![[ Visit Client Website ]](images/banner.gif)
Hospital-based violence intervention programs (HVIPs) serve populations exposed directly and indirectly to violence in the community, increasing the need for mental health services. Recent research, however, suggests that there is a lack of mental health services reported by HVIPs (Bonne et al., 2022). Due to diverse client needs, HVIPs frequently partner with other organizations. To inform local and national efforts in this space, the aims of this mixed-methods study were to understand 1) what aspects of mental health are relevant for populations served by HVIPs, with a special interest in youth, 2) how HVIPs integrate mental health services to address the effects of violence, and 3) the function of community partnerships for HVIPs.
Methods
Developed via participatory research methods, a survey was administered to members of the Health Alliance for Violence Intervention (HAVI; n= 55). Members of the HAVI Mental Health Working Group (MHWG) were invited to participate in 30-minute virtual, structured interviews. Using a triangulation design, the interview and survey questions focused on the program's experience with how mental health presents, and is addressed, among people served by HVIPs, with attention to gender and racial equity. Participants were asked about the structure, strengths, and challenges of relevant partnerships. Quantitative data was analyzed with descriptive statistics using SPSS and qualitative data was thematically analyzed in Dedoose. The results of these analyses were then merged to enrich interpretation and validate across findings by two doctoral-level trained scholars.
Results
Sixteen HAVI members completed surveys and 4 MHWG members completed interviews. The majority of HVIPs screened for mental health, with half utilizing a validated screening tool, one-third using clinical interviews, and 18% implementing an internally developed tool. Post-traumatic stress, anxiety, and depression were reported as the leading mental health issues. Over half of respondents reported screening for social determinants of health. Qualitative data indicated that therapeutic alliances, non-traditional therapeutic modalities (e.g. drumming), addressing social determinants of health, and prioritizing client-centered care were strengths of HVIP mental health services. Programs reported running 1-2 support groups on average to address mental health, with a sense of connection, peer healing, and cultural responsiveness as valuable aspects of these groups. HVIPs reported maintaining approximately 15 partnerships each. Focal areas for partnerships included basic needs, legal assistance, and mental health. Among the basic needs, housing was the most significant partnership need, followed by food and utilities.
Conclusions and Implications
Results emphasize the importance of mental health services and community partnerships for HVIPs, and could assist new and developing HVIPs to effectively address these needs. HVIP mental health services could be enhanced through relevant training opportunities, culturally responsive staff, development of peer support groups, and use of non-traditional therapeutic approaches. Results suggest that addressing basic needs is a critical first step in building relationships and addressing mental health. Therefore, implementing screening questions for social determinants of health is suggested. These efforts would help HVIPs to center the lived experience of clients, and to build the rapport necessary to help patients heal from trauma.