A Critical Step That Should be Followed with Even Greater Trauma Recovery Investments
The Alliance for Safety and Justice, and its partners in the National Coalition for Shared Safety, applaud Congress for including in the Bipartisan Safer Communities Act significant new investments in community-based safety solutions that support vulnerable communities. The inclusion of these investments will increase access to mental health, violence prevention and school-based services for people impacted by gun violence.
The Bipartisan Safer Communities Act will increase federal resources for local programs that:
- Help vulnerable young people to achieve stability. The bill improves access to mental health care in schools by requiring the Center for Medicaid Services to provide states with critical tools and resources to implement, enhance, and expand school-based health programs under Medicaid. The bill provides $1 billion for programs to keep students safe and healthy, including mental health resources, drug, and violence prevention, mentoring, and crisis intervention. Childhood exposure to violence can make it more likely a young person will have difficulty in school, abuse drugs or alcohol, act aggressively, suffer from depression or other mental health problems, and engage in violence as adults. This bill invests in the lives of young people who experience violence and trauma, increasing safety for all.
- Expand mental health crisis responses to break the cycle: This bill provides $750 million over five years for crisis intervention programs under the Edward Byrne Memorial Justice Assistance Grant (JAG) formula grant program to allow states to use the funding to implement crisis intervention programs. The bill also provides states the flexibility to choose whichever crisis intervention programs would work best for them. When people facing mental health challenges lack access to help, too often, they can be victimized, or the justice system ends up being the main public system responding to a psychiatric crisis.
- Increase interventions to prevent violence. This bill appropriates $250 million over five years for community violence intervention programs, like those that were established under the Community-Based Violence Intervention and Prevention Initiative (CBVIPI) and enacted in the bipartisan omnibus spending package. Too often, youth and young adults living in unsafe environments have few options to protect themselves or stay out of the cycle of harm. Many are disconnected from programs that can support people navigating unsafe environments and provide connections, opportunities, and pathways to success.
“The Bipartisan Safer Community Act is crucial and we applaud the leaders taking action to enact this legislation. This can be built upon to expand much needed support for victims of violence,” said Shakyra Diaz, Chief of Federal Advocacy for the Alliance for Safety and Justice.
Additional Investments Needed: Trauma Recovery
Alliance for Safety and Justice offers key steps that can be taken in addition to the investments included in the Bipartisan Safety Act through subsequent legislation. Trauma recovery needs among survivors of gun violence are immense and must be the focus of additional action.
Every year, three million violent crime victims experience a diminished quality of life because of their victimization. If unaddressed, the trauma that crime victims experience can have a devastating impact on their lives, and on our entire country. About half of those who experience trauma will have resulting psychological or social difficulties akin to post-traumatic stress disorder (PTSD)—with symptoms that can include nightmares, insomnia, fear, anger, and depression—unless they are given some form of effective treatment.
Fortunately, there are models that can address the crisis of unaddressed trauma.
Trauma Recovery Centers (TRCs) are a breakthrough and evidence-based model for helping the hardest-to-reach victims of violent crime heal and recover from the effects of trauma. Support is provided in many ways, including trauma-informed clinical case management, individual, group, and family psychotherapy, crisis intervention, medication management, legal advocacy and assistance, and support in accessing victim compensation funds.
While there are 39 Trauma Recovery Centers dotted across eight states, there is no dedicated federal funding stream to fuel their expansion to the scale needed. Instead, funding for these vital services for crime victims has been cobbled together, year-by-year, preventing these vital programs from growing.
There are also barriers in federal law, policy, and practice that limit the expansion of Trauma Recovery Centers’ ability to address the needs of all victims, some of which are being addressed through Congressional direction by the Bipartisan Safer Communities Act for child victims.
These barriers include a lack of federal policy on:
- Using Medicaid to pay for the trauma recovery for crime victims. States can narrowly define medical necessity for mental health services as only for chronically and persistently mentally ill individuals, such as people diagnosed with schizophrenia, or people who are diagnosed as bipolar. That can leave out crime victims with PTSD. Lawmakers should build on the direction they provided to the Center for Medicaid Services (CMS) on children’s issues, and direct CMS to clarify how Medicaid can be used to pay for services to address crime victims’ PTSD symptoms.
- Treating the trauma of people at-risk of substance abuse because of their victimization. The relationship between trauma, PTSD, and substance abuse is well documented, but the state operating regulations vary in how they interpret whether a victim experiencing trauma can have their treatment paid for through Substance Abuse Mental Health Services Administration (SAMHSA) grant funding if they are at risk of substance abuse. Lawmakers should direct SAMHSA to clarify for all states that anyone at risk of substance abuse because of their post-traumatic stress should be eligible to have their treatment paid for through SAMHSA grant funds.
- Ensuring that the workforce to address crime victims’ trauma is reimbursable under Medicaid. In addition to employing psychologists and psychiatrists, the Trauma Recovery Center model employs individuals who have cultural competency, have experienced injury or trauma themselves, and have been trained through specialized programs. While their work is critical, it may not currently be reimbursable under Medicaid depending on the state. Lawmakers should direct CMS to clarify this issue to ensure these important supports are more widely available.
About the Alliance for Safety and Justice
The Alliance for Safety and Justice is a national organization that aims to win evidence-based new safety priorities in states across the country, and through federal policy. It also brings together diverse crime survivors to advance policies that help communities most harmed by crime and violence, as part of Crime Survivors for Safety and Justice – its national network of over 90,000 crime survivors.