Maggie McKay (Host): Le Bonheur Children's Hospital has a program called SHIFT to support and help individuals heal from trauma. Today, Lydia Walker, SHIFT Program Manager, joins us to explain what their hospital-based violence intervention program offers and how they are shifting the trajectory. Welcome to the Peds Pod by Le Bonheur Children's Hospital. I'm Maggie McKay. Lydia, thank you so much for joining us today. I can't wait to hear more about this program.

Lydia Walker: Maggie, thank you so much for having me. I'm delighted to be able to talk about it.

Host: What does SHIFT stand for to begin with?

Lydia Walker: It stands for Supporting and Healing Individuals from Trauma. And this name was given to us by the Trauma Program Director, Anissa Cooper. We were searching for something that would describe the program and we found that that gave us just the feel of what this work is all about.

Host: And what is your role and who else makes up the SHIFT team?

Lydia Walker: So, SHIFT consists of currently three violence interventionists and myself as the program manager. These interventionists, two of them are currently working with the SHIFT program. But recently, we were also graced to be able to have an OJJDP, that's the Office of Juvenile Justice grant. And we have third person who is working with the e-SHIFT, that's Extended SHIFT. So, they're providing services for youth through juvenile court. We are also in the process of hiring our third violence interventionist that'll be directly with the SHIFT program.

Host: And your role as manager is what?

Lydia Walker: So, in addition to managing the team, it's really more about building those relationships with our partners. We'll talk a little bit more about that whole dynamic. The staff itself, of course, needs the direction of how this program is going to move forward. So in working with our trauma team, that's Regan Williams, the Trauma Medical Director, and Anissa Cooper, the Trauma Program Director, we're often collaborating on the direction of where we want to go with the program, what we're able to track within this program. So, managing all of those dynamics is a big part of my role.

Host: That sounds like a lot of hats that you wear. What's the intended purpose of hospital-based violence intervention programs and do they work alongside any other clinical teams?

Lydia Walker: Let me give you a little history. Violence intervention programs have been around probably since the '90s, just not here in Memphis. They started, to my understanding, I believe, in California. And we came into existence in 2022. And our program, because of Dr. Williams seeing the impact of community violence, in particular, gunshot wounds in the community starting to rise in 2017, the violence intervention program was really birthed out of that. And Dr. Williams, seeing those impacts on the children, recognized that while they could do all of the things medically, the surgeries, the bandaging, et cetera, once that child left here, there was an entirely different dynamic for that healing process to occur afterwards.

And so, that's where we came into the picture And so with that, we get to deal with those things that describes as a social determinants of health. So if a child returned home, but the home itself wasn't safe, then we're getting to intervene with that. And so, the partnership that we have is with that trauma team. We're working directly with them. We're working with that trauma social worker. We are working with other departments within Le Bonheur who are able to address, both the medical and then support those social determinants of health that are truly impacting the community violence and our children.

Host: And what are some organizations that Le Bonheur partners with to offer wraparound services? And you might want to explain what wraparound services are.

Lydia Walker: To me, this is the strength of the work that we're doing. The ability to be able to cultivate those partnerships with people who are already doing similar work or work that addresses needs that maybe we cannot address directly. So in addition to the trauma team, in addition to our on site mental health counselors, we're collaborating with the City of Memphis, their Violence Intervention Program, and these are people we would describe as credible messengers that are already in the community. They're providing mentorship to not only that patient who has been harmed, but also their siblings. We'll work with UT. Their Center for Youth Advocacy and Well-Being has programs that offer additional mental health. Let's say if we couldn't address the mental health here on site, they would be a support for that. They also have a gang intervention program and a program that addresses children who have medical needs, but become truant due to those conditions.

So, the Youth Villages' SWITCH Program is very similar to what we do, but they have three persons that will actually do in-home care with the youth. They have an interventionist, a coach, as well as a mental health provider. And they will do intensive case management within the home with the youth and the entire family.

So, that's why I say this ability to be able to provide wraparound is us, the partners, we're constantly communicating both with the families and amongst ourselves to make sure that we're helping to stabilize the household and to move the child in a forward trajectory.

Host: Lydia, are families automatically enrolled and how does that process work? I'm wondering if some families say, "We don't want you coming into our home" or whatever.

