At a press conference on Friday, June 2, Dr. Jennifer Avegno, the city health director, announced that the city of New Orleans will partner with University Medical Center to restart a hospital-based “violence interrupter” program that was shelved two years ago.
Violence interrupters try to curb retaliatory violence: they respond to shootings, speak with victims and their families and friends, find out who is most likely to retaliate and then try to negotiate with them.
Also known as “credible messengers,” violence interrupters usually know how to negotiate in the streets because they came from them. Most have criminal records. To maintain street credibility, the program maintains a strict separation between violence interrupters and law enforcement.
Their roles also are different. “Police solve crime. Violence interrupters prevent it,” said Norris Henderson, the head of Voice Of The Experienced, who helped to implement the concept, then within the program CeaseFire, nearly a decade ago. He likens the work to “going into the lion’s den and saying, ‘I’m asking you to chill out. Don’t be hungry.’”
To Dr. Jennifer Avegno, the city’s health director, the violence interrupters are a key piece of three new violence-prevention initiatives, which she hopes will “create an ecosystem of prevention, sustainable for generations to come.”
Henderson applauded the re-introduction of the violence-interruption program, which he believed had been truly effective in preventing bloodshed, while it existed. “Just don’t let politics get in the way,” he said, referring to the program’s recent two-year cessation, which has yet to be fully explained.
At the program’s onset, then-Mayor Mitch Landrieu’s administration had hailed the violence interrupters and the success of the CeaseFire program, part of his broader NOLA For Life violence-reduction efforts. As a Councilwoman, Mayor LaToya Cantrell also was a fan; when she took office she announced that the program would be re-named Cure Violence and expand to include more social services. “Nothing stops a bullet like a job,” as she often says.
But somewhere along the way, either by neglect, because of poor finances, or a shift in overall philosophy, Cure Violence began to ramp up victim services and to take violence interrupters off the streets. In 2021, as their supervisors began re-assigning them, asking them, for example, to weekly attend COMSTAT meetings at police stations, violence interrupters balked. Soon, they say, the street-team basically dissolved.
Patrick Young, head of the mayor’s Office of Gun Violence, which oversaw the team then, said he was not asking them to cooperate with law enforcement, merely to attend a few meetings with them. There were many factors that contributed to the team being shelved, including low literacy among the violence-interrupter team and financial factors – a large foundation’s grant had helped the city build up the hospital team, he said, but when the grant expired, they faced a financial cliff.
Then, in December 2022, all of the Office of Gun Violence activities ceased, when the office’s agreement with its fiscal sponsor – Urban League of Louisiana – lapsed.
This time around, Avegno said, the city is the convenor of the partnership with UMC and will provide oversight. But instead of the program’s past model, which used a fiscal sponsorship with the Office of Gun Violence Prevention, this iteration will be financed by a three-year partnership agreement forged directly by the city with the hospital. The hospital will hire and supervise violence interrupters; the city will provide funding and oversight, according to the Cooperative Endeavor Agreement.
Avegno also emphasized that, despite the two-year lapse, the administration has always supported violence interrupters. “There was no deliberate malice to destroy a program,” she said.
Violence: a true public-health crisis
In the public announcement of the re-launch, Avegno appeared first at the podium, clad in an orange-flowered dress to mark the annual occasion, Wear Orange Day.
Across the nation, people wore orange on Friday to draw attention to National Gun Violence Awareness Day.
Yet most people in this city don’t need a special color to remind them of the harm caused by firearms, since homicide rates here – 70 per 100,000 people – top all large cities in the nation, Avegno said. “In New Orleans, our awareness is already pretty heightened.”
Even throughout the short event, some remarks were hard to discern, because of a long wail of sirens, the city’s current soundtrack.
Avegno rolled out data for a recent four-year period, 2018-2021, when gun violence was the seventh leading cause of death for New Orleanians as a whole. For Black men in the city, it was the fourth leading cause. Those astronomical levels of violence, experienced almost unceasingly by generations of New Orleanians, have created “a true public-health crisis,” she said.
Yet Avegno refuses to believe that violence is endemic to the city. “We have to stop normalizing this, saying ‘That’s just New Orleans,’” she said.
Speaking at the same press conference, City Councilman Eugene Green – wearing an orange vest and matching tie – recalled 50 years ago, as a student at St. Augustine High School, writing a paper about the impact of gun violence. Since then, roughly 13,000 people have been victims of homicide in the city, he said. Even though the city is known for its carefree ways, that didn’t need to include gun violence. “Culture does not mean calamity,” he said.
