Before and After: The Case for Primary and Secondary Prevention Jimmie was 15, from what one would call a typical family. His parents worked, owned a smallish but well-tended home, did their best with three children, and participated in their children’s lives as much as they were able. Jimmie, as the oldest, was responsible for managing his younger sisters after school until his parents came home. His chores included getting them snacks, playing with them or helping them with homework, and keeping them “within sight.” Jimmie, now 16, began to resent the responsibility, believing he was missing out on being with his friends. Their texts and Facebook posts were ever-present reminders of being left out. Rebelling, Jimmie began to self-medicate; it eased the pain and resentment. His slow decline was missed by his working parents. They didn’t notice the change in friends and Jimmie went from argumentative to listless, which they mistook as acquiescence, until the accident. Driving a friend’s car, leaving the sisters at home unattended, high on something a friend said was great, Jimmie went off the road. Damage to the car and to a neighbor’s property was moderate; no one was hurt beyond a few bumps and bruises. Jimmie and his friends were arrested. Jimmie was charged with driving without a license, driving while intoxicated, reckless driving, and possession of drugs. The parents, running a gamut of emotions, were referred to the town’s community youth services where they could meet with a social worker as well as with a police officer prior to court. They were offered a one-time diversion because this was Jimmie’s first offense. Diversion, if followed, would keep Jimmie out of court, away from drugs, and leave him with a clean record. Several meetings later, Jimmie went before the diversion board to outline with his family, the social worker, and police officer the plan for primary and secondary prevention. This was a contract signed by all. One year later, Jimmie, now 17, and his family had fulfilled the contract. Jimmie’s case was released without prosecution. What risk factors, in retrospect and for future consideration (thinking of the sisters), could be addressed through primary prevention? How could the family's environment be employed to prevent a recurrence?
Before and After: The Case for Primary and Secondary Prevention
Jimmie was 15, from what one would call a typical family. His parents worked, owned a smallish but well-tended home, did their best with three children, and participated in their children’s lives as much as they were able. Jimmie, as the oldest, was responsible for managing his younger sisters after school until his parents came home. His chores included getting them snacks, playing with them or helping them with homework, and keeping them “within sight.” Jimmie, now 16, began to resent the responsibility, believing he was missing out on being with his friends. Their texts and Facebook posts were ever-present reminders of being left out. Rebelling, Jimmie began to self-medicate; it eased the pain and resentment. His slow decline was missed by his working parents. They didn’t notice the change in friends and Jimmie went from argumentative to listless, which they mistook as acquiescence, until the accident.
Driving a friend’s car, leaving the sisters at home unattended, high on something a friend said was great, Jimmie went off the road. Damage to the car and to a neighbor’s property was moderate; no one was hurt beyond a few bumps and bruises. Jimmie and his friends were arrested. Jimmie was charged with driving without a license, driving while intoxicated, reckless driving, and possession of drugs.
The parents, running a gamut of emotions, were referred to the town’s community youth services where they could meet with a social worker as well as with a police officer prior to court. They were offered a one-time diversion because this was Jimmie’s first offense. Diversion, if followed, would keep Jimmie out of court, away from drugs, and leave
him with a clean record.
Several meetings later, Jimmie went before the diversion board to outline with his family, the social worker, and police officer the plan for primary and secondary prevention. This was a contract signed by all. One year later, Jimmie, now 17, and his family had fulfilled the contract. Jimmie’s case was released without prosecution.
What risk factors, in retrospect and for future consideration (thinking of the sisters), could be addressed through primary prevention? How could the family's environment be employed to prevent a recurrence?
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