“We can stitch them up, but we can’t make them well.”
These heart-rending words came from Alicia Boccellari, Ph.D., director of the Trauma Recovery Center at the University of California, San Francisco (UCSF) Medical Center, during a presentation at the first annual Oregon Justice Reinvestment Summit. Dr. Boccellari was expressing the frustration and hopelessness that medical providers face when working with victims of violent crime who come to the UCSF Medical Center for healing. Medical providers were able to offer victims help for their physical injuries but weren’t able to address their psychological wounds.
The wounds of violence can run deep if they are not addressed. According to a 2009 report from the Academy on Violence and Abuse, the cost of violence on the U.S. health care system is between $333 billion and $750 billion each year. Seventeen percent to 37 percent of total health care costs are spent on the chronic medical consequences of untreated trauma. Researchers found that people who survived violence in the past access health care 2 to 2.5 times more frequently than people who do not have a history of surviving violence.
Recognizing that people who have survived crime need more than their physical wounds addressed in order to heal, the UCSF Medical Center created a Trauma Recovery Center. The Trauma Recovery Center envisions a community that heals the wounds of violence and embraces hope for a nonviolent, compassionate world. They offer wrap-around services to victims of violence who come to the UCSF Medical Center for help. They begin with a simple but incredibly important question: “What has happened to you?” This is a shift from the traditional therapeutic question that victims were asked in the past: “What is wrong with you?”
The Trauma Recovery Center provides an integrated model of care and works to meet crime victims’ needs that would not traditionally be addressed through the medical system. A multidisciplinary and culturally diverse team addresses not only the survivor’s medical needs, but the survivor’s mental health, housing, legal, financial and other basic needs. A key element to the services is that the team does outreach and engagement wherever works best for the survivors. This could mean in the hospital, at their home, or anywhere in the community. Staff meet victims where they are — literally.
Many of the victims who are served by the Trauma Recovery Center are people who would not typically be able to access other services, such as people who struggle with chronic mental illness or have complex psychological issues, people who are recent immigrants or are part of refugee groups, and youth victims who have had contact with the juvenile dependency or justice system. Many of the victims served are young men of color who have been stabbed or shot. A 2013 study by Californians for Safety and Justice found that victims of violent crime in California are more likely to live in low-income communities, be under 30 years old and be Latino or African-American. But few of these people had access to victim services that were provided by the justice system.
In creating this new model of care, the Trauma Resource Center found a huge gap between crime victims eligible to apply for victim compensation funding and people who actually knew about the funding. Crime survivors may have high medical costs or lose income or even their jobs due to inability to work, which can result in a loss of housing and other basic needs. Many victims also have little financial resources to access costly — but needed — services such as counseling. Victim compensation is one financial resource available to survivors who have been the victim of a violent crime and can be used for covering medical expenses, counseling and other needed services in the aftermath of victimization. While waiting for the funding, though, victims have to pay out of pocket for services and some have gone into bankruptcy just to access resources and support. The Trauma Resource Center helps alleviate this barrier by offering free services and helping survivors access compensation funds.
Each person reacts differently to being the victim of a violent crime, but one thing is clear: Trauma can have a detrimental effect on survivors unless they get the support and resources needed to heal. We’re in an exciting time in the United States, as the need to reform our public safety system has come to the forefront of elected officials’ and communities’ call for change. As we advocate for a more effective and just public safety system, we must ensure that crime victims can access the resources they need — in the community, in schools, in the justice system and in the medical field.
When we rebuild victims’ lives, we rebuild our communities.
Heather McDowell is the policy and advocacy intern at Partnership for Safety and Justice. PSJ is a statewide, nonprofit advocacy organization dedicated to making Oregon's approach to crime and public safety more effective and just.