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On The Importance of Timing
Tue January 14, 2014
At Portland Hospital, Counselors Target 'Golden Moment' To Reduce Gang Violence
A Portland hospital is reporting success by bringing gang members together with counselors at just the right moment — immediately after they've been shot.
Counselors call it the “golden moment.” And after six months, the Healing Hurt People program says so far, it’s working.
‘A Moment In Time When They May Be More Apt To Listen’
Joshua Lathan is a counselor with Healing Hurt People.
“More often than not, I’ll see it on the news and then my phone will ring,” he said.
When he gets the call, Lathan drives straight to the hospital because he wants to make use of the golden moment, which he says lasts about four hours after someone’s been injured.
“That’s a moment in time when they may be more apt to listen to you,” he said. “A fresh wound, they’re scared. They may be thinking to themselves, ‘Man, this may be my perfect time to get out.’ And they see someone come into the room and offer them a doorway to leaving. They may be more apt to be [saying], ‘Yes, I’m with it.’”
Getting Families On Board
And it’s not just the young man who’s open to change at the hospital.
Lathan’s co-counselor Cheryl Johnson says it’s a good time to catch the family as well.
“If Josh and I happen to go out on a call together, it’s usually him that’s interacting with the young person, and it’s me relating to the mom,” she said. “And just really checking in and getting the story.”
Johnson asks questions like: “Who has influence in the family? What happened? Are they interested in retaliating? Are they upset?”
“Just really getting a good idea of what the mood is,” she said.
Forming ‘A Small Village Around The Young Man’
Legacy Emanuel Medical Center has allowed the Healing Hurt People program to come to the hospital for the last six months.
The program is new to Portland, but similar efforts are now running in 22 gang-affected cities.
The program is aimed exclusively at men of color between the ages of 10 and 25, according to its website. And once a young man has made the decision to leave, Lathan works with the family, the school and anyone in his life to keep him on the straight and narrow.
“We all stay in communication with each other as well, and just form like a small village around the young man,” he said.
Healing Hurt People will help the family move if the victim doesn’t feel safe in his neighborhood. The program will also help him set up a safety plan: Who is he going to avoid when he gets out of hospital? What’s he going to do during the day? Is he going to get a job?
“It may take a little prodding for some,” he said. “But for the most part, they’re staying out of trouble. [They say,] ‘If I’ve got to get out of trouble, that’s what I’ll do.’”
The Hospital's Considerations
Giving counselors access to someone who’s just been in surgery can be a worrisome proposition for a hospital. Lori Morgan, CEO of Legacy Emanuel and a trauma surgeon, says Legacy went to great lengths to make sure counselors don’t badger patients when they’re frightened and at their most vulnerable.
“They essentially had to hit all the targets that we would require of our employees in terms of background checks, and HIPAA violation training,” Morgan said.
Morgan says the hospital basically treats the counselors like contractors.
“So they do carry contractor badges, so they’re always identified,” Morgan said. “I think the most important thing for me as we were developing the program was to make sure that there wouldn’t be interference with medical care.”
But Morgan says, after six months, she’s been impressed.
“They often interact with the families, which is a little bit more difficult for medical personal to do,” she said. “I mean, we had one instance where one of our physicians called Josh while the patient was an inpatient and having some difficulty and saying, ‘Hey, can you come over here and talk to this guy?’ That wasn’t planned; that was spontaneous.”
Morgan says the hospital agreed to take part to reduce the loss of human capital from gangs, but also to save money. Gunshot victims are expensive to care for and most are not insured.
Praises From the Governor
Healing Hurt People has worked with about a dozen Oregon gang members so far. At a presentation for Gov. John Kitzhaber, staff told him none of them has been rearrested or reinjured.
The governor expressed his support saying gang violence isn’t only a criminal justice issue; it’s also intricately linked to education and unemployment.
“If we were able to do a full-cost accounting of these young people,” Kitzhaber said, “your program downstream saves untold millions of dollars, not to mention human potential.”
The program costs about $200,000 a year, with two-thirds of the funding coming from donations and one-third from fees.
Supporters are hoping the state will pick up part of the cost in the future.
The Question Of Impact
Does the Healing Hurt People program reduce gang violence?
Theodore Corbin, an Emergency Room Doctor at Drexel University College of Medicine in Philadelphia has been working with the program for six years. He says more research is needed to answer that question.
“It’s very challenging to say that we’re having an impact on decreasing violence, because you really don’t see anything like that until 10 years out,” he said.
Corbin is working to get the program into every level-one trauma center in Philadelphia, so it becomes clear whether the men who’ve been through the program are really staying out of trouble, or just going to another hospital when they’re reinjured.