Journal of Health Care for the Poor and Underserved

138 Presentation MOVING AWAY FROM AN EMERGENCY ROOM MENTALITY: AN UNORTHODOX VIEW OF THE JUDICIAL ROLE IN VIOLENCE PREVENTION ANDREW J. SHOOKHOFF, JD. Juvenile Court of Davidson County, Tennessee Abstract: Discussions about the role of the judicial system in dealing with violence focus on cases of violent crime. While the criminal courts are an important component of any overall violence reduction strategy, the response is largely reactive rather than preventive. Family law cases, on the other hand, provide opportunities for the provision of prevention and early intervention services to families at risk. Such services are critical to successfully address the epidemic of violence. Key words: violence, criminal justice system, violence reduction, prevention , early intervention Most discussions of the role of the court system in regard to violence suffer from an emergency room mentality. Emergency rooms are crisis-oriented; they respond to medical problems that are at an extreme stage. Similarly, courts that deal most directly with violence—the criminal courts—have no role in reducing violence until a crucial event has occurred. In this sense the court system is reactive rather than proactive. When thinking about the judicial system and violence, we tend to focus on the picture of a criminal court that handles violent crime cases. Just as an emergency room responds to medical crises by treating acute injuries, the criminal justice system confronts violence with reactive strategies—trying, convicting, and incarcerating the offender. Although incarceration of violent offenders is primarily a reactive strategy , it does prevent further violent behavior. Judge Shookhofp presides over family law cases at the Metropolitan Nashville Davidson County Juvenile Court, 100 Woodland St., Nashville, TN 37213. journal of Health Care for the Poor and Underserved · Vol. 6, No. 2 · 1995 Shookhoff 139 First, it prevents the person who is incarcerated from committing another crime in the community for as long as that person is in prison. Second, at least in some cases, incarceration deters an offender from reoffending after release, especially if the offender is provided rehabilitative services while incarcerated. For example, if alcohol and drug abuse is the triggering mechanism for the violence, successful treatment in prison may have the effect of preventing further violent activity . Third, an argument can be made, at least with regard to some categories of violent crime, that the role of a strong visible criminal justice response, of which incarceration is a critical component, as part of a broad-based coordinated community effort, can help change certain sociocultural norms (or reflect and reinforce changed norms) that may condone some kinds of violent behavior. Domestic violence is an example of a behavior to which many communities turn a blind eye, thus tacitly condoning this behavior. Combined efforts on the part of both courts and community organizations can deter domestic violence by making it clear that it is now unacceptable, and can encourage earlier intervention by making people feel more comfortable with reporting and responding to domestic violence when they become aware of it, or experience it themselves. Thus programs in San Diego, California and Newport News, Virginia that combine vigorous law enforcement and prosecution with support services for victims and community education , have actually reduced domestic homicides dramatically.1'2 Improving the criminal court response to those who commit crimes is an important aspect of an overall crime prevention strategy. As noted, programs that address domestic violence early can reduce domestic violence. And because children exposed to domestic violence are at higher risk of becoming violent themselves, there is a long-term preventive effect as well. Another example is mandatory treatment of drug offenders, either as part of incarceration or as an alternative to incarceration , which has been shown by drug courts in Miami and Phoenix to reduce recidivism.3'4 Because of the link between drug and alcohol abuse and violence, these special drug court programs are part of a violence prevention strategy. We need, and will continue to need, a criminal justice system "emergency room" to deal with those who commit crimes, just as we will continue to need hospital emergency rooms, even in a reformed health care system. Efforts must be made to increase the effectiveness of the criminal justice system, and the potential impact of...