Early Identification and Referral

Beat Intro
Voiceover
00:00	This is the Beat—a podcast series that keeps you in the know about the latest community policing topics facing our nation.

Interview
Cindy Pappas
00:08	Hello and welcome. My name is Cindy Pappas, and on behalf of the COPS Office I would like to thank you for joining us for the final podcast in a series of five on the issues surrounding school safety, the role of police in schools, and the importance of community coordination in the identification and referral of children who have been victims of or witnesses to violence, as well as children with emotional or behavioral health needs. I’m pleased to introduce our two distinguished guests today, Dr. Steve Marans and Chief Dean Esserman. Dr. Marans, Harris professor of child psychiatry and professor of psychiatry, is the director of the childhood violent trauma center at the Yale University School of Medicine. Dean Esserman, chief of the New Haven Police Department, is a nationally renowned leader in innovative and community-oriented approaches to law enforcement practices and policies. They are here to talk with us today about the importance of early identification and referral of children who have been exposed to violence and the vital role of law enforcement along the continuum of care for these children in need. Welcome to you both.

Both
01:10	Thank you.

Cindy
01:12	Dr. Marans, as director of the National Center for Children Exposed to Violence and the founder of the Child Development Community Policing Program, can you please talk briefly about this model and, particularly, law enforcement’s role in partnering with mental health service providers to better assist children and families exposed to violence.

Dr. Steve Marans
01:30	Sure. I guess the first thing is that I’m just delighted that we have the opportunity to talk with you and be able to do this with the co-founder of the Child Development Community Policing Program, my dear friend and colleague Dean Esserman. 

	The first point, I guess, is that our work began in 1991, based on the recognition from the child study center and from the New Haven Department of Police Service that we were not adequately addressing the concerns, the needs of kids and families who were exposed to violence when we continued to work in isolation of each other. What we know is that early identification and early intervention of kids who are exposed to violence and potentially traumatized is the best predictor for good outcomes and by that I mean moving from traumatization to recovery. The issues of law enforcement and mental health partnering together in many ways now seems quite obvious. At the time, the police were the folks who were still making house calls 24/7. They were the folks who were called upon when kids and families and entire communities were exposed to violent episodes that left people traumatized. They were the first point of contact, and therefore the best folks, both to identify and to begin interventions with affected kids and families.

	From the mental health side, remaining in our consulting rooms only would leave us often not seeing these kids at all—the ones who are at greatest risk for long-term difficulties due to their violent traumatization. We need to work together as partners to respond together and to take advantage of the expertise from law enforcement and from mental health.

Cindy
03:37	Thank you. Could you tell our audience whether you might be able to find out more specific information about the Child Development Community Policing Program?

Steve
03:45	Sure. If they go to the Yale Child Study Center website, they will see under that website—listed under the trauma section—there’s a description and then references to the CDCP Program.
	
Cindy 
04:00	Great, thank you. Chief Esserman, clearly law enforcement’s responsibility when responding to an act of violence that involves anyone, especially or including a child, is first and foremost ensuring the child is physically safe and then to ensure the proper collection of evidence. What do you believe is the role that law enforcement should have in addition to working with community partners to properly address the medical, emotional, and psychological needs of children who have been exposed to violence?

Chief Dean Esserman
04:28	This partnership over a generation has really changed the way a New Haven police officer thinks about who the victims are and how to help a victim. I still remember that first night 20 years ago when we were at the scene of a domestic murder. The four children were at home and we told them just to keep their feet up so they didn’t get their feet in the blood of their mother and they could just watch TV. They just weren’t witnesses to us so they didn’t demand our attention. I look back on that as a pivotal moment in the New Haven Police Department. That would be handled so differently today.

	Today, the New Haven police officer has an expanded view of who the victim is and how to bring support to the victim. We do a type of policing today that feels more like a social service agency, and I’m proud to say that. We haven’t abrogated our law enforcement responsibilities; we’ve simply built upon them.

	The officer today will follow up with a contact to a clinician at Yale Child Study Center, which case will then be talked about at a case conference every Wednesday—talking about that family, talking about those children, a week after the initial call. That’s how the New Haven Police Department does business now. It’s not how most police departments do business, but it’s how we have fundamentally changed the delivery of our services to every family, every event we ever respond to.

Cindy
06:08	That is so important. I think the key to that is not just focusing on those who are direct victims but those who are witnessing it in their homes, schools, and communities. They do need the services in addition to those who are the direct victims.

