Serious Youth Violence Presentation

1. Serious Youth Violence Presentation John Anthony Strategic Lead Youth Offending Service

2. Serious Youth Violence: trends • Long term trend is of an overall decrease in SYV over a 3 year period by a small amount • Knife crime 3 year trend is stable – same levels over 3 years • Some seasonal variation – such as peaks in early summer and dips in August and December

3. Serious Youth Violence – crime reports • Map shows hotspots of crime across the borough • Hotspots around Stockwell, Brixton, Loughborough Junction, Streatham High road • NO link between schools & violence – SYV tends to happen outside of schools some distance away • HOWEVER, clear link between transport hubs and SYV. Each hotspot area is a major transport hub for the borough

4. Serious Youth Violence – health data • Map shows ambulance call-outs for assault for those 19 and under • Similar hotspots to reported crime – transport hubs e.g. tube stations, rail stations and bus routes • BUT some differences – ambulances are called out to other areas where reported youth violence is much lower, such as estates • Highlights the need & involvement of public health in the long-term solution

5. Serious Youth Violence – suspects • Majority of suspects are aged 16 to 19 • For gender, men outnumber women more than 10 to 1 • 67% of suspects are black, with “unknown” as the next largest category, followed by 11% white • Key point – 99% of young people are not involved in crime at all

6. SYV – who are the victims? • Majority of reported crime victims are boys – 84% • A&E data shows a higher proportion of girls, with 35% of victims of assaults • Majority of victims are aged 16 to 19 for both police & hospital data • 56% of reported victims are black, again disproportional to the population • Majority of victims are young, black boys, especially in the more serious SYV cases such as knife crime

7. Lambeth gangs ABM RSG • Nine main gangs in Lambeth • Main areas for gang activity continue to be across central part of Lambeth • These include Coldharbour, Stockwell, Vassall • Historical gang tensions and confrontations • Gang alignment OTREY GAS/SIRU TN1 NOTRE DAME T.DOT.BLOCK NEW PARK GUNNERS SQUEEZE SECTION

8. Lambeth gangs • SERIOUS YOUTH VIOLENCE • Year on year performance =43.3% decrease (Sept -2012) GUN CRIME • Year on year performance =44% decrease (PIB - 04/10/2012) • 5th largest decrease in gun crime offences compared to other boroughs in the Met.

9. Police and CS Interventions • Operation Allegra – multi-agency referral, intel sharing and action • Operation Fresco – compliments Allegra with tactical police enforcement • Safe and Secure – emergency housing move for those at highest risk levels • Gang Mediation Referrals - using London wide gang mediation experts • Community Safe Messaging – regular communication to neighborhoods & communities • Street a week – targeted, focused work in neighbourhoods

10. Scale of the Problem • Permeates large sections of youth in Lambeth • Permeation can be by association, affected by or indirect horizon limiting • Permeation of gang activity is across race, gender and potentially impacts on a range of services

11. Impact on Service Provision • Challenges exist around the geographical provision of services • Collective delivery of services is difficult • Evidence base around interventions is still embryonic • Need for co-produced relevant services also presents a challenge • The focus in Lambeth increasingly has been around Evidence Based Practice and innovative solutions to gang related serious youth violence

12. E.B.P. and aligned Services • Commissioning based on E.B.P. in relation to promoting positive outcomes for young people • Information and intelligence led targeted services require wider partnership input especially schools and Adult Services • Gang Matrix is a useful starting point • Parenting/ Troubled Families and Adult Criminal Justice Services could benefit from greater alignment • Challenge is how do we deliver integrated Serious Youth Violence support and challenge

13. E.B.P. and aligned Services continued • How do we articulate a different CAMHS provision so that it reduces propensity for violence? • What role can the MATs and Social Care play in delivering bespoke case work conversations? • How do we align Early Years work with a violence reduction strategy? • How do we engage schools?

