Trauma recovery center helps patients overcome impacts of violence

March 15, 2023


When the staff of the Mercy Health — Toledo Trauma Recovery Center in Ohio began working with a 36-year-old man and his 4-year-old son last August, the pair were homeless. The father was the victim of domestic violence. He had suffered a history of family violence before that.

The center provided counseling and other support for the man and boy. The pair had moved into a home in January, but the center paid to relocate them to a safer one, away from the person who had physically assaulted the father for years.

OraLee Macklenar, the center's supervisor, says the father's life has stabilized. He is working full time and providing for his son. "He and his child are doing better emotionally, and he is focusing on being a good father and is striving to break the cycle of violence for his son and the next generation," Macklenar says.

The father and child are among about 2,000 crime victims and their families who the center based at Mercy Health — St. Vincent Medical Center has assisted since its founding in 2019. The services of its seven-member team of licensed social workers, clinical counselors and a certified victim's advocate come at no charge to clients who are victims or impacted by crime. The cost is covered by federal Victims of Crime Act funding via a grant administered by the Ohio Attorney General's Office and by support from the Mercy Health Foundation.

Mercy Health is part of the Bon Secours Mercy Health system, based in Cincinnati.

Healing body, mind and spirit
Dr. John Leskovan, trauma medical director at Mercy Health — St. Vincent Medical Center, was among those who applied for the state funding that helped establish the trauma recovery center. The hospital is a Level I trauma center and a Level 2 pediatric trauma center and has specialists on staff to treat life-threatening and other serious injuries from accidents, violence and disasters.

Leskovan says he saw that while the 3,000 or so trauma victims coming to the hospital every year were getting solid medical care, many of them also needed mental health care to process their traumatic experiences. That's why he and some of his colleagues quickly responded when they saw an email about the state administered grants to support recovery services for crime victims.

Their hope, Leskovan says, was to lock down funding for interventions that would help crime victims move past the trauma and avoid complications of post-traumatic stress such as crippling anxiety and depression that can impact health and well-being. "We thought, 'What better way to provide a prevention program than to help the survivors of violent crime?'" he says. The trauma recovery center also treats family members impacted by the injury to a loved one.

Leskovan says he refers patients to the trauma recovery center every day. Not all of them are crime victims. Since its founding, the center has branched out to offer billable inpatient and outpatient care to people who have been traumatized by accidents, and to intensive care patients treated at the medical center who may feel depressed and anxious as they adapt to diminished capacity related to critical illness. The trauma recovery center's staff does bedside assessments of patients whose injuries or serious illnesses have prompted medical staffers to suspect they might benefit from trauma therapy.

The Substance Abuse and Mental Health Services Administration, part of the U.S. Department of Health & Human Services, calls the impact of trauma "a behavioral health concern." The agency notes that research has linked traumatic experiences, especially adverse childhood experiences, to chronic disease, mental and behavioral health issues and risky behaviors including substance abuse.

"Because these behavioral health concerns can present challenges in relationships, careers, and other aspects of life, it is important to understand the nature and impact of trauma, and to explore healing," the agency says.

Outreach to the marginalized
During her 20-plus years as a therapist, Macklenar has specialized in the treatment of people with anxiety, trauma and substance use disorders. Most of her work has been with adults. Other therapists on the center's staff specialize in treating children.

A therapy room at the Mercy Health – Toledo Trauma Recovery Center is furnished for sessions with adults and children. The recovery center provides free counseling and advocacy services to help people in Northwest Ohio who have been impacted by crime reach stability and well-being.

Not all of the state's trauma recovery centers provide services to children. Macklenar says she and the other founders of Mercy Health — Toledo Trauma Recovery Center wanted it to offer therapy for children. "We know that the need is there and there's just no way we could not address that population," she adds.

The center is part of the National Alliance of Trauma Recovery Centers, which has 44 member programs in 10 states. The programs are based on a model developed at the University of California San Francisco in 2001. The goal of the outreach model is to provide therapy, care coordination and advocacy services for survivors of violence who are in underserved communities and falling through the cracks of traditional victim services.

Macklenar participates in monthly virtual gatherings convened by the alliance to talk about services and share ideas.

The Toledo center's staff hosts conferences to teach law enforcement and other professionals about the impact of trauma and how best to approach and assist victims.

'Prevention piece'
Last year, the trauma recovery center added what Macklenar calls a "prevention piece" to its services. The center received a $145,000 state grant that allows her team to offer proactive victimization prevention to at-risk youth through the use of psychosocial support groups, psychotherapy, and case management services.

The grant also covers an education program for kids ages 11-17 about potentially risky behavior, specifically in the area of human trafficking prevention. The center's staff underwent training on an anti-trafficking curriculum developed by the state. They are teaching the curriculum at the clinic and in a school in a Toledo neighborhood, which has a high number of children in the legal system, exposed to family violence or in foster care.

The curriculum is typically taught over the course of about five days. Its goal is to provide safety, stabilization and engagement for the students. The instructors gather information from the kids at the start about their attitude toward unsafe behaviors — such as alcohol and other drug use — and score them for risk.

"Once they're trained, we do another test and find out that their score is significantly improved because they've now been educated and they are less likely to engage in those risky behaviors that could potentially lead them into becoming a human-trafficking victim," Macklenar says.

Restoration, healing
Human trafficking victims are among those that Macklenar and her team provide free services to at the trauma recovery center. Others are victims of gunshots, domestic violence, stalking and various forms of physical and emotional brutality. Most of the patients are women and children traumatized by violence. Macklenar says the recovery center offers its services as long as it takes patients "to get on the other side of trauma." Some of the patients have been treated for as long as a year.

One patient was referred by the county prosecutor's office after being hospitalized several times because of assaults by her domestic partner. Macklenar says the woman's attacker was notorious for being able to locate her after her attempts to leave him.

At the time of her referral, the woman was pregnant. The temporary shelter where she had been living had discharged her to the street after 30 days. She was staying in a hotel rather than with family because her attacker had been able to locate her relatives' homes.

The trauma recovery center first helped the woman find safe temporary shelter and began supportive psychotherapy for her trauma. Working with an FBI victim's advocate, the center recently was able to help the woman enroll in a program that is providing recovery support and housing for the woman and her infant for a year.

"She will be working with a program that is building her resources and stability so that when she leaves, she will be able to successfully take care of herself and her child," Macklenar says.

On her final visit to the trauma recovery center, the woman told the team they had helped her turn her life around.

Macklenar says: "We feel blessed and honored to do this work to see victims find restoration and healing."

Recovery center offers range of services

Mercy Health — Toledo Trauma Recovery Center is one of eight such centers in Ohio and the only one in the northwestern part of the state. It has served people from as far away as Dayton, about 150 miles south. The assistance the center offers includes:

  • Clinical case management.
  • Trauma-focused counseling that includes the use of eye movement desensitization and reprocessing therapy, cognitive behavioral therapy and cognitive processing therapy.
  • Legal and court advocacy, such as assisting with filing for victims of crime compensation.
  • Safety planning.
  • Screening for alcohol and drug abuse issues and assistance with referrals for additional recovery services.
  • Group therapy for grief, loss and trauma.
  • Bedside support for those who are hospitalized.

Crime victims get referrals to the center from law enforcement, community agencies and clinicians at Mercy Health — St. Vincent Medical Center, where the center has offices and therapy rooms on the second floor.

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