Interrupting and deescalating violence: St. Louis, MO

Results & accomplishments

43%

According to city data, in the three 10-square-block catchment areas where Cure Violence operates, homicides fell by 43% between 2020 and 2021.

26%

Homicides across St. Louis declined by 26% between 2020 and 2021. While evidence is not causal, Cure Violence's effectiveness in the three neighborhoods it serves may have contributed to this decline.

600+

In Cure Violence's first year of operations in St. Louis, violence interrupters were able to intervene in more than 600 conflicts across the three geographies it serves.


  • Strong political support for the program: The Cure Violence implementation in St. Louis enjoys buy-in from the city’s Board of Alderman, mayor, and many members of the public. The program has continued through two mayoral administrations in St. Louis, both of which supported the effort. Most recently, St. Louis Mayor Tishaura Jones re-affirmed her commitment to violence prevention work by launching an Office of Violence Prevention which houses Cure Violence and other programs.
  • Early indications of declining violence in target areas: Homicides have declined overall in St. Louis, and some evidence has suggested that Cure Violence is helping prevent and reduce violence in the catchment areas where it has been implemented. This evidence is not conclusive, however, and a more rigorous program evaluation is underway by researchers at Washington University in St. Louis.
  • Hundreds of interruptions logged and promising decreases in violence: After its first year of operation, Cure Violence staff had intervened in more than 600 active conflicts, and crime statistics showed meaningful decreases in violence that many believe were due at least in part to Cure Violence’s work.

Overview

Summary

  • St. Louis has historically had among the highest rates of violent crime in the country. In 2017, the US Department of Justice released a report that found that St. Louis had higher rates of homicide and gun-related crime than its peer cities. The city’s existing violence prevention efforts were under-resourced, and community leaders began calling for larger and broader investments.

  • After partnering with existing community-based organizations, Cure Violence began operating in St. Louis in 2020. The Cure Violence model takes a public health approach to reducing violence. Under this approach, trained violence interrupters and outreach staff identify and intervene in potentially violent situations, conduct outreach to those most likely to engage in violence, and work to change community norms that perpetuate violence acts.

  • Keys to the program’s success include hiring and retaining effective program staff; leveraging training and support from Cure Violence’s parent organization, Cure Violence Global; an intentional effort to build and maintain community backing; and strong support across multiple mayoral administrations.

  • Challenges faced by this program include disagreements between key stakeholders, capacity limits in local government due to COVID-19, difficulty raising public awareness of the program’s effectiveness, and the loss of a key champion on the Board of Aldermen.

What was the challenge?

  • Alarming rates of gun violence in St. Louis: St. Louis has experienced among the highest rates of gun violence in the country in recent years. The city had the highest rate of murders per capita in the United States in 2016. In 2017, census data showed that of the 63 most violent census tracts in the United States, eight were in St. Louis.

  • A public with skepticism towards police: Compounding the problem of violent crime in St. Louis was a lack of public trust in the police, due to years of policing practices that were perceived as racist and ineffective. A 2014 report by the Missouri Attorney General’s office found that Black Missourans were 75 percent more likely to be stopped by the police and, despite a lower likelihood of possessing contraband, Black and Latino Missourans were 90 percent more likely to be arrested after a stop. A significant portion of the population doubted the ability of the police to credibly address street violence.

  • US Department of Justice report highlights the severity of the city’s violence: In 2015, the city of St. Louis requested technical assistance from the United States Department of Justice’s Diagnostic Center. The Diagnostic Center’s report found that St. Louis had higher rates of homicide and gun-related crime than peer cities and the national average. The report recommended that the city invest in community-led violence prevention initiatives, specifically mentioning the Cure Violence model. This report created an additional sense of urgency among elected officials to address gun violence in new ways.

  • Community-based organizations in need of broader public investment: St. Louis already had local organizations focused on violence prevention, but they did not have the resources needed to significantly reduce violent crime. Community leaders began advocating for larger and broader public investments into these violence prevention programs, putting further pressure on local officials to act.

What was the solution?

  • A community-driven, health-based model to address gun violence: The Cure Violence model uses a public health approach to addressing violence in cities. In Cure Violence programs, trained staff known as “violence interrupters'' identify and mediate conflicts to proactively prevent escalation and retaliation. Outreach workers build relationships with high-risk individuals and connect them to services in an effort to make them less likely to engage in violence. The program requires trusted messengers who can serve as community advocates and carefully follow the organization’s model.

  • Violence interrupters deployed in areas with the highest violence: Cure Violence in St. Louis began in the Wells-Goodfellow/Hamilton Heights area, and then expanded to Walnut Park East and Dutchtown. These neighborhoods were chosen because they had the highest incidence of violence in the city. The program is administered by local nonprofit Employment Connection in the Wells-Goodfellow/Hamilton Heights and Dutchtown areas and the St. Louis Urban League in the Walnut Park area.

