Dr. Corbin's Opinion on Trauma-Informed Strategies Published in The Philadelphia Inquirer

As an emergency-room physician, I am used to dealing with the results of violent attacks. But after many years of stitching up injured young people, I understand ever more urgently that this is not enough. We must break the cycle of violence.

We can start by intervening in hospital emergency rooms, the place where we engage victims right after someone has tried to kill them.

Every year, thousands of Philadelphians are shot, stabbed, or beaten. Some of them die. In 2011, there were 324 homicides, almost one a day, with nearly half the victims younger than 25 and more than 80 percent of them African American males. But many survive, at least for a time.

When treated in the emergency room, victims may get prescriptions for painkillers. But there is no drug to protect them from someone who still wants to do them harm. There is no way to vaccinate them against the urge to retaliate.

Victims of neighborhood violence may experience some of the same symptoms as war veterans who suffer from post-traumatic stress disorder. They may be "hyper-vigilant," constantly tense and "on guard" for danger, and unable to concentrate on school or work. They may mentally reexperience the trauma they suffered or block it from memory, increasing the risk for more trouble.

Studies show that up to 44 percent of the victims of violent injury will be violently reinjured within five years, and 20 percent will be dead.

There are programs that are making a difference. At the Drexel University School of Public Health and College of Medicine, one called Healing Hurt People works out of emergency rooms at Hahnemann Hospital and St. Christopher's Hospital for Children. The program shows that we can educate victims about trauma and connect them to follow-up resources guided by a team of physicians, nurses, social workers, outreach workers, and researchers.

It is one of 19 similar programs around the nation, but there should be more. Such "trauma-informed" strategies can help hospitals, schools, mental-health facilities, job-training centers, and the criminal justice system, direct young victims to new paths to recovery.

Prevention is always cheaper and smarter than treatment. Reducing injuries would cut medical costs, not to mention expenses to the city on all levels. According to a recent report from the Center for American Progress, Philadelphia is burdened with a $736 million direct annual cost from violent crime. Given that potential, trauma-informed strategies should not be dependent, as they are now, on foundation grants and government funding. They should be reimbursed by Medicaid and private insurance. That is the sort of long-term, sustainable approach that can make the change we need.

Medical insights into trauma also can help us establish effective public policies. Right now, Philadelphia's Interdisciplinary Youth Fatality Review Team investigates the deaths of young people with an eye to preventing more such deaths. Why not develop a citywide panel to study violently injured youth to discern new methods to prevent future deaths, retaliation, and imprisonment? In Milw Of course, we also need renewed attention to the root causes of violence: poverty, abuse, and neglect; dysfunctional families; and poor educational and economic opportunities. And we must listen to those from impacted neighborhoods to identify community-based partners and organizations to cultivate momentum for change.

Let me be clear: We are not suggesting that perpetrators of violence be excused from accountability. But research and experience tell us that intervention can help us break the cycle of violence, one individual at a time. At stake are their lives, the lives of their potential victims, and the future of our city.

From philly.com