Category Archives: Violence and Trauma

Jul 20 2012
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Building a Resilient Community: Resources in the Aftermath of the Colorado Shooting

Several mental health organizations and government agencies have announced online or telephone resources to help citizens and professionals  cope with worry, fear, anxiety and stress in the aftermath of the Colorado shooting at a movie theater early this morning that has taken at least 12 lives and injured dozens more:

  • The Centers for Disease Control and Prevention has a web portal dedicated to disaster response with resources for direct victims and the larger community.
  • Mental Health America, a national advocacy and education group on mental health issues, has developed guidelines and a fact sheet  to help facilitate discussions about the tragedy.
  • The Disaster Distress Helpline (800-985-5990) of the Substance Abuse and Mental Health Administration provides immediate crisis counseling and help to people in the US coping with the shooting incident in Colorado, or any other disaster. The helpline operates 24/7 and connects callers with trained professionals from the closest crisis counseling center in the nationwide network of centers. The helpline can also be accessed by text (Text: TalkWithUs to 66746).
  • The Department of Veterans Affairs has a helpful fact sheet on post traumatic stress disorder after a disaster.
  • UPDATE: One of our commenters shared resources from the National Child Traumatic Stress Network, which is funded by SAMHSA. See the comment below for more details.

>>Weigh In: Do you have a response system ready for local and national disasters? 

Jul 12 2012
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Preventing Violence: Discussion at NACCHO Annual

Oxiris Barbot Oxiris Barbot, Baltimore City Health Director

>>EDITOR'S NOTE: On 9/13/2012 CeaseFire changed its name to Cure Violence.

A group of impassioned attendees of the National Association of County and City Health Officials Annual Meeting attended a screening of The Interrupters, a documentary about the CeaseFire violence prevention program that began in Chicago and is now a prominent, effective program in other U.S. and international cities. CeaseFire takes a unique public health approach to stopping gun violence in communities. Findings from a study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health show that shootings and killings in even America’s most violent communities can be reduced using the CeaseFire model—a model that employs disease control and behavior change strategies to reduce violence. CeaseFire employs ex-offenders who have unique credibility with community members and effectiveness in getting people to rethink the impulse to resolve disputes using guns.

Safe Streets Baltimore was launched by the Baltimore City Health Department in 2007 as a CeaseFire replication site. Speakers at last night’s screening included Ricardo “Cobe” Williams of CeaseFire Chicago and Oxiris Barbot, MD, the health director of the city of Baltimore in Maryland.

A health officer from Cambridge, Mass., asked the speakers about one thing they’d like to see changed in their communities. Dr. Barbot said: “We need a health in all policies approach with better housing, education [and other social changes] to improve the environment.” NewPublicHealth recently spoke with Dr. Barbot about the impact the program has made in the city.

NewPublicHealth: How does the Safe Streets program build on the CeaseFire model?

Dr. Barbot: We replicated what was done in Chicago, but our implementation differs in that the Baltimore health department houses the Safe Streets program–our name for the CeaseFire model—and we provide technical assistance for that community-based organization to actually carry out the model. We think that that works for us because it helps to create community ownership of the model, and it also allows us to focus on administering the program and making sure that the fidelity of the model is adhered to. We oversee the program and community groups implement it.

We’ve got staff on board that work intensively with the community-based organizations to make sure that they are tracking the number of mediations that occur, that they are tracking the number of face to face meetings, and if those numbers aren’t at a particular level, we do retraining so that the interrupters that are working in that particular neighborhood feel more comfortable in what they’re doing. Similar to any other chronic disease intervention model, the folks who are actually doing the work need to have ongoing professional development to make sure that their tools are as up to date as possible.

NPH: What has your success been since the program began?

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Apr 24 2012
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Public Health News Roundup: April 24

Stricter Seat Belt Laws Push Teens to Buckle Up

Teen drivers and passengers are more likely to use seat belts in states with "click it or ticket" laws, according to a new study in the American Journal of Public Health. These laws, also known as primary enforcement laws, allow police to stop and ticket drivers for not wearing a seat belt. Under a secondary law, police can only ticket drivers not buckled up if they are stopped for some other reason, such as speeding.

The study found that in states with secondary laws teens were 12 percent less likely to wear a seat belt when driving and 15 percent less likely to do so as a passenger than teens in states with primary laws. Read more on public health law.

