Five years ago on October 1, 2017, a gunman fired more than 1,000 rounds into a crowd attending the final night of a country music festival on the Las Vegas Strip.

Some of the lessons learned from that horrific night, that's this week on Nevada Week.

♪♪♪ Support for Nevada Week is provided by Senator William H. Hernstadt.

-Welcome to Nevada Week.

I'm Amber Renee Dixon.

The Route 91 Harvest Festival shooting ultimately left 60 people dead, hundreds wounded, and thousands more traumatized.

From the darkness of that first day in October grew the Vegas Strong Resiliency Center, a place of healing and support serving survivors and victims' families for the past five years.

Its role, though, is expanding.

More on that ahead.

But, first, the story of Survivor Rosemarie Melanson who has chosen to donate some of the proceeds from her new book to the Resiliency Center after learning firsthand the necessity for the resources it provides.

Rosemarie Melanson was enjoying some country music and the company of her two daughters, Paige and Stephanie, when she was shot in the chest at the Route 91 Harvest Festival.

(Rosemarie Melanson) And I just remember thinking, I think I just got shot.

And then I pulled my cell phone out of my front pocket, and I texted my husband.

And I said, "I just got shot.

I love you."

-Rosemarie's memories of that night include these pictures and an out-of-body experience.

-I could see my dead body on the ground.

I could see my girls over top of me.

I could see their friends.

I could hear the bullets going.

I could see people running and jumping.

I could see the whole scenario down here of people.

(Paige Melanson) Our mom was lying there, and she's not moving; and she is faced, like, face down, palms up.

And that was a really scary thing to see, because we thought, Oh, well, maybe mom's just a mom, and she knows what to do in this situation, and maybe we should just lie still too.

But it's not until when we crawled over here, she gave us no direction.

She literally was lifeless at that point.

And we flipped her over, and that's when we realized she had been shot in the chest.

-It broke two ribs.

It punctured my lungs.

It blew out the junction where the esophagus meets the stomach.

It just blew that junction right out.

Went through my stomach, took out a third of my liver, went through my spleen.

My kidneys were infected, I had a torn rotator cuff.

So I was on life support for two months.

-After 13 months in the hospital and 20-plus surgeries and procedures, Rosemarie authored this book.

-To inspire people that if I can get through what I went through, I wasn't expected to live, you can get through it too.

Part of the proceeds, she says, will benefit the Vegas Strong Resiliency Center.

-Because I want them to be able to use it for mental health awareness, because it's such a problem.

You know, like I said, whether you're going through a divorce, whether you're going through cancer, whether you're going through-- you're bipolar, whether it's trauma, PTSD, whatever obstacle you're facing, therapy can definitely help you navigate through the issues that you're having.

-How crucial was therapy for you?

-It was everything.

It was everything.

I don't know where we would be today without doing it.

-Throughout their lives, Paige and Stephanie have utilized dance as a form of therapy.

Alongside their mother, they run a studio called Dance Dynamics.

(Stephanie Melanson) The way that music can carry you and the way that you allow your body to move through it, sometimes you just get lost in the class and the music and the steps.

And it's a really, really good release for whatever you're feeling.

But after 1 October, Rosemarie felt her daughters needed traditional therapy to talk to someone, which they did try immediately after the mass shooting, only finding the right fit about a year later.

We just kind of blindly picked someone and said, You.

Okay, we'll go.

And it was not the outcome that I was looking for.

-I found another place.

And a minute after meeting my therapist, I knew, Oh my gosh, this is him.

Well, a minute after meeting him, I started telling my story.

And I just started crying and crying.

I didn't realize how much I needed therapy.

-We were definitely very blessed.

I mean, he was the best person I could have ever talked to about everything that I needed to go through and talk about, and really, really grateful for that.

-Gratitude for each other is what binds the Melanson family, as does their shared experience of tragedy, which all three agree they will likely never fully recover from.

-But I don't let it bring me down, because this is the way I look at it is I don't think God gives us more than we can handle.

Although, that was a lot to handle.

It was a lot to handle.

But the way I look at it is when that gunman decided to do that, it brought-- It was awful, awful, awful, but if you allow it to fester inside of you, you're going to be walking around like this all the time with your shoulders down.

And I just refuse to do that.

I refuse to allow him to win.

I will not allow it to happen.

-Thank you to the Melanson family for sharing their story.

