Road to recovery: How an innovative community-centered program is helping children and families build lives after trauma
January 29, 2021
My name is Christine Goggins, and I'm a violence-recovery specialist at the University of Chicago Medicine.
The goal of our program is to be a direct support to individuals that have been victims of intentional violence, and we try to provide them with the tools that they need to make a comprehensive recovery. I got into this work due to losing someone to intentional violence. I met Blair when I was about nine or 10 years old.
He was just one of those people that you wanted to be friends with. We did everything together. Any free time that we had, we spent it together. On May 10, 2007, Blair was on a CTA bus. A young man got on the CTA bus and opened fire. Five people were shot. Blair was one of them. His friend was standing next to him on the bus, and he threw himself in front of her. He was shot in the abdomen one time, and the doctors did everything that they could do, but he passed away, unfortunately.
Blair's death totally changed my life. At the time, I wanted to be an ER doctor, but I realized I can't be the person giving a death notification to a family, and so I changed from emergency medicine to counseling. To work with people that have actually survived their injuries gives me hope and keeps me going in this work.
I treat my patients how I would have wanted Blair's parents to be treated when he was killed. I listen to a lot of our patients' stories because they matter. I let my patients know it's OK to not know what to do right now. We're focused in today, in this moment, and I'm here for you in this moment.
Our work with patients does not end when they are discharged from the hospital. That's actually when the bulk of our case-management work begins. And we're assessing patients for reinjury risk, for safety, and then linking them to the mental-health services that they need, helping them find employment, helping them find housing.
Patients need to know that somebody is there with them through their most vulnerable moments until the resilience shines through. I understand the angst of waiting to hear what happened to your loved one, what it's like to know that somebody died because of a violent injury, and I know the resilience that comes after going through an experience like that.
It's just the light at the end of a very dark tunnel. That's what resilience is.
Nina Johnson watched over her 17-year-old son, Romel, as he slept fitfully in a hospital bed, recovering from a gunshot wound in his stomach. After an argument, Romel had been shot by a friend of a friend, barely escaping with his life when the gun jammed before any additional shots could be fired. Nina prayed and held Romel’s hand, devastated and afraid for her son.
In the days after the shooting, Nina found a soothing presence in visits from counselors, violence recovery specialists, and child life specialists that are part of the University of Chicago Medicine’s BHC (Block Hassenfeld Casdin) Collaborative for Family Resilience. They visited Nina and Romel in the hospital soon after the shooting, offering support, information and counseling.
The BHC Collaborative helped Nina understand that after Romel’s physical injury healed, he would still have ongoing pain, nightmares and mood swings from post-traumatic stress disorder (PTSD). She said that the program was a “godsend” for Romel and for herself. It helped her know what to look for in her son’s recovery, and how she could be there for him. She is also learning how to better take care of herself.
While Nina gladly accepted this support, Romel needed some coaxing to be comfortable. Eventually, he opened up about his pain, anger and struggles after being shot.
“The program helped me a lot,” Romel said. He is learning to control his anger, he said, and now understands what it means to recover from violence.
Mainly, Romel was glad that people were there to help his mom.
“Everybody was just so nice and so kind,” Nina said, crying softly as she remembers the warmth of the BHC Collaborative’s staff. “Your mind isn’t right when you see your son laid up with stitches and staples.”
According to a 2019 Erikson Institute analysis, 30% of Chicago children under age 5 lived in neighborhoods that experienced more than 10 homicides; 7% lived in a community that experienced more than 30 homicides. Young people in Chicago are exposed to considerable community violence, which can lead to trauma and adverse health outcomes.
The BHC Collaborative started with a simple premise: children and their families affected by trauma should be treated holistically. Their wounds are psychological as well as physical.
In April 2019, the hospital received a $9.1 million gift from the Ellen & Ronald Block Family Foundation and the Hassenfeld Family Foundation and formed the BHC Collaborative. The BHC Collaborative provides personalized holistic care for the child and family in the medical center, which continues through discharge and recovery — and extends into the home, school and neighborhood through a network of community resources. This care is available whether the child is the immediate victim of trauma, or a witness to a parent or close family member’s trauma.
