Caught in the Crossfire

Closing the Revolving Door of Violence

The CAUGHT IN THE CROSSFIRE hospital-based peer intervention program hires young adults who have overcome violence in their own lives to work with youth who are recovering from violent injuries. These highly trained Intervention Specialists offer long-term case management, linkages to community services, mentoring home visits, and follow-up assistance to violently injured youth. The purpose is to promote positive alternatives to violence and to reduce retaliation, re-injury, and arrest. Our program was the first of its kind in the nation, and led to the founding of the National Network of Hospital-based Violence Intervention Programs.

Without a CAUGHT IN THE CROSSFIRE staff member there, your family and friends think healing means retaliation. They stand by your bed and make a plan to go get the guy who put you in here to show how much they respect you. -- Sherman Spears, co-founder, CAUGHT IN THE CROSSFIRE

KTVU ran this story in September 2013, when Youth ALIVE! celebrated the 20th anniversary of Sherman Spears' first visit to a gunshot victim in the hospital, the start of the Caught in the Crossfire.

Without intervention, hospitals discharge these patients to the same violent environment where they were injured, with no "prescription" for how to stay safe, and with great pressures to get revenge. Too often, this results in a "revolving door" of violence: after youth are injured and hospitalized, they and their friends often retaliate, causing even more injuries or death, arrest, and incarceration. 

Data published by the US Department of Justice bears this out: studies show that hospitalization for violence-related injuries is recurrent, with hospital readmission rates for subsequent assaults as high as 44 percent and subsequent homicide rates as high as 20 percent.

One violent act leads to another . . . and another. . . and another. The violent cycle continues.


The staff members, or "Intervention Specialists," have grown up the same communities where they now work. Many have survived violence themselves. The Specialists act as case managers and mentors, working closely with the youth and their families to help them avoid violence and thrive.

How Caught In The Crossfire Works

As soon as a young person is admitted to the hospital with a violence-related injury, hospital staff call in the Intervention Specialist, who arrives within one hour at the hospital room, helping the injured patient and his or her families and friends cope with the injury and start talking about alternatives to retaliation. In the clip below, Caught in the Crossfire Program Manager Kyndra Simmons, interviewed after a screening of The Interrupters, explains what happens at the initial visit to the hospital.

At these initial bedside visits, the Intervention Specialist focuses on developing a trusting relationship with the patient, providing comfort and emotional support, working to prevent immediate and future retaliation, promoting alternative strategies for dealing with conflicts, identifying the youth's short-term needs, and developing a plan for staying safe.

My CAUGHT IN THE CROSSFIRE caseworker was the first person who made me realize that my life is worth saving. -- 17-year-old CAUGHT IN THE CROSSFIRE participant

After The Hospital

After the young person leaves the hospital, the Intervention Specialist continues to foster a relationship, easing the youth's transition back into the community through frequent personal and telephone follow-up contact. The Specialist provides support and mentoring to the youth, as well as to his/her family, through intensive case management.

The CAUGHT IN THE CROSSFIRE Specialist provides a continuum of care for as long as the young person desires, typically for six months, contacting the young person at least once a week.

Gang members are 60 times more likely to be killed than non-gang members.

How The Youth Are Helped

The Intervention Specialist coordinates assistance from social services providers, probation officers, teachers, administrators, guidance counselors, hospital social workers, and other youth service professionals. This results in a network of wrap-around aid to the youth. The Intervention Specialist, on an ongoing basis, links the young person and his or her family with local resources that meet participants' basic needs and promote healthy, nonviolent lifestyles, such as:

Referring patients to the Caught in the Crossfire program

  • medical coverage and follow-up care
  • educational programs
  • job training programs
  • employment opportunities
  • counseling
  • life skills training
  • legal assistance
  • recreational programs
  • substance abuse intervention
  • anger management classes
  • safe housing

Youth participants have re-enrolled in school, received mental health counseling and job training, secured part-time and full-time employment, and found relief from crisis situations involving housing, food, transportation and health care.

Caught in the Crossfire: Results

Speaking from personal experience, once you've been shot, it's all in the aftercare, whether you really heal or retaliate. There's a small window of opportunity where we (the recovering victim) can receive help.

-- Caught in the Crossfire Intervention Specialist

  • Over 1,300 Oakland and Los Angeles youth and several thousand of their family members have been helped by CinC since 1994.
  • In 2007, 100% of all active CinC participants avoided re-injury & 91% of CinC participants were not arrested.
  • A study published in the Journal of Adolescent Health in March 2004 demonstrated that youth who participated in CinC were 70% less likely to get arrested & 60% less likely to have any criminal involvement than injured youth who were not involved in CinC. Results from a follow-up study demonstrating similar results were published in the Journal of the American College of Surgeons in November 2007.

Caught in the Crossfire Los Angeles

In 1994, CAUGHT IN THE CROSSFIRE began working with hospitalized youth at Highland Hospital in Oakland. In 2006, the program was started in East Los Angeles in partnership with LA County + USC Medical Center.

National Recognition: Former Attorney General Janet Reno selected CAUGHT IN THE CROSSFIRE as a model to be replicated throughout the country in 1999.


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