Current Bullying Prevention Programs may not Thwart Cyberbullying

A new study by researchers at the University of British Columbia found that a survey of 17,000 Canadian students in grades 8 to 12 showed that 25 to 30 percent admitted to cyberbullying, while only twelve percent said they had participated in schoolyard bullying. The researchers say that indicates that current prevention programs may not be sufficient to protect kids from online bullying. Read more on violence prevention.

Killing in Wartime Linked to Later Suicidal Thoughts

Researchers analyzing data from a survey of Vietnam War veterans have found that those with more killing experiences were twice as likely to have suicidal thoughts as those with fewer or no experiences of killing.

The researchers, who published their findings in the journal Depression and Anxiety, say the association between killing and suicidal thoughts remained even after adjusting for variables such as post-traumatic stress disorder, depression, substance use disorders and combat exposure.

"We want clinicians and suicide prevention coordinators to be aware that in analyzing a veteran's risk of suicide, killing in combat is an additional factor that they may or may not be aware of,” says Shira Maguen, PhD, the study’s lead researcher. Read more on military health.

Mar 20 2012
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Bullying: Take Action, Join the Conversation

“They said he was a geek, he was worthless and that he should go and just hang hisself, and I think he just got to the point where enough was enough” – spoken by Kirk Smalley, father of Ty, in the forthcoming documentary, Bully. Ty, 11, hanged himself in 2010.

file

An astonishing thirteen million kids face bullying each year according to government surveys, making it the most common form of violence experienced by young people in the United States. Bullying’s effects can impact every aspect of a child’s life from grades to self-esteem and, as Ty’s story shows, even the desire to live. The new documentary Bully, set to hit theaters across the U.S. on March 30, offers an intimate look at how bullying has affected five children and their families.

Parents and schools have been invited to sign on to a Twitter Town Hall on bullying to be hosted TODAY by the Centers for Disease Control and Prevention (CDC) between 3 p.m. and 4 p.m. EST. Follow the conversation using the hashtag #vetoviolence, or by following the CDC Injury Center on Twitter. The Town Hall will feature experts from the CDC, the Anti-Defamation League, the Health Resources and Services Administration, and the Department of Education.

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Feb 3 2012
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Stephen Colbert Meets "The Interrupters"

>>EDITOR'S NOTE: On 9/13/2012 CeaseFire changed its name to Cure Violence.

Earlier this week on The Colbert Report, Stephen Colbert likened Ameena Matthews, a violence “interrupter” at CeaseFire, a Chicago-based organization that employs a public health approach to stop the epidemic of gun violence in cities around the country, to an antibody. Matthews works in tough neighborhoods to stop the transmission of violence from person to person in much the same way that disease control professionals contain and prevent the spread of infectious illnesses.

Matthews can be seen in “The Interrupters," a documentary about CeaseFire that will be aired on PBS Frontline on February 14, 2012.

Recommended Readings:

  • Read NewPublicHealth interviews with CeaseFire founder Gary Slutkin and Tio Hardiman, director of CeaseFire Illinois, first posted when “The Interrupters” was released last year.
  • Also check out the first rigorous evaluation of the CeaseFire model outside of Chicago. In Baltimore, researchers found the Safe Streets program cut homicides by more than half in the Cherry Hill neighborhood.
  • Watch The Colbert Report video and read more over at APHA's Public Health Newswire.

Jan 24 2012
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Upcoming Webinar: Gun Violence, Mental Illness and Firearms

Swanson Jeffrey Swanson, Duke University School of Medicine

The Public Health Law Research Program as well as the American Society of Law Medicine and Ethics, the Network for Public Health Law and the Public Health Law Association and will be hosting a webinar on Thursday, January 26 at one p.m., looking at laws related to mental illness and firearms. The webinar will focus on what is known about the contribution of mental illness to violence and will consider the implications of research literature for law and policy that seek to limit firearms access for people with mental disorders who may pose a danger to themselves or others. The presentation will discuss research findings on whether current federal and state firearms restrictions reduce gun violence, and will lay out an agenda for needed future research.

>>UPDATE: Check out the recording of Thursday's webinar on the Network for Public Health Law website, here.

NewPublicHealth spoke with Jeffrey Swanson, PhD, Professor of Psychiatry and Behavioral Sciences at Duke University School of Medicine, and a presenter for the webinar.

