It has become trendy for media reports to compare neighborhoods plagued by gun violence to war zones.
It’s time for us to take a “grownup” look at the violence that plagues all of our lives and our communities.
Violence claims two victims, the person or people victimized and the community, which experiences trauma, fear, and stress. Each year in the United States, millions of residents fall victim to violent crime, which also causes fear and stress to neighbors, children, businesspeople, and other community members.
The chances that young men who experience trauma in their neighborhood will end up in jail are astronomically high, studies show. Studies have also shown a high correlation between neighborhood disorder and physical abuse.
According to the National Association for Mental Illness, some 70 percent of youths in state and local juvenile justice facilities suffer from mental health problems – part of a broader trend of prisons and jails becoming warehouses for the mentally ill. These youths are in many cases cut off from mental health care and from their communities and families; an untold number will be released back into society as hardened, unstable adults.
Aggravating the crisis in communities, state mental health programs lost more than $4 billion in funding from fiscal year 2009 to 2012 – a cost passed down to the hospitals and courtrooms that ultimately must absorb the burden.
Studies show that, overall, about 8 percent of Americans suffer from PTSD at some point in their lives. But the rates appear to be much higher in communities – such as poor, largely African American pockets of Detroit, Atlanta, Chicago, and Philadelphia – where high rates of violent crime have persisted despite a national decline.
A growing number of programs treat post-traumatic stress disorder (PTSD) in war veterans. But far fewer treat Americans who suffer from the PTSD that comes with their zip code. And this kind of PTSD may be affecting even more people.
PTSD can directly hurt a person’s brain by messing with the amygdala — the part of the brain that triggers a chemical to release to help you decide between “fight or flight” in a threatening situation. If someone is exposed to prolonged, repetitive, or extreme trauma, the amygdala stays in alert mode. And the neurons, the pathways to this part of the brain, lose their ability to recover.
A person’s memory becomes corrupted like a bad computer hard drive and it can hurt a person’s ability to separate out new experiences and determine whether they are safe or dangerous. The longer a person stays in the hyper-vigilant mode, the greater the chance of permanent damage. In a child, damage can be magnified and lead to problems like dissociative identity disorder.
For most people, untreated PTSD will not lead to violence. But “there’s a subgroup of people who are at risk, in the wrong place, at the wrong time, of reacting in a violent way or an aggressive way, that they might not have if they had had their PTSD treated,” according to Dr. Kerry Ressler, a medical investigator and psychiatrist, who studied this issue extensively.
Researchers at Drexel University in Philadelphia found that people with symptoms of PTSD may be more likely to carry a weapon in order to “restore feelings of safety.”
Hospital trauma centers, which work on the front lines of neighborhood violence, could help address this lack of treatment. Indeed, the American College of Surgeons, which sets standards for the care of patients with traumatic injuries, recommends that trauma centers “evaluate, support, and treat” patients for post-traumatic stress.
A trauma center is a hospital equipped and staffed to provide care for patients suffering from major traumatic injuries such as falls, motor vehicle collisions, or gunshot wounds. In light of the plethora of violence injuries from guns and other weapons, we know all too well that it is inexcusable that more of these hospitals aren’t providing the care and treatment of the PTSD that is ever-present in these situations.
But it’s not a requirement, and few hospitals appear to be doing it.
The publication, ProPublica surveyed a top-level trauma center in each of the 22 cities with the nation’s highest homicide rates. Just one, the Spirit of Charity Trauma Center in New Orleans, currently screens all seriously injured patients for PTSD. At another, Detroit Receiving Hospital, psychologists talk with injured crime victims about PTSD.
Trauma and violence are widespread, harmful, and costly public health concerns. They have no boundaries with regard to age, gender, socioeconomic status, race, ethnicity, or sexual orientation. Trauma is a common experience for adults and children in American communities, and it is especially common in the lives of people with mental and substance use disorders. For this reason, the need to address trauma is increasingly seen as an important part of effective behavioral health care.
Trauma must be recognized as a disease process. It is also age dependent; the youngest are most vulnerable. Like heart disease and cancer, trauma has identifiable causes, established means of treatment, and defined means of prevention. But unlike heart disease, trauma is communicable. People injure other people. Injury from behaviors associated with untreated PTSD is not an accident; it is a predictable and preventable disease.
We must develop the political will as a society.
Remember, I’m not a doctor. I just sound like one.
The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan.)
Glenn Ellis, is a regular media contributor on Health Equity and Medical Ethics. He is the author of Which Doctor?, and Information is the Best Medicine. Listen to him every Saturday at 9 a.m. (EST) on www.900amwurd.com, and Sundays at 8:30 a.m. (EST) onwww.wdasfm.com. For more good health information, visit:
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