TULALIP — A dozen eager fourth-graders gathered in a circle in the teen room at the Tulalip Boys &Girls Club, preparing to sing.
The song, led by Danielle Valdes, was simple, and the kids knew the drill. They sang “We’re going to do a little dance that you don’t know.”
Then Valdes turned to Mahayla Williams, who began to improvise a little shimmy. “Do, do the Mahayla!” the kids sang, imitating Mahayla’s dance.
It’s also one of several initiatives the tribes have undertaken in the past year to enhance the mental well-being of its members.
It all falls under the category of “trauma-informed care,” a theory and practice that allows communities that have been exposed to extreme trauma to find a way to recover and heal, and which often extends beyond the initial triggering incident.
On Oct. 24, 2014, the 15-year-old son of a prominent tribal family shot five of his friends in a Marysville Pilchuck High School cafeteria before taking his own life. Four of his teenage victims died.
The shootings tore a rift in the Tulalip community that leaders have tried since then to mend.
“There was a real conversation about not putting our head in the sand and pretending this didn’t happen,” said Misty Napeahi, the general manager for the Tulalip Tribes.
The tribal leadership realized that, even as they worked with the city of Marysville and the Marysville School District on a joint recovery program that encompassed the larger community, they would need to revamp the tribes’ own internal mental health care services.
But how to do it? “We didn’t know what that looked like, we had no idea,” Napeahi said.
There were many offers to help, some well-meaning and some from “weirdos,” Napeahi said.
There were visits from families of the Sandy Hook shooting victims. One member of the Red Lake Nation, a Minnesota tribe that was wracked by a high school shooting in 2005, came to visit as well, if only to issue a warning.
“He said, ‘Don’t act like this didn’t happen, don’t bury your head, stand firm. If you don’t, more people are going to die,’ ” Napeahi said.
That was a sentiment echoed by some members of the tribal community, including families of the victims, who came forward in December to say that the tribes should not remain silent about the shootings or allow the shooter to be presented as a victim.
How to treat the shooter and the shooter’s family was one of the key issues the Tulalips confronted. Since the tribe is essentially a large extended family, that adds another level of complexity to the effort of finding a way to talk about that day, Napeahi said.
Many tribal officials do not use the shooter’s name and refer to the shootings as simply “the event,” “the tragedy” or just “October 24.” They prefer to focus on the victims and the larger community, she said.
The Tulalips also have hired four new staff for their Family Mental Wellness Program (three of whom were paid for through a federal grant from the Office for Victims of Crime), instituted suicide and trauma screenings as a regular part of health care, offered music and dance therapy programs in the schools and the Boys &Girls Club, and turned the tribe’s emergency manager position into to a full-time recovery manager position.
The kids’ songs and activities are designed to help develop healthy social behaviors and skills, said Karla Hawley, the music therapy director for the Snohomish County Music Project.
Some songs are designed to teach self-regulation, she said, while a Mad Lib-style fill-in-the-blank song fosters negotiation skills. Others build resilience, impulse control, and support learning.
“They don’t have the language to say ‘I’m happy because of this.’ They’re more likely to act it out than use words,” Hawley said. “So let’s give them an opportunity to express themselves in a safe place.”
“We call it ‘stealth mental health,’ ” she added. “They don’t know that good things are happening. They’re just having fun.”
The trauma-informed care model was brought to the tribes by The International Trauma Center. The Boston nonprofit has worked with governments and organizations after natural disasters such as the 2010 Haiti earthquake, events like mass shootings and the Sept. 11 terrorist attacks, and helped build more resilient mental health care systems around the world.
The group also has done significant work with indigenous communities both in the U.S. and abroad, said Robert Macy, the center’s founder and president.
“What folks have found at this point is that if you have immediate intervention and support in general, the psychological impact can be lessened significantly,” Macy said.
Trauma informed care is a way of helping organizations, families and even nations to manage relationships by addressing the significant trauma shaping their experience.
Since November 2014, the Trauma Center has held monthly consultations and training sessions with the Tulalip administration and community, and also the Marysville School District and the city of Marysville, recognizing that all the communities are tightly interwoven.
“The idea was to get people into treatment, and that’s still the idea,” Macy said.
But people don’t necessarily embrace mental health care treatment, especially in Native American communities that can be leery of a system put into place by “colonizers,” he said.
Removing the stigma of mental health care is one objective of this undertaking, Napeahi said, and the tribes have had some success in getting more tribal members the care they need.
“I’d say the overall goal of 2015 was not to have a contagion, no more suicides,” Napeahi said.
Suicide rates in Native American communities, especially among youth, are much higher than outside. One federal Indian Health Service study pointed out that suicide is the second-leading cause of death among native youth between the ages of 15 and 19, a rate 2.7 times higher than youth of all races in the U.S.
Tribal therapists have been working in the schools, providing care for both native and nonnative youth, Napeahi said, and the tribal health system has partnered with Providence Health and Services to more effectively manage its case loads.
The outreach to children has been especially important, said Rochelle Lubbers, the tribes’ recovery manager.
“It is apparent that children have been affected by trauma, and that these interventions are vital to catch at this age,” Lubbers said.
The goal is to create healthy family environments, she said, and because children often don’t have the ability to process trauma on their own, reaching out to the adults in the community has become another priority, so that they will in turn have healthier children.
More than 100 tribal staff members have been trained through Macy’s organization in psychological first aid and post-traumatic stress management techniques, Lubbers said. Even non-native tribal employees have been screened for signs of trauma because of their proximity to the shootings.
Layered on top of that is trauma experienced over decades for those living now, and across centuries for tribal culture as a whole.
Macy said that those traumas can’t be considered in isolation. In any sample of, say, 100 people who are acting out or otherwise being affected by a specific violent event, maybe 20 or 30 of them are being more strongly triggered by something else in their lives.
Trauma-informed care is centered around dealing with that primary trauma, whether it is a violent event such as a mass shooting, or something else, such as getting into a fight with an alcoholic parent, or the cumulative effects of trans-generational trauma.
Trauma is subjective to the person suffering it, Macy said, and that must guide treatment.
“A community that suffered the boarding school trauma that this tribe suffered, that’s going to interact with the shooting trauma, and have an effect with family violence and community violence,” he said.
Those kinds of histories of trauma have also allowed those groups to develop a certain amount of resilience and creativity, he said. But that doesn’t negate the combined negative effects of the sorts of trauma native communities have experienced, and support is still necessary, Macy said.
The Tulalips had been attempting to address this history before Oct. 24, Napeahi said.
The shootings provided a catalyst for more rapid change.
“Our community, prior to Oct. 24, had trauma embedded in it from historical aspects, from boarding schools to our history of being Native American,” Napeahi said. “We needed something here that was sustainable and that would improve what we’re doing.”
There’s also a recognition that, just as there are stages of grief, there are also stages of trauma the tribes, both collectively and as individuals, have been moving through.
“Overall, I think we’re all coming out of the shock of what happened,” Napeahi said. “It’s taken a full year for us to wrap our heads around what’s taken place.”