Implementing the New York City Crisis Management System
The New York City Mission Society is one of the oldest nonprofit human services organizations in New York City and serves as the host organization for the Harlem Cure Violence program. The organization has been providing services to the most under-served children, youth and families since 1812. The Mission Society offers educational and mentoring programs, teenage pregnancy prevention programs, child abuse and foster care placement prevention programs, and reentry programs for the predominantly African-American and Latino population in Harlem and the Bronx.
The Mission Society has been running a Cure Violence program since 2010. The program was funded initially by New York State and then by the Mayor’s Fund to Advance New York City. In 2012, the agency began to implement the wrap-around component of the New York City crisis management system to combat gun violence. The Mission Society’s Cure Violence office is located at 653 Malcolm X Boulevard, which is within the program’s catchment area, extending from 127th Street to 145th Street between Lenox and St. Nicholas Avenues.
Cure Violence Component
The Harlem Cure Violence program staff includes the Director of preventive services and the Harlem SNUG initiative (“Guns” spelled backwards), the program manager, six outreach workers, the supervisor of outreach workers, and five hospital responders (three of whom are also violence interrupters).
The credibility of all members of the staff is essential in implementing and carrying out the Cure Violence model. For this reason, hiring panels are assembled during the recruitment phase of each of the staff members. A hiring panel involves a set of community stakeholders who can vouch for the street credibility of potential candidates. This practice fashions a team of culturally sensitive workers who are able to reach out to the young people who may be involved in gun violence.
Members of the Harlem Cure Violence staff receive official training from the national Cure Violence team. The training consists of an intensive week-long seminar in which the staff learns about the Cure Violence model. Role playing is an integral part of training. The Violence Interrupters must know how to respond to any type of situation. Practicing in a mock situation helps them to be prepared to react quickly in actual life-threatening situations. The team literally takes turns role playing the Cure Violence staff member and every type of possible participant (e.g., gang member, bystander, student, bully). During the training, outreach workers learn to consider the stage of development and maturity of the youths that they are working with, as well as their strengths and weaknesses.
Violence interrupters identify and mediate violent conflicts among high-risk youth. They form relationships with the major crews and key players in the neighborhood who are likely to engage in gun violence. While canvassing each block, they might attend basketball games, go to local parks, and merely hang around the neighborhood. Violence interrupters also use social media sites (i.e. Facebook, Twitter, and Instagram) to discover potential conflicts that they can mediate. For example, a large group of neighborhood youth was recently filmed while preparing to fight. The videos were posted on social media sites, and the violence interrupters were able to prevent the fight from happening. Violence interrupters are on call 24 hours a day, 7 days a week.
Outreach workers contact the high-risk individuals identified by violence interrupters. Each outreach worker carries a caseload of 15 participants who are thought to have a high likelihood of future involvement in gun violence. Once a youth agrees to work with the Harlem Cure Violence program, an outreach worker conducts a violent behavior risk assessment. The outreach worker then develops a risk-reduction plan and begins to link the participant to whatever services and opportunities might best meet their needs. Outreach workers, according to the Cure Violence staff, are like “street social workers.” They spend a significant portion of their working hours on the streets making sure that their participants are staying away from violent situations and are engaged in pro-social activities (i.e. school, job training program, playing sports). They conduct home visits and make at least six face-to-face or phone contacts per month with each participant.
Outreach workers and violence interrupters work collaboratively on the daily operations of the program and to create a daily “game plan.” The game plan is essentially a guide to the daily activities that staff should follow. The game plan suggests particular areas to canvass and the staff members who should participate in canvassing. Violence can erupt at a moment’s notice in high-risk areas, so the perceptions of current danger in a given area help to determine how many individuals are assigned to each area at any given time. At the end of each evening, outreach workers and violence interrupters regroup to discuss the operations of the day, sum up the outcomes of the game plan, and devise the steps to take the following day. During the course of these meetings, the staff also writes up the day’s case notes and completes conflict mediation logs as necessary.
Violence interrupters and outreach workers distribute public education materials to inform the community about their work. This information notifies the public about the Cure Violence model and helps to initiate conversations with youth in the community. The public education materials inform community members and organizations about gun violence in the neighborhood and they urge residents to be “part of the solution” by joining and participating in program activities.
Mental health services for staff: Cure Violence staff members sometimes experience traumatic events in the course of their work day. This results in high burn out rates and heightened stress levels. The New York City Mission Society developed a relationship with a consulting firm that will work with the Department of Health and Mental Hygiene to provide motivational interviewing and support to staff members. In addition, the Mission Society hosts a professional development series to discuss trauma, self-care, how to handle stress, how to make the transition from street life to employment, and the effects of race and gender on the relationships of staff members.
Data orientation: The Harlem Cure Violence program staff enters data into the Chicago Project for Violence Prevention (CPVP) database. The Cure Violence staff also sends monthly data reports to the DOHMH. According to information from the CPVP database for July 2012 through June 2013, outreach workers in Harlem served a total of 131 participants.
