Psychosocial needs of young persons who are victims of interpersonal violence.

OBJECTIVE: Although most emergency departments (EDs) in the United States treat a large number of patients who are victims of interpersonal violence, few address their psychosocial needs. We conducted this study to determine the needs of victims of interpersonal violence using a psychosocial assessment tool administered in the ED.
METHODS: We conducted a descriptive study of a prospective, consecutive random sample of young victims of violence in an inner city, level I adult and pediatric ED with 44,000 annual visits. Youths aged 10 to 24 years who were victims of life- or limb-threatening interpersonal violence in 1998 and 1999, excluding domestic violence, sexual assault, and child abuse, were interviewed using an assessment tool designed to determine the psychosocial needs of young persons. The youth assessment tool was composed of 13 constructs, including exposure to violence, legal issues, drug use and abuse, mental health problems, gang issues, gun accessibility, educational needs, employment, life skills, pregnancy and parenting issues, medical care, and recreational activities. The study was approved by our Institutional Review Board.
RESULTS: We interviewed 112 victims of interpersonal violence with a mean age of 18.6 years; 83.9% were male, 67.9% were African American, and 30.4% were Hispanic. Of the youths interviewed, 72.1% had been shot, 15.3% had been stabbed, and 12.9% had been assaulted. In addition, 66.3% had been involved with the law, 73.7% used alcohol, and 65.3% used illegal drugs. Of the interviewees, 41.2% answered yes to at least one question in the CAGE (cut down on your drinking? annoyed by criticism of your drinking? Guilty feeling about your drinking? ye-opener drinking?) assessment, 42.0% reported feeling sad or "down" prior to their injury, and half (54.1%) were involved in a gang. A total of 63.4% of the victims were not in school, did not finish school, or had not obtained a graduate equivalency diploma. The top psychosocial needs were determined to be educational issues (21.8%), occupational issues (ie, job; 16.8%), social issues (eg, gang involvement; 14.9%), and mental health problems (13.2%).
CONCLUSIONS: Young persons who are victims of interpersonal violence have a significant need for educational support, employment assistance, mental health services, and gang intervention services.