19th October 2019

"Stratford Stabbing: Boy, 15, killed in East London"

13th January 2020

“Poplar stabbing: Boy found in pool of blood after knife attack”

In both cases, the perpetrators were 15-year-old males arrested for murder and grievous bodily harm.

In July 2019, I took a taxi from Whitechapel to Heathrow. My driver Rizwan and I sat in bleary 5am-silence for a while, before he opened with the customary “Where you off to then?”. In his own words, Rizwan “should’ve been a politician”; the man has strong opinions on everything from house rents (“You’re being ripped off woman”) to racism (“I’ll go back to my country if they let me take the diamond”), delivered with an air of indisputable authority. A former youth worker, Rizwan was laid off, when budget cuts closed down several youth centres (places for young adults to engage in after school activities and seek mentorship). It was our ensuing conversation on the rising rates of youth knife crime and gang violence that inspired months of research and interviews, resulting in this article.

In 2017, young people aged 15- 19 years represented 35% of all perpetrators of violent crime and 10% of victims, a gross overrepresentation considering they only make up 5% of the population. “Broadly speaking, austerity and the related socioeconomic impact has created an environment where many young people feel forced to use criminogenic means to achieve fundamental needs,” says Ms. Lisa Rowles (Director of Evidence and Innovation, at the charity Khulisa). "Often the young people we work with are already under pressure to be the breadwinner. In this environment, they are easy prey to gangs, drug peddling, and the related and inevitable violence."

Khulisa was founded in a postapartheid South Africa in 1997, focusing on reducing violence and crime in some of the world’s most dangerous cities. A testament to their success, they won a ‘Best Practice Model of Transformational Social Impact’ award in 2006 from the UN Office of Drugs and Crime. In 2007, the British chapter of Khulisa was founded with the aim of working with youth in communities, schools, and prisons to identify and mitigate factors that lead to engaging in violence and crime.

Youth violence, Ms. Iman Haji (Research and Programme Coordinator at Khulisa) explains, is usually an amalgamation of factors, ranging from mental and physical stressors due to poverty, a lack of mental health support and education on wellbeing, cyberbullying, and peerpressure. "Almost all our participants have experienced childhood trauma due to Adverse Childhood Experiences (ACEs)," continues Ms. Haji. ACEs, usually divided into Abuse, Neglect, and Household Adversity (parental mental illness, substance abuse, domestic violence, etc.) are known to affect brain development, leading to poor decision making, impulsiveness and a tendency to react with violence instead of logic. These factors often culminate in expulsion or suspension from school, resulting in poor employment prospects, increased exposure to negative influences, and engagement in criminal activity. According to a 2019 education committee report, school exclusion is the single largest predictor of crime and antisocial behaviour. Cue budget cuts in the past decade resulting in a lack of youth clubs and community spaces in deprived areas, the product is a generation of youth easily accessible for exploitation in unsupervised spaces such as public parks and shopping centres, with knives being the weapons of choice.

Historically, the response to crime has taken the form of increased police personnel, stop-and-searches, and making knifes inaccessible to youth. ‘[However] there is an emerging understanding that these issues won’t go away with enforcement alone,’ says Mr. Michael Carver, Lead Nurse for Violence Reduction at Barts Health. In this role, Mr. Carver is responsible for conducting research into the demographics and trends in violence, to determine how health services can help prevent future injuries. In 2018, Mayor Sadiq Khan commissioned the establishment of Violence Reduction Units, modelled after existing systems in Glasgow. The endeavour adopts a novel Public Health approach to violence, an interdisciplinary undertaking consisting of media campaigns (such as ‘London needs you alive’), funding grants for community youth centres, and partnerships with third party sectors. A product of the VRU is the ‘NHS Violence Reduction Network’, which has helped establish teams of caseworkers at the Royal London in partnership with Tower Hamlets Council, St. Giles Trust, and Victim Support. Similar ventures exist in the other three major London Trauma centres to ensure the presence of trained workers to deal with young patients holistically.

"We used to treat someone and send them straight back into the social circumstances that may have harmed them in the first place", continues Mr. Carver. "Now we try to understand what’s happened, the precipitating factors, and if we can do anything to prevent it from happening again." However, traditionally the role of the Health Service is to treat injuries and illness and offer advice on prevention; Is addressing the social side of youth crime really our responsibility? "It is absolutely our responsibility. Perhaps not legally, but it should be our moral responsibility," states Mr. Carver. As a demographic, 70% of young people witness real life violence once a month, and 16% witness it daily. The research on ACEs and deprivation also shows their association with long term morbidity including smoking, alcohol use, poor diet and of course, a tendency towards violence victimisation and perpetration resulting in bodily harm. From a public health perspective, a young person’s admission into hospital is a crucial opportunity to identify and address circumstances which, left untreated, stand to burden themselves and the NHS through the life course of the victim. Consequently, there is also a call for General Practitioners to become more informed on recognising ACEs and referring to appropriate community services.

There is no single solution to youth crime; it is a symptom of underlying social circumstances leading to exclusion, requiring a systematic approach to mitigate the root causes. "The most difficult part is showing these young people they have other options," Says Mr. Shafiur Rahman (Executive Director of the Osmani Trust, a youth charity based in Whitechapel). "We need to offer them something better than quick money from drugs and gangs." One of the Trust’s main initiatives is the ‘Aasha Program’, which provides mentoring, hobbies, employment counselling and gang mediation for at risk-youth aged 12-25, aiming to help prevent exclusion and reintegrate them into the community.

At Khulisa, the interventions fall under three categories; prevent, rehabilitate and reintegrate. Their trauma-informed approaches are based on the latest research in neuroscience and neurodiversity, seeking to teach emotional regulation, increase self-confidence and aid rational decision making to deter criminal engagement. The success rates are impressive, with only a 7% reoffending rate among their participants. Both charities are working on their community strategies and building partnerships and expanding their presence in schools to reach more children at a younger age.

For a city that boasts of Canary Wharf, the Shard, and the opulence of South Kensington, London's underbelly of deprivation and its consequences astound me. How this came to be, and what that says about our social and political structures is a separate discussion (Rizwan has lots of unflattering opinions), but the gory headlines and pools of blood are the realities that face many children today. However, if there is one thing I have learnt writing this, it is that London has woken up. The Public Health approach to violence has worked in Scotland to dramatically reduce their crime rates, and London’s multidisciplinary approach is rising to the challenge. Coupled with increasing awareness of and research into the factors surrounding youth crime, I am hopeful that we have started down the right path.