WINDER, Ga. — About an hour after gunfire erupted at Apalachee High School, ambulances began arriving at nearby Northeast Georgia Barrow Medical Center with two students and two adults suffering from panic attacks and extreme anxiety — not gunshot wounds.
A fifth patient with similar symptoms later arrived at another local facility, according to a health system spokesperson.
The day after the Sept. 4 school shooting that killed two students and two teachers, about 80 families showed up at a county office for counseling from volunteer therapists who converged from across metro Atlanta, according to a medical provider. That Sunday, nine people received free treatment at a local church for post-traumatic stress disorder from volunteer providers from the Atlanta area. On Monday, the state opened a temporary recovery center to help local residents find counselling, religious support or other assistance. The needs remain great.
“We don’t really know where we are,” said Amanda McKee, whose son, Asa Deslonde, is a senior at Apalachee, two days after the shooting. “It’s second by second. It’s minute by minute. The last two days have been unimaginable.”
When shootings of any magnitude occur, survivors often suffer invisible injuries that can lead to life-altering and sometimes paralyzing symptoms. But these problems can take time to manifest. Panic attacks and anxiety can increase throughout a community after a shooting and can be more intense when people return to the scene, said Howard Liu, chairman of the American Psychiatric Association’s Communications Council.
That’s why health care providers are concerned that in the coming days, months and years, the community will struggle to find help for its mental health needs. Barrow County, along a highway that connects Atlanta to the college town of Athens, is a community where agriculture is steadily giving way to development.
Before the shooting, the area had one inpatient mental health facility — located in Gainesville, about 30 miles from where the shooting occurred in Barrow County — that was “constantly overwhelmed,” said Sean Couch, a spokesman for Northeast Georgia Health System. And, the latest federal data show, Barrow would have to add at least 13 full-time providers to no longer be considered a mental health workforce shortage area.
“We put a Band-Aid on a chronic situation and that Band-Aid is not going to last,” said Roland Behm, co-founder of the Mental Health Policy Association of Georgia, an advocacy group that represents mental health organizations in the state. “What will happen three months from now?”
The shortage of mental health providers in Barrow County is emblematic of the state as a whole. Georgia ranks near the bottom among states in access to mental health care resources, according to Mental Health America, a nonprofit that advocates for increased mental health spending. More than 5 million Georgians live in areas with a shortage of mental health professionals like Barrow County.
Paying for mental health care to treat these kinds of traumas is difficult across the country. But Georgia is one of 10 states that have not fully expanded eligibility for Medicaid, the country’s lifeline for low-income people and also the largest payer of mental health services. The state has an uninsured rate of 13.6%, which is 4.1 percentage points higher than the country as a whole, according to 2022 data from the U.S. Census Bureau.
Even people with private health plans have trouble finding affordable, in-network mental health care because of a lack of providers willing to accept low insurance reimbursement rates, Behm said.
Tamara Conlin, chief executive of Advantage Behavioral Health Systems, said people who showed up for initial counseling sessions her group helped organize at a county office showed a lot of sadness and anxiety.
“Some of them are still in shock and trying to come to terms with what happened,” he said.
Even before the shooting, students at Apalachee High School reported significant mental health issues.
According to the latest Georgia Student Health Survey, nearly 200 of the 1,725 students surveyed reported that they had seriously considered attempting suicide one or more times during the previous year. Top motivators included problems with peers, friends or family. About half of the school’s students who responded said they had felt sad, depressed or withdrawn at least once in the previous 30 days.
County residents complained of having to travel for psychiatric care and said a “shortage of psychologists and counseling services led to high rates of untreated anxiety and depression” during a 2019 focus group on access to health care.
Lack of mental health care remained a top concern in the region during a follow-up assessment in 2022. That year, Barrow County’s opioid overdose death rate was among the highest in Georgia, according to state data, and the five-year suicide rate was above the state average.
The Barrow County school system, which includes Apalachee High School, received a $1.8 million federal grant to boost mental health resources in schools from 2023 to 2028.
But in the immediate aftermath of the shooting, mental health providers across the region still had to pull together free resources for area residents. Three volunteers helped with last Wednesday’s response at Northeast Georgia Medical Center Barrow. Advantage Behavioral Health Systems kept its Barrow clinic open Sunday and is providing counselors for community events and local schools as they reopen.
William Smith, who runs the Atlanta EMDR Center, is planning sessions using eye movement desensitization and reprocessing therapy to address post-traumatic stress disorder (PTSD), at least one for first responders and one for residents.
Over the weekend, Lutheran Church Charities brought in nine golden retrievers as “comfort dogs” to help mourners. The group’s dogs have been used in the wake of other school shootings, including the massacre in Uvalde, Texas.
“We can’t fix what they’re feeling,” said volunteer Paul Soost, as people gathered around a campus flagpole where they delivered flowers and messages. “We can bring comfort to them.”
Many health care providers expect community needs to increase as students return to Apalachee High School and national attention on the shooting wanes.
“That’s when people start to experience trauma,” said Conlin, of Advantage Behavioral Health Systems, who compared the current crisis to the surge in patients she saw after the immediate threat of the Covid-19 pandemic passed.
His Barrow County clinic already had about 750 active clients before the shooting, about 120 of whom were under the age of 18.
McKee said she knows recovery will be a long process for her son, Asa. One of his football coaches, Richard Aspinwall, was among the four killed. A key step came the day after the shooting, she said, when the school’s football coach called the team together to share how much he was hurting.
“The coach confirmed to them that they were injured and encouraged them to accept that they were injured,” McKee said. “They are not physical injuries caused by the senseless act, but they are injuries nonetheless.”
If you or someone you know may be experiencing a mental health crisis, please contact the 988 Suicide and Crisis Hotline by dialing or texting “988.”
