While the world struggles to deal with a very real public health crisis, community cohesiveness, kindness, and empathy are at a premium. There is a complexity to healing, though, and the newest threat does not eliminate those in the community already suffering — many invisibly. The wounds related to the looming public health threat surrounding mass shootings, the linked suicide crisis, and post-traumatic stress still fester.

Saturday, March 21 marks the 15-year anniversary of the school shooting at Red Lake High School on the Red Lake Indian Reservation in northern Minnesota. Although occurring somewhat sequestered from the public spotlight and amidst an independent indigenous sovereign, in many ways the 2005 rampage resembled other school shootings. A suicidal male student stole his grandfather’s guns, killed his grandfather and his girlfriend, broke into his own school, and shot a teacher and teenagers before taking his own life. Sadly, it has become a common American narrative and pattern.

At Red Lake there were warning signs. There are always warning signs, which, somehow, if heeded, might prevent tragedy. The warning signs at Red Lake, each taken alone 15 years ago, were not so alarming to make him a likely mass shooter. After the fact, though, they painted a very troubling picture. Not uncommon, the shooter at Red Lake was an obviously suicidal teenager crying for help. And, he had access to guns.

It is, however, the aftermath and the indigenous style community response that set this shooting apart. At Red Lake, the killer’s family did not have difficulty finding a place to bury him, and the killer was given a traditional funeral and mourning rituals, which were well attended. In contrast to the way the community treated the mother of the shooter of the Sandy Hook Elementary School shooting in Newtown, Connecticut, for example, at Red Lake, the shooter’s grandfather was counted as a victim and wasn’t blamed for the killings. His funeral was also well attended. What was most remarkable, though, was that the tribe included the killer’s family in the distribution of victim-compensation funds, helping to pay for his funeral and burial expenses. In Red Lake, parents of victims thought the murderer deserved some recognition from the community so he would not be forgotten. A number of the victims’ relatives forgave the killer and considered the circumstances that led to the massacre.

Yet, like other rampage killings, the shooter left behind a long trail of surviving victims, some with debilitating physical injuries and others with permanent psychological wounds. Comparing victims’ injuries is difficult, but those with psychological trauma are no less injured.

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“A lot of us still have wounds that are tender to the touch,” says Missy Dodds, the math teacher in the Red Lake High School classroom who witnessed and survived the 2005 rampage. The students in Dodds’ study hall experienced the vicious reign of terror with frightening proximity. After blasting his way into their locked classroom, wrestling with and shooting a football player, a teacher and seven students lay dead, including the killer himself. Imagine the horror.

Fifteen years later, the memories are vivid and terrifying. Today, Missy Dodds suffers from post-traumatic stress disorder. She suffers from survivor’s guilt and a profound sadness that she failed to protect her students, whom she calls “her babies.” Today, Dodds is still concerned about the surviving children, now adults, and their well-being. “I worry about the help my students did not get in the aftermath and even now, 15 years later.”

The desire for the Red Lake indigenous community to be separate and independent meant the tribe could control the environment following the massacre. For some that was an advantage, and for others it had unforeseen consequences. The traditional Ojibwe Anishinaabe mourning process is private and usually not visible. That left some survivors feeling forgotten by the world, not counted. Today, the high school building is still in use, as is the very classroom. There is no public memorial or annual ceremony.

Often the legal process inhibits rather than facilitates healing. This case is no exception. In this case, the tribal chairman’s son was arrested in connection with the incident, and that had to have had an impact on the community. Further, the workmen’s compensation proceedings brought by 12 teachers and the manner they were handled also harmed victims in dire need of help. The claims brought by the teachers sought compensation for psychological impairment. But, denied by the district, Dodds had to go through a trial to get a financial recovery, a grueling process that took many years. Eventually, after Dodds’ trial, the district settled with the other teachers.

The world is in an all-hands-on deck public health crisis. We would be remiss, though, if we neglected the critically important public health crises of mass shootings and, in addition to paying fitting tribute to the victims who died like those at Red Lake, also remember the survivors.

James D. Diamond of South Kingstown, Rhode Island, is the former director of the Tribal Justice Clinic at the University of Arizona in Tucson and the author of “After The Bloodbath: Is Healing Possible in the Wake of Rampage Shootings?” (Michigan State University Press). Diamond practiced criminal law in Connecticut for 25 years as a prosecutor and defense attorney. He is dean of academic affairs of the National Tribal Trial College.