As Mainers continue to grapple with the aftermath of the October shootings in Lewiston, the head of victim services for the state wants to ensure that all those who need help get it.

Cara Cookson wants the public to remember the 18 killed and 13 wounded, but also the estimated 87 others who were at Just-In-Time Recreation and Schemengees Bar & Grille that horrific night.

In addition to those with gunshot wounds, more than a dozen others suffered physical injuries, including muscle tears and lacerations.

Many of those who lived, which includes several children, are suffering from “survivor’s guilt” and other psychological side effects.

“Ultimately, in a small and inter-connected state like ours, and especially in the wake of a two-day lockdown and manhunt for a dangerous suspect, it’s hard to imagine any person in Maine who is conscious of these events and was not impacted in some way,” said Cookson, director of victim services for the Maine Attorney General’s Office.

Cookson shared details Thursday about the state’s 46 victim witness advocates during a presentation to the independent commission investigating the shootings.

On Oct. 25, Robert Card, 40, of Bowdoin committed the deadliest mass shooting in state history and disappeared for two days until police found his body in a recycling trailer in nearby Lisbon Falls.

Cookson told the commission that her office sprang into action immediately after hearing about the shootings, working closely with the FBI and state police to coordinate support for victims.

Six months following the shootings, she’s worried about the long-term impacts on law enforcement, the medical examiner’s office, mental health workers and victim advocates who continue to help others even as they are traumatized themselves.

“Needless to say, attrition was one concern before Oct. 25,” Cookson said. “It is one of my greatest worries now.”

Moving forward, she wants to ensure that all cities and towns have plans for reacting to mass casualty events. One lesson learned from the Lewiston tragedy is that officials need to designate one location for people to reunite with family after a tragedy and a different place for them to come to pick up personal items.

In Lewiston, officials chose the Armory in both instances, causing some victims to delay getting help because of the prospect of returning to a traumatic place.

Cookson listed some of the 475 “non-evidentiary items” that victims returned to the Armory to pick up after the shootings: purses, car keys, bowling balls, cornhole bags and pool sticks.

She said a mass trauma event also affects those not directly involved, including survivors of domestic violence and members of the Deaf community who lost childhood friends that night.

She said many people across Maine fall outside the typical definition of victim.

“These categories don’t address the re-traumatization of those who have come to Lewiston and Auburn fleeing violence in their own countries and who endured two days of lockdown,” she said.

On Thursday, the commission held its ninth public meeting to investigate the circumstances that led to the shootings and the police response to it.

An interim report released by the commission in March concluded that the Sagadahoc County Sheriff’s Office had enough information to take Card into protective custody a month before the shootings but failed to do so.

Since then, the commission has focused largely on the involvement of the Army Reserve and whether top officers there did enough to get Card — who exhibited paranoid behavior and was becoming increasingly violent — the help he needed.

Army officials took Card to get psychiatric help in July, but after two weeks he was discharged. Two months later, he punched his best friend in the face following a night of gambling and his erratic behavior led his friend to warn Army officials that he feared Card might commit a mass shooting.

Throughout, the commission has been critical of law enforcement and Army officials who relied on family to confiscate weapons from Card rather than acting themselves.

On the recovery side, Cookson said while the state continues to look for ways to help all victims, including more funding set aside in the state budget, it’s important to remember everyone has the power to work toward healing.

“I would be remiss if I didn’t acknowledge that the process of healing and resilience belongs to all of us here in Maine,” she said. “Some of the best tools — connection, stories, laughter, breaking bread, singing, crafting, board games and physical activity — can be pursued without advocates involved.”