We need to take a public health approach to youth violence—it’s not just a criminal matter

Knife crime gets a lot of attention in the UK press and we should take this worrying trend seriously. But we should also remember that it’s only part of the story. In reality, stab wounds make up a small proportion of the total hospital admissions attributed to violent incidents, and much of the media coverage sensationalises the topic.

That’s why we wanted to provide quality data and hard facts—to bust some common myths—in our new State of Child Health indicator dedicated to youth violence.

To me, the rise in youth violence signals a broader challenge facing our society—widening inequality. It is not surprising that violence flourishes within low-income BAME communities and those living in the country’s most deprived areas—exacerbated by cuts to funding for indispensable youth services. The fact is that we have more young people living in poverty. And the diminishing availability of community support services puts these young people, in particular, at risk of entering the cycle of violence.

We need targeted services that address the interplay of the many social factors often working against these young people.

Our report calls for a public health approach to preventing youth violence altogether. This involves identifying risk and protective factors among all young people, then using this knowledge to mount a multi-agency response to test and scale interventions. It is, however, helpful to understand that there are many vulnerable young people who are already trapped in the cycle of violence. We need targeted services that address the interplay of the many social factors often working against these young people. 

At face value, the story of youth violence is one that primarily concerns young men. Indeed, they are a highly represented group, comprising the majority of both perpetrators and victims. Yet to focus on the direct actors alone is to miss the negative consequences for their families, friends and communities. Many young women and girls, for instance, have to deal with mental health challenges as indirect victims of violence—their stories must not be excluded from the narrative.

Just as we must consider the causes of youth violence through a holistic lens, so too must we tackle it. By looking at the ‘upstream’ drivers encouraging young people to enter the cycle of violence, we have an opportunity to break that cycle. In particular, we need to pay special attention to adverse childhood experiences—including living in care, physical and emotional abuse and exposure to domestic violence. The impact of these experiences can accumulate, and we need to advocate for better targeted services for those most at risk.

There is also something to be said for our approachability. Doctors can often be so detached from the reality of such challenging circumstances that we can struggle to relate. This is also partly due to the perceptions of doctors by young people. Thus, we must work collaboratively with other agencies, such as our youth worker and social care colleagues, who are often better placed to provide support in this context.

If there is a model for what good looks like, we should turn to Scotland. By treating youth violence as a public health issue instead of a criminal matter, the country has gone from the most violent in the developed world to one with decreasing rates of violent crime. The approach has, however, taken several years to come to fruition. In other words, the fix is not a quick one. But by addressing upstream drivers and investing in youth services, now, we will eventually reap the benefits—and do justice to our communities most in need.