Healing Hurt People: Helping Victims of Violence Heal from Their Trauma and Become Community Peer Health Workers

Healing Hurt People started in 2008 as an initiative to help victims of violence heal and deal with the trauma of their injuries; more than a decade later the organization has created a sustainable model for hospitals across the city of Philadelphia. Young men that have dealt with violence are encouraged to go through training, become community peer health workers, and help those who have gone through similar experiences. 


We spoke with emergency physician Ted Corbin, MD MPP, co-director, Drexel University Center for Nonviolence and Social Justice, and primary care physician John A. Rich MD, MPH, professor and director, Health Management and Policy Center for Nonviolence & Social Justice, about the effects of trauma on Black people and the importance of having community peer health workers.


How has Philadelphia and its level of violence influenced the work of Healing Hurt People?

Ted Corbin: I’m an emergency room physician and saw a lot of young people come in shot, stabbed and assaulted. There were no resources for doing the appropriate follow up care that one would need, after being shot, stabbed or assaulted, given those symptoms of trauma that go unnoticed. That’s the impetus behind it. John noticed in his practice in primary care that young men of color weren’t seen in primary care but were seen in trauma or STD clinics. This effort was to go deeper to see how young people (particularly young men of color) that are affected by intentional injury most heal.


The three things HHP does is to get people better, working to decrease symptoms of trauma, and get them connected, because we want them to get plugged into long term care, primary care, behavioral health services, educational and job resources. 


John A. Rich: Trauma is the force that in all of us can lead to changes in your body, mind and behavior. We want to make sure we provide opportunities for people to heal from trauma. Part of the push for this has been we know there is a cycle of violence. People that have trauma from violence are also likely to have other things happen to them. Their health will deteriorate, they may have difficulty concentrating so they have trouble at work or school or they may have broken relationships in their lives. We’ve learned more as we’ve gone on to think about this holistically. 


My work in Boston was as a primary care physician and I saw the same thing. Young people were coming in with medical problems but the real issue was the trauma. That sometimes bears a lot of explaining because there is a tendency, particularly with young men of color, to see them only through the lens of violence. That’s the only thing we focus on and that’s a terrible misrepresentation of their humanity and potential in the world. If we said all we would do is stop violence, that doesn’t help people thrive or heal, with all of the structural violence raining down on people. This is an effort as Ted said to focus on healing and how we can create connection and support. 


What are some things you’ve learned from doing research on the impact of Healing Hurt People on its participants?


John: We’ve been doing an evaluation on the program for the last five years and just looking to get a sense of what the “special sauce” is. What we know and are able to do is we are able to decrease symptoms of PTSD. We’re also able to improve sleep quality. Sleep’s importance for you to get the best performance in selected spaces often goes neglected. We did qualitative interviews with participants and they’ve said that having a social worker working with them is really helpful.


Primary care physician John A. Rich MD, MPH, professor and director, Health Management and Policy Center for Nonviolence & Social Justice, and emergency physician Ted Corbin, MD MPP, co-director, Drexel University Center for Nonviolence and Social Justice.


How important has it been for men that have survived violence to become community health workers?

John: That work has been transformative for us. It really comes out of the practice. Part of how we sometimes think about our work is in the social entrepreneurship space, which is where we’re both providing services and doing direct work, but we’re also looking at advocacy and policy to make sure that we’re not just doing one of those two, because we feel like being close to the work allows us to see what the possibilities really are. 


We’ve engaged some of those people as interns and it reaffirmed to us how much potential these young people had once they were in an environment that was healing. 


We had a grant from the Office For Victims of Crime at the Department of Justice to support an organization called the National Network of Hospital-Based Violence Intervention Programs. As that grant was ending, the director of the Office For Victims of Crime came to us and said she had been focusing mostly on women victims and asked us what we thought the key things to do would be. We said we really believe there is an opportunity to train young people who had been injured as community health workers. They then released a request for proposal (RFP) that included that as a possibility. We applied and got that funding. 


Each year, the community worker peer training academy graduates 8-12 amazing young men, all of color, that have gone on to work in other agencies and organizations because there is a tremendous need for their expertise. We’ve also learned a lot from them about how young people together can create this environment of healing, particularly young men, and how they can take on toxic masculinity. They can bring that to the fore and take on homophobia, transphobia and also take on their own healing. 


