'Prevention is not a luxury': Other cities taking a broad-based approach to fighting gun violence

July 15--Madison is far from alone in its struggle to address escalating gun violence.

Bigger cities that have suffered jumps in gun violence now look far beyond law enforcement, employing hospital-based and public health initiatives in an attempt to slow cycles of violence.

Milwaukee, which saw a 76 percent increase in firearm-related homicides from 66 in 2010 to 116 in 2016, spent 10 months creating a public health-based "Blueprint for Peace" that's now guiding actions in some of the city's most vulnerable neighborhoods.

"Prevention is not a luxury," said Reggie Moore, director of the Milwaukee Office of Violence Prevention. "It's essential to public safety."

In Minneapolis, a rise in violent crime involving youth inspired the city and Minneapolis Foundation to launch an effort to reduce youth violence in 2007 that a year later produced the Blueprint for Action to Prevent Youth Violence, which has helped produce a precipitous drop in young victims of gunshots and violent crime.

As far back as the late 1980s and early 1990s, a grassroots effort produced the Youth Alive! initiative in Oakland, California, a community-based, public-health-centered nonprofit now with a staff of 29 and annual budget of $3.7 million.

In 1995, Chicago was the first city to adopt the Cure Violence model, in which trained violence interrupters and social workers seek to prevent shootings by identifying and mediating potentially lethal conflicts. Its first program, called Ceasefire, begun in the West Garfield Park neighborhood in 2000, is credited with a significant drop in shootings in the first year.

Chicago homicides dropped from 663 in 2000 to a low of 419 in 2013, rose to 473 in 2015 and jumped to 762 in 2016. Cure Violence contends the rise coincided with city decreases in spending on the program.

More than 50 cities now use the Cure Violence model, including Milwaukee, with places and organizations that adopt it regularly experiencing reduction in violence between 40 and 70 percent in the first year and larger reductions later, the organization says.

Increasingly, hospitals are also creating formal violence intervention programs and engaging patients during and after recovery to reduce retaliation and recidivism.

"Do something sooner rather than later," advised Sasha Cotton, Minneapolis' youth violence prevention coordinator and group violence intervention manager. "There is no perfect starting place. Run with the low-hanging fruit. Build momentum and real authentic buy-in with community. They will be your champions if you make room for them."

In 2015, Milwaukee experienced one of its deadliest years in a decade, with homicides jumping from 87 in 2014 to 146 the next year.

Many people in the city were already working to prevent violence but they weren't necessarily working together. So the city spent 10 months creating the Blueprint for Peace, a 100-plus page plan focused on six main goals: stop the shooting; promote healing and restorative justice; support children, youth and families; foster strong and safe neighborhoods; and better coordinate violence prevention.

"Law enforcement alone is not a sustainable way," Moore said. "The community needed a plan to deal with this."

Among the strategies: The city has budgeted $280,000 in 2018 for its Ceasefire initiative, which will be focused in 10 neighborhoods with high rates of assaults, shootings and homicides.

"We're hiring people who know the street," Moore said.

The Blueprint, shaped with the input of more than 1,500 people, also offers strategies for prevention and intervention, including strategic long-term investment to improve conditions in parts of the city most affected by violence.

The plan has not always gone smoothly, Moore said.

"It's one thing to align (groups) on paper; it's another to align in practice," he said. "That is where the rubber will truly meet the road."

Also, some don't empathize with the population targeted by the plan, and more conservative elected officials prefer spending more on policing, he said.

"A Blueprint has to be owned by the community," he said. "It has to be bigger than any elected official or political term, otherwise it will die. It's better to do something and perfect it than do nothing and expect it to change. Right now, it's the best plan we have."

At the hospital

The city is also implementing an anti-violence initiative at Children's Hospital of Wisconsin, the state's lone member of the National Network of Hospital Based Intervention Programs and one of 40 nationwide.

The program, called Project Ujima, provides special services for youth victims of violence including case management, social and emotional support, and mental health and medical services.

