Two years after twenty children and six educators were killed at Sandy Hook Elementary School in Newtown, Connecticut, the scope of the psychological damage to children, parents, and others is becoming clearer, the Associated Press reports.

Mental health officials said the demand for treatment from individuals affected by the December 14, 2012, shooting is high, with many reporting substance abuse issues, relationship troubles, depression, a tendency to overthink things, and an inability to sleep. "We've found the issues are more complex in the second year," said Newtown school superintendent Joseph Erardi. "A lot of people were running on adrenaline the first year."

To address some of those issues, the school system has launched a long-term program to teach children and youth how to handle their feelings and is setting up a mental health center at the middle school to help students who were in elementary school at the time of the tragedy, while Newtown itself has received about $15 million in grants from the federal departments of Education and Justice for recovery programs. In addition, Melissa Brymer, director of terrorism and disaster programs at the UCLA-Duke National Center for Child Traumatic Stress, has been consulting with town officials to develop a plan which ensures that the community's mental health needs are met for another twelve to fifteen years.

Elsewhere, the Resiliency Center of Newtown, a program of Tuesday's Children that was created after the shooting, has seen rising demand for its offerings, which include art, music, and play therapy, while the Newtown-Sandy Hook Community Foundation has paid out more than $7 million to the families of victims and children who survived the shootings. According to director Jennifer Barahona, the foundation has spent about $60,000 a month on one-on-one counseling for people who have no insurance or coverage for such treatment, and more people are reaching out for help every day.

Beth Hegarty, who was at Sandy Hook Elementary that day for a meeting with Principal Dawn Hochsprung, who was killed, said she and her three daughters have had trouble sleeping and difficulty with loud noises and in crowds. RCN's programs have helped her become more "even-keeled," said Hegarty. "For my girls, there is less running down the hallway in the middle of the night and climbing into my bed," Hegarty told the AP. "They want to go more places instead of staying at home all the time....Are we 100 percent? No. But will we ever be 100 percent? We might not be."