Research In Action

Research In Action

youth violence
A Bridge Between Youth on Probation and the Healthcare System
March 4, 2021

Hospital-based, violence intervention programs (HVIPs) are critical to effectively curbing the violence epidemic ravaging the United States. HVIPs offer victims of violence (VOVs) reporting to Emergency Departments (EDs) relationship-based mentoring and culturally informed, intensive case management. This enables them to navigate complex systems of care within the communities in which VOVs live and tackle the social determinants of health that increase VOVs’ risk of future violence exposure and revictimization [1]. Not only are HVIPs key to preventing future episodes of violence for VOVs; they are fundamental to effectively disrupting the pipelines that push youth into lifetime violence and justice system involvement.

Why Do Youth on Probation Need HVIPs?

Youth on probation, in particular, represent a unique adolescent subpopulation for ED providers to connect with HVIPs after a violence-related injury. Probation refers to community-based, court supervision and is used with youth found guilty of delinquent acts, as well as those at risk of further justice system involvement and as a way to informally monitor youth at risk of further serious delinquency and system involvement [2].

Unlike youth in detention or placement, youth on probation remain in their communities and have more interaction with neighborhood factors, such as community violence, that predispose them to future justice system involvement and violent injury. Additionally, youth on probation from communities of color have higher hurdles to overcome in avoiding rearrest and staying safe. In comparison to their White peers, Black and other racial minority youth are on probation longer, are assigned more probation conditions, violate probation at faster rates [3], and are extremely vulnerable to violence-related death [1].

Racial minority youth are on probation longer, are assigned more probation conditions, violate probation faster, and are extremely vulnerable to violence-related death.

Linkage to regular, trusted healthcare providers is critical to the physical and mental health of these youth and successful compliance with their probation requirements, like school attendance and remaining clean and sober from drugs and alcohol. Unfortunately, youth on probation face barriers in accessing community-based physical and mental health care [4, 5].

How Can HVIPs Help?

HVIPs can bridge the gaps between youth on probation and healthcare providers and services—thereby interrupting the cycle of violence, lack of care access, and justice system involvement. Violence Prevention Specialists (VPSs), the agents of change in HVIPs, are instrumental in fulfilling youths’ and their families’ basic human needs, such as food, clothing, and shelter—with the hope of reducing future violent involvement, premature violent-related death, and rearrest. VPSs help schedule and transport youth to vital medical and mental health appointments, some of which are required as part of community supervision.

Additionally, VPSs can integrate court conditions into a youth’s post-injury rehabilitation program, such as coordinating remote substance abuse or trauma-focused mental health treatment if a youth is unable to leave their home following injury. Further, VPSs can advocate for youth across school, medical, and the legal systems to ensure that their safety is prioritized and have the tools needed to make progress on probation conditions, like regular school attendance (even if virtual!), and long-term goals, like post-secondary education and/or vocational training. Most importantly, VPSs are instrumental in working with youth on conflict de-escalation and resolution to keep them out of and away from violent situations that could increase their future victimization and rearrest.

Research shows greater juvenile correctional cost reductions and youth success when more comprehensive, higher-quality aftercare plans are utilized that engage and collaborate with youth, their families, educators, community organizations, and stakeholders [6, 7]. HVIPs can provide additional support to ensure that youth on probation remain physically and mentally safe, successfully complete probation, and are directed towards trajectories away from future justice system involvement—thereby helping local juvenile probation departments:

  • save on costs
  • better allocate resources to more high-risk youth
  • genuinely live out the rehabilitative purposes of juvenile probation case management

At CHOP, we host one of the only HVIPs in the country located at a pediatric healthcare institution; our Violence Intervention Program works with assault-injured youth ages 8-18 to provide assault injury prevention strategies, mental health, and other service needs (e.g., medical, education, legal, housing) to promote safety and recovery, and prevent future violent events. For additional information on HVIPs across U.S., visit The HAVI.


  1. Bonne, S. and R.A. Dicker, Hospital-based violence intervention programs to address social determinants of health and violence. Current Trauma Reports, 2020. 6(1): p. 23-28.
  2. Office of Juvenile Justice and Delinquency Prevention [OJJDP], Statistical Briefing Book: Juveniles on Probation. 2020b.
  3. Dir, A.L., et al., The point of diminishing returns in juvenile probation: Probation requirements and risk of technical probation violations among first-time probation-involved youth. Psychology, Public Policy, and Law, 2020.
  4. Golzari, M. and A. Kuo, Healthcare utilization and barriers for youth post-detention International Journal of Adolescent Medicine and Health, 2013. 25(1): p. 65-67.
  5. Barnert, E.S., et al., The role of parent engagement in overcoming barriers to care for youth returning home after incarceration. Journal of Community Health, 2020. 45(2): p. 329-337.
  6. Altschuler, D.M. and T. Armstrong, Intensive aftercare for high-risk juveniles: A community care model: Program summary. 1994, Department of Justice: Washington, D.C.
  7. Office of Juvenile Justice and Delinquency Prevention [OJJDP], Statistical Briefing Book: Juvenile reentry & aftercare. 2020c.