  • Collaborative teams and diligent data collection in each area: Each catchment area has a site manager, outreach supervisor, three violence interrupters, and three outreach workers, totaling eight staff per site. Each day, staff come into the office and debrief on potential conflicts and developments in the community before going out to meet with people throughout the neighborhoods. Violence interrupters spend between two and six hours per day walking the areas with the most violence, visiting gathering places, and talking to community members. They also proactively share information on services available to community members in high-risk areas. At the end of the day, they spend significant time documenting where they went, who they engaged with (without using real names), and other information in an effort to collect high quality data to predict and prevent possible violence.

  • Community advocacy builds political support for the program: The momentum for Cure Violence's implementation began with calls from two community-based organizations, the Coalition Against Police Crimes and Repression (CAPCAR) and the Organization for Black Struggle (OBS). Both groups had become aware of the model through its implementation in Kansas City, MO and called on city officials to bring the program to St. Louis. The Board of Alderman, then led by Lewis Reed, came to support the idea, later approving an allocation of $8 million in public funds for the program.

  • Housing violence prevention in the Department of Health: As leaders contemplated the administration of the Cure Violence program, it was originally suggested that the program be overseen by the Department of Public Safety. However, community members and stakeholders expressed concerns that a widespread distrust of police in at-risk communities would undermine the program’s mission. For that reason, the city later agreed to place the program under the oversight of the Department of Health. Community leaders believe that this approach adds credibility to the program and has enabled its success.

What factors drove success?

  • Hiring the right people and offering competitive compensation: Much of the success of Cure Violence comes from interrupters and outreach workers being able to productively engage with the individuals most at risk of committing or falling victim to violence. Given that, it is crucial for the organization to hire people with lived experience and a deep understanding of the challenges faced by those at risk. For that reason, Cure Violence St. Louis has exclusively hired Black men and women who have been involved in the criminal legal system to serve as violence interrupters. Most of the staff have a deep personal history of being involved in street violence in their past and feel an “almost spiritual” calling to anti-violence work. Competitive salaries and benefits help ensure the staff is well-compensated for their effort and feel valued by the organization.

  • Training and support from national leaders: From the beginning of the program, St. Louis’s Cure Violence program received extensive training, support, and assistance with recruiting from the Cure Violence parent organization, Cure Violence Global (CVG). CVG conducted site visits and provided technical assistance, training for staff and administrators, and access to consultation calls to assist in program implementation. CVG continues to manage the database that local Cure Violence staff use to track incidents and synthesize these data in monthly reports shared with the city’s health department.

  • Maintaining community support: Community trust is a key ingredient in the success of Cure Violence. Because of this, the program has invested in building and maintaining public support for its efforts. One of the main ways the organization has built support is through a steering committee composed of credible community leaders. The steering committee plays an active role in the program’s work and serves as its primary bridge to the communities being served. The committee meets every two weeks, trains staff, and liaises with residents to help build awareness and support. It also played a critical role in providing additional capacity to the Department of Health when the arrival of the pandemic overwhelmed their resources.

  • Mayoral support across administrations: Cure Violence has spanned two mayoral administrations in St. Louis and derived significant support from both. The program started under the mayoralty of Lyda Krewson, who had a background of anti-violence and criminal justice work. After a record breaking year of violence in 2020, Tishaura Jones was elected in 2021. Reducing violence was a major component of her mayoral campaign, and after taking office, Jones moved to address police misconduct, directed the city to hire social workers to assist with 911 calls, and directed federal COVID relief funds into a new Office of Violence Prevention which houses CURE Violence, among other steps.

What were the major obstacles?

  • Disagreement and delays in preparation for launch: When the city released its first RFP for Cure Violence, some members of the steering committee felt that the pool of potential vendors was inadequate. At the same time, steering committee members and the city also disagreed at times on the goals and scope of the program. This caused tension between activists who wanted to see progress quickly and city officials and others who had not yet agreed on the best path forward. For more than a year after the direction of city funds to the program, the program had not launched, leading some members of the steering committee to lose faith in the city’s effort and resign. Ultimately, only one Cure Violence site launched in Wells-Goodfellow in April of 2020, taking until November to launch the other two sites.

  • An overburdened Department of Health: Initially, it was suggested that Cure Violence be overseen by the Department of Public Safety. However, when community members expressed concerns about the credibility of police in at-risk neighborhoods, the decision was made to place the program in the Department of Health. When the COVID-19 pandemic arrived in 2020, it badly overstretched a health department that was already under-resourced, making it all the more challenging for the department to manage the launch of Cure Violence.

