Hospital Trains Focus On Ending Cycle Of Violence

Hospital emergency rooms are filled with the fallout of violent crime. Sometimes, the victims and the perpetrators are one and the same. It's a cycle of violence many would like to end. At the University of Maryland Medical Center in Baltimore, doctors and others have developed an outreach program that appears to be working, and it has been modeled by others.

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Many big, American cities continue to struggle with violent crime - Baltimore, Maryland, among them. Stabbing, shootings, the fallout from these assaults often finds its way into hospital emergency rooms. And that's why some doctors are working proactively to break the cycle of violence.

NPR's Allison Keyes reports on a program at the University of Maryland Medical Center that's seeing encouraging results.

ALLISON KEYES: Howard McCray(ph) is doing the equivalent of door-to-door sales.

Mr. HOWARD MCCRAY: How are you doing? My name is Howard McCray.

KEYES: But he's doing it through four floors of hospital beds in the University of Maryland Medical Center shock trauma unit, stopping at the bedsides of men suffering from gunshot and stab wounds, some breathing through tubes, to get them to join the hospital's violence-prevention program.

It follows the patient from the treatment stage at the hospital to their lives and their communities, in hopes of giving them the skills so they don't again become the victims or perpetrators of violence. Some days, McCray, an outreach worker who landed in the program after being shot twice, gets an immediate yes. Sometimes not.

Dr. Carnell Cooper, the program's team leader, says the point of it is to stop a seemingly endless cycle: injury, a hospital stay, then the whole thing all over again.

Dr. CARNELL COOPER (University of Maryland Medical Center): I thought if we caught them at the hospital while they're there, while Mom and Dad are at the bedside crying, they will stop for a moment and go, hey, you know, what am I doing?

KEYES: The program here started in 1998, and is one of the first of its kind in the country. At least 11 hospitals, from California to Wisconsin, are using some version of this model. Cooper says his team designed the program to address a whole series of risk factors, including lack of education, lack of income and substance abuse.

Dr. COOPER: We deal with a population of folks that people just simply would rather have just go away than be involved with.

KEYES: Cooper, who's black, says the mostly African-American men admitted to the trauma center looks like guys he had grown up with. Not bad men, he says, but men who didn't know how to help themselves.

Dr. COOPER: When we meet our folks sometimes, they are deep in a hole. They have no idea how to climb out of the hole. And what we do is try to show them, in a step-by-step basis, how to climb out of the hole - and help them.

KEYES: Cooper says the program saves lives. He points to a 2002 University of Maryland study showing that out of 100 patients with violent injuries, program clients were three times less likely to be arrested for committing a violent crime. Funding for the program comes from the city and state as well as private foundations.

It includes everything from home visits, help with housing and education, meetings with social workers, a parole probation officer, and group counseling meetings with its mostly male participants. The men talked forcefully about the pressure they're under to show that they are hard-core, strong men that deserve respect.

Unidentified Man #1: You got two people there. You've got one person...

Unidentified Man #2: Go ahead, do it.

Unidentified Man #1: The other person's like, man, you'd better think of your kids, fool. Go sit back down.

KEYES: They talk about defining moments where friends, or the pressure to prove one's prowess on the street or to their women and families, have led to crimes that can land them in jail - or in a grave.

Sean Manning(ph) is a 31-year-old program client.

Mr. SEAN MANNING: I joined it from when the day I came home from incarceration.

KEYES: He's walking through the heart of downtown Baltimore, where several violent clubs used to be packed with folk looking for trouble. And he spent two years in jail after a stint as what he calls a city pharmaceutical consultant. But Manning decided he needed to get out of a life where violence was normal.

Mr. MANNING: There's always some way that you got to prove yourself, whether you're proving it to yourself or you're proving it to somebody else.

KEYES: But now, the father of four is applying himself to the program.

Mr. MANNING: Just to keep me out of trouble. And it's basically to keep me focused on what I want to do in life.

KEYES: Manning wants to keep others from the same pitfalls.

Mr. MANNING: Give back to the kids that's growing up under me, that basically that's coming up under my generation.

KEYES: Program parole probation agent Lillian Carter(ph) says she thinks the program is successful because it offers support to clients who most people look down upon.

Ms. LILLIAN CARTER (Parole Probation Agent): Everybody needs nurturing. Everybody needs caring. And we know as human beings, when we get those type of things, we do better in life in general. It's the same thing with these individuals. It's just now - that they may have been a part of the criminal justice system before, they may have been in a gang before. But now, they're turning their life over. They have something to look forward to.

KEYES: The violence prevention program's team leader, Dr. Cooper, says he'd like to see such programs exist worldwide.

Allison Keyes, NPR News, Washington.

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