For more now on the evolution of the Vegas Strong Resiliency Center, since its start five years ago, we bring in Tennille Pereira, Center Director; Lorea Arostegui-Johnson, Family Assistance Center Victim Specialist for Clark County; and John Steinbeck, Clark County Fire Chief and former Clark County Emergency Manager.

Thank you all for sharing your time with Nevada Week.

Tennille, I'll start with you.

The Vegas Strong Resiliency Center, what did it start as, and what has it become in the five years since 1 October?

(Tennille Pereira) So it really began as a place for anyone impacted by 1 October to connect with resources or whatever they needed for healing.

And that has always been our focus is healing.

But since, you know, the needs have evolved for the impacted community.

But we also wanted to ensure that this resource didn't disappear.

Right now it's funded by a federal grant, but that has a termination date.

And we knew from talking to other communities that have an incident like this, that the needs of the survivors and the families don't end at that termination date.

And so we wanted to ensure that we stayed open.

At the same time, we know there's a lot of trauma in our community by, you know, violent victimization and other situations.

And we wanted to help those people as well.

I mean, we've learned so much from our work with the 1 October population.

Why not use that to bring some light to our community for everyone dealing with trauma?

And so that's really what we're looking at now is transitioning and building in that additional programming.

-You said that the needs of survivors change over the years, and that reminds me of the story that we just watched.

Well, these women, they didn't realize they needed therapy until well after-- a year after 1 October.

What are you seeing now five years later, even people seeking help?

-So in that clip, I also kind of noticed how they did start.

Her daughter started therapy and then immediately recognized this isn't the right fit.

So that's a scenario that we see often.

They'll start, and then it doesn't work.

And so, you know, we'll kind of pull them back and say, Okay, let's try something else, because everybody's healing path is different.

So a lot of times, it's just reevaluating what is working, what is not working.

But the immediate needs were a lot of, like, emotional support, you know, faith-based counselors kind of just calming that immediate storm.

But a lot of people just kind of charged through.

So sometimes we hear from people we've never heard from before, but then others have kind of stabilized.

But when something happens that brings that trauma back up, it can kind of take them back there.

So a lot of times it was, you know, those immediate needs.

But as people have stabilized, it's kind of just reevaluating and, you know, looking at different resources.

And then along the way, we had COVID, which brought a whole other layer of trauma into it and needs, you know?

And then it was a lot of times housing and financial.

So, you know, kind of is a range.

-Chief Steinbeck, what is your history and relationship with the Vegas Strong Resiliency Center?

(John Steinbeck) Yeah.

So immediately right when the shooting began, we opened up what we call the Multi-Agency Coordination Center.

And that's basically an Emergency Operations Center to help with the operations and also the recovery.

And that's a dual role.

That transitioned.

Once rescue work was completed, that transitioned to family reunification, which is very haphazard and informal of just identify a place and try to get people to know where people are and take care of immediate needs.

And then that transitioned the next morning right into the Family Assistance Center.

The Family Assistance Center was opened up at the Las Vegas Convention Center.

We assisted over 3,700 people there over the next 20 days.

And we knew, just like Tennille just said, that that was not going to by any means be an end; it was going to have to continue far beyond that.

We had people come in from Orlando, kind of tell us a little bit about what had occurred in the Pulse nightclub.

And that gave us a little bit of a roadmap to move forward from there.

We knew we had to set up a Resiliency Center.

So while we were operating that Family Assistance Center, which was based-- We handled all kinds of problems there.

Because our goal, our absolute goal, was to lessen suffering in any way possible.

So when you came in, you would get a navigator.

If you couldn't come in-- Because you've got to remember, we had victims from every state.

Some of them just got on a plane and took off the next morning, right?

And some of them were-- Many were still here in town.

Obviously, our hospitals had a lot of them there.

So we had to make it so that we could go mobile to them, we can make it virtual to come in, or we had a place where everything was centralized.

And none of this was really established before this shooting.

It was in plan, but it wasn't established.

So we had to build that as we went.

-Someone might not think that emergency management would be involved in a place like the Vegas Strong Resiliency Center.

-So there was a gap, and we filled the gap.

That's what we're supposed to do in emergency management.

So it's very complex.

There's no agency that was ever assigned to take care of that, right?

There's not a specific recovery agency after a disaster.

So emergency management's job is to find that, and that's what we did.

-And, Lorea, you have a unique role in all of this.

Where do you fit in?

How did you become involved in the first place?

(Lorea Arostegui) I used to work for the Clinical unit in Department of Family Services.

