Meet Franklin Cosey-Gay, PhD, UChicago Medicine's new Violence Recovery Program Director

The University of Chicago Medicine’s Violence Recovery Program (VRP) helps trauma patients and their families, providing everything from wraparound care, crisis intervention, psychological first aid, social support, case management and connection to community-based social services.

Launched in 2018 when the South Side health system opened its Level 1 adult trauma center, the VRP has engaged more than 5,700 patients and families by helping them while they’re in immediate crisis and supporting them as they navigate a complex system in the days, weeks and months after an injury.

The work is critical because research shows survivors of intentional violence are at higher risk of being re-injured or injuring someone themselves. But as gun violence climbs in the city, so does the program’s caseload.

Franklin Cosey-Gay, PhD, former director of the Chicago Center for Youth Violence Prevention, took over as VRP director in November 2021. Here he explains the importance of partnering with the community, building resiliency and coordinating the smartest minds to get things done.

You grew up 10 blocks south of the University of Chicago. How did you become interested in public health?

My dad drove a CTA bus while he was working on his accounting degree, and I would ride with him when I was off of school. One thing that always compelled me was how segregated the city was. On the 39^th Street bus, I saw the housing projects when we went across the Dan Ryan Expressway. Later I learned about structural racism and how housing projects were used to contain Black residents and how the Dan Ryan expressway disrupted existing Black communities became a dividing line between Black and white residents.

In my neighborhood, I noticed that my friends’ parents were losing their jobs, and though I didn’t call it public health, I knew there something impacting the healthiness of the community.

As a student at the University of Illinois Chicago, I became interested in looking at these structural issues and how social ecology impacted the health of young people. I began conducting research with Deborah Gorman-Smith (now dean of UChicago’s Crown Family School of Social Work, Policy, and Practice), looking at violence prevention in several ways. That included implementing and evaluating family-based programs to understand how supportive family networks can buffer against common youth behavior outcomes. We also looked at classroom-based interventions. That's when we realized violence prevention work needed to go beyond family programs to address structural roots that impact the health of communities. That included things like Chicago’s history of school closings, destruction of public housing and the disappearance of work. I received my master’s in public health in 1998 and my PhD in 2019.

You’ve been with UChicago since 2009 and were formerly the director of the Chicago Center for Youth Violence Prevention. How did that help prepare you to lead UChicago Medicine's violence recovery program?

Our work at UChicago began with trying to understand the nature, distribution and causes of community violence. We also wanted to examine factors promoting positive outcomes for urban youth whose communities have been impacted by those major structural constraints. We evaluated programs like Cure Violence, which uses street outreach to reduce shootings while connecting residents to mental and behavioral health support (along with other resources for housing, jobs and education). Then in 2015, we began working with Pastor Chris Harris from Bright Star Community Outreach, which showed me the power of convening organizations to strengthen communities. It was that work, and those two experiences, that really formed the foundation for my work with UChicago Medicine's Violence Recovery Program.

Through the violence recovery model, team members work with patients and their families from the moment they are admitted to the hospital to connect them with other programs and agencies. How is that unique among hospital programs?

At UChicago Medicine, we have six teams that are part of our violence recovery work. They include spiritual care, child life, social work, psychological and clinical programs and our violence recovery specialists. We all work together to provide crisis intervention, risk and need assessments and case management for patients and families affected by intentional violence. Our partners, which include dozens of community organizations, help patients with their comprehensive recovery. They’re an essential component, because recovery can’t just happen at the hospital. In fact, our level of coordination both within the hospital and among our community partners makes us unique among hospital-based violence intervention programs.

As you take on your new role as director of the violence recovery program, what challenges does the team face?

UChicago Medicine’s trauma center is seeing an increase in patients, which leads to an increase in people engaged by our program. In fact, our team saw a 24% increase in patients using our services in 2021.

When we started the VRP in 2018, we only had two violence recovery specialists. They provided immediate support to patients and families after someone came into our emergency department with an injury from intentional violence. Now we have 15 violence recovery specialists who provide 24-hour coverage. And we hope to increase that number even more as we expand to cover outpatient follow-up visits.

As the number of patients grows, I also recognize the impact of this work on the frontline staff doing crisis intervention and case management. Summer is coming, and with it, the typical seasonal increase in violence and traumatic injuries. We want to make sure we focus on the wellness and morale of our staff before we see the summer's caseload increases. We also recognize that our partners are overwhelmed. How can we help build capacity for mental health wellness and resiliency within those organizations, too? Sharing assets with partners is important to help build trust in the community.

UChicago Medicine’s violence recovery program has been around for more than three years — what are your goals for the future?

This program has been amazing, but it is still very young. We need to understand the right metrics to measure the impact we are having, beyond just caseloads. So far, we know we’ve been able to have contact with more than 5,700 patients and families. But what are other measurements we should be looking at? For example: Housing is a big indicator of safety and many patients are discharged right back into the setting where they are at high risk for re-injury. So what are the outcomes of survivors related to their housing? Then there are things like building skills to maintain jobs and overall resiliency. We want to do more research to demonstrate the impact of the program and we want to have equitable collaboration in the research. That means involving our frontline staff in the research process.

You emphasize coordination and collaboration to help survivors of intentional violence. How is that important?

We have so much talent in this institution and with our community partners. That excites me. Let’s share the UChicago and UChicago Medicine brain power with our community partners so everyone can be stronger.

My ultimate goal is that 20 years from now, they will tell the story of how we coordinated with community partners, researchers and experts in the field to create a comprehensive approach that finally reduced violence. We want to embed these structural resources so victims of violence always have access to legal aid clinics, housing resources, and meaningful workforce opportunities. That would reflect the institution's commitment not only to the South Side but to the city in general.