Steve 
06:22	Cindy, I would also add that one of the things that Chief Esserman was referring to and the question you raised goes to the heart of what we actually mean by trauma. Trauma really is not just about being upset; it’s about the loss of control and the sense of helplessness and terror. Law enforcement’s role when organized in the way that the chief was describing really takes advantage of the role of benign authority in the establishment first and foremost of safety, both at the time of the event, providing order and structure where folks need it the most, and when it’s done hand in hand with clinical colleagues, when we train each other to understand each other’s work, we’re able to really address the disorder quite quickly. In follow up, in the meetings and case discussions that the chief was referring to, it’s also an opportunity to assess whether the threat of danger is continuing and how to address those threats from multiple angles, first and foremost from a law enforcement angle.

Cindy
07:37	Thank you. That actually leads into my next question. As we’re talking about providing support services to victims and witnesses, you also know, both of you directly, that the first responders—law enforcement and other first responders—are responding often to violent and catastrophic events. I would like to ask you both to please briefly discuss what first responders can do to immediately protect themselves from vicarious, or what is often referred to as second-hand, trauma.

Steve
08:09	I guess the first way of responding is, when the chief was describing our weekly case conferences, what is also involved is cross-training of all clinicians and all officers who work together. Meaning that we have to learn first about each other’s work, we have to learn about each other’s perspective and develop it into a shared frame of reference. That may sound academic but what that really means is that clinicians spend hours and hours and hours in squad cars with our colleagues and our colleagues spend hours with us learning about the work that we do from the clinical side.

	That means that when we respond to these terrible, tragic events, we are working shoulder to shoulder. That actually has enormous significance in terms of neither officers nor clinicians being alone in carrying the emotional burden of what we do.

	The second part is as we’ve developed very specific protocolized approaches in how we respond acutely, immediately on scene and the follow up that Chief Esserman was referring to and the longer-term evidenced-based care that we provide clinically, there is an opportunity to feel effective, to be active, and to no longer be in the situation that the chief was describing earlier where one has to keep blinders on and then swallow the emotional response that one’s having and to feel, like the victims on the scene, helpless as if we can’t do anything. That has an enormous function in terms of guarding against the emotional burdens that any first responders—clinical and policing—may have. It also establishes the relationship—personal, professional relationship—that allows us to really look after each other and know that there’s always somebody that we can talk with about what we’re experiencing.

Cindy
10:15	Very good. Chief Esserman, would you like to add any additional information or viewpoints from the practical application of responding to these types of incidents and then working in partnership with your mental health service provider? 

Dean
10:30	Over the years, I’ve heard so many stories of officers feeling frustrated when they encounter a child or a family and they feel that there’s not much they can do. It brings a terrible sense of frustration and often a terrible sense of anger. That’s mitigated here because there’s something they can do. The clinicians from the Yale Child Study Center participate at our weekly COMPStat. For 20 years, the Yale Child Study Center has hosted the Wednesday case meeting where all the district commanders for the city come together, often with the detectives and officers, to talk about the cases that they’ve referred together, with DCS, with others in the room in a collegial way.

	Now officers are feeling, I think, like they have more ability to do something than in the past and have the ability as well to follow up and talk about it. Officers encounter so many things that frustrate them. They start so many things that they never know how they finish. There’s less of that now in New Haven and I think that’s good for everyone involved, including the people who are doing the work, like officers and clinicians.

Cindy
11:48	Absolutely. Dr. Marans, could you please talk about the partnership between the International Association of Chiefs of Police and the National Center for Children Exposed to Violence under the Attorney General’s Defending Childhood Initiative to develop specific tools and resources to help law enforcement and their community partners better identify, respond, and refer children exposed to violence.

Steve
12:09	Sure. It’s actually a wonderful opportunity and it’s just fantastic to be working with our partners at IACP who were awarded this grant. The chief and I are working together as part of that grant in order to take advantage of what we’ve learned over the years. This is an opportunity to take materials that we’ve developed, translate them into guidelines and information for law enforcement agencies about the specific roles that they can play in helping children and families recover, and to really take advantage of the broad areas of work that IACP is involved with in the areas of law enforcement, juvenile justice, etc., both in terms of the best ways of communicating and taking advantage of the tremendously successful network that has already been established by IACP.

Cindy
13:14	That was an award from the Office of Juvenile Justice and Delinquency Prevention at the U.S. Department of Justice. For our audience, when do you think that they can expect to see some of the tools and resources developed? Is that a 2-year award?