NewPublicHealth: What’s the scope of the problem?

Jeffrey Swanson: Firearm violence is a major public health problem in the U.S. More than 300,000 people died from gunshot injuries from 1998 to 2007—a death toll five times greater than the number of U.S. military casualties in the Vietnam War. Very public acts of gun violence by persons with mental illness—such as the mass shootings at Virginia Tech in 2007 and in Tucson in 2011—suggest that the current patchwork of state and federal firearms laws may be ineffective at protecting the public from dangerous individuals. But, in fact, research shows that the large majority of people with mental illness are not violent, and that most violent acts are not caused by mental illness.

Two consequences can result from the varying state laws—mentally ill people can be kept from their constitutional right to own a firearm, and some laws can put firearms into the hands of mentally ill people who may use them not to kill others, but to commit suicide.

NPH: What’s the status of your research on the topic?

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Jan 11 2012
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Study: CeaseFire Model Can Stop Epidemic of Gun Violence, Replicated in Baltimore

Men talking in lobby of metro system.

>>EDITOR'S NOTE: On 9/13/2012 CeaseFire changed its name to Cure Violence.

New research released today reinforces the concept that gun violence can be reduced and prevented by taking a public health approach to the problem. Findings from a study conducted by researchers at the Johns Hopkins Bloomberg School of Public Health show that shootings and killings in even America’s most violent communities can be reduced using the CeaseFire model—a model that employs disease control and behavior change strategies to reduce violence. CeaseFire employs ex-offenders who have unique credibility with community members and effectiveness in getting people to rethink the impulse to resolve disputes using guns.

Safe Streets Baltimore was launched by the Baltimore City Health Department in 2007 as a CeaseFire replication site, and research released today represents the first rigorous study of a replication of the CeaseFire model. In Baltimore, researchers found the Safe Streets program cut homicides by more than half in the Cherry Hill neighborhood. An earlier Department of Justice evaluation found 41 to 73 percent drops in shootings and killings in CeaseFire zones in Chicago.

NewPublicHealth spoke with CeaseFire founder, Gary Slutkin, about the CeaseFire model earlier this year. “If you release yourself from preconceived ideas about good and bad people and just look at what is actually happening, empirically you see that [violence] spreads like any other infectious disease,” said Slutkin. In another interview, Tio Hardiman, director for CeaseFire Illinois, commented on the CeaseFire approach, “You have to be able to detect conflicts before they arrive and before they escalate.”

Findings from the CeaseFire replication study in Baltimore include:

  • The Safe Streets program cut homicides by more than half in the Cherry Hill neighborhood.
  • In communities studied where Safe Streets wasn’t put into place, young people were seven times more likely to think it is okay to use a gun to settle disputes, compared to young people in Safe Streets neighborhoods.
  • Sites structured to follow the CeaseFire model most closely performed better than sites that deviated from the model. For example, sites that managed the program out of a single location appeared to have a greater impact on reducing shootings and killings than those spread across multiple neighborhoods.
  • The program was associated with reductions in gun violence in 3 of the 4 neighborhoods where Safe Streets was implemented.

UPDATE: Watch Daniel Webster, Deputy Director of the Johns Hopkins Center for the Prevention of Youth Violence, talk about the study.

Because of the promising results seen in this evaluation, the Safe Streets program will be expanding, having received a new $2.2 million grant from the U.S. Department of Justice that will help bring the program to additional Baltimore neighborhoods.

>>Bonus: Read a Q&A with Kristin Schubert, director and a specialist within RWJF on violence prevention, on efforts to prevent the spread of violence.

 

Nov 21 2011
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Preventing Violence: A NewPublicHealth Q&A with Kristin Schubert

file Kristin Schubert, Robert Wood Johnson Foundation

>>EDITOR'S NOTE: On 9/13/2012 CeaseFire changed its name to Cure Violence.

Violence is preventable. It's a simple statement, but one that has sparked considerable dialogue in the field of public health and beyond. Groups like Start Strong, which works on preventing teen dating abuse by educating pre-teens on healthy relationships, and CeaseFire, which helps prevent the spread of gun shootings and killings by tracking and containing it like an infectious disease, are some of those leading this critical discourse. These programs focus on changing behavioral norms and community conditions so that violence does not spread from act to act, person to person.