And our unit was requested to come and assist with the families during the coroner notification.

So during those notifications, I assisted the families at the Family Assistance Center.

And then once the Family Assistance Center shut down at the Convention Center and transitioned to the Resiliency Center, we had staff that came over from the county in different departments to help with that transition.

And I've stayed on the project since then.

So I now report to Chief and Office of Emergency Management.

But I work at the Vegas Strong Resiliency Center half the time so that we can keep that connection and the different county programs involved.

-So what does that look like?

What does your role look like now working between these two organizations?

-It's busy.

It's a very busy role.

It's a lot of planning.

It's a lot of thinking outside of the box and trying to figure things out and research the different programs in different areas or states, how they've handled different situations, and bringing those ideas to the table to see what we can do to better it.

-How unique is this partnership?

-To our knowledge, it's pretty unique.

And we've had-- One thing is we've had the opportunity to go to a lot of other communities that have also had mass violence since then and bring our lessons there.

But I believe that this current partnership that we have is fairly unique, but I can't speak to all of the past locations.

-So I'm actually part of a group.

It's called the National Resiliency Center Directors Forum.

And it was started during the COVID shutdown.

I think it was in planning well before that, though.

And I get to work with all these different Resiliency Center directors across the country.

There's no-- There's no brochure or class, that you can take on how to run and manage a Resiliency Center.

And so it's been this really great resource, but there is no other organization that is doing this type of structure.

And, you know, it's building in, you know, victim services into the emergency management worlds and planning, and it's such a great opportunity, because not only are we going to be ready and prepared if something like this happens again, but we're now bringing that victim's voice to all of the planning.

So Lorea is talking about a lot of different planning that she's doing and coordinating.

But she goes to, you know, tabletop exercises when, you know, emergency management is working through their plans to see how they'll work.

And she gets to tell them, You might want to look at this, or You might want to look at that.

Because she's looking at it from the victim's perspective.

-Lorea, let's have you chime in here.

-Yeah, it's true.

I go to a lot of tabletops.

I've been to some exercises through the fire department.

And I do see things kind of from a different light.

They're first responders.

They're there to make the rescue.

And my perspective as a social worker is the resiliency part, the after part, like, what would help after, or what is going to trigger something that's going to linger.

So I bring those ideas or thoughts or things that I see to their attention so that we can maybe help with that process to go a little bit smoother for victims and their families.

-Could you give me an example?

-An example?

For example, we did a hospital exercise in which they made it look, kind of look like 1 October where there was a mass influx of injured people arriving at an emergency room and trauma center and how the hospital would respond, like where that many ambulances or public cars would pull up and how they would get these people the help that they need.

And I just noted that-- the way that some of the people handled some of the injured or deceased could be construed by somebody from the outside as not really caring about them.

And so it was just something that they would be able to take back and include in their future plans of how not to do that.

-Chief Steinbeck, how have your men and women accepted this kind of new training, I guess?

-Oh, very well.

So we've evolved over the years of fire service.

Early history was that it was mostly fires and some related emergencies; but then in the '70s, we got much more into EMS.

Now that's 90% of what we do, right?

And so this is just another evolution.

The men and women that work for our department, they're ready to participate in anything that helps the community.

So if that's running a COVID vaccine site, if that's running a Family Assistance Center, they bring in a skill set that is needed, which is to run a scene or to run an operation or to problem solve.

And so, they love that.

-Lessons learned from 1 October from the Vegas Strong Resiliency Center perspective, Tennille.

-So many lessons learned.

Just even going back to becoming more trauma-informed as a community as, you know, a response.

Language matters.

Different words that are used; for example, anniversary.

They don't like the term "anniversary" because anniversary is something positive.

And so we've transitioned to using "remembrance events."

There are a number of things that we've done and implemented that have made even us more trauma-informed.

One example, going back kind of to Lorea's comments, there was a survivor in the hospital.

She had been shot three times.

You know, her injuries were so severe that she couldn't talk.

She had a feeding tube, her whole life was kind of ripped out from under her feet.

And she had some individuals in the hospital working came in and told her she was one of the lucky ones.

And she said she just laid there and could not believe that they would say that to her and that it was really hard for her to kind of process that, that it added additional trauma to her because it minimized what she was going through and invalidated her experience.

And so we take things like that and we spread that information, not just in what we do, but through the system, through this collaboration.

So it's just been a great opportunity to make positive change.