Hospital Component
Beginning in January 2012, The New York City Mission Society partnered with Harlem Hospital Center to implement the hospital component of the Cure Violence model. The hospital component enables trained program staff members to respond immediately to violence-related trauma cases at Harlem Hospital Center. Cure Violence staff members provide follow-up services to patient/participants, their family members, and even their friends as appropriate. Establishing contact at the hospital following a violent incident allows the staff to capitalize on the time when victims are most reflective about their experiences and when they are often open to intervention. Violence interrupters and outreach workers are also able to offer support to victims and to preempt retaliatory violence.
New York City Mission Society employs two “hospital responders.” They react to all emergency trauma cases related to assaults, shootings, and stabbings in the neighborhood. The two staff members are on-call 24 hours a day because their primary goal is to prevent retaliation. Hospital responders receive special training from the Harlem Hospital Center to ensure that they understand hospital procedures and protocols. Similarly, hospital staff members learn about the purpose, process and goals of the Cure Violence model.
Wrap-Around Component
The New York City Mission Society staff is supportive of the implementation of the New York City crisis management system and believes it has enhanced the Cure Violence model. The Harlem program offers wrap-around services for the youth, their family, and the community as a whole. Wrap-around services consist of the following:
Mental health: One of the key goals of the wrap-around services component is to provide mental health support to neighborhood residents. According to the staff of the Harlem program, the local community is often inclined to resist mental health services and people typically avoid following through with mental health referrals. The Cure Violence program attempted to adapt its approach with a less conventional, community mental health model. The Mission Society does not insist on a traditional treatment approach in which each client meets regularly with an individual therapist. Participants can see a social worker in any moment of crisis. This service is free and does not require enrollment in any other aspects of the program. Mental health services at the Mission Society focus on changing a client’s perceptions of guns and the consequences of gun violence. The goal is for staff to form a relationship with participants and to encourage them to seek help before they reach a stage of crisis. If a participant needs specialized services, like substance abuse treatment, the New York City Mission Society refers them to the Fortune Society. Additionally, the Mission Society partners with Harlem Mothers Save, which works with parents who have lost children to violence.
Job readiness and training: The New York City Mission Society runs the Keeping Every Youth Successful (KEYS) program, which provides youth with vocational assistance and educational supports. The staff helps participants to explore career options, to develop individualized paths to success, to identify barriers to success, and to find solutions to overcome such barriers. Participants learn interviewing and communication skills, as well as career planning skills. The staff identifies and connects participants to their next educational step (in-school support, GED prep, postsecondary, etc.). Participants are placed in internships and are assisted in finding employment. The program also has a community service component. Staff works with community organizations to identify community service projects and to coordinate the involvement of Cure Violence participants. Program participants are chosen for participation in KEYS based on the extent to which they have shown positive change in their behavior and a willingness to work on community service projects. As of spring 2013, seventeen participants were enrolled in the KEYS program.
Conflict mediation: The Harlem Cure Violence program staff provides conflict mediation in local schools, including the Bread and Roses Integrated Arts High School. The program consists of weekly workshops on bullying and domestic violence prevention techniques, mediation and conflict-resolution skills, how youth can build self-confidence, and how they should interact with the police to avoid conflict. The program relies partly on youth who are trained in peer mediation. Fifteen youth were enrolled in the peer mediation program in the 2013 spring semester. Under the supervision of Cure Violence staff and school officials, peer mediators facilitate non-violent disputes among students. The program focuses on high-risk students identified by school officials, but Cure Violence staff offers mediation services to the entire school as needed.
Legal services: The Legal Aid Society in Harlem provides legal services and advice to Cure Violence participants and their families, as well as community legal education.
Strengths and Challenges
The success of the Harlem Cure Violence program builds upon effective coordination between the host organization and the key agencies and organizations in the Central Harlem community. The NYC Department of Health and Mental Hygiene (DOHMH) monitors the implementation of the program and ensures that the site maintains fidelity to the Cure Violence model. The DOHMH provides the Cure Violence team with regular technical assistance and feedback on implementation. Similarly, the City Council Task Force assists the Harlem Cure Violence team with periodic support. Additionally, the city supports coordination between all the sites that are implementing the crisis management system in NYC. The Mission Society has weekly phone calls and a monthly meeting with all of the other NYC sites. DOHMH coordinates and hosts these meetings.
The Harlem community has been supportive of the implementation of the crisis management system. Community members report to the Harlem Cure Violence staff that they have voluntarily engaged in conflict mediations in the neighborhood by following the model of Violence Interrupters. Parents of youth from the neighborhood have stopped staff members on the street to tell them about how their children have utilized the knowledge and skills that they have learned from violence interrupters and outreach workers.
Staff from the Harlem Cure Violence program agrees that implementing the crisis management system has enhanced its methods for combating gun violence. Staff members mention obstacles as well, however, including the challenges of developing, documenting, and running multiple programs simultaneously. Staff members feel as if they are being pulled in several different directions at once, and the sheer volume of assigned tasks can become overwhelming. In addition, the program has struggled to serve its entire catchment area (73 square blocks) and the staff expresses concern that there are insufficient resources to cover such a large and densely packed area. Nonetheless, staff members remain optimistic and devoted to the goal of reducing shootings and killings in Harlem.