Life’s difficulties, busy schedules, a lack of insurance, the high costs of healthcare even if you have it, or simply distrust — they’re just some of the many reasons someone may not seek a therapist or mental health resources. For some, the simple utterance of the word “therapist” can evoke hesitation.
Yet mental and behavioral health services, particularly considering the trauma of the past few years and a surge in community violence, has the potential not only to help change lives, but save them.
“If there was an extreme need, it’s in this area,” said Karl Johnson, a Multnomah County Juvenile Services Division Community Justice Manager with the Resource Intervention Services to Empower Unit, or R.I.S.E.
“We’re trying to put a Band-Aid on a dam right now and we are really working hard to make sure that we have every opportunity to be successful.”
For over 30 years, Johnson and his Juvenile Services Division (JSD) colleagues have helped change the trajectory of youth whose lives intersect with the justice system. The division provides supervision to youth on probation to give them the best chance for positive outcomes. Over the years, their work has expanded to develop and leverage strong partnerships with families, community-based organizations, schools, public safety partners and the County’s Public Health Division.
However, as gun and community violence across the country reached well-documented highs, including in Multnomah County, JSD and the County pinpointed a need to help youth, and even their families, deal with the repercussions of violence involving firearms.
“When we talk about gun violence, it affects everyone differently. It affects entire families,” said Johnson. “A lot of times when people carry that trauma. It’s not on display. It’s like an invisible cloud of gas that can hurt you.”
The division recently began collaborating closely with the Behavioral Health Division’s Gun Violence Impacted Families Behavioral Health Response Team (GVIFBHRT). The specialized team is composed of mental health clinicians and is designed as an easily accessible, trauma-informed and home-based service. As a program designed to be culturally specific, they work with people from African immigrant, African American, and Latinx communities, and address root causes that are rooted in trauma and racism.
Mental health services are combined with support from credible messengers, such as peers who have successfully disentangled themselves from gun and group violence. The program also works in partnership with POIC + Rosemary Anderson High School, IRCO Africa House and Latino Network.
“We’re gaining momentum, making connections to community partners and building more trusting relationships with clients and families,” said Yolanda Gonzalez, a senior manager with the Behavioral Health Division’s Direct Clinical Services. “Once that’s established, we have the ability to continue to grow. It is preventative work, when I look at the full perspective of someone’s life.”
The team began taking clients in the summer 2022.
Once individuals and families who have been affected by violence are enrolled, the team works to provide a comprehensive array of mental health services in an accessible and timely way. The teams many goals include:
- Getting fewer people to even engage in group and gun violence in the first place
- Connecting youth to mental health services
- Improving family dynamics to create healthier and more meaningful connections
- Increasing the community’s use of healthy coping mechanisms
- Raising awareness of how cyclical trauma affects the community
- Increasing prosocial community engagement
- Improving academic achievement
Portland Police recently reported some encouraging news: a decline in gun violence from January 2022 to 2023 with 127 reported last January compared to 95 in January 2023. Still, the work of combating gun violence remains critical, particularly as incidents involving firearms can unfold near schools. Classes were canceled at Franklin High School in Southeast Portland after a shooting in early March.
The entire Gun Violence Impacted Families Behavioral Health team showed up in person and was able to provide support to students, as well as the school’s administration.
“Not too long ago, one of our other youth was grazed at a local high school and wouldn’t leave the house,” said Johnson. “We had to have a therapist be there and help his mom understand what’s going on with the youth. The way that shootings have been happening so randomly, you don’t know where it’s going to come from.”
“For school-aged youth, you don’t always see that trauma. They don’t know how to ask or understand. You want to get people who can get in there and understand and engage. There’s science to addressing and talking.”
So far, one-fifth of the referrals to the Gun Violence Impacted Families Behavioral Health Response Team comes from the six partner school districts and the Multnomah Education Service District.
Gonzalez says that the program is “building a bridge” with schools.
An additional, 33% of program referrals have come directly from credible messengers or people with lived experience who establish deep connections with clients. More than a quarter come from partners within the Department of Community Justice, including Johnson’s team.
The Gun Violence Impacted Families Behavioral Health Team is a low-barrier program without stringent requirements for participation. Anybody aged 10 to 25 who has been impacted by gun violence can receive services.
That, Gonzalez says, can be “someone who witnessed (gun violence) in the community and had a traumatic response. Someone whose parents are incarcerated.”
As a former therapist, manager and associate director at Latino Network, Gonzalez not only brings experience with home-based and community-based services to the County program, but also a depth of understanding of how its services can affect young people.
“We know across the board that if people have positive, healthy relationships in their life, they’re less likely to engage in acts of violence,” said Gonzalez.
“Increasing prosocial activities or seeing folks in their community doing positive things — that also has a positive impact on outcomes. And overall we know that when folks are in a healing space, a more grounded space, a less triggered space, they can achieve goals like academic success or job stability or housing stability.”
A person’s mental and overall well-being, she says, has ripple effects in their personal life and in the community.
Gonzalez has also worked closely with Johnson over the years through the Community Healing Initiative (CHI), a culturally responsive program designed to decrease youth involvement in the justice system.
The addition of these kinds of services that the Gun Violence Impacted Families Behavioral Health Team offers, Johnson thinks, is natural and necessary.
“We need our community to feel safe going to a school event. We get the therapist on board and the therapist helps the youth understand some of the issues around trauma,” said Johnson. “It’s not a tough love approach, but a trauma-informed perspective so the young person can understand what and how they’re feeling.”
Clinicians do still battle a stigma associated with mental health resources.
“Addressing gun violence from a mental health standpoint is still new,” said Johnson.
Johnson says that in the past, the system has lost, or hasn’t earned, the trust of many immigrant communities and communities of color.
““So many people get misdiagnosed and the therapist can’t even develop a relationship,” Johnson said. “In the African American community and in the Latino community, the mental health provider has been grandma or Abuela. But when they see someone, a therapist, that looks like them, they start to talk.”
The interrelated services that the Gun Violence Impacted Families Behavioral Health Team offers can benefit entire families, Johnson and Gonzalez say.
“The treatment for the trauma is going to help them stay in those other programs because now they know how to connect,” said Johnson.
“Therapists can also educate families on what it means to understand and how to work through elements of trauma. Families also have a better understanding of what therapy is all about. So a lot of the therapy is getting educated about what treatment can provide.”
Johnson recognizes that the program won’t always be able to singlehandedly overcome the hesitation that participants may feel about working with government services, “but building the relationship, that’s where we start breaking those barriers.”