“Only with gun violence do we respond to repeated tragedies by saying that mourning is acceptable but discussing how to prevent more tragedies is not. But that’s unacceptable. As others have observed, talking about how to stop a mass shooting in the aftermath of a string of mass shootings isn’t ‘too soon.’ It’s much too late.”
– Ezra Klein, American journalist, political analyst
President Joe Biden is calling for $5 billion over eight years for “evidence-based” community violence-prevention programs – or programs that treat gun violence as a public health crisis, rooted in economic insecurity and chronic trauma, rather than as a problem best solved by law enforcement. The projects would target economically distressed neighborhoods where Black and Latino people are disproportionately affected by gun violence.
Researchers have identified several types of community-led programs they say help curb shootings sparked by arguments, drug rivalries and gang conflicts. All have one theme in common: the importance of identifying the people who are most at risk of shooting someone or becoming victims themselves and giving them intense help — from housing to employment to mental health services, including care for the psychological trauma that makes violence contagious.
“Every day in the United States, more than 200 people are murdered or assaulted with a firearm. Little research has considered the role of interpersonal ties in the pathways through which gun violence spreads.”
Social contagion accounted for 63.1% of the 11,123 gunshot violence episodes analyzed, leading to the shooting of 9,773 individuals, some more than once. According to the study, co-offenders – who typically share preexisting social ties with their "infector" (the person most responsible for exposing the subject to gun violence) – were shot, on average, 125 days later.
The Journal of the American Medical Association (2017) found that when one co-offender becomes a victim of gun violence, the likelihood of the other co-offender being shot increases.
JAMA concludes gunshot violence follows an epidemic-like process of social contagion that is transmitted through networks of people by social interactions. Violence prevention efforts that account for social contagion, in addition to demographics, have the potential to prevent more shootings than efforts that focus on only demographics.
(Ben Green, Thibaut Horel, and Andrew V. Papachristos. “Modeling Contagion Through Social Networks to Explain and Predict Gunshot Violence in Chicago, 2006 to 2014.” JAMA Intern Med. 2017.)
At last, a concentration on an evidence-based approach to curbing gun violence. Biden's final plan is in the works. Which violence prevention programs deserve the money? Here are four of the contenders.
(Jon Schuppe. “Biden wants to give anti-violence groups $5 billion. Here's how it could be spent.” NBC News. April 14, 2021)
Note: Read Schuppe's entire article here by clicking here: https://www.nbcnews.com/news/us-news/biden-wants-give-anti-violence-groups-5-billion-here-s-n1263990#anchor-Violenceinterrupters.
1. Focused Deterrence
Created in Boston in the 1990s, the focused deterrence model brings together police, prosecutors, outreach workers and service agencies, who identify the people most at risk of being affected by gun violence. The people are called into a meeting and are offered help – jobs, housing, health care – and warned that if they reject the help and are involved in violence, they’ll be targeted for law enforcement crackdowns.
These strategies seek to change offender behavior by understanding the underlying violence-producing dynamics and conditions that sustain recurring violent gun injury problems and by implementing a blended strategy of law enforcement, community mobilization, and social service actions.
Researchers have found that the method can dramatically reduce shootings. It has succeeded in Oakland, California, where it was credited with helping to cut homicides in half from 2012 to 2018. (As in many big cities, homicides increased in Oakland last year.) But community activists in some cities have argued against the use of focused deterrence because of its reliance on police, which they say can damage public trust.
Cities including Philadelphia and Baltimore dropped their programs years ago after funding and elected officials’ interest waned, though they have recently decided to try again in response to rising homicide rates. The cost of the programs in Philadelphia has been estimated at $750,000 a year, and about $600,000 in Baltimore.
“When done well, it can be an effective strategy, but it should never be done absent services,” said David Muhammad, executive director of the National Institute for Criminal Justice Reform, which helped Oakland develop its program. “Enforcement should be a last resort.”
(Jon Schuppe. “Biden wants to give anti-violence groups $5 billion. Here's how it could be spent.” NBC News. April 14, 2021)
The available scientific evidence suggests that these new approaches to violence prevention and control generate gun violence reductions. The positive outcomes of the existing body of evaluations indicate that additional randomized experimental evaluations, however difficult and costly, are warranted.
(Anthony A. Braga1 and David L. Weisburd. “Focused Deterrence and the Prevention of Violent Gun Injuries: Practice, Theoretical Principles, and Scientific Evidence.” Annual Review of Public Health Vol. 36:55-68. March 2015.)
2. Violence Interrupters
This method centers on outreach workers – people with street credibility, often people who have spent time in prison or who have past involvement in gun violence. Trained in crisis intervention, they develop relationships with high-risk people and keep an eye out for simmering disputes, stepping in to help people resolve them before someone fires a gun. The workers also try to steer people into social services.
(Jon Schuppe. “Biden wants to give anti-violence groups $5 billion. Here's how it could be spent.” NBC News. April 14, 2021)
Interrupter programs, developed at the University of Chicago, have been credited with reduced violence in several big cities. From 2010 to 2019, data shows the Crisis Management System has contributed to an average 40% reduction in shootings across program areas compared to 31% decline in shootings in the 17 highest violence precincts in New York City.
But researchers say the model can falter if workers aren’t given enough training or technical assistance, or if officials don’t commit to it for the long term. In New York, Mayor Bill de Blasio agreed last year to spend $10 million to expand Cure Violence into four high-crime areas.
