Healing Hurt People

Stoneleigh Fellow: Theodore Corbin, 2011-2016

The Need

Each year, 1.5 million people are treated in an emergency department for a violent injury and survive their wounds.  These victims find themselves at a potentially life-changing moment:  while being treated, many weigh the decision to change their way of life or to retaliate.  Most are discharged to the hostile environments in which they were hurt, without supports to address the issues that led to their injuries.  National statistics demonstrate the devastating long-term effects of this approach: within five years of their release from the hospital, 45 percent of severely wounded victims will be reinjured; nearly 20 percent will be dead.

Healing Hurt People

Recognizing the need to intervene during this crucial time in victims’ lives, the Healing Hurt People (HHP) model was developed at Drexel University by: Dr. Ted Corbin; Dr. John Rich, a public health expert; Dr. Sandra Bloom, a psychiatrist who developed the Sanctuary Model; and Linda Rich, a psychotherapist with extensive experience in health policy and program planning.  In 2008, HHP began serving clients at Drexel-Hahnemann and has since expanded to serve victims ages 8-30 in four additional emergency departments across the city:  Einstein Medical Center, Penn Presbyterian Medical Center, St. Christopher’s Hospital for Children, and Temple Hospital.  

HHP addresses the physical, emotional and social needs of young people once they are released from the hospital and resume their lives in the communities where they were injured.  The ultimate goal of the program is to intervene in the cycle of violence that can trap these youth, particularly young men of color.  To meet these goals, HHP’s model includes three main program components:

  • Assessment in the Emergency Department.  Before discharge, a master’s-level social worker verifies that the client has a safe place to go, offers referral services, and advises the client about likely traumatic-stress symptoms.
  • Intensive Case Management in the Community.  A trained outreach worker follows up through phone calls and home visits and provides ongoing case management services to facilitate clients’ access to medical care, housing, education, employment and legal help.  
  • Ongoing Mentoring & Structured Peer Support.  Clients participate in one-on-one mentoring and in evidence-based, psychoeducational peer support groups to discuss the trauma they have experienced and generate momentum toward change.

In addition, HHP staff engage with clients’ family and friends, who are often vicariously traumatized, to help prevent retaliatory violence.  On average, clients and their families are engaged in the program for six months to one year. 

Sustainability

The program is primarily funded by the Philadelphia Department of Behavioral Health and Intellectual DisAbility Services.  HHP also receives limited support through Medicaid reimbursement for behavioral health services.  Private funders, such as the Stoneleigh Foundation and the Annie E. Casey Foundation, and federal agencies, including the US Department of Justice, are also key supporters of this work.  With current funding, HHP can serve about 300 clients in Philadelphia – far short of what is needed to serve the thousands of young people who are violently injured across the city each year.

Results

Currently, rigorous research is underway to assess HHP’s long-term impact on re-injury, retaliation, trauma symptoms, and involvement with criminal justice system.  This research will also reveal the program’s effect on participants’ connections to physical and mental health services, employment and education.  Early study findings have shown promising reductions in trauma symptoms among program participants.

National Reach, Local Impact

HHP has gained significant national attention and is a leader in the movement to end violence using a public health approach.  HHP serves as the headquarters for the national Network of Hospital-based Violence Intervention Programs, and the HHP model has already been replicated in hospitals in Portland, OR, and Chicago, IL.  In addition, HHP advances system-level solutions to prevent violence in Philadelphia — in part through an innovative citywide case review model that engages leaders from law enforcement, medicine, behavioral health, human services, and education.