After Lauren Miller lost her father in January to covid-19, her longtime friend Jay Kleiman advised her not to wallow in grief and to seek counseling to ease her pain.
Now she finds herself grieving again -- only this time for Kleiman, one of scores of people believed to be underneath the rubble of a 12-story condominium tower in Florida that collapsed over a week ago, killing at least 24.
"I'm sure he'd tell me: 'It's OK to be sad -- this is very, very sad -- but you have to move forward, and you have to be strong,'" Miller said.
While hundreds of rescuers continue their desperate search for survivors within the remains of the Champlain Towers South in Surfside, a smaller cadre of mental health counselors has also been deployed to help families and other loved ones confront overwhelming feelings of grief, fear and anger.
For every person still unaccounted for -- 121 as of Sunday -- many more lives have been turned upside down as people await word on loved ones or answers that will explain what brought about the calamity. It has been a week since any survivors have been pulled out, and the emotional and psychological fatigue are taking their toll.
More than two dozen grief counselors are on duty at the family assistance center in a hotel ballroom where daily briefings are held.
"Sometimes you're just putting a hand on a shoulder and don't say a word," said Miami-Dade Police Capt. Rita Rodriguez, a crisis intervention officer consoling the families.
During the briefings, the counselors scan the room for signs of distress and rooms are available for anyone who needs private counseling.
Alfredo Lopez, who narrowly escaped his home with his wife and son, rattled off the names of missing friends. The survivor's guilt was so overwhelming in the first few days after the collapse that he sought help from the counselors.
"They spoke in a very soothing, very loving, motherly way," said Lopez, 61. "It meant a lot to me."
A website, surfsidestrength.com, has been set up as a portal for accessing help later or for those who are grieving from afar -- like Miller, who is in New York.
Florida bills itself as the first state in the nation to establish a "disaster recovery mental health coordinator" position whose sole focus is to marshal critical mental health services following a disaster.
"This is very tough, because it was unexpected and it was extremely tragic," that official, Darcy Abbott said.
Florida has had its share of traumatic events, from the mass shootings at Marjory Stoneman Douglas High School and the Pulse nightclub to the periodic hurricanes that level entire communities.
While different, the horror of the building collapse can have similar psychological fallout, said Dr. Katherine Shear, director of Columbia University's Center for Prolonged Grief. The danger, she said, is when people find their lives grinding to a standstill and can no longer function in a meaningful way.
"Over time most people will come to terms with it," Shear said, "but some people just can't."
Emergency responders are at risk for mental trauma, too, as they labor around the clock and encounter heartbreaking scenes. On Friday they pulled from the rubble the body of a 7-year-old girl, the daughter of a Miami firefighter who was part of the search effort.
Information for this article was contributed by Kelli Kennedy of The Associated Press.
