Marans S, Berkowitz S J, Cohen D J
Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA.
Child Adolesc Psychiatr Clin N Am. 1998 Jul;7(3):635-51.
Coordinating responses through the Child Development-Community Policing Program has led to multiple changes in the delivery of clinical and police services. Mental health clinicians and police officers have developed a common language for assessing and responding to the needs of children and families who have been exposed to or involved in violence. Learning from each other, these unlikely partners have established close working relationships that improve and expand the range of interventions they are able to provide while preserving the areas of expertise and responsibilities of each professional group. The immediate access to witnesses, victims, and perpetrators of violent crimes through the consultation service provides a unique opportunity to expand the understanding of clinical phenomena from the acute traumatic moment to longer-term adaptation, symptom formation, and recovery. In turn, the initiative introduces the systematic study of basic psychological and neurobiologic functions involved in traumatization as well as the investigation of psychotherapeutic and pharmacologic therapies. Similarly, program involvement with juvenile offenders has led to a coordinated response from the police, mental health, and juvenile justice systems. This project provides an opportunity to develop detailed psychological profiles and typologies of children engaged in different levels of antisocial behavior as well as to determine the characteristics that might predict with whom community-based interventions might be most successful. A recent survey of New Haven public school students has yielded promising evidence that community policing and the program are having a positive impact on the quality of life. In a survey of sixth-, eighth-, and tenth-grade students there were substantial improvements in students' sense of safety and experience of violence between 1992 and 1996. When asked if they felt safe in their neighborhood, there was an increase in the percentage of positive responses from 57% to 62% for sixth-grade students, 48% to 66% for eighth-grade students, and 53% to 73% for tenth-grade students, and when asked if they had seen someone shot or stabbed there was a decrease in positive responses from 43% to 28% for sixth-grade students, 46% to 31% for eighth-grade students, and 34% to 28% for tenth-grade students. Today, we are all too familiar with the developmental trajectory that leads children into violent crime. Newspaper articles and clinical case reports have taken on a dreary repetitiveness. These young criminals are often poor, minority, inner-city children who are known to many agencies to be at risk because of family disorganization, neglect, and abuse. They are failing in school or are already on the streets. One day they are victims and the very next they are assailants. We are all familiar with the inadequacies in the social response to these children, from their preschool years through the point at which they become assailants themselves. What is shocking is that the age at which children make the transition from being abused to being abusive seems to be getting earlier, and the number appears to be increasing. On the positive side, there is an increased awareness of the need and the ability of the various sectors of society to respond in concert. The institutions that function in the inner city--schools, police, mental health and child welfare agencies, churches--are all concerned about the same children and families. By working together, with a shared orientation to the best interests of the children, they can intervene earlier and more effectively: first, to disrupt the trajectory leading to violence; and, second, to help those children who are already caught in the web of exposure to violent crime and inner-city trauma. The experience with community-based policing and mental health in New Haven, now being replicated throughout the United States, can thus stand as a model of an active social response to an overwhel
通过儿童发展-社区警务计划协调应对措施，已使临床服务和警务服务的提供发生了多方面变化。心理健康临床医生和警察已经形成了一种共同语言，用于评估和应对遭受暴力或卷入暴力事件的儿童及家庭的需求。这些不太可能成为伙伴的人相互学习，建立了密切的工作关系，在保留每个专业群体的专业领域和职责的同时，改进并扩大了他们能够提供的干预措施范围。通过咨询服务能够立即接触到暴力犯罪的证人、受害者和犯罪者，这为从急性创伤时刻到长期适应、症状形成和康复等方面扩展对临床现象的理解提供了独特机会。反过来，该倡议引入了对创伤中涉及的基本心理和神经生物学功能的系统研究以及对心理治疗和药物治疗的调查。同样，该计划与少年犯罪者的合作促使警察、心理健康和少年司法系统做出协调应对。这个项目提供了一个机会，来制定参与不同程度反社会行为的儿童的详细心理档案和类型，以及确定哪些特征可能预示基于社区的干预措施对哪些儿童最有效。最近对纽黑文公立学校学生的一项调查得出了有希望的证据，表明社区警务和该计划正在对生活质量产生积极影响。在对六年级、八年级和十年级学生的调查中，1992年至1996年间，学生的安全感和暴力经历有了显著改善。当被问及在邻里中是否感到安全时，六年级学生给出肯定回答的比例从57%上升到62%，八年级学生从48%上升到66%，十年级学生从53%上升到73%；当被问及是否在那里看到有人被枪击或刺伤时，六年级学生给出肯定回答的比例从43%下降到28%，八年级学生从46%下降到31%，十年级学生从34%下降到28%。如今，我们对导致儿童走向暴力犯罪的发展轨迹已经非常熟悉。报纸文章和临床病例报告都呈现出令人沮丧的重复性。这些年轻罪犯往往是贫困的少数族裔城市中心儿童，许多机构都知道他们因家庭混乱、忽视和虐待而处于危险之中。他们学业失败或已经流落街头。前一天他们还是受害者，第二天就成了攻击者。我们都熟悉社会对这些儿童从学前阶段到他们自己成为攻击者这一过程的应对不足。令人震惊的是，儿童从受虐转变为施虐的年龄似乎越来越小，而且数量似乎在增加。从积极的方面来看，社会各界越来越意识到需要并且有能力协同应对。在内城区发挥作用的机构——学校、警察、心理健康和儿童福利机构、教会——都关注着相同的儿童和家庭。通过共同努力，以儿童的最大利益为共同导向，他们可以更早、更有效地进行干预：第一，打断导致暴力的轨迹；第二，帮助那些已经陷入暴力犯罪和城市中心创伤网络的儿童。纽黑文基于社区的警务和心理健康经验目前正在美国各地推广，可以作为社会对这一压倒性问题的积极应对模式。
