Amid Chicago violence epidemic, PTSD for survivors

There have been 318 homicides in Chicago so far this year. Most of the homicides occur on the South and West sides of the city where the majority of the residents are black. Indeed, 74 percent of homicide victims are black and 83 percent of all of those killed are male.

In 2016, Chicago had a 58 percent increase in homicides making it the deadliest year in two decades. The city is on trend to match these numbers for human lives prematurely lost this year.

{mosads}While city officials and policymakers have struggled to understand the causality for the sudden spike in homicides and to find a solution to end rampant violence in the city, they’re only just beginning to consider the traumatic effects of exposure to violence and explore remedies to the potentially chronic and debilitating symptoms it causes. 

It is imperative that we urgently address the root causes of violence, the behavior and the impact of exposure to violence for we are in the midst of a dangerous and deadly equation. Even when the violence has ceased, the consequences of this period of time will be pervasive and enduring.

As a clinical psychologist and assistant professor in the Department of Psychiatry and Behavioral Sciences at Northwestern University, I conduct community based research on barriers and facilitators of mental health service use among low-income, racial/ethnic minority adults.

An estimated 24 million people, or eight percent of the U.S. population, will experience PTSD at some point in their lifetime. Those who are repeatedly exposed to traumatic events such as violence and death have an exponentially greater risk for developing PTSD.

In the wake of the violence in Chicago, the term “trauma” has been introduced colloquially to generally convey a bad feeling after a negative experience; but in fact, it is poorly understood.

Post-traumatic stress disorder, or PTSD, is a psychiatric disorder that develops in some who have experienced a scary, shocking or dangerous event. Symptoms include re=experiencing the traumatic event (i.e., flashbacks, nightmares), avoidance of thoughts, feelings or places related to the event, feeling tense or irritable, negative thoughts about oneself or the world, or feelings of guilt or blame. 

An overwhelming 70 percent of adults in the U.S. have experienced some type of traumatic event at some point in their lives. The most prevalent traumatic events to which people have been exposed include physical or sexual assault (53.1 percent), the death of a family member or loved one due to violence/accident/disaster (51.8 percent) and natural disaster (48.3 percent).

Approximately one in five of those who have been exposed to a traumatic event will develop PTSD. Peritraumatic dissociation, or altered perceptions during or immediately after a traumatic experience, is the factor that most strongly predicts PTSD developing later. Emotions such as helplessness, fear, horror, guilt, and shame, perceived lack of support, perceived life threat, family history of mental illness, personal history of mental illness and prior trauma are also predictors.

Black men in the U.S. between the ages of 15 to 34 are most likely to die by homicide. These men are not only fighting daily to stay physically alive, but they are also fighting to preserve their mental health and ability to function productively in society — a formidable task given the plethora of risk factors in their shadows and the dearth of resources available to support them.

The majority of the homicides in Chicago occur in low-income and impoverished communities. In the Austin neighborhood, were 32 homicides have occurred so far this year, 27 percent of the residents live below the poverty level and 21 percent are unemployed. Austin ranks 15th for violent crime, 30th for property crime and 7th for property crime among Chicago’s 77 neighborhoods. Further, high neighborhood disorder and poor community cohesion increase the likelihood of PTSD symptoms among low-income black adults.

In a recently published study I co-led with my colleague, Sungyhun Hong, we found that among a group of 72 low-income black women, over half (52 percent) reported experiencing a traumatic event including physical or sexual assault and exposure to violence. Of those, 29 percent met criteria for PTSD. The majority of these women had never previously received mental health treatment.

In my experience as a clinician and researcher it is evident that there are large numbers of people who experience significant symptoms of stress, depression and anxiety and are either unable to access the mental health care system due to the lack of available community resources, lack of insurance coverage, or are reluctant to seek professional help due to stigma and embarrassment.

The means to treat symptoms of trauma are limited by the lack of community mental health resources, particularly on the South and West sides of the city. Yet, it is critical that the psychological effects of trauma are taken seriously and included as part of the discussion of community violence.

Illinois cut $113.7 million in funding for mental health services from 2009 to 2012, which resulted in closing two inpatient facilities, six of twelve mental health clinics and several community health agencies. Four of the six agencies that closed were on the South and West sides of the city, where the majority of violence occurs, and where such services are desperately needed.

To be sure, in an effort to begin to rebuild community based mental health resources, last year the Cook County Health & Hospitals System established a pilot 24/7 Community Triage Center in the Roseland neighborhood on Chicago’s south side to provide early intervention services for individuals at risk of detention or hospitalization due to mental illness. Additionally, Bright Star Community Outreach led by Pastor Christopher Harris in the Bronzeville neighborhood on the South Side has partnered with community members and institutions, including Northwestern University, to address violence and trauma. These efforts are essential, but hardly enough to support the mental health needs of communities in such peril.

The psychological effects to exposure to violence are chronic and expansive. Gun violence affects not only those who are directly involved, but also families and communities who endure the constant threat of violence and grieve the unexpected loss of loved ones.

As a community, and far beyond Chicago, we are tasked with urgently seeking ways to reduce the myriad overlapping risk factors for violent behavior and trauma symptoms. In doing so, we can’t casually claim we’re going to address “trauma” but instead must intentionally cultivate communities of support, implement effective trauma interventions within community health agencies and other social service systems, and empower individuals with the access and agency to participate in available services.

Trauma is more than a buzzword — the symptoms are real and have a profound impact on human lives. Until we recognize the fully realize the cyclical effects of neighborhood disorder, violence and its after effects, the open wounds in our communities cannot fully heal.   

Inger E. Burnett-Zeigler is a clinical psychologist and assistant professor at Northwestern University, Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences. She is an NU Public Voices Fellow with The OpEd Project.​

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