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Baltimore implements trauma-informed care practices, prioritizing community buy-in

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Monica Guerrero Vazquez, the Executive Director of Centro SOL, speaks at a Friday news conference.

Baltimore City leaders announced Friday they will pour more than $1.4 million into programs to implement trauma-informed care — that is, a healthcare methodology that attempts to heal trauma and provide culturally-competent service.

The Mayor’s Office of Neighborhood Safety and Engagement will put $900,000 in American Rescue Plan Act money toward the Healing City Act. Another $510,000 will be used to help the task force created by the act develop basic community training.

Mayor Brandon Scott called the announcement at a news conference “especially appropriate after the dark and violent week and year we’ve had.”

“Every single time that we lose a resident in Baltimore to violence, I think of the impact that those horrific tragedies have on our communities,” the Democrat said. “This is very deep and very real harm that impacts our residents, especially our young people, for the rest of their lives.”

Councilman Zeke Cohen, the author of the Healing City Act, said in an interview that the law aims to create trust and safety in healthcare for vulnerable communities.

He recalled a string of 2017 incidents in which Immigration and Customs Enforcement agents detained two men at a South Baltimore Walgreens, as they were buying medicine. Another man was detained outside his nine-year-old’s school in front of their classmates.

“We saw folks literally go underground, stop sending their children to school, stopped communicating with law enforcement in any kind of meaningful way, and just a tremendous amount of fear and shame and trauma that people experienced,” Cohen said.

Members of the Healing City Task Force have worked since February to reach vulnerable communities, including Latinos — a population that healthcare providers say does not have enough resources, despite a recent burst of growth. The 2020 census showed that Baltimore’s Latino population grew by 75% over the last decade, up to about 31,500 residents.

Monica Guerrero Vazquez, the Executive Director of Centro SOL, a group that promotes equity in health and opportunity for Baltimore Latinos, said that some components of trauma-informed care are as basic as making sure that providers speak fluent Spanish.

Another component is cultivating safety and trust. Throughout the pandemic, she said, fear held many immigrants back from seeking help from medical institutions until they were seriously ill with COVID.

“People went to the emergency room when they were extremely sick, like their lips had a different color,” she said.

Guerrero Vazquez says that when a community’s most trusted members administer healthcare, the distrust lessens.

“Many immigrants call the priest or call the office from their church saying, ‘Hey, my mom did this’ or ‘this happened to my sister, what can I do?’ They don't call the hospital for care,” she said.

The task force’s work includes a pilot at the Sacred Heart Church in Highlandtown. Leaders of the Catholic church are working hand in hand with task force members including Lindsay Gavin, a pediatric psychologist at Mt. Washington Pediatric Hospital. Together, the partners provide services such as COVID-19 vaccinations and are working on physical health and depression screenings.

“A church and a faith organization is a really trusted, sacred space that is accessible to the community,” she said. “Unfortunately, traditional medical institutions are not those spaces. Those institutions have a history of intentionally or unintentionally harming the community, taking advantage of communities, coming in with their interventions and programs, and then leaving.”

She pointed to a trend she observed as a student: that children of color were more likely to be misdiagnosed by white providers.

“They would get medicated for issues they didn't have. They would get seen in therapy for under diagnoses that were not accurate. And so the treatment plan would not work,” she said.

She recalled an incident in which a therapist called security on a Black family after a nine-year-old said they would hit them.

“But they're like a nine year old kid, and they weren’t going to do anything,” she said. “We see this like replaying of biases and discrimination.”

Young Elder, a Coppin State University student who serves on the youth subcommittee of the task force, is developing strategies to bring more Black social workers into Baltimore, along with faculty at her college, Morgan State University and the University of Maryland.

“There's so much stigma around social workers, especially for youth just growing up in Baltimore,” she said. “A lot of people go to therapy and the therapists give them tools, they give them different strategies. But sometimes you just need somebody to say, ‘I know exactly how you feel.’ ”

At the heart of trauma-informed care is the notion that community members should define what healing looks like for them, she said.

“I feel like none of the trauma that youth have experienced in Baltimore should go to waste,” she said. “So if we have youth who are going to do things or have been able to get themselves out of positions, then they need to be the ones that are equipped with the set to help other people as well.”

Guerrero Vazquez of Central Sol said channeling that community expertise will improve health outcomes.

“That's where we see the social inequity thing in Baltimore is because there is no exposure and really no understanding of what the communities are experiencing,” she said. “When you have a lived experience, it's easier for you to walk the path of where the solution could be.”

Gavin noted that policy leaders also need to implement policies that aim to prevent trauma, not just attempt to clean up after it.

“Those areas will prevent future trauma from just multiplying and multiplying to the point where we get to where we are right now,” she said.