14. Gang Reduction Multiple Pathways • Pathways focusing on Early Years • Teenage transition points which highlights the importance of schools • Bespoke co-ordinated casework conversations which cover step up and step down procedures • Development of co produced evidence based interventions • Targeted enforcement and support legitimised by the community • Nuanced approaches which capture violence against women and girls.

15. Thank you

16. Knights Youth CentreStu Thomson reinventing hope for young people, families & communities

17. reinventing hope

18. reinventing hope What is it really like for a young person associated with gang activity?

19. reinventing hope Story about a Prince

20. reinventing hope Addictive Acceptance Support Cash Rebellion Buzz Fearful Dangerous Painful Trapped Risky Restrictive Unhealthy

21. reinventing hope How can good youth work provide a lasting alternative? “If the young men aren't initiated into the village, they will burn the village down just to feel its warmth."

22. reinventing hope THE DREAM… To provide: each young person with tangible hope and tough love whilst delivering a spectrum of positive alternatives that will provide immediate impact with lasting, long term benefits..

23. reinventing hope HOW? • Self worth • Commitment and consistency • Productive partnerships • Striving for change • Never, never give up

24. reinventing hope Some examples… • TYLAP • The Enablers • E.X.I.T • Let me Play Sports

25. reinventing hope “Where there is no hope, one must invent hope” Albert Camus

26. Public Health Approach to Violence 4th March

27. World Health Organisation report on violence and health, WHO • the response of the health sector to violence is largely reactive and therapeutic… • … public health places emphasis on preventing disease or injury from occurring or reoccurring rather than treating the health consequences.. • … violent behaviour and its consequences can be prevented

28. Four stages of a public health approach to violence, WHO • Understand the epidemiology • Understand the risk factors – can they be modified through interventions • Find out what works to prevent violence • Implement effective and promising interventions in a wide range of settings

30. What causes youth violence ? • Balance of risk and protective factors • Risk factors are: • Interdependent • Cumulative

32. Early Life Experience and The Brain • Hypothalamic – Pituitary Adrenal Axis (Cortisol) Overly developed life preservingparts of the brain hair trigger alarm system • Neutral cues become threats What are you looking at? • School – State of non-receptive heightened anxiety Poor learner, disengaged

34. Short Term Actions: Enforcement – knife arches, stop and search Injury surveillance – A&E data sharing Medium Term Actions: Identification and signposting Long Term Actions: Parenting strategy – Family Nurse Partnership, Bullying Prevention Programme, Promoting Alternative Thinking.. Anti poverty, Education, Regeneration Short, medium and long term interventions

35. RECORDING OF VIOLENCE BY THE POLICE AND IN HOSPITAL EMERGENCY DEPARTMENTS • Only 25-50% of violence which leads to hospital treatment is known to the police • Non reporting reflecting fear of reprisals, inability of injured people to identify assailant(s), unwillingness to have own conduct scrutinised and need for emergency treatment • Non recording of reported incidents

36. Cardiff Model: Sharing of ED data with Police Step One: 24 hour electronic data collection (precise violence location, time and weapon) by ED reception staff when patients first attend Step Two: Monthly anonymisation and data sharing by hospital IT staff with crime analyst Step Three: Monthly combination of police and ED data by analyst Step Four: Summary of violence times, locations and weapons – for police deployment and license regulation Step Five: Continuous implementation and updating of prevention action plan

37. The Model works by facilitating earlier and more frequent police intervention through the use of information from EDs – and keeps people out of hospital and out of prison

38. & Interventions • ED information identified a source of blunt weapons – a construction site next to a night club with skips containing bricks, concrete blocks and pieces of wood. Skips were removed • ED information identified street violence hotspot where local authority had switched off street lights. Switched back on. • ED information identified several violence hotspot pubs/night clubs. Alcohol licence conditions imposed and some licences revoked.

