The San Francisco Wraparound Project, a public health–based injury prevention program for victims of interpersonal/youth violence ages 10 to 30, has reduced recidivism, saved money, and become a model for hospitals across the country.
“Latino/a and African American communities in San Francisco have been hardest hit by interpersonal violence … Homicide is the number-one cause of death in African Americans aged 10-24 years old and number two among Hispanics … [and while] African Americans in our city make up about 6 percent of the population, [they] represent about 60 percent of the gun violence victims.” The Wraparound Project
To address these disparities, the Wraparound Project makes cultural competency a key component of care. The project’s three case managers come from backgrounds similar to the patients they see, which helps to establish understanding and trust between case managers and victims.
Through the Wraparound Project:
- Case managers first visit victims at the bedside following injury and complete a needs assessment by reviewing risk factors.
- Those deemed high risk for repeat injury and/or incarceration are enrolled in the program.
- After patients leave the hospital, case managers work with them for a period of six months to one year.
- Case managers provide assistance with obtaining a GED, vocational training with partners such as Goodwill, tattoo removal, mental health services, court advocacy, and other risk-reduction services to help keep patients out of the hospital.
Since 2006, the program has enrolled 254 clients, nearly 70 percent of whom were injured by gun violence. During this period, only 4.5 percent of participants returned to San Francisco General with a violent injury, compared to the hospital’s historical recidivism rate of 16 percent.
Researchers studying the program estimate the program can save San Francisco General more than half a million dollars per year. The researchers also found that mental health resources and employment are significantly associated with program success. In fact, if mental health needs were met, a patient was six times as likely to be successful.
For more on San Francisco General Hospital’s Wraparound Project, please contact:
Rochelle Dicker, MD
Director, Wraparound Project