Few people would contest that violence is having a virulent impact on the mental and physical health of American youth. But how can this violence be prevented?

One strategy is to bring about a dramatic culture shift at the community level. So argued Chicago psychiatrist Carl Bell, M.D., at the annual meeting of the National Medical Association, which was held in Washington, D.C., in August. The reason, he explained, is that when the lives of young people, especially poor young people, are improved in various ways, they are less likely to commit violent acts or be victims of violence.

But Bell, who is president and CEO of the Community Mental Health Council and Foundation, Inc. (a nonprofit organization providing mental health services in the Chicago area), as well as vice chair of the APA Task Force on Psychiatric Aspects of Violence, is doing more than preaching. He is actively involved in helping bring about a seismic culture shift on his home turf—Chicago—and specifically in the lives of the young people who attend Chicago’s public schools.

Seven years ago the CEO of the Chicago public schools, as well as some other people on staff there, started implementing violence prevention strategies that Bell had advocated. Bell served as a consultant in these efforts. And in the seven years since, and with Bell’s ongoing help, a number of the strategies have been put in place—some throughout the entire school system, others only in those schools with the greatest social needs.

One strategy is requiring children to wear school uniforms. Another is offering character education in the fifth through eighth grades. A third is canceling social promotions. Still a fourth is alternative schools for youngsters who were expelled from school and who want to return. A "Cradles to Classrooms" program is available; pregnant girls are provided with counseling, mentors, and health care services.

Young people are taught social skills— say, how to resolve conflicts by talking instead of hitting. The schools have mediators to help them resolve problems, and teachers do not know how to handle unruly youngsters are taught how to do so.

Efforts are also being made to protect young people from danger. "We have cops in schools; there is a police presence," Bell said. There are also parent patrols in which parents are paid to walk with the youngsters to and from school and to protect them from drug dealers. People in the community are hired to help deal with special pockets of drug abuse.

As a result of these and other efforts to rebuild Chicago’s communities, some good things are happening, said Bell. There has been an increase in the academic performance of the students, which gives them a sense of power. School attendance rates have increased. Fewer pregnant girls are dropping out of school than used to be the case, and they tend to have only one child, not two or three, by the time they reach 18 years of age. Suspensions, expulsions, and arrests of students are down. "So we think this is working, that this is making a difference," Bell said.

Or as he put it to Psychiatric News: "These different parts are working in synergy to do violence prevention."