Hospital-based Programs Break Cycle of Violent Injury

Victims of stabbings and shootings, usually gang-related, are often followed to the hospital by friends and relatives planning retaliation on behalf of the victim.

Retaliatory violence creates a vicious cycle, revealed starkly in hospital statistics. Within five years, 17 to 20 percent of victims will be readmitted to the hospital and won’t survive.

“When you’re the victim of violent crime you’re looking for justice, you’re looking for answers,” said Richard McClendon, who was shot in 2011 and paralyzed instantly. Raymond Estrada, a case worker for Caught in the Crossfire, a program of Oakland-based youth violence prevention agency Youth Alive! stepped in to help McClendon survive after he left the hospital.

A growing network of hospitals and community organizations across the country are sending streetwise mentors like Estrada to the hospital bedsides of youth with violent injuries. Those trained interventionists hope to catch victims and their loved ones at a critical point when they realize how much is at stake and may be open to change and alternatives to retaliation.

“They let you know you’re not standing in a corner by yourself,” said McClendon, who was not a gang member but lived amid gang activity. Estrada helped him submit paperwork for supplemental security income, unemployment and college and stuck with him for a year, providing emotional support.

A growing number of cities are adopting hospital-based violence intervention programs like Caught in the Crossfire, which has become a model program nationally. The first of its kind when founded in Oakland in 1994, it led to development in 2009 of the National Network of Hospital-Based Violence Intervention Programs (NNHVIP).

That network now has about 29 members, including programs in San Jose, Richmond, Los Angeles, Oakland, San Francisco and Sacramento. They each launched projects within the last 12 years. New programs are emerging in Antioch, Salinas and San Diego, said Anne Marks, Youth Alive! Executive Director and training director for NNHVIP.

These programs rely on peers, people who have overcome violence in their own lives and who can de-escalate situations that might otherwise lead to another violent act.

Kacey Hansen is executive director of John Muir Health’s trauma center which runs Beyond Violence, an intervention program serving residents in Antioch and Richmond for the past four years at the John Muir Medical Center in Walnut Creek. Hansen said what she looks for in interventionists is street credibility, people who have overcome the same issues.

“I’m looking for a rap sheet,” she said. “Because I haven’t been there and I’m not the best person to look these young people in the eye and say, ‘You can live your life differently.’”

Caught in the Crossfire began with the work of Sherman Spears, who was shot 21 years ago and is now a paraplegic. He remembers his family and friends conversing around his hospital bed.

“They wanted retribution,” Spears said. “I guess that was the hardest part.” No one but Spears was looking forward at his life after discharge and wondering what came next. “There was nobody I could talk to about the questions I had and how I was feeling.”

In 1993 Spears’ doctor asked him to talk to another young gunshot victim at Highland Hospital in Oakland. He did and continued visiting other patients. About a year later his doctor introduced him to Deane Calhoun, founder of Youth Alive! and together they created Caught in the Cross Fire.

That program has now helped roughly 2,000 people, with mentoring, financial assistance, employment, medical coverage, counseling, safe housing, substance abuse intervention and recreational programs.

Victims of violent trauma visiting emergency departments have a 16.5 percent chance of dying from another violent injury within five years, according to a 2012 study in the Western Journal of Emergency Medicine. Earlier studies put that risk as high as 20 percent.

Daniel Mora figures he was destined to be among those statistics. He had a violent home life and at 15 had been in and out of juvenile hall six or seven times. His probation officer knew that a Caught in the Crossfire case worker, Emilio Mena, was a former gang member from Mora’s block and she coordinated a meeting. It made a life-changing impression on Mora who said he saw a reflection of himself in this 30-year-old man.

Mena assisted Mora on multiple levels including getting him a job at a local youth center where he started as a janitor and transitioned into doing workshops.
“I became a community activist without knowing it,” Mora said.

“He was like almost my father,” Mora said of Mena. “Without Emilio I would be dead or in prison.”

Mora earned a BA in Ethnic Studies from the University of California, Berkeley, has collected numerous local, state and federal honors for his work with youth and speaks all over the country.

Marks is among the advocates pushing for hospital-based violence intervention programs to become standard practice at trauma centers with high incidences of violent injury. Ideally it would eventually be funded through the health care system, Marks said.

These types of programs got some recognition from the state in September when Governor Brown signed Assembly Bill 1629 allowing the California Victim Compensation and Government Claims Board to compensate these programs for outpatient violence peer counseling.

Richard McClendon is proof that these programs make an impact. He still lives with the pain of a bullet in his back. It’s too dangerous to remove it. But he’s walking again and, at 26, is close to graduating from Merritt College in Oakland with an Associate in Arts degree in child development and African American studies.

“I want to show a good example for my kids, so they won’t have to come up in the poverty that I did,” he said.

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