  • Difficulty communicating about the results of the program: Public officials have found that much of the public still does not have a detailed understanding of what the Cure Violence program is, what it is not, and how to measure its success. Some see that crime still exists in the city and feel that the program is failing. Others attribute declining crime rates in some areas to Cure Violence, even though these areas are not where the program is operating. The city is attempting to raise awareness that the program is a rapid-response program, not a cure-all, and has a limited reach in the city as of now.

  • Skepticism toward the program’s efficacy: From its launch, community members have expressed confusion and skepticism around Cure Violence and whether or not it can achieve its goals. A full evaluation of Cure Violence in St. Louis is being undertaken by researchers at Washington University in St. Louis, but findings have not yet been released.

  • Losing the program’s legislative champion: The longtime president of the St. Louis Board of Aldermen, Lewis Reed, sponsored and advanced the legislation which secured funding and city support for Cure Violence. In June 2022, Lewis was indicted on federal bribery charges and later pled guilty. Reed’s departure from the Board of Alderman has not impacted the program, but was a significant setback for those working to bolster the program’s reputation.

Timeline

Implementation process

How did leaders confront the problem?

  • Public leaders declare that the level of violent crime is intolerable: The city of St. Louis had long faced high rates of violent crime. In 2017, multiple reports showed that the violence in St. Louis was among the worst in the country. When the federal Department of Justice released a report showing the severity of the violent crime in the city, this created urgency among city leaders to take immediate action and try new strategies to address the problem.

  • Community activists draw attention to the problem and a potential remedy: In the period following the federal report on St. Louis, activists from the community groups Coalition Against Police Crimes and Repression (CAPCAR) and Organization for Black Struggle (OBS) had learned about the Cure Violence program in Kansas City, Missouri and began calling on the Board of Alderman to implement the program in St. Louis. One of their strategies was to hold public hearings on the severity of the violence to build public support for remedies and put political pressure on the city to act. Some activists also met with elected officials and political candidates individually to urge them to back the program, including then-president of the Board of Alderman, Lewis Reed.

  • Community groups invite Cure Violence Global to meet with local leaders in St. Louis: CAPCAR and OBS eventually reached out to Cure Violence Global (CVG), the national umbrella organization, inviting them to explore St. Louis as a potential site. The groups also connected CVG to political leadership, resulting in meetings between CVG and members of the mayor’s office and Board of Aldermen to explore a potential program.

  • Cure Violence Global visits St. Louis: Following discussions with community groups and city officials, representatives from Cure Violence Global (CVG) traveled to St. Louis to meet with local leaders over the course of several days. During the visit, they met with both community groups and city officials to understand the challenge, examine local crime data, and assess whether the city had the civic infrastructure in place to implement the program with fidelity. Ultimately, CVG agreed that St. Louis was a suitable partner for a local implementation.

  • Elected leaders move to bring Cure Violence to St. Louis: After the visit from Cure Violence Global and ongoing conversations with community groups, the then-President of the Board of Aldermen, Lewis Reed, put the issue before the mayor and city comptroller to gain their support. Reed then put forward a bill that would apportion city funds to an implementation of Cure Violence in St. Louis. The Board then passed legislation directing $5 million in public funds over two years to a local implementation of Cure Violence.

How was the strategy designed?

  • A steering committee to liaise between the city and community: Once funding was allocated, local leaders recognized that building community trust would require separating it from policing and decided to house the initiative in the Department of Health. One of the earliest moves by leadership was to form a steering committee, which ultimately grew to include more than a dozen leaders of nonprofits, city officials, and faith leaders. The goal of the committee was to act as a liaison between the city and community by building public awareness and support for the program and providing advice and support to the health department as it implemented the program. The steering committee would also weigh in on the area in which the first site should be located.

  • Selecting areas of the city in which to launch the program: Recognizing that violence was more acute in some areas than others, local leaders carefully selected the areas in which to implement Cure Violence, starting with one neighborhood and later adding two more. To make the selection, they looked at 10 years of crime data including homicides, armed robberies, and assaults. Based on these data, they selected Walnut Park East, Wells-Goodfellow, and Hamilton Heights.

  • Securing suitable vendors to implement the program: Because the Cure Violence program hinges on community trust, it was important to hire vendors who were credible in the communities where they would be working. Program leaders sought organizations with a history of providing wraparound services to young men such as job skills training, mental and behavioral health services, mortgage and rental assistance, and financial assistance. Following two RFP processes, program leaders selected Employment Connection and the Urban League.

