Health costs of surviving a school shooting extend far beyond medical bills

Survivors of mass school shootings face medical bills, long-term mental health care, and a cascade of financial pressures that stretch for years. A HuffPost report centers on two-time survivors Mia Tretta and Zoe Weissman and details how gun violence can ripple through families' finances long after the emergency subsides. Tretta, 15 at the time of a 2019 California shooting that killed two students, including her best friend, is now a Brown University student who survived another shooting on campus when an armed man opened fire inside an engineering building, killing two more and wounding nine others.

Flight changes and rebooking costs have become a visible, immediate burden for students and their families. Some airlines have waived fees for students in crisis, but not all do. Delta and American Airlines were cited as offering waivers in some cases. In Brown's wake, Autumn Wong, a recent Brown graduate and resident adviser, drained her own checking account to pay for five students' rebookings and launched a GoFundMe that has helped at least 46 students with transportation costs. As of Dec. 19, students were seeking about $15,503 in reimbursement for flight changes. Brown University offers its own resources, including an emergency fund for income-eligible students and a Student Emergency Support Fund, and a shared online document listing local discounts and free rides.

Hospital bills can be astronomical. Tretta's initial hospital stay after the California shooting totaled more than $178,000. A 2022 study found medical costs for mass shooting injuries average $64,976 per person, covering treatments that may include ambulance rides, anesthesia, and multiple specialists. The Tretta family had private insurance and applied for California's gun violence victim's compensation fund, which reimbursed portions not covered by insurance. Tiffany Tretta considers herself lucky that she could dedicate all her time to her daughter’s insurance paperwork, driving her to appointments and paying for hospital parking: “We told Mia ... we would always take care of anything we could for her, just to lighten this, because it’s just a shitty hand that she was dealt.” She recalled having to explain to an insurance adjuster asking for a responsible party that the gunman had died by suicide after the shooting. “You’re trying to explain something that completely shattered and wrecked your life, and explain that there isn’t somebody [else] that can be financially responsible for this, and so I guess it is just us.” There are also unexpected costs a gun violence survivor may need to pay years later to feel whole again. Mia Tretta wants to have kids one day, but being shot in her lower stomach has affected this possibility. “This coming summer, I’m freezing my eggs because there’s so much uncertainty of whether or not I’ll be able to have kids on my own, and all my doctors have recommended just doing it now,” she said. “So that’s something that the state is obviously not going to cover, because it’s not an essential thing, but feels pretty essential to me.” Tiffany Tretta said the estimate for her daughter’s egg-freezing is $20,000. Therapy bills can be “upwards of $200 per appointment.” Illustration: HuffPost; Photos: Reuters Mia Tretta (left) and Zoe Weissman (right) are both two-time school shooting survivors. The ongoing mental health costs to deal with the effects of gun violence can be lifelong. Erika Felix, a professor of clinical psychology at the University of California, Santa Barbara, who studies children’s long-term mental health following mass shootings, said that “many people will recover and be resilient,” but the most common trauma symptoms can include elevated symptoms of anxiety, untreated post-traumatic stress disorder that could evolve into depression, and having trouble concentrating and paying attention in classes. Zoe Weissman is only 20, but the Brown shooting is also her second mass school shooting. In 2018, at 12 years old, Weissman was a student at Westglades Middle School, which is next to Marjory Stoneman Douglas High School, where a former student fatally shot 17 students in Parkland, Florida. In Florida, Weissman had a child psychologist that did not accept insurance, and Weissman said her family paid “upwards of $200 per appointment” because she “saw that private therapist for over six years and at the height of my treatment was seeing her weekly.” “Although they were able to pay, it’s undoubtedly cost them tens of thousands of dollars, something that I do feel guilty about even though I know I need the help and my family is more than willing to provide it for me.” Mia Tretta said she initially went to a therapy program for victims of violent crime that was covered by the state of California, but said this is hard for many other victims to get into “because there’s so many waitlists and just not enough providers for victims.” As an adult, she is now seeing a therapist who is covered by her insurance: “It’s about $15 a visit, but $15 once a week for 50 weeks out of the year, it really adds up,” she said. What someone needs to feel safer can go beyond therapy costs. Tretta said she got $200 noise-canceling headphones to study because loud noises are a trigger for her. “Someone dropping a book in the library that no one else would really be fazed by” is a trigger, she said. Shin said she is grateful she didn’t have to pay for her ride back home, but she expects to pay more for Ubers in the future to get around campus after dark. The monetary costs of shootings add up to $557 billion annually. But there are other hidden costs. Beyond the medical bills and transportation fees, there is also the incalculable price to one’s sense of safety that no amount of money can restore. A mass shooting in a community hurts everyone, even if they were not directly affected. A 2022 study by nonprofit Everytown for Gun Safety estimated that gun violence causes a $557 billion loss a year due to immediate costs like medical treatment and long-term costs like criminal justice system resources, lost wages, and diminished quality of life for victims and their families. But beyond the medical bills and transportation fees, there is also the incalculable cost of one’s sense of safety that no amount of money can restore. Shin is shaken by the fact that she almost went to the engineering building to study for her finals with her friends last weekend. “We were about to head into the engineering building when another friend intercepted us and said, ‘Oh, let’s go to the Rock [library] instead,’” she recalled. “For that [decision] to become such a huge life-defining and significant moment is so scary to think about ... A lot of my friends are also grappling with that, too.” No one is the same after witnessing and surviving gun violence. “The biggest cost for me has been a loss of my old sense of ‘normal,’” Weissman said. “After developing PTSD, I had to learn how to accept that my life would forever be different: I am hyper-vigilant in public, my senses are incredibly heightened, and I experience a higher baseline level of anxiety.” Tretta said the “mental load” of surviving a shooting is also a big repercussion people like her deal with for years, if not decades. For Brown students like her, Weissman said, obtaining mental health treatment will certainly be a longer-term cost. But that’s a price that can be paid. “However, the loss of innocence and safety is something that is priceless,” she said.

