Innovation and positive change — these were reoccurring themes of Mayor  Nutter’s keynote address at the Greater Philadelphia Chamber of Commerce’s Annual Mayoral Luncheon on Monday. With talk of green technology, pop-up gardens, the Reading Viaduct, and redevelopment initiatives targeting Market East and North Broad, Nutter depicted a city on the rise filled with citizens and government leaders who aren’t afraid to think outside the box. 

When it came to the topic of doing something about endemic violence that  plagues our city’s streets, however, the mayor’s speech took an unexpected turn toward stagnation and the status quo. In discussing the importance of public safety to business development, the mayor announced violence-prevention strategies—more cops, harsher punishments, and bounties on people's heads—that sounded better suited for a Wild West frontier town than the forward-thinking metropolis he otherwise portrayed the city to be.

I suggest that hospital-based violence intervention programs—an innovative, evidence-based, cost-effective strategy for violence prevention—are better aligned with the city’s progressive endeavors; and something that the mayor should consider.

Healing Hurt People (HHP) is a hospital-based violence intervention program in Philadelphia designed to break cycles of violence by reaching victims (and potential perpetrators) of violence at a critical moment in their lives: right after someone has tried to kill them.

Typically, when people are violently injured, they go the hospital, get stitched up, and get sent back to the street—often on the same day. HHP is founded on the notion that this process misses a major opportunity for violence prevention by failing to recognize three factors:

• Someone on the street probably still wants to do the injured person harm.
• The injured person might be planning to retaliate against the assailant.
• The psychological trauma of being the target of attempted murder might contribute to behaviors which increase risk of re-injury and retaliation.  

If violence begets violence, it makes sense to intervene right after violence occurs.

Since 2008, HHP—a program of Drexel’s Center for Nonviolence & Social Justice—has acknowledged this reality and engaged clients in a trauma-informed process to prevent re-injury and retaliation. With support from the Scattergood Foundation and Philadelphia’s Department of Behavioral Health, HHP operates out of the emergency departments of Hahnemann Hospital and St. Christopher’s Hospital for Children.

At each hospital, HHP employs a social worker and community intervention specialist to provide a range of services—such as psychoeducation, case management, and mentorship—to positively change the life course trajectory of victims of violence

As Theodore Corbin, MD, HHP’s director, often says: “Our young people are dying and we can stop it.”

At present, there are at least 19 hospital-based violence intervention programs operating across the U.S.  Recently, Philadelphia became the headquarters of the National Network of Hospital-based Violence Intervention Programs. A program similar to HHP was also launched at the Children’s Hospital of Philadelphia last month. 

Why do such programs keep popping up across the country? Because they work.

Studies have shown that individuals who participate in emergency department-based violence intervention programs end up with lower rates of re-injury (8 percent vs. 20 percent) and arrest (18 percent vs. 57 percent) and higher rates of employment (20 percent vs. 82 percent) than those who do not.

Corbin, who is a Stoneleigh Foundation fellow and received support from the foundation, HHP is currently undertaking a comprehensive evaluation of the program’s impacts.

Hospital-based violence intervention programs are unique as they recognize that a violent injury is often the beginning of a cycle of violence—not the end.  Research shows that 44 percent of victims of violence are re-injured within five years, while 20 percent die.

In 2010, 1,615 people were shot in Philadelphia, 244 fatally. In the absence of emergency department-based violence intervention programs, that’s 1,371 opportunities for violence prevention missed. HHP, and similar programs, should be replicated in emergency departments across the city. Such programs have enormous potential to stop violence in our city and are in keeping with the positive trends toward innovation and change that the mayor accurately articulated.

Read more about The Public's Health.