We’re able in the current structure from a policy perspective to include them in the package because they are trained not only as community health worker peers but also as certified peer specialists, so the agencies can bill them for the work that they do. 


How has trauma impacted people of color?

Ted: We’ve taken the perspective that there’s the physical trauma but then there’s the emotional trauma that goes with that. But you think about the environment and unfortunately some young people come from environments that are impoverished and resources are limited and that adds that added stress to an individual — food and security. Then take the additive of racial trauma and all of those forces come down on a person without the tools to navigate them are challenging. We recognize that and incorporate some modalities of social workers as well as community health worker peers we’ve onboarded to have a conversation about it. We challenge white people on staff to have those conversations with young people of color.


John: We have an amazing colleague at Drexel in Kenneth V. Hardy, a national expert in racial trauma for people of color. He has a very specific framework for talking about how on a daily basis people of color deal with racial trauma. He calls devaluation a circumstance when you are not valued and anything you do is not valued, so it becomes the dehumanization of loss. For people of color it’s not seen as important when you lose something. It means that your losses aren’t taken as seriously. 


Hardy talks about how the destruction of community can happen and how people can manifest rage, which is a deep sense of injustice but that’s often interpreted as anger. So they send you to anger management when what you’re doing is channeling a sense of being fed up. That has influenced our work a lot because we can introduce how racial trauma affects people to community health worker peers.


What methods does HHP use to to protect the narratives of clients while sharing the work it does in the community?

John: We haven’t been focused on as much of telling the HHP story, but we do believe it’s important that the young people’s voices be mobilized. Our community health peer workers and clients engage in a storytelling workshop. What we want to do is invite clients when they feel comfortable to tell their stories, but their privacy is very important. We sometimes have journalists and documentary filmmakers who want to share the stories but we want to protect clients’ stories. [Recently] our goal was to work with a strategic communications firm to open a social media campaign on how people heal. 


What are some common misconceptions of young people dealing with violence?

Ted: The notion that they are bad or sick kids are two extremes, but there is no focus on the idea that the kid is hurt. There is a judgmental aspect of things, so sometimes it’s not recognized that the survival mode the young people are in requires desperation. In some instances the easiest way to get money for Mom’s rent or a girlfriend’s child is to involve themselves in the illicit economy, when in fact the access to other resources just may not be known. That judgment is palpable in a lot of spaces in the healthcare system, particularly when it’s a young person of color.

John: When young people are in a hospital suffering from trauma, they may have a certain way they look. There’s something called dissociation when you’re talking about something terrible but somebody may say there’s a disconnect and that’s a common consequence of trauma. But if you don’t know that, it may look like the person is not telling the truth. The symptoms of trauma like jumpiness or feeling unsafe may lead you to judge a person. That’s one of the most powerful misconceptions. 


Ted: The fact that we have the community health workers on our team is really invaluable. Again, I think they’ve taught us things and hopefully we’ve taught them some things, and as a team, Dr. Hardy took us through four days of racial trauma training as a team and it was uncomfortable, but his framing is that, “Everyone has the right to be safe; no one has to be comfortable.” It was to get to understanding how race is so woven into so many things and how for a white person working with a young Black person, what you can say to diffuse situations and show that they understand.


John: One way to think about it but not the way we think about it is, you have young people of color with community health worker peers is that you could construct an opinion of them in terms of exceptionalism, so people with negative opinions of young men of color may say, “they’re different.” But with racial trauma training we ask how do these young people have the tools to engage the staff we’re working with and make steps forward so we’re not just having poster children representation of what we believe white people, who don’t understand young people of color, want to see. We want to make sure we’re having a dynamic conversation and that we all buy into that. 


What are some future goals for HHP?

John: We want to build stronger partnerships across sectors and build relationships with other hospitals across the city. We want to create a larger community where these conversations are happening, where people dealing with trauma can weigh in and emphasize that we can heal from trauma. That includes nature, green space, community and music. That’s a part of the goal of the #OurWordsHeal campaign 


Ted: Recognizing and identifying where the policies can happen so that these efforts are sustainable is important to us. 


This article was written in partnership with The HIVE at Spring Point. The Hive is a collection of organizations, individual practitioners, and youth who focus on strengths-based youth development that empowers young people to make positive change in their lives and their world.