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Shock Trauma targets 'cycle of violence'


Two-thirds of the patients admitted to the Maryland Shock Trauma Center for injuries caused by guns, knives, baseball bats and other implements of violent crime were treated for similar injuries before, according to a survey released yesterday.

To try to keep them from becoming victims again, officials have begun a pilot program to counsel their former patients and even find jobs for them.

The survey paints a portrait of a population that for the most part does not arrive at the trauma center by sheer accident. Among its findings:

* A third of the violent-crime victims were previously hospitalized at

Shock Trauma or elsewhere with similar injuries. Another third were treated before as outpatients.

* 74 percent were substance abusers.

* 56 percent had prior run-ins with police or had been imprisoned.

* 38 percent were assaulted by relatives, friends or acquaintances.

* 78 percent were unemployed, and 54 percent were uninsured.

"Whenever you find unemployed, poverty-stricken people, you find violent crime of this type," Dr. Cuthbert O. Simpkins, a surgeon who played a leading role in the survey, said at a news conference yesterday.

The survey looked at 50 randomly selected patients who were admitted to the trauma center in 1992 and 1993.

In December, health care professionals organized a program to deal with what Dr. Simpkins calls "that vicious cycle of violence" that turns many people into repeat victims.

The program, funded with $96,200 from the Maryland Department of Health and Mental Hygiene, is run by the University of Maryland Medical Center and the University of Maryland at Baltimore School of Social Work.

Social workers enrolled 10 patients in the program, then counseled them over the weeks and months after their discharge. Five of the people have obtained jobs with maintenance crews attached to state health department, said Mary Hampton, the program's clinical supervisor. Two are in drug-treatment programs, she said, and several are planning to enroll in high school equivalency classes.

It is futile to drop the chronically unemployed into jobs without preparation, Ms. Hampton said, so social workers have accompanied the former patients to job interviews. They are also counseling families.

"The cost is really a pittance compared to what the potential savings are," said Maryland Health Secretary Nelson J. Sabatini.

The average cost of treating a violent-crime victim at Shock Trauma is $42,347. If the program prevents three people from becoming injured again, he said, it will have paid for itself.

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