This model represents a dramatic shift in trauma care: Instead of providing only medical care to trauma patients, the BHC Collaborative’s approach includes wraparound services to help children and their families during and after their hospital stay. This means offering mental health and social service support, healthcare navigation, help finding childcare, and much more.
Thanks to the gift, the hospital has been able to significantly expand the scope and reach of its existing violence recovery program (VRP), facilitating integration with internal clinical resources and external community services. The VRP now helps patients and their families recover from other kinds of trauma — including domestic, sexual or child abuse. The BHC Collaborative also partners with community-based organizations to help people get housing, food, work, or to simply stay safe. Sometimes, because of threats of violence, people need to be relocated to another city; the program has helped them find new homes.
Brenda Battle, vice president of the Urban Health Initiative at the University of Chicago Medicine, said that one year after the gift, the medical center was able to triple the BHC Collaborative staff, as well as its reach. In addition to three violence recovery specialists and a violence recovery manager, the program now has five child life specialists working 24/7, a social worker, a chaplain, a child psychologist, two child psychiatrists, a data analyst, two trauma intervention specialists and two postdoctoral psychology fellows.
The program has helped nearly 2,000 people since it began, Battle said, meeting a greater number of patients soon after they enter the hospital — when they’re more likely to accept help. The program’s violence recovery specialists have engaged 83% more patients. Child life specialists — who work to ease children’s stress during hospitalization — have been able to engage 400 percent more patients since the launch of the BHC Collaborative.
“The gift has allowed us to accelerate our work in helping people who have been impacted by violence and trauma,” Battle said. “This means getting them into a recovery phase, helping them avoid being further injured or killed, and keeping their family from being harmed.”
Meeting patients and families as soon as they arrive at the emergency department has been the most rewarding job of Christine Goggins’ life. As a violence recovery specialist with the BHC Collaborative, she assesses the safety needs of patients and helps them recover from trauma. Goggins provides case management and helps patients with issues such as court advocacy, housing issues and emergency funding requests.
Goggins has been an advocate against gun violence since 2008, when she was 17 years old. That year, her best friend was shot and killed on a CTA bus while shielding another friend from gunfire. Goggins, sad and angry at the senselessness of her friend’s death, wanted to put her feelings toward something positive. A year later, she started advocating against gun violence and hasn’t stopped. But Goggins’ advocacy work is different with the BHC Collaborative.
Goggins compares her work to doing rounds, just as a doctor would. She meets with patients and their families, taking extensive notes — the patient’s age, what kind of injuries they have and how they’re feeling. On days when Goggins is on call, work can become hectic. When her pager beeps, as it does often during the summer, that means that there’s a new patient in the emergency department. She’ll head there to wait for medical staff, the trauma surgeon, police, family and anyone else she can speak with to gather information.
Once patients are conscious and their family is present, Goggins and a social worker introduce themselves, check in with how the patient and their family are feeling, explain medical procedures and next steps if needed, and assess their immediate needs. Goggins wants to be a friendly voice amid chaos. Sometimes patients and their family feel like talking — other times, they don’t want to talk or simply can’t.
“We don’t push the envelope,” Goggins said. “We just wait until the next day because they're in pain.”
Goggins continues checking in with patients, even when they don’t initially want to talk. Do they need any resources? Are they in danger? If so, she wants to help keep them safe — she’ll help find them new housing, if necessary. If patients want help, she and the social worker arrange hospital-based resources, such as trauma intervention and psychiatric assessment, or external resources, linking patients with services from Metropolitan Family Services (education and advocacy), Chicago Survivors (services for families of homicide victims), and the Heartland Alliance (health, housing, and jobs), among others. These are services patients wouldn’t likely know about without Goggins.
“It’s rewarding to help people in a time where they're at their most vulnerable, where they've lost all sense of control in their lives,” Goggins said. “And just being an advocate for these people — I cannot imagine a better job.”
