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Abstract
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In regular medicine if a patient goes to a doctor to be treated for a rat bite, the physician cleans the bite, dresses it, gives antibiotics, and gives a tetanus shot. The physician practicing social medicine would give our imaginary patient the same treatment but would go a step further; he would arrange for someone to go into the patient's community and set rat traps. A similar distinction is made between general psychiatry and community psychiatry, and this distinction highlights one of the main principles of the community psychiatrist's mission, community development. Community development being the art of helping a community achieve a social and interpersonal milieu that promotes an optimum level of mental health (Freed, 1972; Freed, 1972). This aspect of community psychiatry takes on an even greater significance when the community being served is a lower socioeconomic, minority community because of the conditions found in such communities that can impair the overall mental health of the community's individuals, families, and groups. This article will illustrate the principle of community development, the role of one psychiatrist in community development, and its importance to deprived minority communities by describing a community psychiatry approach to the problem of black-on-black homicide.
VioLit summary:
OBJECTIVE:
This article examined black on black homicide from a health/medicine perspective including description of the problem and actions which should be taken. The use of community psychiatry in the black community was discussed.
METHODOLOGY:
This study utilized a non-experimental literature review to explore the issues of black on black violence and to describe some efforts that have already been taken.
FINDINGS/DISCUSSION:
Black on black homicide was stated to be the leading cause of death in black males aged 15-34. Black males are more likely to be murdered than white males, black females, or white females; black females were more likely to murdered than white males or females, the study reported. Interpersonal relationships were also reported to have high amounts of nonlethal violence meaning that black on black homicide is only the surface of the violence problem among blacks. The author reported that the impact of murder and violence on the black community has far-reaching effects; persons witnessing violence, victims of assault, families of victims, and families who must cope with the long term care of children and other familial problems are all affected by black interpersonal violence. The effects of interpersonal violence in the black community, it was argued, require attention to psychiatric issues including both the emotional nature of the offending and the aftereffects of violence. Three approaches to the etiology of the problem of black-on-black murder were discussed. The biological perspective argues central nervous system damage is a suspicion in the root of lethal violence. The results of studies linking head injury to violent persons have provided another possible biological link. Other acquired biological causes of violence have been linked to alcohol abuse which was argued to be linked to low levels of serotonin. A psychological approach to the problem, as described by the author, would look at stress from inadequate socioeconomic status and self-deprecation linked to racism and the dominant culture. Sociological factors discussed by the author included social groupings--such as gangs--that promote violence. An active medical interest and involvement in violence was argued to be an important area for development.
AUTHOR'S RECOMMENDATIONS:
The primary thrust of this article was discussion of the role the author thought the medical community should play and a plan for coping with the phenomenon of black interpersonal violence. First, the author argued that consciousness-raising must take place. This would require community development groundwork among blacks that did exist. The Community Mental Council, Inc. (in Chicago) was used as an example of a consciousness-raising effort from connection to the mass media about black violence issues, a T-shirt campaign to stop black-on-black murder to the establishment of a "No Crime Day" which involved the business sector as well as the public sector. Primary prevention strategies should follow, the author stated. These would involve establishment of social networks for families at risk, support groups, parenting classes, family orientation to support services in the community, family therapy, and group family therapy. Other primary efforts could include vocational programs, alternative activities for youth, and prevention through better infant care and child safety. Secondary prevention, the author said, would involve identification and treatment of individuals who have been perpetrators of violence but not murder. Also, the identification of potential victims would be an important component to secondary prevention. The author argued that the best place for these activities would be the mental health system and other medical or psychological support services. Treatment with medicines and better identification/treatment of potentially violence-producing injuries was argued to be important. Active involvement of the community psychiatrist in eliciting public funding and support to aid in the secondary prevention of black-on-black murder was advocated. Tertiary prevention, as the author stated, would occur after the fact of a black-on-black murder to cope with stress and difficulty after a murder has occurred. Included in this would be assistance for murderers, particularly those released into the community, and exploration of current offenders for clues to primary and secondary prevention. In summary, the author argued for a community psychiatric approach to the phenomenon of black-on-black violence through social medicine in the black community itself.
EVALUATION:
The problem of violence in the black community has been confounded by both the attitudes of the dominant culture and the relative inability of the black community to assist itself. This problem is, consequently, not diminishing but increasing. The approach advocated by this author involves psychiatric/medical expertise within a community context. The point that the community-level is the appropriate level to begin is a point well taken. Individuals do not act in isolation but do so within a context of others who are often unwillingly involved whether it be as victims, families of victims, or witnesses. The cultural context of the black community is one such context which likely has a dramatic impact on the shape and frequency of black violence. (CSPV Abstract - Copyright © 1992-2007 by the Center for the Study and Prevention of Violence, Institute of Behavioral Science, Regents of the University of Colorado)
KW - Black on Black Violence
KW - African American Offender
KW - African American Victim
KW - African American Violence
KW - African American Juvenile
KW - African American Adult
KW - Violence Prevention
KW - Public Health Approach
KW - Juvenile Offender
KW - Juvenile Violence
KW - Juvenile Victim
KW - Adult Offender
KW - Adult Violence
KW - Adult Victim
KW - Public Health Intervention
KW - Public Health Prevention
KW - Homicide Prevention
KW - Homicide Offender
KW - Homicide Victim
KW - African American Homicide
KW - Intraracial Violence
Language: en |