40. Epidemiology: national level • Violence in general population: 35,000 emergency hospital admissions and over 300,000 ED attendances in England each year. • Child maltreatment: NSPCC estimates that I million secondary school students in UK have suffered maltreatment at some point in their lives • Youth violence: in 2010/2011 there were 13,000 emergency hospital admissions for assault among 13-24 yr olds. One in seven involved a knife or sharp object. • Intimate partner violence: almost 900,000 women and 600,000 men in England and Wales are estimated to have suffered abuse at the hands of an intimate partner in the past year • Sexual violence: 400,000 women and 80,000men in England and well are estimated to haver suffered a completed or attempted sexual assault in the past year • Elder abuse: one in forty older patients seen by the average GP or family physician will be suffering form abuse or neglect • Violence against staff: 8% of NHS Staff report experience of physical violence from patients, their relatives or member so of public in past 12mths

41. Adolescent mortality vs early years

42. Males years of life lost

43. Epidemiology: Local levelYouth violence Oasis& Redthread • Youth work intervention at Accident and Emergency Department at St. Thomas’ hospital to contribute to reducing harm to young people from violence’ • 585 young people entering ED department 70% (409) from Lambeth and Southwark. 70% were male (average age 15) 30% female • 66% of injuries were incurred from fighting or being assaulted (not during a fight). • For where there was information: • (213) 17% attack recorded as gang related • (109) 46% use of alcohol/drugs in the fight/assault • Of the 585 young people 19% (109) had data about CAHMS involvement. Of these 40% had current or previous involvement: 3% were undergoing referral to CAHMS.

44. Child Death Overview Process2008-2011 Unexpected deaths50% due to unnatural causes e.g. RTA, fires, homicide, working with gangs and knife crime, housing issues, early warning systems and escalation policies in hospitals

45. VAWG • Gaia Centre: Jan 2012-13: 1409 female referrals for domestic violence over 50% aged 20-40 years of age. • 38 young women aged between 13-17 yrs of age • 60 men referred to Gaia • IRIS Project in GP practices: 81 female referrals to the IDVA • FNP Clinical Audit on Prevalence of vulnerability factors 164 young women in Lambeth & Southwark over 40% of clients had experienced domestic violence as a child, a past abusive relationship and a difficult relationship with own mother.

46. Health Service work in Lambeth and Southwark re: youth violence • A& E data Sharing: Kings and GSTT with Lambeth and Southwark CRDP’s since 2010 • Potential to inform local interventions • Youth Liaison worker in GSTT. Redthread youth worker in Kings

47. Oasis Youth Support Service Pathway

48. Prevention • Lambeth Health and Well-being Partnership: Ongoing work to support schools deliver PSHE through Health and Wellbeing Programme offered to all primary and secondary schools and special schools and targeted youth projects: includes SRE, Substance misuse, EHWB and drama based work tackling intimate partner violence, promotion of healthy non violent relationships. • VAWG strategy: Annual training programme on VAWG (324 people trained). Gaia Centre work with young women, Awareness campaigns • Barnardos work with boys and young men: self esteem, masculinity, relationships • National CPD programme for teachers and school nurses on PSHE focus on sex and relationship education • Teens and Toddlers Programme in 5 schools 100 graduates • Learning to Lead co-production work with young people in 5 schools

49. Young Parents • Universal Health Visiting Service: increased numbers • Universal and Targeted Parenting Programmes • St Michaels Fellowship: One to one support work with mothers and fathers to be and young parents • Group Work in Children Centre focusing on preparation for parenthood, parenting, child health outcomes relationships domestic violence etc. • 2010/2011 Over 200 young mothers & 100 young fathers • Family Nurse Partnership: one to one programme working with first time parents aged 19 and under from the antenatal period until the child’s second birthday. The programme is evidenced based and one of only two programmes worldwide shown to prevent child abuse.(Olds et al 2004)

50. Next Steps • Recognise importance of the life course • Evidence argues for a public health approach • Need to map what we are doing across life course and public health evidence • Identify gaps • Commit to the development of a sustained long term co-ordinated programme to reduce violence: not projects • Welcome and encouraged that Lambeth is adopting the public health approach.