A case study of integrated mental healthcare with violence intervention programming
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This study will describe Boston Medical Center's (BMC) Community Violence Response Team (CVRT) a program that provides mental health services to victims of interpersonal violence. Though these services are offered to all traumatic injury patients regardless of specific injury type, CVRT patients are almost exclusively victims of gunshot and stab wounds. This study focuses specifically on this patient population. CVRT counselors work in close collaboration with members of BMC's Violence Intervention Advocacy Program, as well as physicians and staff of the Emergency and Trauma departments. While many hospitals have violence intervention programs (VIPs), BMC is one of the first hospitals in the country to integrate mental health services into the hospital-based model of violence intervention and violent injury prevention. It is planned to conduct anonymous recorded interviews of people who have been through the violence intervention programs and received mental health services. A professionally licensed member of CVRT will screen the patient database for potential interview subjects. Subjects will be chosen based on when and for how long they were involved with our programs, as well as other factors such as injury type and language spoken. The subjects' anonymity will be protected and risks minimized as much as possible throughout the screening and interview process. Interview data will be examined for trends among the clients served. This will be a first look at evaluating CVRT, which was launched in 2011. The purpose of this study is to provide feedback on BMC's novel model for an integrated hospital-based violence intervention program and mental health services program for victims of interpersonal violence. The patient's perspective on these programs will provide valuable insight on this approach to violence intervention. The benefits of this model will be explored to identify any ways in which violence intervention services at BMC might be improved. Outcomes of the assessment of study data will be used to generalize the model for adaptation in other trauma centers. In addition, it is anticipated that this study will demonstrate the importance of seamless, integrated collaboration between community advocates of hospital-based intervention programs and trained professionals dedicated to providing mental health care to this vulnerable patient population and their families. It is hypothesized that BMC's integrated model for violence programming makes it easier for patients to take advantage of mental health services. This ease of access and comfortable transition from advocacy interventions to mental healthcare may translate into better long-term outcomes for patients. More patients may also use mental health services with this model than with a model that requires patients to access mental health services at another facility. A detailed explanation of BMC's programs complete with patients' experience will inform other institutions which may choose to adapt this integrated model to their practices. Finally, this pilot study will inform future research on violent injury patients and their treatment. This research has the potential to improve recovery and quality of life for future violent injury patients at BMC and other trauma centers.