HARTFORD, Conn. — With final edits and approvals, members of the Sandy Hook Advisory Commission have begun to think of the impact their report on the Newtown, Conn., school massacre will have on parents of victims and surviving children, as well as people who may be reading the document 20 years from now.

Should Nancy Lanza, killed by her son before he went on the rampage, be acknowledged as the 27th victim of the Sandy Hook Elementary School tragedy on Dec. 14, 2012? Should the report begin, as is contemplated, with a detailed, graphic, almost forensic, recounting of Adam Lanza’s movements inside the elementary school that day? Should there be a disclaimer saying the account will be painful and objectionable to some? And should the report refer to Lanza as “A.L.” — as the draft does throughout — or use his name, in the face of the rage and resistance it stirs in the parents?

Friday, at its second to last meeting, the panel confronted these questions and reached a consensus:

The much anticipated report, due out in February, will be dedicated to the 20 first-graders and six educators killed in the school that day, the Newtown community, and all in Connecticut’s cities and far beyond who have been the victim of devastating violence. The names of the 26 will be listed.

Dr. Harold Schwartz, panel member and the chief psychiatrist at Hartford’s Institute of Living, said he had mixed feelings about bringing up Nancy Lanza’s possible inclusion in the dedication.

“Why would we not consider Nancy Lanza a victim? What is the argument, other than an argument of blame?” said Schwartz, suggesting that her death be marked by an asterisk and footnote at the bottom of the dedication.

Panel member Chris Lyddy said he envisioned the dedication as a recognition of those innocent victims killed inside the school, and that the last line acknowledging the world’s victims includes Nancy Lanza – a sentiment that was ultimately embraced by the panel.

Members also noted that 20-year-old Adam Lanza, who killed himself as police arrived, and who did not receive the mental health treatment that he needed as a teenager, according to a report by the state child advocate’s office, has been, in some quarters, referred to as the 28th victim.

In its mental-health section, the commission’s report will also explore “the systems that did or did not fail Adam Lanza,” said Dr. Alice Forrester, panel member and executive director of the Clifford Beers Guidance Clinic in New Haven.

Mayor Scott Jackson of Hamden, who chairs the panel, said his town sounded 28 bells during the first memorial after the tragedy. Some communities sounded 26 bells, others 27.

Dr. David Schonfeld, chief pediatrician at St. Christopher’s Hospital for Children in Philadelphia and a leader in school-crisis planning, said he found the recounting of the crime in the opening of the draft report to be overly graphic and potentially devastating to Newtown parents.

Schwartz agreed that the account, based on Danbury State’s Attorney Stephen J. Sedensky’s summary of the voluminous state police investigation, is “shocking.”

“The factuality is graphic, but I think it belongs where it is,” said Schwartz, adding that people reading the report 10 and 20 years from now may not appreciate what happened on that tragic day.

Panel member Patricia Keavney-Maruca, a state board of education member and former high school teacher, said that an unflinching, realistic account is needed so that the public can appreciate the recommendations about gun and ammunition control, police response, and school security measures that come later in the report.

Schonfeld said a disclaimer warning of the graphic nature of the crime should be included. And he and Forrester said the opening account should go beyond the murders and reflect the surviving children’s frantic escape and traumatic hours afterward as the families waited in agony to learn the fate of their children.

Jackson said he would add an introduction to the account, as well as a passage reflecting the hours following the shooting, and submit the additions to the board before its final meeting.

A majority of the board supported leaving the graphic facts intact, with Jackson noting that the impact of the nation’s tragedies begin to fade when the details fade.

Dr. Ezra Griffith, panel member, professor emeritus and senior research scientist in psychiatry at Yale University, questioned why the draft report uses Lanza’s initials rather than his name.

“The omission is quite striking to me … I just don’t know what we’re trying to say about this,” said Griffith.

Schwartz, who also worked on the child advocate’s report, said he, Child Advocate Sarah Eagan, and Associate Child Advocate Faith Vos Winkel, met with Sandy Hook parents.

“We learned that to continue to name (the shooter) was enraging and unacceptable to the parents, who felt the very use of his name humanized him …, and could be interpreted as attempting to excuse him, to the extent that (the attempt at) understanding and explaining, is excusing.

“Is it necessary,” Schwartz continued, “to thrust into an important audience of this report the presence of this person in this way?”

Schwartz said repeated references to Lanza also feed an online subculture of mass-murder enthusiasts.

Jackson, recalling remarks by Sandy Hook father Jeremy Richman, said the names of mass killers, such as those in Oklahoma City, Columbine and Newtown, tend to be known and remembered, overshadowing the names of the victims.

Forrester said Lanza’s full name needs to be mentioned at least once when the shooter is introduced, to which other panelists agreed.

The panel also approved the mental-health section of the draft report.

At a press conference Friday morning, Gov. Dannel P. Malloy was asked if the commission’s recommendations would arrive in time for him to craft legislative proposals that could be acted upon this year.

“We have not waited for the Sandy Hook commission to complete its work before we’ve acted,” the governor told reporters. “We have financed heavily security improvements in schools through rounds of competitive grants. We’ll continue that process.”

Regarding other recommendations, Malloy said: “Some of those can be acted on administratively. Some of them will have to be acted on legislatively. I think there are sufficient bills to attach some of those recommendations to.”

Asked if there is money to implement those recommendations, particularly regarding mental health services, Malloy paused. “Well, everybody wants to spend more and nobody wants to pay more so those judgments have to be made. I will point out that we are spending more on mental health since I became governor and even in difficult times, we’ve found ways to balance.”

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(Courant Staff Reporter Daniela Altimari contributed to this story.)

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