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Community Health

How One Hospital Works To Improve The Lives of Violent Crime Victims

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Keith Smitherman works as a violence intervention specialist for Prescription for Hope. The program is run out of Eskenazi Hospital and connects victims of violent crime to social workers who help connect them to career and educational opportunities.

On a recent hot day in Indianapolis, Keith Smitherman made a stop at an apartment complex in one of that city's most violent neighborhoods, near 38th Street and Sherman Avenue. He was there to deliver food vouchers to a young, pregnant mom, and he got invited to the baby shower.

“I ain’t coming to no baby shower,” Smitherman said with a smile, before getting back into the car.

It was really hot that day and I was sweating into the seat of his car—and he told me, in his work, temperature matters. “People start getting shot more as it starts getting warmer,” he said.

This is the time when they're real tender and ready for some kind of intervention.

Violence in Indianapolis is on the rise. With 222 non-fatal shootings and 53 homicides as of mid-June, 2016 is trending toward being one of the worst on record. 

And a lot of victims of violent crime end up at Eskenazi Hospital, the city's public hospital. Smitherman works there for a program called Prescription for Hope that's trying to tackle the violence.  

When someone lands in the ER for a violent injury, like a gunshot or a stabbing, Smitherman, one of the program's violence intervention specialists, appears in their room to talk to them.

It’s easier to reach out when someone has been that close to death.

“It's the teachable moment,” he said. “This is the time when they're real tender and ready for some kind of intervention.”

Getting At the Root

Prescription for Hope got started in 2009, when doctors at Eskenazi noticed a problem: The emergency department had a lot of repeat customers.

“It was not uncommon that we’d have a person who might be a victim of violent trauma, and within a three-to-five year time period, there was a 30 percent chance or higher of them coming back,” explains Clark Simons, a trauma surgeon at Eskenazi who helped start Prescription for Hope.

He says they realized the young people coming in with gunshot wounds were nearly always involved in crime because they had few other choices.
 
“For some, that’s the only option they have to provide for their family,”  he says. “So poverty itself is a public health issue.”

Teenage impulsiveness is often blamed for youth violence, but according to recent research from the Center on Juvenile and Criminal Justice, poverty is the root cause of violence. Poor neighborhoods tend to have worse schools, lower graduation rates. And, if you’re black, multiple studies have shown it’s harder to get a job. Connecting people with jobs, education and insurance can help lift them out of poverty, and tackling poverty may be one way to tackle violence.

It just seemed like it could bring change.

 From bullets to big trucks 

Smitherman works with young people, between 14 and 30. Most are black males, and they’ve grown up poor. Smitherman helps them with signing up for insurance, finding a job, finishing their education. “It's important to us that they go get their GED.” he said. “The only way to get a good job that you’ll keep is to get some education.”

One of the program’s participants is Tyler Wilson, a 23-year old who used to sell drugs. He lives in an apartment with his sister on the east side of Indianapolis. Last year, he was at a friend’s house when someone pointed a gun to his head, demanding money. Wilson fought back.

“The bullet's actually still in my leg right here,” he said. “I can feel it with my fingers.”

Before the incident, Wilson had been arrested for possession, which made him want to change his life. He was shot shortly after bonding out of jail, which put him in the hospital for almost a month. That’s when Smitherman showed up and told him about Prescription for Hope. Wilson was hesitant at first but eventually agreed to join.

“It just seemed like it could bring change,” he said.

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Tyler Wilson was shot during a robbery last year. The bullet entered near his knee and is still embedded in his leg.

Wilson needed help getting a job, so he could pay his bills without falling back on selling drugs. He says Smitherman pushed him every step of the way, and he’s now in the process of getting his commercial driver’s license, so he can drive semis.

“I always wanted a CDL,” he said. “But I probably wouldn’t be getting it so soon.” Prescription for Hope paid for his training.

Small victories

Eskenazi modeled Prescription for Hope on other successful violence intervention programs around the country designed to reach out to crime victims.

“Most of these individuals, they're asking for help,” says Simons. “As a healthcare professional, I think it is our obligation to help our patients.” 

And Eskenazi says the program’s working: Just 4.6 percent of program participants end up back in the ER.

But it’s not zero, a fact that eats at Smitherman.

After taking a bullet to the leg while dealing drugs and landing in the ER, Tyler Wilson, 23, joined a hospital-run program that helped him train for a commercial driver's license.
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Tyler Wilson, 23, lives on the east side of Indianapolis. He joined Prescription for Hope last year and is now working on getting his commercial driver's license.

“We’ve had one guy killed after he joined the program.” he says. “That’s about as big a failure as you can have, so that one really bothers me.”

There are thousands of violent crimes each year in Indianapolis. The program can’t reach everyone.  

Smitherman and the other social workers can only work with people who come into the hospital, or sometimes their family members. They can’t help the people who call their office, asking to enroll. They can’t help others who might need need help getting a job or signing up for insurance or paying for groceries.

So Smitherman celebrates the small victories for the people he is able to help.

“For some people, not coming back to the hospital, not getting injured again is a huge success,” he says. “For some people, just getting a job is a huge success. For some people, just getting insurance is a huge successThe success is relative.”

“To have so few come back with a violent injury,” he said, “shows the program is highly successful.”

This story was produced by Side Effects Public Media.