How Does Treating Gun Violence As A Public Health Crisis Work? One Bronx Program Offers A Potential Flagship Model

The Violence Intervention Program at the University of Maryland Medical Center's Shock Trauma Center helps people meet basic needs after they have suffered a gunshot injury. Along with clothing, transportation vouchers, and toothbrushes, the program's social workers also provide talk therapy. The goal is to keep victims of violence from becoming victims again, and the approach is to build trust by giving the help without strings attached. Many people return for the help, and the therapy.

Next Step is a hospital-based violence intervention program based at Minneapolis' Hennepin County Medical Center that counsels gunshot victims to try to help lower the chances that they will be harmed again or seek to harm others. Focusing on young adults and their families, the program starts its work when a victim is hospitalized. The counseling and connections to support services can continue for months and even years.

Outreach workers with CRED (Create Real Economic Destiny) in Chicago's Roseland neighborhood are paid under a city grant to de-escalate and mediate disputes among the same gangs that some of the workers once belonged to. Able to win the trust of people who distrust the police, CRED's violence prevention workers also provide therapy to trauma victims and job development help, in order to address the underlying causes of violence in a neighborhood where a lack of hope can breed a lack of respect for others' lives. Fatal shootings in Roseland are down by one-third while up elsewhere in Chicago.

Since the 2018 opening of a trauma-care center near the neighborhoods most affected by Chicago's gun violence, the University of Chicago Medical Center's Violence Recovery Program has helped survivors and victims' families to address the emotional harm that can go untreated when only physical harm is treated. Part of a growing field nationwide, hospital-based violence intervention, the program's nine specialists counsel people through the immediate shock of a gun injury or death. Then they address longer-term needs for services. The goals are both humanitarian and pragmatic, to head off more violence.

The Wraparound Project at Zuckerman San Francisco General Hospital and Trauma Center turns gunshot victims' hospital stays into "a teachable moment," by providing them with services aimed at helping them avoid a repeat injury. Getting shot once is a key risk factor for a second injury, particularly for gun violence's most common victims, young Black men. Wraparound is one of the nation's oldest hospital-based violence intervention programs. It has helped about 850 clients, mostly with mental health counseling, housing, and jobs. The program is associated with a decreased reinjury rate in San Francisco.

Philly Truce is a mobile app that lets people in crisis ask for help from volunteer conflict mediators without involving the police. The app connects people to social services and to volunteers who can help ensure that a personal conflict does not turn violent. Two Philadelphia men with a modest investment launched the app in May 2021. Hundreds already have used it to de-escalate disputes or to volunteer to join the effort to reduce violence. The founders hope to expand the project to other cities.

Healing Hurt People helps the survivors of gun violence and other assaults starting bedside in hospitals and continuing during a patient's recovery. The group, partnering with other services providers, treats mental trauma with cognitive therapies led by peer counselors – people with the street credibility that earns trust among the young people who are the target of these services. When people better understand their experience, they can learn from it and find safer, healthier ways to live.

In Philadelphia, public agencies and funding serve homicide victims' families. But grassroots groups target the enormous gaps in services for the survivors of gun violence, people whose unaddressed needs – medical, financial, and especially emotional – can fuel cycles of retaliatory violence. Because trauma and anger increase the risks for future violence, groups like The ECO Foundation and Northwest Victim Services provide both immediate responses, starting bedside in hospitals, all the way to long-term care and counseling, plus preventive counseling and services to make for healthier communities.

A college professor and a former stabbing victim counsel young men in the hospital soon after they are shot or stabbed. These interventions, based on trust and shared experiences, are meant to prevent repeat injuries, which are common for people with traumatic experiences. Of 116 men they've counseled, one was later murdered, one was rehospitalized, and all the rest have found safety and some measure of success in reorienting their lives -- a far better rate than was the norm at that hospital before the program started. Their work is the subject of a new documentary series, "Life After The Gunshot."

VIP Fort Worth modeled itself on a number of violence-intervention programs with a blended approach that has been so successful in such a short time that Texas officials are considering investing in a statewide version. Street outreach workers, many of them former gang members, mediate disputes and counsel young men at risk of getting shot or shooting others. In its first five months, it says it has prevented dozens of shootings through hundreds of direct contacts with people on the streets. Like the programs it's modeled on, it is an alternative to policing, operating independently.