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YSPN  currently has five district-based social workers and two city-wide social workers placed in police districts around the city of Boston including B-2 (Roxbury), C-11 (Dorchester), B-3 (Mattapan), D-4 (South End/Lower Roxbury, Youth Violence Strike Force and Victim Services Unit.  The Roxbury and Dorchester stations have two social workers due to the high volume of referrals and being communities most impacted by youth violence. The station-based social worker receives consistent support and clinical supervision from a Senior Social Worker (LICSW).

Youth referred to YSPN receive assistance under a three tiered system: 1) intake and assessment, 2) short-term clinical case management and, 3) ongoing clinical services. The station-based LCSW consistently receives support and supervision from a Senior Social Worker (LICSW) who in turn receives weekly supervision from the Clinical Director of YSPN. This process of supervision fosters a level of communication that ensures quality services for its clients.

Three Tier Model:

1. Intake & Assessment - Generally involves short-term interventions focused on finding appropriate resources that meet the short and long term needs of youth and their families. An assessment of family and individuals strengths and weaknesses help determine the level of service provision. A determination of which service providers are already involved with the youth and family is made and these relationships are strengthened by the intervention. This intervention may be as short as one interaction with the family and youth with an understanding that the youth advocate and social worker are accessible if needed. The family is likely to be referred to preexisting services in this paradigm. 50% total caseload.
2. Clinical Case Management - Youth and their families are seen in weekly or monthly meetings with focuses on parent guidance and support counseling. Clients seen in this level of service generally do not have any pre-existing relationships with major service providers like DYS, DSS, and school-based services. The intervention at this level is to connect clients to local non-profits who can provide social service. Initially in some cases, clients prefer not to engage in formal service contract with providers and take service, as they feel comfortable from the YSPN social worker. This level of services is open-ended with an eye towards making referrals to local agencies. 30% total caseload.
3. Individual and family therapy - Youth and their families are seen weekly in psychotherapy for issues related to truancy, delinquency, school performance and family functioning. At this level of service youth are generally seen individually and family meetings are monthly. Youth and families may be involved with DYS and probation but typically not with DSS. Often these clients have some ambivalence about working with traditional agencies and YSPN's capacity to provide home visits and flexible scheduling has enabled difficult, high risk youth and their families access to social service. 20% total caseload.

CASE EXAMPLES:

Example I:

Over a six-month period, Boston police officers in District B-3, Mattapan, had responded to 19 calls for help to a home with a mother and her five children. The children ranged in age from 10 to 17. Several of the children had a history of assaults on people outside the family. The father had been killed in a stabbing. The mother had a gambling problem and a history of assaults as well. An officer who had repeatedly responded to service calls for this family referred the case to the district based social worker. This LCSW worked with the family for a six-month period during which there were only six calls for service, a reduction of over two-thirds. The older son clearly responded to the social worker's outreach; thus one of the needs identified by the referring police officer, for an adult male counselor, was met. The other children were referred to after-school programs. The mother was coaxed into a parenting class, which has significantly improved her effectiveness as a parent and her interactions with her children. Calls for police service in the third six-month period had dropped from six to two.

Example II

A 15-year-old high school student who was a bystander to incidents that led to a shooting was repeatedly harassed and threatened by gang members. He felt unable to confide these threats and his fears to anyone, but finally blurted them out to his algebra teacher who sought help from YSPN. The YSPN social workers went to the child's home that night and met for several hours with the boy and his family. This allowed the boy the opportunity to discuss the situation and his fears with his parents and the social workers. The YSPN social workers were then able to develop a safety plan and intervention strategies with the family

Example III

One of YSPN's clients is a 17-year-old boy who had been attacked by a crack addict with a machete. One of his hands had been severed in the attack and was re-attached by emergency surgery. His other hand, his legs and his back were also severely damaged. The boy was one of four children of a single mother, who herself had a history of mental health problems and trauma. He had a history of sexual abuse by older women in his neighborhood, and had been arrested and convicted for arson when he was 14. He had spent time confined in a Department of Youth Services facility as a result of that conviction, and was being seen regularly by DYS clinicians at the time of the attack. Over the course of the last year and a half, the LICSW clinician worked weekly with the 17-year-old, his mother and the younger, 12-year-old brother, who became suicidal after the assault. The clinician provided trauma counseling, advocacy, clinical case management and worked closely with all the other systems involved in this family's life (the Department of Youth Services, the Boston Public Schools, the medical providers, SSI Disability, etc.) The 17-year-old client was finally placed in a foster home outside of the city for stabilization and safety reasons. The 12-year-old brother was reassigned to a new school that could better meet his emotional and educational needs. The mother and the 17-year-old continue to use the YSPN clinician for counseling and support.

Boston Cares for Injured Youth:

Boston Cares for Injured Youth is a program within the program. The Boston Police Department's Youth Service Providers Network (YSPN) has partnered with the Boston Cares for Injured Youth to provide aftercare for intentionally injured youth in Boston. Boston Cares for Injured Youth was developed at the New England Medical Center in response to data from the Boston Emergency Department Surveillance System (BEDS). BEDS identifies patients treated for violence-related intentional injuries (non-abuse) prospectively at triage, at Boston Medical Center, Children's Hospital, New England Medical Center, and Massachusetts General. BEDS data have shown that the 100,000 youth in Boston have a 1 in 150 chance of being intentionally injured and the chance of re-injury within a year increases to 1 in 25. The purpose of Boston Cares for Injured Youth is to provide intentionally injured youth with appropriate community-based aftercare in order to assist them in dealing with their injury and to reduce their risk of re-injury.

Begun in October 1998, the goals of Boston Cares for Injured Youth are:

• Increase the number of intentionally injured youth who receive follow-up care.
• Reduce the rate at which injured youth are re-injured.
• Increase awareness, cooperation, and collaboration between hospitals and community providers in the areas of youth violence treatment and prevention.

More than 500 cases of intentionally injured youth are reported every year, with approximately 40 cases of re-injury within the same year. Boston Cares for Injured Youth hopes to reduce the number of re-injured youth. When the program receives a referral from one of the four hospitals, the Boston Cares for Injured Youth Injury Services Coordinator, (a YSPN licensed clinical social worker (LCSW) working out of the Youth Violence Strike Force), assesses the injured youth's needs and makes an appropriate referral to a community-based human service provider. After a referral has been made, the coordinator performs active follow-up to determine if a treatment plan has been implemented. In addition to making referrals, the coordinator will continuously develop lists of community-based service providers and work with hospitals to improve patient identification and referral.

YSPN DATABASE:

The Youth Service Providers Network has designed and created a central database used by the clinical social workers to help clients within a social work model that incorporates outcomes, yet is not driven by outcomes. The database uses the best of the managed care model to track outcomes of social work services: particularly, in regard to reducing risk factors for delinquency. The primary risk factors tracked are issues of school performance, family functioning, substance abuse and trauma history.

The database asks the social workers to respond to topics under headings that create the template for a bio-psychosocial assessment. This enables social workers to gather a comprehensive assessment without spending a lot of time writing out the information in a narrative form. Additionally, the database has the capacity to search a name before starting a file in order to prevent the duplication of services

The database allows supervisors to run reports that help to organize basic demographic data and track service outcomes. Supervisors are able to use the secure database as a quality assurance tool to monitor caseloads and review client files off-site.