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Ideastream Public Media is bringing you stories about the surge in gun violence plaguing many Northeast Ohio neighborhoods. Gun violence is not new, but mass shootings and community violence have reached a fever pitch — destroying lives and tearing some communities apart. We're talking with residents, activists, victims and experts about prevention strategies and solutions.

How do you change young gun violence victims' lives? This UH surgeon says you treat their trauma

Donta Padgett, Jr. was just 10 years old when he saw his father shot to death before his eyes.

In 2015, the two were driving along Martin Luther King Blvd. near Shaker Blvd. after Padgett's football game when someone fired into their car and killed his 29-year-old father.

"I looked at my dad," said Padgett, who was also hit. "It looked like he was trying to move. He was moving his head back and forth. And then he just stopped and blood started coming out his mouth. That's when I called his name. I said 'Dad,' and I didn't cry."

The little boy was rushed to University Hospital's Rainbow Babies & Children’s for a gunshot wound in his shoulder. There he was treated by Dr. Edward Barksdale, Jr., now the hospital's surgeon-in-chief.

Barksdale had been working at UH for a couple of years when an ambulance brought Padgett into the emergency room. The surgeon had patched up too many young people only to see them back in his hospital again — victims of depression or self-destruction or gun or other violence. He wanted to do something.

"My very first patient was a 15-year-old boy who was shot in the leg and died," he said. "He was one year older than my oldest son and looked like my oldest son.”

A couple of years after he treated Padgett, Barksdale, inspired by the 10-year-old with a shoulder wound who'd lost his dad and others he'd treated, started UH's Antifragility Initiative to stop the cycle of destruction unleashed on the lives of young people by acts of unspeakable violence.

Padgett and his mother, Lakia Johnson, say the program, which he was able to join even though it launched after he was injured, has helped him move forward in the world. The therapy and mentoring have kept him focused and driven, he said.

"It has helped me keep on going and keep on pushing, and it definitely encourages me," he said.

His mother said the program has also helped her deal with the trauma.

"I see that even though it felt like it was the worse for us that it wasn't, in the fact we ... lost his dad, but I was still able to keep him," Johnson said of her son. "You'll have hard days, it'll be a struggle. But you got to constantly pray and just think of trying to just stay positive."

'Life in urban Cleveland means living in fear every day'

The violence Padgett faced as a 10-year-old is a far too common occurrence in Cleveland, said Barksdale, who has seen has seen countless youth traumatized by gun violence and many others killed.

"I recognized that this was a city that in many ways was bathed in youth violence," he said. "Life in urban Cleveland means living in fear every day."

That violence not only causes physical harm for the victim but can perpetuate the cycle of violence through acts of retribution, Barksdale said. The trauma can also be mentally debilitating, leading to various mental health issues, he said.

As a surgeon, Barksdale treats between 70 and 80 young people with gunshot wounds each year and estimates that around 30% of those victims are treated at the hospital again within two years with a second or third gunshot wound.

Another 30% of the young people who are shot will come back to the hospital within those first three years severely depressed, some even having attempted suicide, he said.

Such violence, and the long-term harm from it, is what Barksdale hopes to address through UH's Antifragility Initiative, which is overseen by program coordinator, Matthew Krock. The program provides personalized mental health support for victims and their families that starts in the hospital when they are first injured and continues for a year after discharge.

The program includes mental health counseling, mentoring and resources for safe housing and academic and career development, including help with any school-related behavioral issues, according to the program's website. There's also access to positive activities in sports and arts. The program's counseling uses a modality called Trauma Focused Cognitive Behavioral Therapy. Treatment includes between 12 and 25, 60 to 90-minute sessions and involves, among other treatment, education, parenting skills, relaxation techniques, emotional regulation skills, cognitive coping, trauma narration and processing, as well as helping children directly face trauma.

Barksdale said the program's goal is first to prevent reinjury and retaliation and then to put these youth on a completely different path, one of optimism, hope and success.

"We hope to move them from hurt to heal to hope to whole," he said.

Success is measured by reducing repeat gun violence

Not only is his program working to provide youth with hope about their futures but with the food, shelter and safety they need to thrive, Barksdale said.

At the root of much of the violence is food insecurity, which Barksdale called the biggest driver of gun violence. The lack of proper resources leads to trauma, he explained.

As such, the Antifragility Initiative also provides emergency housing, especially when young people and their family are in danger, food supplementation and clothing. Doing so helps significantly change their environment for the better, lessening the chance of continued violence, he said.

"Violence isn't just a bullet going into a person, it's not just someone being beat up," Barksdale said. "It has to do with the lived environment."

Barksdale said the results have been encouraging. Of the approximately 400 children treated under the program, only 10 have shown up again with gunshot wounds or related trauma as compared to roughly a third of victims who do not participate.

It comes down to money

The program doesn't have the money to help all the victims brought to the hospital each year, Barksdale said. He can only help around a third of the youth he sees due to insufficient funds. The program has received $3.2 million to date and requires approximately $600,000 to $700,000 annually to work at full capacity, he said.

The program is primarily funded by the state funds provided by the federal Victims of Crime Act. Gov. Mike DeWine, when he was Ohio's Attorney General, allocated some of those funds to the Antifragility Initiative. The program also receives grant support from the Cleveland Foundation and other entities. However, cuts to the federal law's funding have negatively impacted the program, Barksdale said.

Barksdale is seeking additional money from the American Rescue Act Plan funding that's been allocated to Cleveland, he said. The city received $163 million in April, the last installment of the act's funding. He is also considering asking Cleveland-born athletes to support the program as many of them grew up surrounded by the same violence his program is trying to fight.

Barksdale is also hoping the Biden Administration approves Medicaid funds to be used for care related to gun violence. Medicaid coverage would be crucial, he said, given the high costs of gun violence, with each gunshot wound costing approximately $50,000 to treat.

Padgett, Barksdale reunite on Juneteenth

By chance Barksdale, Padgett and Johnson bumped into each other at a Juneteenth celebration last month in Cleveland. The three hadn't seen each other in several years.

There were hugs and a lot of positive news to share. Padgett just graduated from high school and has started a small vending machine business with his brother. He plans to take a gap year to focus on his business before heading to college, he said.

For Barksdale, Padgett's successes exemplify the Antifragility Initiative's goals.

"He completely illustrates the concept of our program," he said. "We are not about resilience. There is no way that he can go back to the way things were before his father was killed or he was injured. He can, however, find a new pathway forward."

Johnson agreed things could have been very different without the pathway the Antifragility Initiative helped provide.

"He very well could have went a completely opposite way," she said. She's seen others in her community face tragedies and not fair as well. "We see people who lose their mind. They're not the same. They're in deep depression," she said.

But she and her son are moving forward.

"You got to try to just make the best of it, that's all," she said. "And so we just do stuff like that to make us happy and just keep building and learning and growing every day."

Stephen Langel is a health reporter with Ideastream Public Media's engaged journalism team.