A Baltimore City Health Department program has quietly been supporting young trauma victims and their families, many who lose loved ones to violence

Published on: October 18, 2022 6:00 AM EDT|Updated on: October 18, 2022 1:01 PM EDT

Families walk through row of open doors and silhouette of a youth

In an instant, Cheyenne Ward’s life as she knew it unraveled.

Her pregnant sister, Angel Smith, was killed in a May drive-by shooting outside her home in Central Baltimore. The baby, born premature, survived.

Months later, a grieving Ward has taken in her sister’s other children, who range in age from 1 to 20 years, and is preparing to bring home the baby girl when she’s released from the hospital. Her two-bedroom apartment suddenly is teeming with life — and anguish.

“My whole life has changed,” said Ward, who lives in West Baltimore. “There are a whole lot of emotions running around.”

Ward has found some help in the Baltimore City Health Department, which runs a program for victims of trauma ages 11 to 24 and their families. Since its inception in 2016, the program has grown from a caseload of about 30 clients a year to around 200 now. The clients have endured everything from bullying and sex trafficking to gun violence.

The program works using referrals from city agencies, including the Mayor’s Office of Neighborhood Safety and Engagement and Baltimore City Public Schools, as well as other partners such as House of Ruth Maryland, a nonprofit organization that focuses on survivors of intimate partner violence. Caseworkers said they also have met clients at city events or while doing other outreach work.

In a city where young people are increasingly finding themselves at the center of tragedy, officials said they work round-the-clock to connect victims, survivors and their loved ones to social services that can support them and perhaps stave off more violence. They also will advocate on their behalf at school, at work or in rent court.

Amid a nationwide mental health crisis, particularly among young people, the program aims to fill a void for some of Baltimore’s most vulnerable residents: children who have been abused, attacked or who have lost loved ones. Although the program can’t solve crimes or heal physical wounds, it is assisting young victims of primary or secondary trauma with basic needs as they get back on their feet.

Ward said she and her nieces, ages 1, 14 and 20, have benefitted from the program. Caseworkers check in regularly, she said, and have provided her with essential items such as diapers and a stroller for the babies. They also are helping pay Ward’s rent as she takes a leave of absence from work, and stepped in when the threat of eviction loomed.

Although considered atypical for a health department to be involved in victims’ services, the program has grown as the lens through which Baltimore views its trauma expands from a public safety issue to a public health issue.

“It’s both a function of the reality that we have had a lot of violence over the past few years, but also a growing recognition of the impact trauma has and how it can be mitigated,” said Baltimore City Councilman Zeke Cohen, who has been at the forefront of the city’s implementation of trauma-informed practices. “It’s important that the health department carries some of this work; they’re a key partner in delivering trauma-informed care trainings.”

The trauma-centered approach comes as some 300 people are killed in Baltimore a year for the past six years. Hundreds more survive their wounds, police data shows. The tragic web of secondary and tertiary victims grows larger every year.

“You wouldn’t think that victim services goes hand-in-hand with the health department, but … there was such a need based on the amount of crimes and the types of victimizations that were occurring in the city,” said Tierra Morales, the program’s supervisor.

Morales said the agency has experienced an increase in referrals for victims of domestic violence and sexual assaults. Nonfatal shootings and relatives of homicide victims account for a bulk of the caseload, she said.

The Baltimore State’s Attorney’s Office, another referral source, houses a similar fund for victims and witnesses of crime, but it generally is reserved for solved cases or those that go through the court system. A scathing report from the U.S. Department of Justice published last year found that people who have been victimized in Baltimore often are mistreated by the criminal justice system and that protection and benefits often are contingent on testifying.

But not every victim of trauma feels comfortable identifying themselves to police or prosecutors, said Mark Mason, the health department program’s director who oversees a staff of four.

The health department has its own criteria for determining eligibility into the program and can accept more people than the state’s attorney’s fund, Mason said. It also serves secondary trauma victims who may not have a pathway to support elsewhere.

One such client, Karen Rivera, said she and her family are not eligible for the state’s attorney’s fund because of their aversion to being identified and potentially having to testify in a criminal case.

Instead, Rivera and her daughter have become beneficiaries of the health department, which has connected them with therapy and driver’s education, helped them relocate and paid two months’ security deposit for their new home.

“I couldn’t get money from the state’s attorney. Names are on discovery paperwork, and nobody wants to be identified and killed over that in Baltimore City,” Rivera said. “It [the Youth Services and Advocacy Program] is really good and they have really good follow through.”

Caseworkers in the health department successfully have allocated at least $300,000 in rent relief for clients since 2016, Mason said, adding that he views access to safe and stable housing as the first priority for his clients. The program also provides funds for groceries, connects clients with mental health care, coordinates transportation and pays for other services such as driver’s education and workforce development training.

Its budget currently stands at about $487,000 a year, Mason said, “but we make do.” The city’s fiscal year 2023 budget allocates $80,000 to rent subsidies for the program, enough for about 20 to 25 households or 60 people.

“We make sure that we actually are able to get connected to those families that may not be reachable all the time,” said Mason, who started as a youth advocate in 2018. “A lot of times, just because those resources are there, doesn’t mean that they’re accessible in the eyes of a victim.”

Mason said his experience as a youth advocate informed his understanding of secondary trauma. During house visits, as he would check in with victims, he would make note of how family members were coping and found that they too suffered from residual trauma; for example, he found young people displaying odd behaviors at school often needed advocates to inform their teachers of the circumstances at home. Sometimes, the secondhand pain would interfere with the family’s ability to stay housed or fed, he said.

Although he would like to see the program grow and expand to cover more people — and especially offer more housing assistance — Mason said he’s proud of his team’s ability to fill in Baltimore’s existing resource gap and meet families and victims where they are.

“A lot of the resources were brought to me from them,” said Jasmine Ramsey, whose 12-year-old daughter, Kaelin Washington, was shot in the chest in February 2021 by a stray bullet. They accessed rent relief, school tutors, therapists and access to the YMCA through the program. “They definitely were all hands-on. If it wasn’t for them, it definitely would’ve been hard.”

Cohen, while appreciative of the health department’s work, also said he’d like to see the agencies collaborate more with the services they offer to victims of trauma: “It’s important that the services be streamlined, and not siloed, because it creates confusion,” he said. The council has been working to address some of the findings of the justice department’s report, including expanding the police department’s benefits program.

But as Ward prepares to bring 5-month-old Angel home from the hospital — she weighs 10 pounds now — she said she appreciates the health department’s assistance in bringing a fragile newborn home and helping the family turn a page.

“Nobody can bring my sister back and nobody can help the situation right here,” Ward said. “But I’ve met some wonderful people who have become family.”