm curious how you start a conversation with somebody. Say it's a young person, where do you start? First start by listening, how has it been for you this time where some scary things have happened and then listen to what they have to say. Some kids might not feel comfortable saying anything. So you might want to just say, you know, it's really normal to feel afraid. It's important to listen to those feelings because that's our stress alarm speaking. And so you have a healthy stress alarm when you have fear. So normalizing fear rather than avoiding it but then also talking about some coping strategies. So what are some things that could help you get back into your normal routine? Get a good night's sleep tonight. Turn off that social media for a minute. Reach out to a friend, play some basketball, do something fun. Great advice. We have to leave it there. Kay Connors with the University of Maryland Children's Hospital. Kay, we appreciate your time. Your health segments are a co-production of Maryland Public Television and the University of Maryland Medical System.