INJURY AND VIOLENCE PREVENTION/INTERVENTION PROGRAMS Hospital - Community Based Education & Awareness Programs

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1 Anne Jordan, MSW, LCSW Injury and Violence Prevention Program VCU Trauma Center INJURY AND VIOLENCE PREVENTION/INTERVENTION PROGRAMS Hospital - Community Based Education & Awareness Programs Prevention Programs Intervention Recidivism Reduction Programs AED Awareness, Education, Documentati on IMPACT Impacting Minors Perception & Cognizant Attitudes Toward Trauma GRACY Get Real - Alcohol Choice & Consequences of Youth Emerging Leaders East End Hospital Community Based Youth Violence Prevention Program Hospital Based Violence Consult Bridging the GAP Hospital Community Based Youth Violence Intervention Program EMPOWER Hospital Community Based Intimate Partner Violence & Sexual assault Prevention Program 1

2 Richmond, Virginia has a High Rate of Violent Injury VCU s Level 1 trauma center receives 85% of all intentionally injured patients in the Richmond area In FY2014, 393 youth ages were treated for violent injury at VCU s ED Location # Deaths Population Rate per 100,000 Richmond 19 69, Virginia 115 2,587, U.S. 4, ,394, Sources: VA. Dept. of Health On-line Reporting System 2010 CDC National Ctr. For Injury Prevention and Control WISQARS 2010 Treat & Street to Treat again 2

3 What is the Role of the Medical Community & Trauma Centers? Band-Aid Spectator Observer BRIDGING THE GAP In-hospital intervention with community case management youth violence reduction program for youth hospitalized with violence related injuries Intervention program Goal is to reduce recidivism Channel at risk youth into programs promoting safe behaviors 3

4 Legal Services Rehab Services Substance Abuse Services Wraparound Services Mental Health Services Mentoring Vocational trainings Case managers connect youth and families to community resources Employment Housing School Community Services Substance abuse Emergency assistance Recreational Educational Vocational Mental health Early childhood Medical assistance Housing Workman s comp Legal Rehab. Services Mentoring Complex Trauma Life-threatening gun shot wound Multiple losses throughout life History of incarceration Not enrolled in school History of mental illness 4

5 Wounded Places Wounded Places 5

6 WHAT DO OUR OWN PATIENTS EXPERIENCE? 87% of patients who developed symptoms refused mental health care referrals pre-discharge Patients with at least one PTSD symptom requested additional referral support at a significantly higher rate than those without symptoms (p=<.0001) Patients with 3-4 PTSD symptoms requested referral information at a higher rate than those with 0-2 symptoms (p=<.0001) How does this reaction to trauma and grief manifest? What do we see in our own patients? Flat affect or numb response to violence and loss Hypervigilance: Angry, fearful, increased anxiety or perception of threat Other common symptoms: difficulty sleeping and eating, nightmares, depression, withdrawal Tips for Survivors: Coping with Grief After Community Violence Substance Abuse and Mental Health Services Administration 6

7 HOW CAN WE HELP BUILD AND SUPPORT RESILIENCE IN THE INDIVIDUAL, FAMILY, AND COMMUNITY? Trauma informed approach Creation of safe housing and public spaces Culturally relevant care: importance of community outreach workers How to Become Trauma Informed Trauma-Informed Care is anchored in the Principles of: Safety. Trust. Choice. Collaboration. Empowerment. "Trauma-informed systems and services are those that have thoroughly incorporated an understanding of trauma, including its consequences and the conditions that enhance healing, in all aspects of service delivery. Any human service program, regardless of its primary task, can become traumainformed by making specific administrative and service-level modifications in practices, activities, and settings in order to be responsive to the needs and strengths of people with lived experience of trauma" (Harris & Fallot, 2008). 7

8 Emerging Leaders & Youth to Lead(Y2L) Hospital-community based violence prevention programs Aims to reduce high prevalence of youth violence in East End Middle school program (ages 10-15) High school program (ages 14-18) Programming includes: Providing positive strategies to avoid using violence exposure to health careers on-going case management community activities Emerging Leaders: East End and Youth2Lead Partners Boys and Girls Club of Metro Richmond VCU Police Department Richmond Police Department Virginia Mentoring Partnership Art180 Mayor s Youth Academy From Jump Rope to Stethoscope 8

9 "And so the voices on the margins get heard and the circle of compassion widens. Souls feeling their worth, refusing to forget that we belong to each other. No bullet can pierce this." --Tattoos on the Heart Father Greg Boyle, Founder and Executive Director of Homeboy Industries 9