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Mission Prevention: Program Targets Violence With Tiered Approach

After Boston experienced a resurgence of violence in 2006, physicians at Boston Medical Center (BMC) and community activists created the Violence Intervention Advocacy Program (VIAP) to equip victims of violence with the skills and services they need to return to their communities and avoid future high-risk situations. 

Through VIAP:

  • victims of violence undergo an assessment in BMC’s ED to determine their risk for recurring violence and the social services they will need after discharge.
  • patients receive services that align with their recovery and development levels, from a dialogue about peaceful alternatives to violence to short-term inpatient outreach or long-term case management.
  • patients are connected with counseling, job training, and safety education.

In addition, VIAP treats patients’ family members and addresses the mental health needs of patients:

  • VIAP has a family support coordinator who assists families in navigating a patient’s medical needs including transportation to appointments and social services.
  • The coordinator also facilitates school meetings and advocates for living accommodations. 
  • The program partners with the BMC Community Violence Response Team, which provides and coordinates mental health services for VIAP clients in the hospital and in outpatient settings.

“Our whole mission and model is to have a trauma-informed approach to care, which means not stigmatizing people and giving them a place to feel safe,” says Thea James, MD, an emergency physician at BMC and champion of VIAP. “Patients can be re-traumatized and suffer increased damage if ED staff reinforce their expectations of hurt and disrespect.”

Each year approximately 400 patients between the ages of 15 and 30 go through BMC’s VIAP, which has inspired a statewide model that now operates in the EDs at Massachusetts General Hospital and Baystate Medical Center. Program tracking statistics show VIAP has reduced gunshot wound recidivism by about 30 percent from 2007 to 2012 and stab wound recidivism by about 49 percent from 2007 to 2012.

Going forward, BMC is considering:

  • offering more services in-house, such as life skills training and alumni meeting groups.
  • developing relationships with local corporations to support an in-house job readiness training program.

For more information about BMC’s VIAP, please contact:

Thea James, MD
Emergency Physician
Boston Medical Center
(617) 414-3564


National Network of Hospital-based Violence Intervention Programs

The Violence Intervention Advocacy Program is a founding member of the National Network of Hospital-based Violence Intervention Programs, which brings together the best and most exciting programs in the country to share knowledge, develop best practices, collaborate on research, and affect policy change.


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