Hospital-based violence intervention programs

Key points

• HVIPs were first developed in the 1990s. There are four components to HVIPs, including:
  • intervention
  • care
  • follow up services
  • Addressing the Social Determinants of Health

Introduction

Hospital-based Violence Intervention Programs (HVIPs) engage patients who seek medical care at hospitals for violence-related injuries. The Health Alliance for Violence Intervention reported in 2023, that violent injuries can be recurrent and create lasting effects on the health of communities and the victim. Interrupting this cycle of trauma at the individual level can contribute to the public health approach for the reduction of risk of firearm injury and death in communities which is created, exacerbated, and sustained by historically racist policies and practices.

The Health Alliance for Violence Intervention also reports that HVIPs employ medical staff and community-based violence prevention partners to provide trauma-informed care, connect patients to wraparound services, reduce the risk of retaliation and re-injury, and reduce healthcare costs.

HVIPs include partnerships with Violence Prevention Professionals, who are often from the communities where they work and are trained to build trust, link individuals with community-based services, and provide long-term case management to reduce risk factors for violence, including firearm violence according to the Health Alliance for Violence Intervention. These professionals also provide mentoring and help patients identify goals upon hospital discharge.

Are hospital-based-violence intervention programs effective?

The National Network of Hospital-based Violence Intervention Programs recommends that hospitals treating 100 or more violence-related injuries per year provide an HVIP.

There are limited and mixed data regarding the effectiveness of HVIPs at a population level, but research from single centers demonstrates that HVIPs can improve mental health and reduce re-injury, violent behaviors, substance use, and involvement with the justice system, particularly among youth (Affinati et al., 2016; HAVI, 2023; Karraker et al., 2011).

Studies from Chicago (Zun et al., 2006) and Baltimore (Cooper et al., 2006) reported that reinjury and rehospitalization rates were lower among patients who participated in the HVIP compared to those who did not. An HVIP in Oakland found that its patients were less likely to engage with the criminal justice system following participation in the program (Shibru et al., 2007). 

Further, HVIPS can be cost-effective and cost-beneficial, particularly when HVIPs are included in state Medicaid benefit packages (HAVI, 2023).

Research on patient-centered outcomes and the availability of long-term funding mechanisms will influence the success of HVIPs moving forward (NNHVIP, n.d.)