The costs extend beyond a single year or a single incident. For many families, the path from emergency care to long-term wellness involves navigating insurance, government compensation programs, and private fundraising. In Tretta’s case, the availability of state and private resources provided some relief, but gaps remain. The private insurance they carried helped cover portions of the hospital charges, yet the bills that followed—physician consultations, anesthesiology, ambulance rides, and post-acute care—still required out-of-pocket expenditure and later reimbursement claims. The family’s experience underscores a broader pattern: even when public programs exist to mitigate costs for victims of gun violence, they do not always fill the entire financial gap, leaving families to absorb substantial expenses directly or through time-intensive paperwork.

Zoe Weissman’s story adds another layer to the ledger: decades of therapy and associated costs, some of which were not eligible for insurance coverage, can accumulate to tens of thousands of dollars. Weissman described a family reality in which access to a trusted private therapist was not guaranteed by insurance, forcing families to shoulder large bills while coping with the psychological aftershocks of Parkland-era trauma that resurfaced after Brown. For Tretta, the more recent incident renewed concerns about safety on campus and the lingering fear that a stable sense of normalcy might never fully return. The mental health burden is not limited to the moments of crisis but often persists for years, shaping academic performance, social life, and plans for the future.

Long-term mental health care represents a persistent, often underappreciated cost in the wake of mass shootings. Erika Felix, a professor of clinical psychology who studies children’s mental health following mass shootings, notes that many survivors recover and show resilience, but post-traumatic stress symptoms, anxiety, and emerging depression can linger or worsen without sustained care. The financial implications of such care, including ongoing therapy and potential medications, can be substantial, particularly for families already navigating high medical bills and disruptions to daily life. The stories of Tretta and Weissman illuminate the human side of these statistics, underscoring that health care for gun violence survivors is about more than treating physical injuries; it encompasses long-standing mental health needs and the unpredictable financial ripple effects that accompany them.

The fiscal footprint of gun violence extends beyond individual households. A 2022 estimate by Everytown for Gun Safety put the annual economic cost of gun violence at $557 billion, reflecting immediate medical treatment costs, long-term health care, lost wages, criminal justice system costs, and diminished quality of life for victims and families. That figure captures a broad, systemic toll that compounds the already heavy burden carried by survivors and their communities. While this macro view helps frame the scope of the problem, the personal narratives—like those of Tretta and Weissman—reveal how the costs accumulate in real time: airport rebookings, ride shares after curfews, and the daily need for mental health support that may extend for years.

Brown University has responded with internal resources intended to ease some of these pressures. The university maintains an emergency fund for income-eligible students facing unique circumstances, along with a Student Emergency Support Fund. An online document lists local businesses offering discounts and Providence-area rides for students and community members, aiming to connect those in need with practical help. Tretta, who now leads the Brown chapter of Students Demand Action, notes that the school’s resources are a benefit but acknowledges that they come with limits: “It’s definitely more [resources] than we had at Saugus [High School, where Tretta was shot]. Brown is also just such a bigger, more well-funded community.” Yet even with institutional support, many costs remain—and some are not easily reimbursed or funded through existing programs.

The personal toll of gun violence—particularly on young survivors who must navigate college life, higher education costs, and future family planning—continues long after the headlines fade. For Weissman and Tretta, the most enduring costs are not counted in the initial medical bills but in the ongoing need for mental health care, the creeping sense of insecurity, and the financial decisions that must be made in the aftermath of trauma. The loss of safety can be invisible, but its impact is tangible in the daily lives of survivors and their families. As Weissman put it, the loss of innocence and safety is priceless, a sentiment that underscores the need for continued attention, resources, and support for those who survive gun violence in schools.