Lydia Walker: Well, they are not automatically enrolled, but what we frame it as they're automatically entitled to our services. If a child comes into the hospital, they expect a certain standard of care that Le Bonheur is going to offer them. So, we are a part of that standard of care, but we are going to address social needs that the medical team want, as we talked about.

And in doing that, we are only working with those youth who come in with gunshot wounds, stabbings, or assaults. So, we're informed of those individuals who come in with the gunshot wounds, stabbings, and assault via an email from our trauma team. From there, we will actually go into the hospital and round with that team, as well as be a part of the huddles. We're going introduce, assess, and then enroll that family into the program, and that's done inpatient.

Now, we will also have those who come in and they are through the ED only. That means that they have come in the hospital but they've not been inpatient within that first 24 hours and they're going back home. We will then make phone calls to reach out to them, send text messages, just whatever method we can use, even oftentimes those families are going to come back because the child will have a followup appointment. Once they are discharged, we'll meet them at those followup appointments. So, we make sure that we are offering them the full extent of our services.

Host: We touched on this a little bit earlier, but I think it's worth delving into a little bit more detail. Do you find that families are sometimes hesitant to accept support services after a traumatic incident? And if they are hesitant, what would you say to a parent or a caregiver who is reluctant to enroll their family in a hospital-based violence intervention program like SHIFT?

Lydia Walker: They are. If you can imagine a situation where your child came in the hospital and they've had one of these types of injuries, it takes a moment to wrap your head around not just what has happened to your child, but the aftermath of that particular injury. So, we have, over this time, this almost three years that we've been doing this work, have recognized every family is going to respond differently and we adjust accordingly.

So, let's say a family says to us, "I'm interested, but right now I don't know what I need to do. Just give me some time." We totally step back, give them the time that they need, and then we come back and just we're really not even talking about the program, we're talking about the child's health, because that's the key thing. What has happened since this child has left this hospital, and then we can get into, "Are there things that we can do to help support in addressing any of those concerns that the family has?"

Host: I can't even imagine how emotional and overwhelming it would be for parents in this situation. So, I think it's great that you just, like you said, you step away and then you circle back later on after things have settled down a little bit. How is this work funded? Is it free for families?

Lydia Walker: Yes, the program is totally free. We are a grant-funded program and we were set up because Mayor Strickland recognized the community violence and we were a part of that response to the work that is being done, both through the mayor's office and, actually, I think it's begun to spread through other hospitals as well. But Regional One had a program and because we are dealing with the youth, we needed to be a part of that as well.

So, he set up a three-prong program to address the community violence. And imagine, I guess, that this is really a captive audience. Those families come here and like we talked about, they are so traumatized by their child's injuries. They need someone to walk alongside them. You know, the scripture uses the term a paraclete and that's the way we view the care that we give them.

As I mentioned earlier, it is a part of our standard of care. They are automatically entitled to this. So, we frame our work as this: This terrible thing has happened to you, but as an answer to some of the needs that may have been pre-existing or exist because of the injury, we come alongside you. And we've been blessed to also get funding through another funder, Formanek Foundation. So, we're in the process of hiring another interventionist at this moment in time. And we anticipate that we'll have other funders. Because really this work is not just necessary, but it's a thing of because we have taken this unique approach, I think people will see the vision to enhance what we're already doing.

Host: Is there anything else you'd like to add in closing?

Lydia Walker: The one thing that I kind of mentioned, but I'd like to add is, with the Formanek Foundation funding, we were also able to add in a mental health counselor. So, all of the trauma patients here at Le Bonheur receive mental health counseling while they're inpatient. And for SHIFT, because these were oftentimes situations where they needed ongoing counseling, we were able to get funding through the Formanek Foundation to have our own mental health counselor.

So, that's been a wonderful addition to the team. it was working well with the previous, group that we were using. But now, we've expanded it so that we're not able to just tap into that team, but we have our own individual person who can be here to do that mental health counseling, and it could be for an extended period of time for the families.

Host: Thank you again so much for making the time to talk with us today, Lydia.

Lydia Walker: Thank you for the opportunity to be able to share this. We really do appreciate it, and have a good one, Maggie.

Host: Again, that's Lydia Walker. And if you'd like to learn more, please visit lebonheur.org/r-services/community-health/shift. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you, I'm Maggie McKay. Thanks for listening. This is the Peds Pod by Le Bonheur Children's Hospital.