The initiative, begun after a sharp increase in youth shootings -- 170 came to the emergency room in 1995, up 31 percent from the previous year -- delivers support where victims are most vulnerable, said director Dr. Marlene Melzer-Lang. She recalled how the hospital had treated a 14-year-old boy who had been shot only to see him return with another gun wound.

"We took care of his injuries," she said. "We didn't take care of him."

Project Ujima, she said, began modestly, starting as a clinic but moving to a community-based model in which trained community liaisons come to the emergency room, connect with families, visit home and school, provide referrals, advocate in court and elsewhere for a year or more.

The offerings also include peer support, mentoring, support groups, day camps and a three-day overnight camp. In 2004, Project Ujima added adult crime victim services.

"No day is typical. Every day is different," said Jermaine Belcher, Project Ujima team leader and one of eight community liaisons handling a caseload of 350 youth and 500 families. "Without it, there would be a huge void."

Prevention is key

Between 2003 and 2006 in Minneapolis, 80 residents between ages 15 and 24 died as a result of homicide -- the leading cause of death for the age group.

In 2008, the city began taking more of a public health approach to violence.

The city added a youth violence prevention coordinator to its Health Department, established a 17-member executive committee and adopted a 35-page Blueprint for Action to Prevent Youth Violence.

"Staffing a project like this is very important," Cotton said. "Even without much money for programming, having a dedicated staff person creates relationships and allows that person to create the brand for the initiative, which could lead to funding opportunities. Relationships are critically important."

Initially, the Blueprint focused on traditional, "primary prevention," such as programming for younger youth, education about violence and prevention and re-examining policies to offer more diversion options for low-level juvenile offenses, Cotton said.

From 2006 to 2015, violent crime victims among those 24 and younger dropped 39 percent, gunshot victims fell 46 percent, and homicides decreased from 29 in 2006 to a low of nine in 2009 and spiked to 24 in 2015.

The city has suffered youth homicides since, but the numbers remain lower than in the years before the plan, and the city is continuing to make adjustments, Cotton said.

In the past three years, the scope broadened to include 18- to 24-year-olds and to offer some programs with little to no age restrictions, she said. Those include a group violence intervention initiative and a hospital-based violence prevention program.

Over time, the city has started to see funding violence prevention work as a critical part of its commitment to public safety, Cotton said.

"Don't reinvent the wheel," Cotton said. "Lots of cities have plans, so look at those and modify the one you like the best."

Lived experiences

One of the best examples of a grassroots response to fighting violence comes from Oakland.

In the late 1980s and early 1990s, gun violence shot up nationally, and especially in East Oakland, in and near Castlemont High School, said Anne Marks, executive director for Youth Alive!

The founder, Deane Calhoun, was a public health worker concerned with how so many guns got to East Oakland and why young people were involved in violence. Calhoun met with students at the school and asked what it would take to end the shootings. They began advocating for laws like the California assault weapons ban and wrote the original "Teens on Target" curriculum to inform peers about the dangers of gun violence and how to keep safe.

A staff member, Sherman Spears, brought to the group his own experience of being a victim of gun violence. Becoming paralyzed after being shot and lying in a hospital bed changed Spears' life. His friends wanted to retaliate, but he wanted the violence to stop and used his story and skills to combat violence through Teens on Target, later visiting gunshot victims in the hospital.

"We learned that providing relatable, committed mentors to young people after they experience trauma helps to break the cycle of violence," Marks said. "We later applied this same consistent, long-term support to young people coming home from incarceration."

The group later began working with the mother of a homicide victim who had been trying to help others in her position focus on healing, which became a key part of its mission.

"The key to Youth Alive's success is that all our programs are homegrown, rooted in the lived experiences of community members affected by violence," she said.

The nonprofit's work, she said, has likely saved thousands of lives and its model intervention programs have influenced other cities and become central to Oakland's violence prevention strategy.

Prevention works, but there are no places where it's funded to the scale it's needed, Marks said.

"If violence prevention efforts received even one-tenth of what law enforcement efforts receive, we would see a dramatic reduction in violence," she said.

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