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
AED
GRACY
Awareness,
Education,
Documentati
on
IMPACT
Impacting
Minors
Perception &
Cognizant
Attitudes
Toward Trauma
Get Real - Alcohol
Choice &
Consequences of
Youth
Emerging
Leaders – East
End
Hospital –
Community Based
Youth Violence
Prevention Program
Intervention
Recidivism
Reduction Programs
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
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 10-24 were treated for violent injury at VCU’s ED
Location
# Deaths
Population
Rate per 100,000
Richmond
19
69,693
27.3
Virginia
115
2,587,313
4.4
4,918
103,394,148
4.8
U.S.
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
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
Wraparound Services
Mental Health
Services
Vocational
trainings
Community Services
Substance abuse
Legal
Employment
Services
Case managers
connect youth
and families to
community
resources
Rehab
Services
Emergency assistance
Recreational
Educational
Vocational
Mental health
School
Early childhood
Medical assistance
Housing
Substance
Housing
Abuse Services
Mentoring
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
Wounded Places
Wounded Places
https://vimeo.com/116083938
5
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
www.samhsa.gov
6
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
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
"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