A City Seeks to Undo a Legacy of Trauma

The Baltimore public library system used to take a hard line on truancy: children and teens who came into a library building during school hours were asked for documentation to show why they weren't in class.

But the Covid-19 pandemic and a new focus by city agencies in Baltimore on the toxic effects of trauma have led library officials to reexamine their punitive approach.

“We're going through all of our policies and thinking about how the world has changed and we’re applying a new lens,’’ said Heidi Daniel, CEO of the Enoch Pratt Free Library system.

“It’s not just about following the rules to a T. It’s about thinking about how these rules impact our community, which we know has experienced a lot of trauma.”

Now children who are in the library during the school day are encouraged to stay. “Maybe they need a safe space,’’ Daniel said. “Maybe they don’t have home internet connectivity. There are a whole lot of reasons why they might be here.”

The library’s policy change is part of a larger effort by city officials to rethink the way government interacts with the communities it serves. The city's Elijah Cummings Healing City Act, signed into law in February of 2020, just weeks before the pandemic struck the U.S., requires agencies that interact with children and families to receive training in trauma-informed care.

The concept isn’t new: it was developed in the 1970s by doctors who were treating Vietnam War veterans suffering from post-traumatic stress. Over the decades, as an understanding of the damage caused by trauma has grown, the idea has been expanded beyond medicine to include human services agencies. 

The approach recognizes the pervasiveness of trauma, especially in poor communities, and the lingering impact it leaves on physical and mental health. The goal of trauma-informed care is to promote healing and recovery, rather than pursuing strategies that could inadvertently re-traumatize.

“We’re looking to move away from policies that are punitive and toward those that are healing-centered,’’ said Zeke Cohen, a member of the Baltimore City Council.

Cohen, a former city teacher, is the chief architect of the Healing City Act. The proposal was developed after a former assistant basketball coach was shot inside Frederick Douglass High School in 2019. 

“Young people had to duck in place, teachers locked doors,” Cohen said. “It was an incredibly traumatizing incident."

At a community meeting afterward, all the typical responses to a school shooting were proposed, including metal detectors and armed school security officers.

“But when we asked the young people, they wanted nothing to do with that conversation,’’ Cohen recalled. “They made it clear that we as the city council spend way too much time thinking about how to better police them. What they wanted was for us to prevent violence from occurring in the first place.’’

'An Incredible Shift'

The Healing City Act led to the creation of a task force charged with developing strategies to reduce trauma across the city. Members of the group range from beauticians and barbers to students and businesspeople.

The legislation also calls for every city agency serving families and youth to undergo training in trauma responsive care. That includes learning the brain science and symptoms of trauma and how it manifests across generations.

And the act requires each city agency to review its policies and procedures, with a lens toward reducing re-traumatization.

Part of the process, says Cohen, involves looking inward at the trauma city government has caused, rooted in a history of segregation and redlining, drug abuse and gun violence.

The city’s library system, a quasi-public agency, was one of the first departments to undergo this type of examination.

“They had a zero-tolerance policy for people who were suspected of using drugs or coming in drunk, which I can understand because you don’t want drunk or high people causing issues in the library,’’ Cohen said.

“But we also know in 2022 that addiction is a disease and criminalizing it or kicking people out of safe public spaces is not trauma-informed and actually reinforces a lot of the stigma that leads to further addiction and overdose,’’ he said.

The library system recently launched a pilot program with the Maryland Peer Advisory Council to bring in recovery coaches, some of whom are themselves in recovery, and train them to use Narcan, a medication used to reverse opioid overdoses.

“It’s been an incredible shift,” Cohen said. “Instead of criminalizing and pushing people out, we are instead supporting people where they are."

Daniel, the library system’s leader, agreed. “When you kick someone out, they just come back the next day…so you repeat the cycle,’’ she said. “It’s not improving anything.”

Like libraries across the nation, Baltimore’s library system had offered trauma-informed programs such as mindfulness training and yoga classes. It also employed social workers and provided legal help on civil matters to its patrons.

 But the Healing City initiative provides an opportunity for a “deeper dive,’’ Daniel said. 

“We still provide access to books and that’s a critical function of what we do but we also provide access to many other services," she said. "Our job is to make sure people have the ability to get what they need to change their lives in whatever way they want. It’s about getting access to a whole community, a whole person and doing it in this space.’’

The Healing City effort received initial funding from the Open Society Institute, in addition to money from the city and about $1.4 million from federal Covid-19 relief legislation.

Cohen said he has heard from officials in other cities, including Toronto and Cincinnati, who are interested in adopting their own trauma-informed programs.

“My hope is that Baltimore, which has not always been on the right side of history, can be a national leader in this kind of work,’’ he said.