Breaking cycle of youth violence is aim of program
Posted March 17, 2010
After repairing one young man’s gunshot wound, only to see him readmitted a month later with another, trauma surgeon Rochelle Dicker was compelled to face the facts: As with a disease, it could be possible to reduce the risk factors and recurrence of violence. The first-year resident at San Francisco General Hospital and Trauma Center created the Wraparound Project in 2006, which works to reduce violent injury recidivism with youth who have been injured in interpersonal peer violence.
UC Davis trauma surgeon Christine Cocanour had seen her fair share of violently injured youth in Sacramento as well. She worked diligently with Dicker to bring the Wraparound Project to UC Davis Medical Center, which launched the program in January 2010 and enrolled its first patient in March.
At UC Davis Health System, the Wraparound Project is a collaborative effort among trauma surgery, trauma prevention and pediatrics and is linked with a city-wide effort led by the Sacramento Office of Youth Development to reduce gang violence. The project also works closely with The Marginalized Youth Collaborative, co-led by Elizabeth Miller, an assistant professor of pediatrics.
“Our hospital treats 300 to 350 people every year between the ages of 10 and 30 who have been shot, stabbed or assaulted,” said Christy Adams, coordinator of trauma prevention at UC Davis Health System. Although social services can step in on a case-by-case basis, “until we brought Wraparound on board, there were no resources in place to help reduce re-involvement with violence after discharge.”
"So many young people have been treated at our hospital for injuries related to violence. ...This is an opportunity to have a positive and lasting impact on their lives long after their injuries have healed."
— Christy Adams
The primary goals of the program are three-fold: provide crisis management to patients and their families; prevent violence retaliation in the community by working with community-based gang outreach groups; and provide intensive case management for up to six months to patients at the highest risk for re-involvement with peer violence.
This last is where Steve Streeter, Wraparound’s case manager, steps in.
The single-most important element in reaching at-risk youth, Streeter said, “is the positive adult who comes into their life and makes them aware of their own potential.” It’s not just conversation, but “someone taking them by the hand and showing them. Often, kids don’t know about the resources available to them.”
Not only do kids need to know a different way is possible, but they need to see concrete examples.
“They’ve got to be able to touch it, smell it, see it,” Streeter said. “The only options they’re seeing are drugs, prostitution and other crimes.”
Streeter is one of those concrete examples — because at one time he was like the youths he now helps. He grew up in Oak Park and was a high school dropout. But he was fortunate to find adult mentors, two of whom in particular steered him in more productive directions: a counselor at the former Skills and Business Center on Stockton Boulevard, and a community college counselor who encouraged him to become a printing press operator.
Having these positive influences helped Streeter turn his life around at age 21, graduate from Sacramento State, establish a 20-year career in law enforcement and “purchase the American dream, the freedom to make decisions based on my values,” he said.
Preventing the predictable
Most unintentional injuries and deaths, such as those that result from not using a seat belt or drinking and driving, are preventable.
The goal of the UC Davis Health System Trauma Prevention Program is to identify and as much as possible eliminate the causes of preventable injuries, including unsafe behaviors, conditions and environments.
For more information about trauma prevention programs, visit their Web site.
When Streeter was recruited for Wraparound, he had just retired as resource coordinator for a youth gang and violence-prevention program developed by the state’s Office of Youth Development. But he was still involved with the state program and the movement, and when Miller approached him at a program meeting and told him about Wraparound, he couldn’t say no.
As case manager, Streeter’s role is to approach young patients who are admitted into the hospital for violence-related injury and tell them about available resources in education, career training, mentoring and other services. The project does not include patients injured from domestic violence, sexual assault or child abuse, as follow-up care for these situations requires a different type of intervention.
In its first three years at San Francisco General Hospital, the Wraparound Project has shown promise — just 4 percent of violent trauma victims have returned for treatment, compared to 35 percent before the program began.
“So many young people have been treated at our hospital for injuries related to violence,” Adams said. “This is an opportunity to have a positive and lasting impact on their lives long after their injuries have healed.”
Funding to pilot the program comes from the Centers for Disease Control and Prevention as flow-through money from UC San Francisco. Interdepartmental efforts are under way to secure long-term funding.