Nov 1 2012
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Hospital Partnerships to Cure Violence

file Sheila Regan

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

Sheila Regan manages hospital partnerships for Cure Violence, formerly CeaseFire, an organization based in Chicago that has pioneered a public health approach to stopping shootings and killings. A grantee of the Robert Wood Johnson Foundation, Cure Violence has been successful at reducing violence in cities across America.

This week at APHA, Cure Violence shared how violence presents all the same characteristics of an infectious disease. Like tuberculosis or cholera, violence appears in clusters; it spreads and can be transmitted. By changing the frame on violence, Cure Violence is able to use proven public health strategies from other epidemics to stop shootings and killings. Hospital partnerships are a key part in stopping the spread and transmission of violence.

NewPublicHealth: Can you explain how Cure Violence’s hospital partnerships work?

Sheila Regan: We have a number of partnerships with level I trauma centers that are committed to the public health approach to violence prevention. We serve patients who are violently injured, typically shootings, stabbings or beatings and work to prevent further violence, retaliation or re-injury, which are seen as normal in our culture. There are the doctors, police, nurses, social workers, and everybody you’d expect to see in the hospital. What we’re trying to do is introduce a third party—our workers—who can impact behavior and mindset around violence at an opportune moment.

NPH: When someone has been injured, what is the goal of Cure Violence working with them in the hospital?

Sheila Regan: Similar to many traumatic injuries or infectious diseases, you look to the place where you last saw the injury or illness to see where it’s going to happen again. So when someone has been injured, they are already at the height of another injury and it’s possible that that whatever lifestyle or behaviors they’re engaging in are putting them at risk.

We’ve seen patients who have been shot and paralyzed who are then shot later. We don’t know who the perpetrator is, but we know that the person who was shot is at a heightened risk compared to the general population for being shot again. We know that that risk increases once you’ve had that initial traumatic instance. We want to get them on a healthy mindset, on a healthy lifestyle so that they can make decisions towards their own health in the future. 

NPH: What does a hospital encounter look like?

Sheila Regan: That encounter looks like an intervention. It looks like dialogue; spirited, individualized, supportive dialogue with the patient who’s been injured, compassion for their situation, compassion for the situation of the family. We help them meet their immediate needs.  We’re providing advocacy within the hospital, linkage to different services within the hospital, and bridging the gap that can sometimes exist in these really hostile situations. 

At the end of the day, we’re trying to make folks more comfortable and support them towards a healthier future lifestyle. We’re there to help them with their basic needs on day one and then address their long term needs on day 30, day 90 and so on. We believe if we are successful at this, you’ll see a community-level impact. 

NPH:  In addition to stopping reinjuries, what are other goals of the program?

Sheila Regan: We’re trying to prevent any more violence or retaliation from happening. Our assumption is that when someone has been shot, all the people in the room are accustomed to a world in which violence is normal, and we’re trying to reverse that norm. So our intervention is saying, hey, we don’t have to do this, we don’t have to stay involved in this, and so the intervention population is the patient, but it’s everyone else in the room as well. We are encouraging them all to make decisions toward the healthy lifestyle.

NPH:  What makes these partnerships successful?

Sheila Regan: Our strongest partners are the level I trauma centers, and we found that in Chicago. Typically the trauma department, the Mission Spiritual Care, the chaplain department, social work department, emergency department are really invested in seeing the health of the community improve. They’re sick of the revolving door of violence and the constant flow of gunshot wound injuries that come through their hospitals. Keeping in line with the Cure Violence model of using credible messengers to bring a message of peace and a message of change, every employee in the hospital becomes one of our credible messengers. They’re a part of the messaging team, basically resounding over and over and over again the message that violence is unacceptable, violence is not normal and violence can be changed. 

NPH:  What else is important for a successful partnership? 

Sheila Regan: Community-level resources are very critical to the partnership, particularly because we have a specific niche of preventing violence and we’re very good at that.  To serve patient’s mental health needs, provide legal assistance or crime victim compensation, we access the community resources that are put in place by elected officials. For example, crime victim compensation is through the state’s attorney’s office and is available to anyone who is a victim of a crime and suffers, like loss of work and not being able to pay for hospital bills. We really rely on those community-level resources so that there’s a safety net, a landing pad that we can send patients to once they’re discharged from the hospital.

NPH:  Any advice on how can you expand this type of program to more cities and more hospitals?

Sheila Regan: Each hospital has its own personality, but there are a lot of commonalities in our goal and in how we approach different situations. The needs after you’ve been shot are similar no matter what your geography is, and so a lot of what we offer in Chicago is similar to what we would offer in Baltimore or New York City, but of course different hospital have different cultures and we definitely want to respect that and integrate ourselves in any of those cultures.

Tags: APHA, Access to Health Care, Community violence, Hospitals, Public Health , Public health, Violence, Vulnerable Populations