NewPublicHealth caught up with Kristin Schubert, MPH, a director at the Robert Wood Johnson Foundation (RWJF) and a specialist within RWJF on violence prevention, about the Foundation’s approach to the issue and strategies in the field that are working to create change.

NewPublicHealth: What makes violence a public health issue?

Kristin Schubert: When people think of violence, they often think of extreme forms of violence—war, gunshots, gangs. They often don’t think about it in its most holistic forms—intimate partner violence, verbal violence, child maltreatment and neglect, date rape, stalking, bullying—anything that makes a person feel unsafe. When we look at violence in the fullest way, it very much is an issue that affects everybody.

NPH: Tell us more about that. How does violence affect all populations?

Kristin Schubert: You take an issue like intimate partner violence or sexual violence. These are issues that cut across socioeconomic status, all racial and ethnic lines. No one is immune.

Violence is an issue that affects everyone. You might not be the direct recipient, but chances are you know someone who has been affected. Intimate partner violence affects one in four women in this country and one in three women worldwide. And we know that is probably a significant underestimate because of the nature of intimate partner violence—it’s something that has been kept hidden and private, and we’re trying to change that. Just using that statistic alone, you can see this is something that is commonplace and very much, a public health issue.

NPH: Why is violence so pervasive?

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Nov 11 2011
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Recommended Listening: Veterans and Suicide

A veteran commits suicide every 80 minutes, according to reported information from the Department of Veterans Affairs. Unreported deaths may push those numbers even higher.

Foundations and government agencies are addressing the issue through screenings that begin during deployment and with continued follow-up after a service member comes back to the U.S. In observance of Veterans Day, Washington, D.C., talk show host Diane Rehm discussed the issue with experts including Barbara van Dahlen, founder and president of Give an Hour, a non-profit organization that provides free mental health services to veterans and their families, Ranjeev Ramchand of the Center for Military Health Policy Research at the RAND Corporation and Jan Kemp, National Mental Health Program Director for Suicide Prevention, Department of Veterans Affairs.

The show’s website also includes resources that can help prevent suicides among veterans:

  • Veterans' Crisis Line: Connects veterans in crisis and their families and friends with qualified responders through a confidential toll-free hotline, online chat, or text message program.
  • Give an Hour: Provides free mental health services to U.S. military personnel and their families affected by current conflicts in Afghanistan and Iraq.
  • Tragedy Assistance Program for Survivors: Offers support for those grieving the death of a loved one who served in the U.S military.

>>Listen to the program.

>>Read more on military health.

Sep 29 2011
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The Interrupters: A NewPublicHealth Q&A With Gary Slutkin

file Gary Slutkin, CeaseFire

>>EDITOR'S NOTE: On 9/13/2012 CeaseFire changed its name to Cure Violence.

The Interrupters,” a new documentary, tells the story of three CeaseFire workers who endeavor to stop the same violence they were once involved with in Chicago. CeaseFire is a unique public health approach to stopping violence in communities before it starts. CeaseFire was begun by epidemiologist Gary Slutkin, Ph.D, who uses an infectious disease model in his work. “Go after the most infected and stop the infection at its source.” NewPublicHealth spoke with Dr. Slutkin about the film and CeaseFire’s model of success.

Watch the trailer for "The Interrupters":

NPH: Tell us about the model for CeaseFire.

Gary Slutkin: CeaseFire is a disease control approach to reducing shootings and killings. We have reevaluated what is going on in the field of violence, scientifically, and used sciences of behavior and of epidemics. Re-dissecting violence you can see that it has the characteristics of any infectious epidemic. If you release yourself from preconceived ideas about good and bad people and just look at what is actually happening, empirically you see that it spreads like any other infectious disease. Therefore, you say well why don’t we actually take the approach that we use to interrupting infectious diseases. It means that we have to detect the potential for an event, in this case a shooting, in other cases it could be for measles or for flu or TB. We have to prevent one event from leading to another, which means that we have to have specialized workers who can have access to information about when a shooting might happen and be trained to be able to persuade that individual or group out of doing it. And so that prevents its spread.

Then we have to put in a second layer of work that prevents relapses. Of course, the third layer is fundamentally shifting the norms about violent behavior. We know how to do norm change. It’s a series of techniques that have to do with diffusing the innovation, using social pressure, using the right peers and involving the whole community.

NewPublicHealth: How did the idea come about to do the film?

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