Young victims of violence who are hospitalized for traumatic injuries no longer need to feel isolated and vulnerable in the months following their medical discharge. A new UC Davis Health program called “Wraparound” is designed to aid emotional recovery and help prevent recurrence of violent injuries among adolescents and young adults, ages 15 to 26, in the Oak Park neighborhood of Sacramento.
Wraparound’s two intervention specialists, Chevist Johnson and Esmeralda Huerta, work to turn tragic circumstances into teachable moments for stabbing, gunshot and beating victims who are admitted to UC Davis Medical Center’s Trauma Service for treatment. Johnson and Huerta seek to develop long-term trusting relationships to help patients navigate through recovery, and to help them make productive life changes to reduce future exposure to violence.
“When victims of violence are admitted to the hospital, I visit them at bedside and start the process of building rapport and assessing their needs,” Johnson said.
“We counsel patients to avoid drug and alcohol abuse, and to disengage from conflict instead of escalating violence. We perform a year of case management for each person by wrapping in multiple community agency partnerships that offer mentoring, employment services, mental health counseling, alcohol and other drug treatment services, and even housing referrals, if needed. That’s why Wraparound is the name of our program,” explained Johnson, who has a background in gang violence intervention and mental health and youth services.
The intervention specialists learn of admitted patients from physicians or nurses, or by checking the database of overnight admissions to identify patients who meet the Wraparound parameters.
“I consider myself an advocate for these young people,” Huerta said. “Wraparound offers a broad range of services, but mentorship is the most important.”
From personal experience, she has come to regard violence as a public health issue that affects everybody, not only injury victims. The murder of an uncle of hers in the late 1980s deeply shook her family, and as a troubled teenager she resorted to violence after being victimized by school bullying.
“When young victims can connect with caring adults who offer guidance, that reduces the chance that they’ll retaliate violently, and improves the chance that they’ll receive appropriate services to recover from post-traumatic stress. That is why I’m here,” Huerta said.
The Kohl’s Cares program awarded a $450,000 grant to UC Davis Children’s Hospital to launch and operate Wraparound throughout 2018 and 2019. The Wraparound program is being launched as part of a larger Kohl’s Cares grant and is one of three grant initiatives to reduce preventable injury among children in Oak Park and surrounding communities.
“The decision to focus on Oak Park zip codes 95817 and 95820 was based on the UC Davis Medical Center's Community Health Needs Assessment and violence injury data from our level I trauma center,” explained Christy Adams, UC Davis trauma prevention coordinator. “Those zip codes have the highest percentage of youths with violent injuries treated at our facility, and Oak Park is a ‘hotspot’ of violence, according to Sacramento Police Department data.”
As a level I adult and level I pediatric trauma center, UC Davis treats hundreds of people every year for violent injuries. Dr. Ian Brown, a trauma surgeon and co-lead for the program, sees Wraparound as an opportunity to extend support for recovery.
“We see the physical effects of violent injuries in these young people but these are only the visible injuries. If we truly hope to effect change and successfully decrease violence-related trauma recidivism, then discharge from the hospital cannot be seen as the end of our intervention. It is only the beginning,” said Brown.
Patients from other parts of the metropolitan area, and patients who are treated in the UC Davis Emergency Department but not admitted to the hospital, are referred to the Sacramento Violence Intervention Program (SVIP). Injured prisoners, people with severe mental illness, and victims of sexual assault, domestic violence or child abuse likewise are referred to other resources.
In collaboration with Oak Park residents, Wraparound is developing a hospital crisis response team to lend support and guidance to families of violently injured patients to help avert retaliation. The Black Child Legacy Campaign and Sacramento Gang Prevention Task Force are participants in that process. Insights gained from Wraparound over time could enable expansion to other neighborhoods.
Johnson views Wraparound, which was inspired by a similar program at UC San Francisco, as one puzzle piece that can help restore equilibrium to the lives of victims. WHY Sac (We Help Youth Sacramento), a community-based network that UC Davis helped develop, functions as a resource referral network encompassing more than 200 youth service providers in the region.
“The strength of the Wraparound program will be in our partnership with the community,” Adams said. “Our goal is to work with victims’ families, friends, schools and churches to support their successful recovery.”