In 2012, when Kathryn Bocanegra was an anti-violence director in Chicago’s Little Village neighborhood, she was dealing with an employee who was struggling to get her work done.

The employee was a street outreach worker, responsible for connecting with gang members, trying to prevent shootings and pulling young people off of the streets. In March of that year she watched one of the young men she was working with bleed to death from a gunshot wound to the stomach.

She was devastated and “totally destabilized” by the young man’s death, Bocanegra said. The outreach worker developed a fear of attachment to her clients. She withdrew from the work.

So, Bocanegra fired her.

“I was so focused on making sure that we could continue to provide a service, to be in compliance with our grants, but also to help the community at a time when violence was surging, that I overlooked the wellness of that worker. And when they could no longer perform a task, they were let go,” Bocanegra said.

As Chicago, and the country, invest more in violence prevention efforts that do not involve police, there is increasing awareness that this growing anti-violence workforce needs support to deal with the violence they are thrown into every day. These outreach workers face levels of distress similar to that of police officers or paramedics, but without any of the institutional support or social esteem.

Bocanegra, now a professor at the University of Illinois at Chicago, is committed to making sure those people working to prevent shootings get more support than she gave her employee 10 years ago. To that end she just conducted a survey of about three dozen frontline Chicago anti-violence workers.

Her findings are stark. The workers feel underappreciated, under-supported and over-exposed to trauma. The lack of support, Bocanegra said, could destroy the lives of people dedicated to improving their communities and is a serious threat to the anti-violence efforts Chicago is increasingly relying on to reduce shootings.

“You forget about yourself”

Street outreach, or street intervention, in which community members with criminal records or past gang involvement go into neighborhoods to try and intervene in disputes and pull people off the streets, has in recent years become a key part of government’s approach to gang violence. The city of Chicago and the state of Illinois have committed millions to the effort. Former street outreach workers have been elevated to positions in the city, state and federal governments. President Joe Biden talked up the value of the work at the White House.

“There’s an expectation that street intervention can deliver the neighborhood safety that we so desperately need,” Bocanegra said. “But the question that’s haunted me … for the last decade is at what cost? And by saving one life, are we destroying another person’s life?”

One worker surveyed described having nervous breakdowns on the way into work, another relayed their fear after a colleague’s car was shot up, another talked about their trauma-fueled, blood-soaked nightmares.

More than three quarters of survey participants said they had witnessed a traumatic death. About 80% have at least one symptom of post-traumatic stress disorder, or PTSD.

Orlando Mayorga said his anti-violence work strained his relationship with friends, family and his partner. He lost sleep and gained weight.

Before moving to his new position as the reentry policy coordinator in Ill. Lt. Gov. Juliana Stratton’s office, Mayorga worked on prisoner reentry at Precious Blood Ministry on Chicago’s South Side. He was one of the people who participated in Bocanegra’s survey.

Mayorga’s job at Precious Blood, which he started shortly after coming home from prison himself, forced him to constantly wrestle with his own past of violence and incarceration.

Everyday he had to work with people traumatized by prison, traumatized by what they’d done to get locked up, traumatized by violence in the neighborhood they were returning to and by the lack of options they had for escaping it. He spent everyday working with people teetering on the brink between life and death.

“You’re so invested in trying to impact the community in a positive way, to impact one single life at a time that you forget about yourself,” Mayorga said.

Mayorga said his coworkers and friends encouraged him to go to therapy. He did eventually, but he suffered without help for years. He remembers thinking to himself, “How can I be talking to a therapist, if I’m the one that’s supposed to be the therapist for others?”

Bocanegra said that’s why organizations that employ street outreach workers have to do a lot more than just encourage workers to go to therapy. They have to make mental health and trauma support a part of their core identity, such as organizing group wellness exercises, modeling good mental health and giving workers time to decompress and take care of themselves.

“You know that death will happen”

Tony Salaam, director of outreach for READI Chicago in the Englewood neighborhood, said organizations should have on-site therapists who exclusively serve their anti-violence workers.

“These courageous men and women who do this work on the ground, we have to provide the resources for them,” Salaam said.

READI is one of the biggest anti-violence programs in the city, and until recently was run by Bocanegra’s husband. It seeks to give jobs and therapy to the men most likely to shoot someone or be shot. That requires workers to go out to Chicago’s most violent corners and connect with people at the center of the bloodshed.

Salaam said READI does not have an on-site clinician for its workers in Englewood. Instead, he said, workers can get help at a nearby site connected to Heartland Alliance, which funds READI.

Salaam said READI does have a plan in place for supporting workers if one of their participants is killed, an occasion that is not infrequent because of the people they serve. It involves healing circles, constant check-ins and encouraging the worker to take time off, although he acknowledged that workers have to dip into their own PTO bank if they want to get paid for their days away recovering.

Prof. Bocanegra said most anti-violence organizations don’t have any plan or procedure in place at all to support employees after someone they work with is killed, even though it’s a sad inevitability. She said it’s a symbol of how little many organizations think about the well-being of their workers.

“If you know that you’re working with people who are trying to kill each other, you know that death will happen, you know that shootings will happen,” Bocanegra said. “And that that will have an impact on your staff at a very basic level. I think you can plan for that rather than react to it.”

Bocanegra said that’s on the organizations doing this work — but it’s also on the government agencies and big nonprofits funding it.

As the city and the country turn more toward street outreach to try and prevent shootings, the people controlling the money need to make sure they aren’t demanding unrealistic outcomes, Bocanegra said. They need to make sure there’s money in the budgets for therapists for the workers, caseloads that allow actual time for healing and pay rates that give workers financial security.

Bocanegra said frontline anti-violence workers are “stopping bullets with their bare hands,” and they need a lot of support to do it.

Patrick Smith is a reporter on WBEZ’s Criminal Justice Desk. Follow him @pksmid. Email him at psmith@wbez.org.