Developing a Trauma-Informed, Emergency Department–Based Intervention for Victims of Urban Violence

Abstract

The Surgeon General's report on youth violence, the Centers for Disease Control and Prevention, and other national organizations are calling for public health approaches to the issue of youth violence. Hospital-based violence intervention programs have shown promise in reducing recurrent violence and decreasing future involvement in the criminal justice system. These programs seldom address trauma-related symptoms. We describe a conceptual framework for emergency department-based and hospital-based violence intervention programs that intentionally addresses trauma. The intervention described--Healing Hurt People--is a trauma-informed program designed to intervene in the lives of injured patients at the life-changing moment of violent injury. This community-focused program seeks to reduce recurrent violence among 8- to 30-year-olds through opportunities for healing and connection. Healing Hurt People considers the adversity that patients have experienced during their lives and seeks to break the cycle of violence by addressing this trauma.

Male Survivors of Sexual Abuse: Becoming Gender-Sensitive and Trauma-Informed

“…These two identities can be in direct contradiction with one another and can lead to the display of all-or-nothing responses (Corbin et al, 2011;Fallot & Bebout, 2012). It is important for service providers to recognize that these all-or-nothing responses can come in the form of overt aggression or withdrawal (Fallot & Bebout, 2012;Foster et al, 2012).…”

“…Thus, there is also a need for trauma-informed and genderresponsive care (Crable et al, 2013;Fallot & Bebout, 2012). Given the low rates of selfdisclosure, this overarching framework is imperative in creating a safe and supportive environment for male survivors being served in the various public systems (Corbin et al, 2011;Fallot & Bebout, 2012;Harris & Fallot, 2001). Difficulty can also arise when working with male survivors because the social expectations of men to be strong and independent can influence and restrict the range of emotions men are allowed to express in public and even recognize privately (Fallot & Bebout, 2012).…”

“…Male survivors should be assisted in developing a wider range of options when expressing emotions (Corbin et al, 2011;Fallot & Bebout, 2012). For example, men may be reluctant to discuss emotions or relationships and this should not be viewed as a lack of engagement in services.…”

Stop Posturing and Start Problem Solving: A Call for Research to Prevent Gun Violence

“…At Drexel University College of Medicine, the Hahnemann University Hospital Emergency Department and the Center for Nonviolence and Social Justice have responded to a rise in urban youth violence with an interdisciplinary hospital-based violence intervention program called Healing Hurt People. By bringing mentorship and support for victims into the emergency department, this innovative program attempts to reduce re-injury and retaliatory violence among youth who present to the hospital after a violent episode that often involves a firearm [20]. At our own institution, we brought together a multidisciplinary group of nurses, attending physicians, resident trainees, social workers, physical therapists, and administrators to recognize routine clinical encounters as opportunities to screen for risk factors for violence or misuse of a firearm.…”

Turning Point-Rethinking Violence: A Youth Violence Reduction Intervention

“…More recently, hospital-based programs have begun to address the issue of adolescent violence. Published reports from these programs suggest an increasing appreciation of the link between youth violence and healthcare costs [20][21][22][23][24][25][26][27][28]. Such programs include those that identify at-risk youth based upon histories of victimization by repeated violent acts and provide intensive psychosocial follow-up to decrease recidivism [21].…”