For many on the streets of Oakland, violence has become so commonplace, death so expected, there exists a sense of chilling resignation.
An almost sinister acceptance of violence persists, leaving generations inflicted with symptoms of post traumatic stress disorder, similar to those of a soldier returned from combat.
"It feels like at times like the Iraq war is right here on the streets," said Franceyez, an 18-year-old rapper. "More and more violence has been created over the years. It's getting repetitive."
The tragic irony is that the people most in need of coordinated, sustained support services to deal with the trauma that violence inflicts most often do not have access to those services until after they hurt themselves or someone else, experts say.
Jail, prison or juvenile hall are the most common entry points for getting help, a sign that necessary services are lacking in communities, these experts contend.
Many others who need help fall through the cracks.
Many who don't get the support they need never commit a serious violent crime. But a common thread among adults and youths who do get help is that they were subject to abuse, neglect and a lack of nurturing, experts say.
Frequently, generations of the same family suffer from undiagnosed mental health issues, such as depression or anxiety, caused by the stress of urban poverty, racism, community and domestic violence, poor-quality schools and limited access to health care.
They feel helpless or powerless, as if they "didn't get theirs and have to do for themselves,'' said Madeleine Nelson, chief psychiatric social worker for Alameda County Behavioral Health Care Services, which oversees the county's mental health and substance abuse programs.
"Putting a gun in their hand makes them feel like they can rule the world," even if the power comes at the expense of others and fuels revenge killings, Nelson said.
Young people are learning, incorrectly, that violence is a tool for getting what they want, said Millie Burns, director of the Crisis Response Services Network, which sends social workers to counsel the family and friends of homicide victims.
"The whole world is saying that violence is a way to get through life," Burns said.
But they are incorporating the violence and trauma into a mental reality that's not healthy, Burns said.
"We have to give them better tools," Burns said.
It feels like war
There have always been violent youths. But today, there are more of them and they are fiercer, said workers at Alameda County Juvenile Hall Justice Center in San Leandro.
Many experts blame the drug market for driving up the rate of killings. Gang turf wars and the craving for respect and attention also are woven into that equation.
However, no child is born a killer, said Omo Lade, director of the Sankofa Project, a mental health program for at-risk youths and families based at McClymonds High School in Oakland.
No one, she said, "holds a baby and says, 'Here is a killer.'''
In other words, people are surrounded by hurt, with too few resources to improve their lives.
One West Oakland mother recalled how her son, who dropped out of high school shortly before graduation, was helping a classmate with her homework one day.
The next day, the girl was dead, said Portia Lee, who has struggled with demons of her own: losing her mother at age 8, alcoholism, drug addiction, homelessness.
She said young people like her son have a "tough, 'I don't care' attitude."
"They think, 'What's the point? I ain't going to make it out of here alive anyway,''' Portia said.
Many advocates, parents and experts contrasted the immediate outpouring of help in cases such as the February shooting at Northern Illinois University, in which five students were killed, to cities such as Oakland and San Francisco, in which children are expected to "go about business as usual," in the words of Nicole Lee, director of the "Silence the Violence" campaign run by the Ella Baker Center for Human Rights in Oakland.
"No one is acknowledging that violence is affecting particular communities here in a very sharp way," Lee said.
'Fighting each other'
More than a third of American children ages 10 to 16 have been direct victims of violence, including aggravated assault, attempted kidnapping and sexual assault, according to a nation study by the Journal of the National Medical Association.
An even higher portion of urban children have witnessed violence or know a victim, the study says.
"We move on so fast because we expect it to happen," said Diamond, a young female rapper who grew up in East Oakland.
There is almost no value on human life, partly because people don't feel valued by the system, she continued.
"When you can't fight the system, you end up fighting each other," she said.
The hurt and trauma become deeper and more complex with each exposure to a shooting, stabbing, beating and violent situation.
These children feel a lot of anger and develop an "absolutely flattened out" emotional aspect, Burns said, a typical symptom of post traumatic stress disorder — an affliction usually associated with war veterans.
Mental health professionals increasingly are recognizing the symptoms exhibited by people who have been exposed to repeated trauma — directly or indirectly — are identical with those of the PTSD.
The National Center for PTSD in White River Junction, Vt., reported that 90 percent of sexually abused children, 77 percent of children exposed to a school shooting and 35 percent of urban youths exposed to community violence develop the anxiety disorder that can lead to self-destructive, violent behavior.
"Oakland has its own mini-Vietnam," said Ron Johnson, director of special programs at Alameda County Juvenile Hall Justice Center.
Young people talk about it differently, but know the same thing.
"We do have trauma to our brains and it's post-something," Franceyez said. "We all have our own stress, but ours come from people being killed and dying for nothing."
Help on the line
Some families are doing everything within their means to help their children. Church, sports and other programs also have stepped in, said Katie Elmore, a mental health social worker at Fremont Federation High School in East Oakland.
Her eight students are socially and mentally disturbed. The majority have been arrested — as have the majority of their parents — and most were born to mothers who used crack cocaine during pregnancy.
"They are angry and rightfully so," Elmore said. "All my students know they got the short end of the stick — born drug-affected, poor and in unsafe neighborhoods."
Elmore said schools expect children to function until they blow up, instead of identifying the problems and getting help to the students.
"It's no surprise they end up in prison," she said. "They've been hit by so much and expected to figure it out on their own."
Instead of getting help, young people with mental health needs are being locked up, advocates said.
A study by the National Coalition for the Mentally Ill in the Criminal Justice System estimates more than 75 percent of all incarcerated children have learning disabilities and mental health issues. The disabilities are often undiagnosed and untreated, although many have been physically or sexually abused and exposed to domestic violence, according to Faith Communities for Family and Children, a Bay Area coalition that advocates for children and families involved in the criminal justice system.
"They're still kids and that's what is being lost," said Brian Blalock, a youth attorney for Bay Area Legal Aid, one of the organizations that participates in the coalition.
Once they are in the criminal justice system — even for minor offenses, it can be hard to get out.
It is a recipe for creating "little time bombs," said Rachel Sing, director of the McCullum Youth Court, which works with first-time youth offenders.
"The services are at the end of the line," Sing said. "Why do children have to wait that long? It all seems very backward."