Three Things To Read This Week

1. New Research Shows That “Treatment, Not Trauma” Is An Effective Framing Device For Efforts To “Send Crisis Responders To Mental Health Calls.”

As the Chicago Sun-Times’ Fran Spielman reports, a Chicago city council committee approved a sweeping measure this week that would:

“create an alternate response system that relieves police officers of responsibility for handling the mental health emergency calls they dread, investing in community care by raising the pay of mental health professionals and dramatically increasing funding for Chicago Department of Public Health…” 

This proposed mobile crisis response system is a key piece of a broader plan known as the “Treatment Not Trauma” measure. What we’re focused on in this newsletter is the framing of the measure, because, when it comes to support from the public and the lawmakers who represent them, how policies are framed can matter as much as the substantive details contained within the policy. 

To that end, the newsletter Notes on Persuasion recently covered two studies that tested the effectiveness of various slogans on support for mobile crisis responder programs including “treatment, not trauma”. The other slogans tested include: “care, not criminalization”; “care, not cops”; “police can’t do it alone”; and “fully fund public safety.”

The studies—“an in-survey Randomized Controlled Trial and a max-diff design”—are described in much more detail in Notes on Persuasion. However, the bottom line is that the “treatment not trauma” slogan—though not the best performing slogan—increased support for the ballot measure in both studies. From the original newsletter:

• The RCT Study: The “police … can’t do it alone” message was the top performing message, increasing support for a hypothetical ballot measure by 4 percentage points relative to the control group … Notably, this is the top performing message across every sub-group (age, gender, race, ideology, 2020 presidential vote). Meanwhile, “Treatment, not trauma” and “fully fund public safety” are neck-and-neck as the second and third best performing messages…”

• The Max-Diff Study: As with the in-survey RCT, “police…can’t do it alone” was the best performing message (indeed, again, it was the top performing message across every sub-group). “Fully fund public safety” beat out “treatment, not trauma” [, which finished third] by a four percentage point margin.

• Takeaway: “‘Police … can’t do it alone’ is worth testing as a slogan for any campaign pushing for a mobile crisis response program. ‘Treatment, not trauma’ and ‘fully fund public safety’ … are [both also] likely to increase support for establishing a mobile crisis response program.” 

Here are the full results.

2. Medicaid Reimbursements For Community Violence Intervention Programs.

Dr. Kyle Fischer, an emergency room physician in Baltimore, Maryland, recently told The Guardian’s Sonya Singh that there aren’t “enough resources to provide the long-term physical, psychological and social care survivors need after their short-term care.” Indeed, as Dr. Fischer—and co-authors Colleen Morris and Dan Piening—explain in an article published in this month’s edition of Health Affairs: 

“Unfortunately, despite the proven effectiveness and potential return on investment of these models, funding for violence prevention services has historically been limited. Consequently, programs have often been forced to rely on grants to maintain their services. The reliance on short-term and often inconsistent funding sources has created persistent challenges for [violence intervention] programs and has hindered their ability to reach programmatic sustainability.”

These funding challenges are why, as part of the Health Alliance for Violence Intervention—or, HAVI—Dr. Fischer “has been advocating for Medicaid reimbursement for more than a decade.” Now, those reimbursements are finally possible. From the Health Affairs article:

“[T]he Biden-Harris administration announced historic investments in community violence intervention, including a provision that offers guidance for states to use Medicaid to support CVI strategies … any [community violence intervention] model that provides long-term health services—such as peer support, psychological services, or case management—would be eligible. 

As of the beginning of 2023, five states—California, Connecticut, Illinois, Maryland, and Oregon—have elected to use Medicaid to support CVI programming.” 

As Dr. Fischer also explained to The Guardian, these Medicaid reimbursements “means that [community violence intervention] organizations can adapt and expand more easily when the need for their services grows, such as when gun violence increased during the pandemic.” Moreover, the “stability and certainty” that these reimbursements offer, while “not a panacea”, help to “shield a city’s violence prevention programs from the downstream effects of different political priorities when, for example, a new mayor takes office.”

Related:  Medicaid reimbursement is also available for mobile crisis response programs. Oregon became the first state to receive the funding last year. And last week, the U.S. Department of Health and Human Services approved California and Kentucky to use the Medicaid reimbursement program to “expand access to community-based mental health and substance use crisis care” allowing the states to fund “services through mobile crisis teams by connecting eligible individuals in crisis to a behavioral health provider 24 hours per day, 365 days a year.” 

3. Yale Hospital Violence Intervention Offers $1,000 Stipends To Shooting Victims and Family Members. 

For WTNH, New Haven’s local ABC affiliate, Jayne Chacko reports on a new pilot initiative of the Yale New Haven Hospital violence intervention program which provides unconditional one-time cash stipends to “shooting victims or families who lost someone to violence.” 

The pilot project seeks to “demonstrate the benefits of direct cash assistance for victims of interpersonal violence” and “reduce violence” (for example, by allowing for relocation costs away from a dangerous situation). As Chacko explains, the program provides murder victim family members with “a one-time payment of $1,000 [via prepaid Mastercard]” while “victims of violence are eligible for two payments of $500 each.”

In a fact-sheet, Yale New Haven Hospital’s partner in administering the cash program explains that this “emergency cash” will “help patients meet urgent needs like purchasing a bus or train ticket to get to the next loved one or to a safe place, paying for food, bandages or a prescription co-pay due to lost wages while hospitalized.” Indeed, as the local ABC affiliate noted, “some [of the victims and victim family members] who have received the money have used it for food, hospital bills or rent.”

Last year, Safer Cities reported results from a national poll showing that nearly two-thirds of voters—65%—believe that “providing a guaranteed income” in order to create more “economic stability for families” is an “effective” policy for “making communities safer.” Put us on the record betting that “cash transfer” programs like the Yale hospital initiative described above are even more popular with voters because the beneficiaries of the stipend are victims of violent crime. We’ll test out this hypothesis in future survey research. Stay tuned.