Community confronts trauma


‘Second responder’ team to offer immediate support to those coping with violence

JACKSON SQ.—Violence has become a regular part of Jim Cote’s life.

“I lived in Jamaica Plain and West Roxbury for years, but I have never been so connected to how violence affects the community as I have been working this job,” the Martha Eliot Health Center (MEHC) executive director said.

Cote started at the health center on July 1 of last year. “I had been on the job for two weeks last summer when two children of staff members at the center were shot.” Since then, “not a week has gone by when a patient or staff member hasn’t been impacted by a violent episode in the city,” he said.

“I am an administrator, not a clinician,” Cote said. Over the past year he has had to learn how to respond constructively to traumatic circumstances on the fly.

But now, Cote, along with about 45 other people from 14 organizations around Jamaica Plain, are taking steps to learn how to do effective trauma response.

The organizations involved include MEHC and the Dimock, Brookside and Southern Jamaica Plain community health centers; Spontaneous Celebrations; Bikes Not Bombs; the Hyde Square Task Force; and the Bromley-Heath Tenant Management Corporation (TMC), among others. Their plan is to set up a team of “second responders” who would be able to provide immediate support to friends and family members of victims of violence.

The team would find out about an incident from the community or the police, Cote said. After the first responders—police, EMTs and the like—had cleared out, “our group would go in next.”

It will be “a team that is well trained and will be able to intervene in situations in the community,” said Bromley-Heath TMC director and Academy/Bromley/Egleston Safety Task Force member Mildred Hailey.

Planning for the team began last September, and trainings began this month with a grant from Children’s Hospital Boston, which runs MEHC.

The development of the team is still in early stages, Hailey said. “This one training was by no means all that was needed. We will have more trainings and then start to develop a team game plan.”

Dr. Robert Macy, founder and director of the Boston Center for Trauma Psychology, is conducting the trainings. According to press materials, Macy is a “pioneer in the field of traumatic incident stress interventions and violence prevention initiatives for youth, families and communities exposed to traumatic events, including large-scale disasters, terrorist events, and political, community and armed conflict violence.”

While Macy himself was not available for an interview with the Gazette, many who participated in the training spoke very highly of him.

Once the team is formulated, Cote said, Macy will lead the first few trauma interventions it undertakes. In addition to Macy’s expertise, the planning process is also benefiting from input from community members who have had to deal with trauma in the past.

Jacqueline Rue is a MEHC staffer taking the training whose son narrowly escaped death from a gunshot last summer. [See sidebar.]

The idea for a trauma response team originated with the Academy/Bromley/Egleston Safety Task Force in the course of broader conversations about violence and mental health issues, Hailey said.

“One of the things we have talked about is the need for mental health services in the community. Mental health and violence go together. Tragic situations in life bring a lot of trauma,” Hailey said.

Historically at Bromley-Heath, support for people dealing with trauma has been undertaken by “one or two people doing the best they can,” she said.

Community groups around JP are “already doing a lot,” she said, “but with a little more structure and training, they could be 10 times more effective.”

Seth Kirshenbaum, who helps run youth programs at Spontaneous Celebrations, said what he recently learned in the training would have been helpful a few months ago.

A number of youths who participate in Spontaneous Celebrations programs were close to Luis Troncoso, who was shot to death April 21 on a Southwest Corridor Park basketball court near the Spontaneous building at 45 Danforth St.

If something like that happened today, Kirshenbaum said, he would make sure to “separate people who have experienced direct trauma from people who have not,” because people’s experience and expression of vicarious trauma can potentially make the problem worse.

He would also know to have a team ready to do the support work. The rule, Kirshenbaum said, is “two is one, and really three is one…You have to make sure there is someone not doing direct work who can step back.”

That way, he said, if someone in a group of people dealing with trauma gets upset or there is a conflict, one responder can split off from the group and talk to that person.

“Good trauma response within the first moments, first 48 hours and first week [after a crisis] can lead to a really different lifetime. Dealing with that pain and anger is part of the healing process and could lead you down a dark path or toward a positive light and a positive lifestyle,” he said.

Kirshenbaum did note that his impression is that youths who were close to Troncoso seem to be doing better than some adults who were close to him. He speculated that having community support, even untrained support, has played a role in that.

Trauma response is somewhat of a watchword these days “within the youth worker field,” Kirshenbaum said. At the same time, he said, he hopes that eventually youths themselves are trained in trauma response work, and that they would be able to get other members of their families involved.

“Currently there are not enough people in [professional] youth worker and street worker positions who are in a position to make an impact” reaching out to youths who are not directly involved in community organizations, he said.

“Young people and their families are more trusted and would be more likely to be let into the inner circle,” he said.

He also said that the needs of traumatized youth are sometimes different from the needs of adults.

“It’s really a matter of where people are at in their lives,” he said. “Young people might not be as emotionally developed or experienced and not as able to identify their own needs. What they might need to calm down is to have some food and water, but instead they are getting drunk and talking about shooting people.”

Cote and Hailey both said that the group organizing the trauma response team is planning to hold youth trainings after the first team is up and running.

How to effectively reach youths is one of many complexities organizers likely will face in developing an effective community trauma response system. “It will take a little time to develop in a genuine way,” Kirshenbaum said.

And, at the moment, it seems like a good chance resources will be there to help that system develop.

MEHC will continue to seek funding to support the initiative through Children’s Hospital, Cote said. That would include funding for a paid community trauma response coordinator, he said.

MEHC and the Academy/Bromley/Egleston Safety Task Force are also planning to develop other programs that would focus on violence prevention and other mental health services, he said.

At the city level, the Boston Public Health Commission (BPHC) is currently looking for funding to hire a citywide trauma response coordinator, and it plans to develop a standard trauma response protocol, BPHC staffer Courtney Gray told the Gazette.

BPHC is supporting the JP effort, along with three or four other similar neighborhood efforts around the city, he said.

“Neighborhoods are really strong where health centers are taking a leading role,” Gray said, “That’s what you see in [JP].”


When Trauma Strikes a Professional Personally

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