Public Health Model to Reduce Youth Violence

Part of the debate – in the House of Commons at 3:54 pm on 13th December 2018.

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Photo of Vicky Foxcroft Vicky Foxcroft Opposition Whip (Commons) 3:54 pm, 13th December 2018

I will start with what motivated me to speak in this debate. I was first elected in 2015, and in September of that year I had to deal with losing two young men in my constituency. I saw the impact it had on the whole community. Since then we have lost 10 young people in Lewisham, Deptford. With 130 lost in London and 263 lost across the country this year alone, this clearly is not something we can simply tackle in Lewisham, Deptford alone.

If that many people had died in a football stadium, a music arena or a workplace, we would be having a national inquiry. From my conversations with experts and young people, I quickly realised that anything we do needs to be cross-party—we cannot play politics with young people’s lives—and evidence-led. That is why we established the cross-party commission on the root causes of youth violence. Warwick University joined as our academic partner, and academics from elsewhere, including the Open University, have supported our work. A public health approach was the key recommendation of our interim report.

In talking about a public health approach, people far too often, and particularly politicians and commentators, say the words but do not understand what they mean or where they come from. In 1996, at its 49th annual conference, the World Health Organisation declared violence

“a major and growing public health concern around the world” and in 2002 it advocated tackling violence as a public health problem. The World Health Organisation identified that violence acts and spreads like a disease.

The focus is on dealing with violence just like any other disease. The World Health Organisation’s evidence shows that violence spreads like a disease and, as such, we need to treat the disease and prevent it from spreading. Across the world, from Chicago to Scotland, there are numerous examples of successful public health programmes aimed at tackling violence. I could name loads of them, but I have had to cut down my speech dramatically to stay within the time limit.

Cure Violence, founded in Chicago in 2000 under the name CeaseFire, runs projects all over the world, including in England at Cookham Wood young offender institution. The project at Cookham Wood resulted in a 50% reduction in violent incidents, a 95% reduction in group attacks and a 96% reduction in youths involved in group violence.

Cure Violence maintains that violence is a learned behaviour that can be prevented using disease control methods. The Cure Violence model has five required components, three core components and two implementing components. Put briefly, the model involves, first, detecting potentially violent events and interrupting them to prevent violence through trained, credible messengers; secondly, providing ongoing behaviour change and support to the highest-risk individuals through trained, credible messengers; thirdly, changing community norms that allow, encourage and exacerbate violence in chronically violent neighbourhoods to healthy norms that reject the use of violence; fourthly, continually analysing data to ensure proper implementation and to identify changes in violence patterns and levels; and fifthly, providing training and technical assistance to workers, programme members and implementing agencies.

In Scotland, the violence reduction unit established in 2005 has reduced the number of homicides by 39% and the number of violent crimes by 69%, which is huge. I could talk for hours about the unit’s work, but I will not. I will simply say that I have nothing other than total respect for the unit’s work and for the magnificent people I have met.

Karyn McCluskey and John Carnochan, who set up the unit, are two of the finest, most dedicated people I have ever met. It has never been just a job to them. They drafted the violence reduction unit’s first plan and they would say that they had lots of dedicated people who worked with them, and I know that to be true. What would be the main things they would say to me if they were here? They would say, “It is about relationships.” I interpret that to mean breaking down barriers, pulling people together on a common aim and enthusing people to do something that is going to work. It is also about the importance of individual relationships. They would also say, “Follow the evidence. Don’t do things that don’t work. Do things that work.” That might sometimes mean trying something, realising it is not working and binning it, and then trying something else that will work. They would also say, “ Listen. Listen to what you’re being told and what the evidence shows you. Listen to our young people and recognise they are so, so often so very vulnerable, even if they put a super-hard act on.” One of the most important things they would say is that our approach must be long term. They had a 10-year strategy, but when we speak to them, they say it could and probably should have been 15 or 20 years long.

I am glad to see that Sadiq Khan, the Mayor of London, has announced the establishment of a violence reduction unit in London, which will establish a public health approach to reducing violence, learning the lessons from Scotland, but appreciating we may need some different approaches in London. Local authorities need to have the legal duty—this is not just about having a consultation on a legal duty—to underpin a public health approach in tackling violent crime. I hope the Home Office can update us on that soon.

Turning back to what the Government can do, we need to learn lessons from what works. We need to be brave and follow the evidence, which can be difficult when the Government do not store data on crucial sources of information. Can the Minister tell me why the Government do not centrally hold data on the time of knife attacks, especially as recent research has shown that young people are especially vulnerable between 4 pm and 6 pm on school days? Data on the number of knife aggravated murders in each city or local authority is also not held centrally, which makes it far harder to compare the efficacy of different local authority approaches over time. The number of prisoners that were excluded at school is also not regularly recorded. Many victims of knife crime do not report their injuries to the police, so should we not be looking for this information in other areas, such as the NHS? The Government do not cross-reference ambulance service dispatch data for knife injuries and police records for knife attacks. Many people believe there is a link between deprivation and levels of violence, so why do the Government not hold this information? Finally, but extremely importantly, why do we not record the number of young people who applied but failed to meet the threshold for child and adolescent mental health services treatment?

Those are all extremely important areas—and I am sure there are many more—where we should hold data, as a minimum to ensure that the Government can successfully deliver on their public health approach. I have asked numerous questions of the Government and others in order to try to find this information, but, sadly, I know the Government do not hold this data. Why is that? Will the Government commit today to seeking to hold this data?

Why do we invest in programmes that we know do not work? For example, there is no evidence to suggest that programmes in schools that say, “Do not use drugs” or, “Do not carry a knife” have any impact. We should analyse the efficacy of these programmes and if they do not work, we must stop them. We know that programmes investing in social development, home visitation, training in parenting, mentoring programmes and family therapy work. We also know that the earlier the intervention, the more effective it is.

I will skip through what I have on adverse childhood experiences, because I know that other Members have gone through it, but ACEs is an extremely important area of work and we need to do a lot more on it. I encourage all Members of Parliament to do the survey on ACEs and get their scores, as I intend to do in the future. I understand that the Government are due to publish a report on ACEs; when will it be published?

I will skip through my comments on schools, but in previous speeches on education I have said a lot about what happens in schools. It is really important that we look into whether school finishing times are right and whether we should stagger them. Should we think about closing down all pupil referral units? Should we look into expulsion? We could absolutely invest that money in our children’s lives far earlier.

Let me conclude my remarks with an important quote from a Member of the Youth Parliament, Ciya Vyas, who spoke about the importance of tackling knife crime in the recent UK Youth Parliament debate on the subject. She said:

“More young people voted for this issue than any other…If there is a will for change on this issue among young people, there is a political will for change here at Westminster. Whether we see the need for a violence reduction unit and a public health approach, as pioneered so successfully in Scotland and endorsed here by London’s Mayor, or the Home Secretary’s recent proposals to increase levels of stop-and-search, this debate is happening now, and we cannot neglect our duty to bring young people’s voices into it.”

After that debate, and following a ballot of more than 1 million young people throughout the nation, the Youth Parliament and the British Youth Council chose knife crime as the subject of their national campaign. Let us make sure that as politicians we do not let them down.