In times of crisis, like the COVID-19 pandemic, BHC Collaborative partners have been essential in helping communities cope and recover.
Brenda Thompson is founder and CEO of The Branch Family Institute, another BHC Collaborative partner, which provides individual, family and group counseling, with a special focus on violence prevention for people ages six to 24. Specialists at the BHC Collaborative refer patients to The Branch Family Institute for treatment.
Amid the pandemic, as violence, stress and health troubles have increased, so too has the community’s need for help with mental health.
“You've got a traumatized community right now,” Thompson said. “People feel more fear as they’re dealing with increased violence, financial insecurity and uncertainty of employment.”
Thompson’s organization offers children play therapy — using video chats to play games — a common way therapists help young children deal with difficult emotions. Older patients receive culturally and trauma-informed therapy that allows them to connect with what makes them stronger, especially important during traumatic times.
Thompson’s organization is focused on reducing barriers to accessing treatment. For example, if a patient’s phone is disconnected, the institute’s therapists circle back to those who referred the patient – like Goggins at the BHC Collaborative — to follow up and ensure the patient receives help. This kind of collaboration has been critical, Thompson said, as the organizations work together to ensure that all patients who seek help can get help, even if their lives have been disrupted.
“Violence is a public health issue. Until we understand that, we will all suffer,” Thompson said. “The BHC Collaborative has been a wonderful partner in our efforts to support the community.”
“We want to work with other community-based organizations that are doing this work,” Battle said. “We want to break through any barriers preventing collaboration. And we want to help with the city's efforts to mitigate trauma and violence in people's lives. It will be a long journey. The systems that support this work are very fragmented. Most have not worked alongside hospitals at the level that the BHC Collaborative brings to reduce violent recidivism. As partners together, we can help close the loop that starts with injury to recovery.”
Over the next year, Battle will continue to strengthen partnerships with community-based organizations that provide wraparound support services to individuals and families who have been impacted by violence. She believes that more can be done when the BHC Collaborative works with other organizations and agencies that also provide violence recovery services — and that by working together, patients would be better supported in their recovery.
Another program the BHC Collaborative is working with is Centers for New Horizons, a South Side social service agency focused on workforce development and violence prevention, which was one of three community-based organizations to receive a capacity-building grant from the BHC Collaborative. Centers for New Horizons is using a portion of their $40,000 grant to hire a street outreach worker for the Washington Park and Grand Boulevard neighborhoods near the medical center.
Christa Hamilton, Centers for New Horizons’ CEO and executive director, says the new outreach worker will provide first-response support, outreach and intervention at crime scenes, hospitals and/or police departments. This outreach worker will also collaborate with community leaders to connect residents to employment resources and opportunities.
“Jobs stop bullets,” Hamilton said.
Hamilton believes that the umbrella of UChicago Medicine helps community organizations and nonprofits come together to prevent violence, address trauma and help the community.
“I've seen everybody look at these things differently, because we're all trying to solve it,” Hamilton said. “And we're realizing that we can't do it by ourselves in a silo.”
Breaking down silos and facilitating collaboration is the “genius of the program,” according to Ellie Hassenfeld Block who, with her family, provided the multi-year founding gift to launch the BHC Collaborative.
“Community collaboration is the highest priority and I’m glad to see that the gift is bringing these vital efforts together to make them even more powerful and effective,” Block said. “That’s something everyone has wanted to see happen for a very long time.”
Romel’s health has been steadily improving. Doctors told Nina that he healed much faster than most patients. Two months after the shooting, Romel was already walking without a brace. In July, he turned 18 and graduated high school.
Sometimes, Nina said, Romel may get angry or depressed, or have mood swings that she understands to be signs of PTSD. Romel isn’t the type to talk about his feelings but he’s opened up more than she expected. She credits the BHC Collaborative with making them both aware of how life after violence would be and for helping them find sanity amid the aftermath of the shooting. She hopes that the program can do the same for others.
“It has been a blessing for us,” Nina said.