Steve
13:28	Yes it is, and, again, many of the materials that we’re going to be capitalizing on have been developed over the last 20 years as an outcome of the partnership between the Child Study Center and the New Haven Police Department. These include protocols about identifying kids and families at greatest risk, also the role of law enforcement in responding to immediate, acute calls for service, follow-up responses in terms of specialized responses in terms of domestic violence, as well as protocols that have been developed in partnering around death notifications and the like. These will start to emerge, hopefully, around the next 6 months and will be coming out in a systematic way as part of our planning process with the International Association of Chiefs of Police.

Dean
14:34	In addition to that, I’ve recently been asked by the IACP president to become the new chair of the juvenile justice committee.


Cindy
14:43	Congratulations! Very good.

Dean
14:45	I don’t know yet, but I’m flattered. It will be an opportunity to bring Dr. Marans and this work, sponsored by the Justice Department, to the committee, which will have a broad dissemination among police chiefs around the country, and IACP members who are invested in this issue.

Cindy
15:07	That is good to hear. Both of your voices are so important on this issue.

Steve
15:11	Can I just add to what the chief was saying? You know the work, it was developed and has been developed over the past 20-odd years, is something that the Department of Justice has been very closely involved in and supported over many years. This grant to IACP and our involvement in it actually represents the fruits of labor, not only in New Haven but in the Department of Justice, and now offers an opportunity for law enforcement agencies and potential partners around the country to benefit from what we’ve learned.

Dean
15:50	You know, I find it interesting that 20 years ago, Eric Holder was the Deputy Attorney General and came to New Haven to see and understand what was going on between the Yale Child Study Center and the New Haven Police Department. Later, he and Attorney General Reno brought us to the White House for the designation of the Yale Child Study Center as a National Center for Children Exposed to Violence. Twenty years later, Eric Holder has now returned as the Attorney General and has maintained his interest and has maintained his relationship with the Yale Child Study Center. The work has been going on with the Justice Department now for two decades.
	
Cindy
16:37	Yes and all of that is currently under the Defending Childhood Initiative. More information can be found on the U.S. Department of Justice website.

Steve
16:45	As well as the report that was just issued by the U.S. Attorney General’s Task Force on Children Exposed to Violence that I served on, and that includes many of the things that the chief and I have been working on these last two decades and includes the very efforts that the IACP award from Justice is aiming to fulfill.

Cindy
17:11	Very good, yes. Thank you for reminding us about the report from the Defending Childhood Task Force on Children’s Exposure to Violence. 

	Chief Esserman, do you have any final words regarding law enforcement’s role in identifying and referring children who have been exposed to violence for us today?

Dean
17:29	You know, I think that officers are involved and engaged in the lives of the community they serve. I think they are engaged and involved in the families for years, over their career. They see the children grow up, they know the older brothers and uncles and fathers who came before them. Officers make 20- and 30-year commitments to their jobs and to the community they serve. I have found, in my experience, that this is one of the most satisfying and rewarding tools we’ve ever given a police officer—a way to help a family and help children and, in so doing, help themselves.

Cindy
18:12	Absolutely, thank you. Thank you for that and for your service. 

Steve
18:16	I would just add one other thing, Cindy, and that is that I would echo what Chief Esserman is saying. One of the things that we have learned from our partners is how to expand what we mean by “therapeutic.” By capitalizing on and expanding on the traditional roles of law enforcement, we have come to recognize the critical role that law enforcement officers have in actually helping people to recover, not just by making referrals, but the way that they respond, the way they exercise their authority in an intended way, and the ways in which their roles in reestablishing law and order and organization—and a sense that somebody’s got your back—plays such an enormously critical role in helping people to recover when they’ve not been able to control the tragic incidents that bring the police to their doorsteps in the first place.

Cindy
19:26	Dr. Marans and Chief Esserman, thank you both so much for your time and your expertise on this important topic. 

Steve
19:33	Thank you Cindy.

Beat Exit
Voiceover: 	
19:35	The Beat was brought to you by the United States Department of Justice COPS Office. The COPS Office helps to keep our nation’s communities safe by giving grants to law enforcement agencies, developing community policing publications, developing partnerships, and solving problems.



Disclaimer:
19:51	The opinions contained herein are those of the authors and do not necessarily represent the official position or polices of the U.S. Department of Justice. References to specific agencies, companies, products, or services should not be considered an endorsement by the authors or the U.S. Department of Justice. Rather, the references are illustrations to supplement discussion of the issues.


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