-What about for you?

Lessons learned, Chief Steinbach.

-So we have a very thick after-action report, right, that we are continuously working on.

As a matter of fact, there's three different after-action reports that include everything from tracking the patients to, of course, having a Resiliency Center phone bank set up properly; having a website that's designed specifically that can be turned on in a moment's notice, not counting on your current ones that can then work through that virtually; and then, of course, the biggest lesson was to have a Resiliency Center in place.

You know, for years I would say, after a fire or after, you know, someone got shot or somebody in a bad accident, where do I send them for assistance, right?

I mean, this is, this is a massive event in which so many people were traumatized and killed and injured, that it comes with some resources.

But you have the one-offs that they don't-- We didn't have those type of resources.

We're in a better place now to try to assist them, which is why we're in business.

So we've learned a lot of lessons.

And now we hope to never have to mobilize like that again; but if we did, we won't be building that airplane as it comes or working off of an abstract set of plans or tabletops.

We have experience, and we have people in place to respond.

And that's because we're not willing to just say the Resiliency Center is done.

It's going to be in place, and it can now surge as needed or just work on a base scale.

-You mentioned a website.

So what would that look like if there were to be another 1 October?

How would that work?

-Yeah.

It's dormant right now and ready to go at a push of a button.

And so what it is, is so that the Family Assistance Center, when you walk in, you have a navigator that assists you and says, Oh, okay, so tell me what your needs are, what it is that happened.

And we've got everything over here from assisting you with immediate physical needs to behavioral, spiritual health.

All of those types of things-- lodging, whatever it might be.

The website is built similar so that if you are out of state, we can assist you in that way and then also get you registered for assistance, because so many people who are victims of crime never understood that there is assistance out there that can help them financially and supportive.

-Lorea, how much better prepared do you think Southern Nevada is for another 1 October?

-I will say that when 1 October happened and we walked into that room, it was scary.

And everybody was doing the best that they can with what they had, but now we have so much more.

We've been there.

We know what we did right, we know what we could have done better, and we built a really strong team from that.

And the collaboration between all the different agencies and departments is very strong.

I think we would be in pretty good shape.

God forbid anything ever happen again, that we would be able to handle it pretty smoothly.

-And the long-term resiliency of Southern Nevada, how are you working toward that?

-Well, that's-- That's the ultimate goal, right?

And from this incident, it was not-- It was also you had to make sure that the individual had the resources that they needed when they needed them.

Not when you thought they needed them, right?

But you also had a community that, that you were trying to move forward and trying to help heal.

And so as a community has faith and sees the results of this work, that that's where the resiliency really comes in.

And to Lorea's point, we have a lot of confidence now because we know, whether we're assisting remotely or on site, when this has occurred in other communities, we can go there and we can advance them weeks within hours.

And so that's the lessons that we've learned which we never wanted to learn, but we learned.

-Tennille, from the story that we watched, the sisters had used dance as a form of therapy.

The Vegas Strong Resiliency Center provides how many different types of therapy?

-Oh, so many different types.

You know, we have kind of broken ground on, under the federal grant that we work with and gotten additional services.

We call those integrative services that complement, you know, the traditional mental health, because I think everyone is comfortable with those evidence-based traditional therapies.

But there are alternatives that really do complement those and really do help people cope with the daily, you know, stress and bring comfort and peace.

And so we do a whole bunch of different ones and explore those and see what helps.

And if it's something that our survivors grab onto, then we're going to support that.

-And real quickly, the 1 October Morial that is-- the deadline has been extended for that.

And that is also a form of therapy.

How would you explain that?

-Yes.

It's creative expressions.

So art is one of the best ways to really express yourself, kind of express those emotions.

And a lot of times that's what therapy does is getting those emotions out, processing them, breaking them down.

So the 1 October Memorial Committee wanted to make sure that the community got to use art, their own creative expressions to heal, but also have it become part of the memorial process.

So we're just excited to see what the community comes up with.

-And the deadline is now extended to October 15, correct?

-Through the end of October, actually.

-Good.

All right.

Thank you all for joining us.

And in this show, we have covered how first responders learn to interact with victims of trauma, but what about the mental health needs of first responders themselves?

That is the topic of our show two weeks from now on Friday, October 14, at 8 p.m.

I hope you will join us then.

In the meantime, for any of the resources discussed on today's show, including a link to the 1 October Memorial submission page, go to our website, vegaspbs.org/nevadaweek.

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