(Jeffrey A. Butts, Caterina Gouvis Roman, Lindsay Bostwick, and Jeremy R. Porter. “Cure Violence: A Public Health Model to Reduce Gun Violence.” Annual Review of Public Health Vol. 36:39-53. March 2015)
3. Hospital-Based Intervention
Hospital-based anti-violence programs focus their attention on emergency rooms. While the victim is still receiving treatment, intervention specialists try to dissuade them from seeking retaliation. They also steer victims toward long-term help, not only with their wounds, but also with mental health care, substance abuse treatment, job placement and housing.
(Jon Schuppe. “Biden wants to give anti-violence groups $5 billion. Here's how it could be spent.” NBC News. April 14, 2021)
Proponents say engaging patients in the hospital, during their recovery, is a golden opportunity to improve lives and reduce retaliation and recidivism. The support network continues once patients are released with a pathway for outpatient care and other services.
A study of one such program, at the R. Adams Cowley Shock Trauma Center in Baltimore, found participants less likely to commit crimes. The program also cut costs of incarceration and health care.
(Carnell Cooper, Dawn M Eslinger, Paul D Stolley. “Hospital-based violence intervention programs work.” J Trauma. September 2006.)
Researchers and health professionals engaged in designing patient-focused interventions need to consider barriers and facilitators across all three identified domains-- system, staff, and intervention – to increase the likelihood of implementation success. The interrelationships between domains are also crucial, as resources in one area can be leveraged to address barriers in others.
(L. Geerligs, N.M. Rankin, H.L. Shepherd, et al. “Hospital-based interventions: a systematic review of staff-reported barriers and facilitators to implementation processes.” Implementation Sci 13. 2018)
4. Cognitive Behavioral Therapy
The cyclical nature of gun violence – beefs that boil over into shootings, which spark retaliatory attacks – is driven by chronic trauma that makes people constantly fear for their lives and use firearms to solve problems, experts say. Cognitive-behavioral therapy (CBT) refers to a class of interventions that share the basic premise that mental disorders and psychological distress are maintained by cognitive factors. The basic model posits that therapeutic strategies to change these maladaptive cognitions lead to changes in emotional distress and problematic behaviors.
Cognitive behavioral therapy teaches people to come to terms with their trauma and reject violence as a way of resolving disputes. Outreach workers act as life coaches and mentors, maintaining close contact over months or years.
One version, called Advance Peace, pays clients for reaching certain goals. A recent study found it helped drive down gun violence in several California cities, costing them from $375,000 to $450,000 a year. Another version, READI Chicago, has shown promising early results in keeping clients engaged and out of trouble.
Finally, one review identified 11 studies that compared response rates between CBT and other treatments or control conditions. In 7 of these reviews, CBT showed higher response rates than the comparison conditions, and in only one review (Leichsenring & Leibig, 2003), which was conducted by authors with a psychodynamic orientation, reported that CBT had lower response rates than comparison treatments.
In sum, our review of meta-analytic studies examining the efficacy of CBT demonstrated that this treatment has been used for a wide range of psychological problems. In general, the evidence-base of CBT is very strong, and especially for treating anxiety disorders. However, despite the enormous literature base, there is still a clear need for high-quality studies examining the efficacy of CBT.
(Stefan G. Hofmann, Anu Asnaani, Imke J.J. Vonk, Alice T. Sawyer, and Angela Fang, “The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analyses.” Cognit Ther Res. February 28, 2013.)
“Historically, the federal government’s approach, particularly when faced with surges in gun homicides, is to fund strategies that over-police. The Biden administration demonstrated a commitment to addressing the root causes.”
– Paul Carillo, community violence initiative director for the Giffords Law Center to Prevent Gun Violence
Conclusion
For President Biden, a longtime proponent of tighter regulations on firearms and police crackdowns on gun crimes, the “evidence based” community violence-prevention programs are a response to Black leaders’ demands that the violence in their communities receive the same attention as mass shootings, and that residents of their communities have more say in how to make them safer.
Anthony Smith, executive director of Cities United, a Louisville, Kentucky-based nonprofit that helps mayors develop public safety initiatives, says …
"This is an opportunity to redefine what public safety means. This country has been used to working one way, which works for white people and not for Black people, for wealthy people and not for poor folks. So, we need to put resources behind strategies and solutions we know will work for everyone.”
(Jon Schuppe. “Biden wants to give anti-violence groups $5 billion. Here's how it could be spent.” NBC News. April 14, 2021)
Gun violence prevention advocates like Fatimah Loren Dreier of the Health Alliance for Violence Intervention share that goal. Dreier says …
"It's incredibly important that these funds be directed to communities that are disproportionately impacted by violence, and that there is ease of access for community-based organizations that are doing the most effective work on the ground. We can't emphasize enough that we want to make this a frictionless transfer of resources to those who are doing the most powerful work."
John Feinblatt, the president of Everytown for Gun Safety, praised the Biden proposal as "extraordinary" but called on the administration to multitask.
"To meaningfully reduce gun violence, we have to both close the loopholes in our gun laws and invest in proven solutions," Feinblatt said. "Congress should move quickly on both tracks to deliver the results the public deserves."
(Juana Summers. “$5 Billion For Violence Prevention Is Tucked Into Biden Infrastructure Plan.” NPR. April 01, 2021.)
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