City Councilman J.P. Morrell deliberately sported a tie with some orange in it, given to him by an Australian delegation. He recalled how the delegation told him how they’d banned semi-automatic weapons after one particularly bad mass shooting in their country. “One mass shooting and enough was enough,” said Morrell, as he urged restrictions on guns as a crucial solution to the city’s murder rate. “In our city, guns kill people,” he said.
‘We might spend the next decade getting out of this’
To address the epidemic in a strategic way requires evidence-based responses, said Avegno, as she summarized three recent city initiatives designed to reduce violence and improve mental health:
- Giveaways of biometric gun locks, cases that can be opened only with certain scanned fingerprints, to reduce the number of children who accidentally shoot themselves or others.
- A brand-new mental-health team, trained to respond to 911 calls involving people in mental-health crisis
- A city initiative that will launch this summer through a partnership with University Medical Center, which will include an expansion of the hospital’s trauma-recovery services for victims and a return of the hospital-based violence-interrupters initiative.
These programs must be in place for the long haul, Avegno said. “We did not get into this crisis in a year and we’re not going to get out of it in a year. We might spend the next decade getting out of this for good,” she said.
Last year, the city saw more than 280 homicides, the highest number of killings recorded in 26 years. And that number would have been much steeper if not for the emergency-room teams at UMC, who have saved nearly 87% of gunshot victims over the past five years, according to hospital data.
“I have a wealth of experience behind me,” Avegno said on Friday, gesturing at the line of doctors in their white UMC jackets, including trauma surgeon Dr. Sharen Taghavi. Next to him stood LSU emergency physician Dr. Annelies DeWulf, who called the credible messengers “incredible messengers who interrupt cycles of retaliatory violence.”
Afterward, DeWulf and Avegno recalled the days when the violence interrupters responded directly to the hospital after a shooting – even sometimes dressed in tuxedos coming directly from Carnival balls – and how quickly they reacted to prevent shootings. On a few occasions, they recalled, violence interrupters were able to to defuse potential shootings when they heard that gunmen were ready to retaliate as the victim’s family members left the building.
‘An awful lot of work to do’
To date, UMC’s new partnership with the city seems to be moving forward quickly. This week, on Thursday, June 8, the City Council will be asked to approve the new CEA with UMC. (The contract’s legislative summary reads simply: “New Orleans faces a severe epidemic of gun violence. Hospital-based violence-interruption programs are evidence-based interventions that can reduce shootings and preserve health and life.”)
By this summer, the Trauma Recovery Clinic at UMC hopes to expand, to provide — among other services — legal advocacy, clinical case management and more wraparound care, said Dr. Erika Rajo, a Louisiana State University Health Science Center clinic psychologist who directs the clinic. Rajo, who also had worked with violence interrupters directly, said that she considered their mental health part of the Center’s mission, since their work could be intense, but also because many had experienced violence in their younger days to the point where they dealt with post-traumatic stress disorder.
A plan for violence interrupters is also written and ready, so that UMC is ready to start this summer. But pulling together and training a new team of violence interrupters may take a bit more time, because the organizers want to hire exactly the right people, said Charlotte Parent, a former city health director who now is vice president of business development for UMC. “We understand that there is some urgency. But we want to take our time and do it right,” she said.
As he expressed his hopes for the new team, Henderson’s mind wandered back to the year 2000, when a jealous man escaped from a federal-prison’s work-release program on Mardi Gras night and committed a double murder in Central City, killing Henderson’s only son, Norris Crawford, 27, along with Crawford’s girlfriend, Keyla Crandle, 23, who was sitting in her car in front of her mother’s house talking to Crawford.
Henderson, who was still in Angola at the time, remembered the mood of the day. “The guys he grew up with were really angry. They wanted to take matters into their own hands,” he said, recalling how guards had accompanied him to the funeral, where he spoke. “All of our hearts are heavy with grief,” he said. “I ask that Norris’ death not be avenged. We’re losing far too many of our children, especially our young men. Someone has to call a timeout and I’m willing.”
To Henderson, the concept of violence interruption hits close to home.
For Avegno, too, the concept is personal. As an emergency-room doctor at UMC who worked on thousands of gunshot victims, she saw first-hand how the street team of violence interrupters was able to anticipate and prevent retaliation.
And from a larger perspective, Avegno wants these new initiatives to succeed, so that her hometown can break its generational curse with gun violence.
“Many of us are working very hard to pull this together,” she said. “There is an awful lot of work to do. And we have no time to waste.”