Violence prevention in the ED: linkage of the ED to a social service agency.

Interpersonal violence continues to be a problem in the United States, most prominent in the inner-city minority young persons population. The medical approach of "treat 'em and street 'em" philosophy has led to foregoing the psychosocial needs of injured young persons. This study describes a program to link young persons who are victims of interpersonal violence to a healthcare system and a social service agency in an effort to meet their psychosocial needs. An unvalidated screening tool was developed by a team consisting of an EP, social worker, and public health scientist to determine the young victims' psychosocial needs. Patients aged 10 to 24 years who were victims of interpersonal violence (excluding child abuse, sexual assault, and domestic violence) were randomly assigned in the study. The control group was given a list of services and the treatment group received an assessment, case management, and referral to appropriate resources. The study site was a community, teaching level 1 trauma center. The study was approved by the institutional review board. Numbers of referrals in both groups were counted and compared using SPSS (version 10, Chicago, IL). One hundred eighty-eight victims of interpersonal violence were enrolled. A total of 82.5% were male, 65.4% were African American and 31.4% were Hispanic. At the end of 6 months, 78 of the 96 young persons (81.3%) in the treatment group made one or more contacts with their case manager and made use of social service, healthcare, and other referrals. Education (21.6%), job readiness (19.1%), and mental health (11.9%) were the most frequently used services. Nine of the 92 (9.8%) in the control group used services; most of these referrals were for social services (7 of 9 respondents) and the others were healthcare-related. The difference in utilization of services between the treatment and the control groups were found to be significant different (95% confidence interval, 1.41-1.55, significance =.00), and there was a strong positive correlation of using services and case management (Pearson coefficient = 0.728, significance =.00). The referral of young victims of violence from the ED to psychosocial services could be successful using a case management model and an alliance between a healthcare system and a social service agency.

RCT Entities:   Population Interventions Outcomes