As many as 10 million children witness acts of interpersonal violence each year. Such experiences can have lasting effects on a child's development and be as traumatic as being a victim of physical or sexual abuse, according to the American Academy of Pediatrics.
To address this major public health problem, which historically has received little public attention, the UCSF/Mount Zion Violence Prevention Project (MZVPP) recently received a three-year $470,000 grant from the Robert Wood Johnson Foundation (RWJF) to establish a program and clinic to treat traumatized children who have witnessed domestic violence.
The project, called Living in a Non-Violent Community (LINC), will identify children who have witnessed family violence and provide a child-centered, developmentally sequenced range of interventions to prevent these children from developing subsequent chronic health conditions.
LINC is a collaboration of the UCSF/MZVPP, San Francisco General Hospital Medical Center Department of Psychiatry, UCSF Division of Behavioral and Developmental Pediatrics, and the San Francisco Neighborhood Legal Assistance Foundation.
"We hope the clinic will serve as a model for other California communities in addressing issues of child witnesses to violence," said Margaret M. McNamara, MD, chief of pediatrics at UCSF/Mount Zion Medical Center and a founding member of the UCSF/MZVPP. "We want our community to recognize this problem and utilize the clinic so that we are better able to respond to the needs of traumatized children and prevent maladaptive effects of witnessing violence in the home."
McNamara added that while services for battered women such as crisis intervention, shelter, housing, counseling, medical and legal services are linked, similar support for their children is often inadequate.
The program will develop standard protocols for responding to situations where a child has witnessed violence, and to refer the family to direct intervention services. LINC will also work with the San Francisco Neighborhood Legal Assistance Foundation to assist families by providing them with legal services.
LINC includes a training component for those who most often come into contact with traumatized kids--including police, doctors, teachers, childcare providers and the staff of community organizations--to heighten their sensitivity to and improve identification of child witnesses of violence. LINC will also provide violence prevention training to middle and high school students.
Each year, the UCSF/MZVPP will train an estimated 50 police officers and 100 health care and community service providers, as well as treat 70 children between the ages of 6 and 12. In addition, 25 parents will enroll in the UCSF/MZVPP's parenting classes that provide education about child development, discipline techniques, and alternatives to corporal punishment.
Annually, San Francisco General Hospital Medical Center will treat an estimated 35 children between infancy and 5 years old, as well as 35 youth between the ages of 13 and 18. The San Francisco Neighborhood Legal Assistance Foundation will provide training for 1,000 middle and high school students and staff on various aspects of domestic violence and strategies for coping with and preventing violence.
RWJF's grant to the UCSF/MZVPP is part of their Local Initiatives Funding Partners Program (LIFP) that identifies innovative, community-based projects that have the potential to develop into national models and are designed to improve health and health care for underserved and at-risk populations. In 1999, the RWJF LIFP program received more than 300 applications. Of those, 29 were chosen for site visits and only 18 projects were funded.
The RWJF LIFP grant is a one-to-one matching grant. Sufficient funds have been secured for the first year, but the UCSF/MZVPP still needs to raise monies for the second and third years of the grant, McNamara said. Funding partners include UCSF Stanford Health Care Community Benefit Program Fund; Lucile Packard Foundation for Children's Health; Mount Zion Health Fund-The Martin Diamond Fund for Community Initiatives; The San Francisco Foundation; UCSF School of Medicine; John and Terry Levin; Lisa and Douglas Goldman Fund; Stuart Skorman (Hungry Minds Foundation); Vicky DeGoff and Dick Sherman.
The UCSF/MZVPP was founded in 1995 by pediatricians and pediatric social workers in the UCSF/Mount Zion Pediatric group. The program has several components. PATHWAYS (People Allied to Help Western Addition Youth Succeed) is a family support program that provides crisis intervention and therapy for families whose children have been affected by violence. A parent education series emphasizes building self-esteem in children and positive discipline techniques with a focus on alternatives to physical punishment.
The UCSF/MZVPP also works in partnership with the Western Addition Health and Wellness Collaborative, which concentrates on the health and well being of children in local schools, the Western Addition Crime Abatement Committee, and numerous other local and national networks committed to violence prevention.
For more information or to contribute to LINC, please call the UCSF/MZVPP at (415) 885-7636.