U.S. can offer Pakistan help in coping with school shooting

Posted at 4:06 PM, Dec 17, 2014

As Pakistan and the world reel from the worst terrorist massacre in the nation’s history at a military school in Peshawar, several charitable groups in the country have reached out for expert help in counseling surviving children and families.

One health-oriented organization, called Naya Javeen, took to social media Wednesday seeking volunteer mental health counselors, psychologists and psychiatrists to provide short and long-term services to the survivors.  Within hours, scores of professionals and students, mainly from Pakistan but also in Britain, New Zealand and the U.S. had responded on the group’s Facebook page.

Although the death toll from the Taliban attack in Peshawar – at least 145 including 132 students--is a bloody milestone for Pakistan, the reality is that schools have been targeted either by terrorists or the mentally disturbed in virtually every nation in recent decades.

In Beslan, Russia in 2004 more than 300 students died in School No. 1 during an attack by pro-Chechen rebels; 20 died in a PLO attack on an Israeli school in 1974 and 17 died in a primary school shooting in Dunblane, Scotland in 1996.

In the U.S., there have been numerous shootings at schools in the 15 years since a massacre by two students at Columbine High School in Colorado claimed 13. Few of the events have claimed multiple lives, but the 33 killed at Virginia Tech in 2007 and the 26 dead in December 2012 at Sandy Hook Elementary School in Newtown, Connecticut have helped frame national debates on preventing the rampages and on how to help survivors and communities recover when they occur.

So is there common lessons in recovery to share between what America has seen of school tragedies and what confronts Pakistanis? Some, but also some stark differences.

The assault in Peshawar, however cruel, was part of a longstanding religious and political war between the Taliban and the Pakistani government. While some school shooters in the U.S. have had grudges against authority, none have been part of any wider political agenda.

“The motives perceived behind an attack matter a great deal in terms of how people respond to it,’’ said Paul Greene, professor of psychology and a trauma counseling specialist at Iona College in New Rochelle, New York, in a phone interview with Scripps.

International aid groups report that at least 1,000 schools have been attacked by the Taliban in Pakistan since 2009, assaults ranging from hand grenades thrown onto playgrounds to the shooting of teachers and students to the burning down of buildings. Girls’ schools are particular targets, especially around the Swat Valley largely controlled by the Taliban.

That was where Malala Yousafzai, the Nobel Prize winner, was shot in the head by the Taliban in October 2012.

Pakistan overall has very limited mental health services, and the impact of the ongoing violence in the Northwest part of the country has left widespread post-traumatic stress, depression and anxiety among residents and refugees, according to assessments by aid groups and the World Health Organization.

Yet despite the need for services, there is also strong distrust of westerners and westernized medicine among many in the region.

So any therapists who might come to Peshawar may borrow some techniques from the U.S., but need to adjust for local culture.

“That’s one of the big lessons we’ve learned in recovery from school shootings or any mass trauma in the U.S., that you have to rely on the natural resources already in the community, the institutions, religion, family ties, to help people cope over the long run,’’ Greene said. “You can’t impose outside solutions.”

And the U.S. experience also underscores that recovery is long term, and that new attacks often bring flashbacks and anxiety to survivors.

Officials in Newtown say two years after the shootings, the need for counseling and other services remain high and new problems continue to emerge for children and adults alike. Experts say extra mental health support will be needed in the community for at least the next 12 to 15 years, when the youngest Sandy Hook survivors enter adulthood. 

[Also by Lee Bowman: Surgeon general's powers are limited]

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