  • Working closely with Cure Violence Global to implement the program with fidelity: Given that many approaches to violence prevention had been pursued in St. Louis, local leaders wanted to implement the specific model with fidelity as defined by the organization Cure Violence Global. Under the model, community organizations train carefully selected members of the community to perform outreach services, violence interruption, conflict mediation, mentoring, and resource provision, among other activities. To this end, the Department of Health directed Cure Violence vendors to work closely with CVG on hiring violence interrupters, training staff, conducting data collection, and other administrative duties.

How was the approach funded?

  • City funds to support program launch and implementation: In addition to other criminal justice reform efforts, the Board of Alderman initially approved $8 million in city funds to support Cure Violence. The funding allocation came primarily from the general fund and funding for crime prevention programs. From these funds, each site received $750,000 to launch, with continued public funds to support operational and personnel costs.

  • Federal COVID relief funds for expansion: Mayor Tisaura Jones and the city’s Board of Aldermen committed additional federal funds to anti-violence work via the creation of the city’s new Office of Violence Prevention. This office will support Cure Violence in addition to many other city and community-based programs. The locations for expansions of Cure Violence have not been determined as of December 2022.

How was the plan implemented?

  • Recruiting violence interrupters: Once funding and vendors were in place, the top priority was finding the right people to do the program’s core work: street outreach and violence interruption. The group who contributed to the hiring process included representatives from Cure Violence Global, the Mayor’s Office, Police Department, a community based organization, and a representative from the steering committee. Given how sensitive and delicate violence is, it was essential to find candidates who understood the communities they would serve and be credible messengers. All new hires were Black, formerly justice involved, and most had been formerly incarcerated.

  • Training staff with Cure Violence Headquarters: In addition to assisting the hiring team, the Cure Violence Global staff provided extensive assistance with the onboarding process, providing mandatory training on data collection and the use of tools like email, something that is new to many of the interrupters. Data collection training was intensive, as many of the staff had little experience with desk-based work.

  • Violence interruption begins: With the program infrastructure in place, staff began their work in the community. Violence interrupters spend most of their time walking their community between 1:00 p.m. and 11:00 p.m., Tuesday through Saturday, the window at which risk of violence crime is highest. They start their day by debriefing at the office on the latest news in the community. Then, they head out to the streets, walking crime “hot spots” and neighborhood gathering places, talking to residents and distributing information. They close the day by entering data on all of their contacts and activities, using pseudonyms to protect community members’ identities.

  • Hundreds of interruptions logged and promising decreases in violence: After its first year of operation, Cure Violence staff had intervened in hundreds of conflicts, and crime statistics showed meaningful decreases in violence that many believe are due at least in part to Cure Violence’s work. Between 2020 and 2021, homicide rates in St. Louis dropped 25 percent, but they decreased even more in four out of the five neighborhoods in which Cure Violence operated (Cure Violence sites focus on specific areas within multiple neighborhoods).

How was the approach measured and refined?

  • Continuous data collection and monitoring: One of the core elements of the Cure Violence model is data collection. At the end of each day, violence interrupters and outreach workers return to the office to report data on how many people they spoke to, the status of conflicts, and other information. That data then goes to CVG, which aggregates it and shares it with the city’s health department on a monthly basis.

  • Evaluation underway: Researchers at the Washington University in St. Louis are currently conducting a program evaluation that will be released in 2024. This report includes a community survey and assessment of milestones and progress. City leaders believe that this will play a crucial role in understanding the strengths and weaknesses of the program’s implementation and where improvements can be made.

  • Adding emergency response to overdose treatment: In 2020, St. Louis saw hundreds of deaths from drug overdoses. For that reason, Cure Violence added the administration of Narcan — an emergency drug which can quickly reverse the effects of opioid overdose — to its training and responsibilities. Cure Violence staff say that this is an increasingly large part of their routine duties as they conduct street outreach.

  • Bringing different components of violence prevention under one roof: Cure Violence focuses on violence interruption, but city leaders recognize that the program can only address one piece of a complex set of social and economic forces that contribute to violent crime. After joining with other local and federal leaders to discuss this at President Biden’s Community Violence Intervention cohort, St. Louis launched an Office of Violence Prevention to invest in a variety of additional violence prevention programs and better coordinate activities. The city allocated an additional $13.6 million in ARPA funds to support this office’s work. The office will lead collaborative efforts between a variety of community-based organizations and city departments, as well as pursue long-term funding.

Acknowledgments

Results for America would like to thank the following individuals for their support in writing this case study: Wilford Pinkney of the City of St. Louis, Sal Martinez of Employment Connection, Mulugheta Teferi of the St. Louis Urban League, Serena Muhammed of the St. Louis Mental Health Board, and Brent Decker, Charles Ransford, Cobe Williams, and Frederick Echols of Cure Violence Global.

This case study was written by Jonathan Timm and Ross Tilchin.