Think about the least desirable neighborhoods around you. You know the places I’m talking about — the areas you think twice about going to in the daytime and deliberately avoid at night. Those zones where police officers are most often called to respond to reports of shootings, stabbings and murders.
Now, think about the people who live in those crime-infested neighborhoods. Think of the young people who grow up watching the violence all around them and fearing it will come for them.
A recent article by journalists at ProPublica.org quoted a growing list of studies that have compared what happens to people who live in dangerous neighborhoods here at home with what happens to soldiers serving in war zones. The unanimous conclusion is that residents of violent neighborhoods can suffer from post-traumatic stress disorder just as so many of our soldiers do. Just like veterans, civilians can experience flashbacks, nightmares, paranoia and social withdrawal.
While the military has established protocols for diagnosing PTSD in soldiers, there are barely any programs in place to help civilians. You can count on one hand the number of hospital emergency rooms that bother to question victims of community violence, those who come in seeking treatment for a severe beating, a stabbing or gunshot wound.
We know from research on military personnel that PTSD is a very real, very terrifying syndrome in which the sufferer has a sudden and distorted sense of being in imminent and extreme danger. They become horrified, hyper-aggressive and violent in response. They gather weapons to help them fight off their perceived threats.
If these recent studies about the growing number of civilian PTSD cases are on target — (one from Drexel University, for example, found that homegrown PTSD victims are more likely to carry a weapon to “restore feelings of safety”) — doesn’t it behoove us to pay closer attention to neighborhoods that could be producing human ticking time bombs?
It doesn't take a risk assessment expert to peg this problem as a solid public safety issue.
Currently, however, only one U.S. hospital performs routine PTSD screening.
ProPublica contacted top trauma centers in the 21 U.S. cities with the highest murder rates. Only the Spirit of Charity Hospital in New Orleans has its emergency room doctors routinely monitor for PTSD and offer treatment options to the incoming wounded.
At Cook County Hospital in Chicago’s inner city, a pilot program began in 2011 to identify PTSD symptoms in pediatric patients. Now, social workers report 42 percent of all patients examined for gunshots, stabbings and other violent injuries had signs of PTSD symptoms. Most of them were male but, when questioned, women and whole families reported “significant levels of PTSD.”
Researchers in Atlanta questioned 8,000 inner-city dwellers and learned that two-thirds had been violently attacked, about half of them knew someone who had been murdered, and one person out of every three interviewed reported having had PTSD symptoms sometime in his or her life.
“The rates of PTSD we see are as high or higher than Iraq, Afghanistan or Vietnam veterans,” project leader Dr. Kerry Ressler said. “We have a whole population who is traumatized.”
ProPublica reports that at Detroit’s Receiving Hospital, psychologists talk with susceptible patients about PTSD, but there’s no real program in place. Staffs at hospital trauma units in Birmingham, Ala., and St. Louis, Mo., say they hope to begin routine PTSD screening by the end of the year. Doctors in Baltimore, Newark, Memphis and Jackson, Miss., all said they would like to have such a program, but their hospitals simply don’t have the money.
The bills of low-income patients are most often paid by Medicaid, which doesn’t cover PTSD screenings. Maybe the program should reconsider, as a bit of public money spent now could save a lot more in the future.
Regular readers of this column know the rate of crime has been going down, nationally, but still there are pockets in America where rates of violent crime continue to escalate.
There are whole neighborhoods in the United States that are so dangerous that they are creating a clinically definable group of people who could violently lash out at any given moment. Think of the damage done in terms of getting an education, family relationships, parenting skills and, in many cases, the frequent inability of adult PTSD victims to hold down a job. You know who pays for their unemployment benefits? We all do. We also pay for food stamps, child welfare, housing allowances, the cost of family and juvenile court, and incarceration costs.
There are so many politicians who, during election cycles, wax eloquently about working for the well-being of all citizens, doing what’s best for the economy and society at large. Funny, I don’t hear many speak about crime, justice or concrete ideas to make us safer where we live.
I guess it comes down to this: Do we want to offer better policing, meaningful counseling and maybe even a relocation stipend to those who have endured violent acts in their own communities — or do we want to wait until something awful happens and pay the increased freight on the back end?
There’s no getting around it. Researchers have been studying this problem since the late 1990s and all have come to the same conclusion. There are parts of America that are as damaging to human beings as the worst foreign war zones.
— Diane Dimond is the author of Be Careful Who You Love: Inside the Michael Jackson Case. Contact her at firstname.lastname@example.org, follow her on Twitter: @DiDimond, or click here to read previous columns. The opinions expressed are her own.