Stop The Cycle

Predicting and preventing youth and family violence

Violence:Explosion at the Intersection of Multiple Disorders

Coordinated Care for Multiple Severe Problems = Violence Prevention



Social Work Week - March 7, 2011

Social Work Week - March 7, 2011 (Photo credit: BC Gov Photos)


Social Work Week - March 7, 2011 (Photo credit: BC Gov Photos)

The horrid violence in Connecticut, Colorado and other places around the world has many people thinking and talking about preventing violence.  It is important to look at the research on what works to solve the violence issues as one step toward less violent and more caring  communities.

The group of people that are violent have multiple problems which will likely include several of the following: Axis I and Axis II Mental illnesses, substance abuse, psychopathy, head injury, developmental disabilities, and histories of childhood trauma and experiencing and exhibiting violence. While overlapping with other problem areas, the propensity for violent behaviors is a separate construct which is defined, measured, and treated differently than other disorders would be treated as a single problem.

Because the problems co-exist, coordinated care will be most effective. This idea is supported by the research, as well. One of the traditional problems in the treatment and social services fields are that each of the agencies (criminal justice, social services, schools, substance abuse and mental health) charged with a particular mission work independently, despite the fact that a problem in one area may affect health in another area.

Coordinated care for folks with many problems and few resources, readily available no matter what company, school, job, or agency that first notices there may be a serious problem. This includes jobs and schools because they may be the first to notice problems. The earlier that strengths and resiliencies are built and problems are addressed and resolved, the greater the likelihood of success and of preventing violence from occurring.

If we want to bring the national and state budgets under control, we use less expensive prevention and early intervention rather than very expensive clean-up operations after a horrible event. Therefore, we need strong wellness/prevention programs like Head Start with family involvement or Healthy Families Home Visiting programs universally available to every family that needs it. Then we need ways to identify which people and families need services and make sure that they get adequate and coordinated care. This includes fighting poverty, poor education, mental illness, poor housing and unsafe communities. For example, increased counseling and social services added to a community policing program has been shown to significantly reduce violence in a community by combining good police work with needed services to individuals and families.

 Part of the answer will lie in Departments of Social Services working closely with Departments of Juvenile Services, Mental Health, Schools, and other groups, especially when they are working with the same families. Other solutions include combining mental health and substance abuse Courts.  The criteria for involuntary hospitalization also needs to be re-examined.

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–Dr. Kathy Seifert

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Kathryn Seifert, Ph.D., is the author of the Child & Adolescent Risk Evaluation screening tool.


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