Knife Attacks – Whose Crime Is It?

I find myself staring at the screen, unable to comprehend how utterly devastating it must be as a parent, to have a police officer knock on your door in the early hours of the morning, to be told that your darling child has been stabbed to death. My heart weeps for the senseless loss of life, young lives stolen away in this rising tide of violence. I know what it is like to break truly awful news to people and their families and my heart goes out to the police officers on the beat or the clinicians in the Emergency Department, who have to break the terrible news to the parents and the siblings, that so suddenly, a bright shining light in their lives, has been extinguished.

 

Knife attacks are a crime, there is no denying that, but the burden of guilt is not so easily apportioned. We are seeing an exponential rise of it in our streets, with a 93% increase in recent years across England, whilst in Scotland, they have seen a 64% decrease over a similar timeframe. We need to examine what has gone on in that time and ask some very uncomfortable questions. We also need to call people to account for decisions which have been made, despite knowing the evidence, and  we desperately need a ‘whole systems’ approach to tackling this epidemic.

 

The Primeminister has stated that “knife crime” is not linked to a decrease in policing numbers. The police chiefs disagree. The truth is, that it’s not only the police who have disappeared off our streets (and these are community police officers, who knew their communities well and were respected and trusted – it takes years to build up those kind of relationships) – we’ve had a perfect cocktail of cuts right across the board which is directly attributable to the mess we are now in. Ongoing austerity, which is a political choice, has also led to the closure of youth centres, more young people than ever excluded from school, (who then have a 200 times higher chance of being groomed into violent gangs) and massive cuts to public health and local government, meaning many preventative schemes have disappeared. When policy fails, it has to be called out and challenged. Everyone with a brain knows that prevention is better than cure. And for those who have lost loved ones, there is now no comfort – this could have been prevented, but has been allowed to escalate at such an alarming rate because we do not have a form of politics or leadership that listens to what is really going on in our communities, but continues to drive through ideological changes without thinking through the consequences. This is unacceptable.

 

When Heidi Allen MP came to Morecambe, she heard the testimony of my friend, Daniel, who grew up in some really tough circumstances, forced into a gang culture in order to help put food on the table and prevent harm coming to his family. Tears streamed down her face as she heard his powerful account of what it meant for him as a young person, to have his youth centre closed, his local high school closed and being told he was not a priority when he was street homeless. She told us that she had not realised the layers to the poverty that many are experiencing across England. And this is how the (perhaps) unintended consequences of remote policy decisions affect ordinary people in droves across the UK. When school budgets are cut and mental health teams are cut and social care provision is cut and youth centres are cut, children and young people from home environments which are already struggling to make ends meet, already processing significant trauma and adversity, fall prey to gangs and criminal networks who use them and abuse them for their gains across county lines.

 

And yet in Scotland, we are seeing an altogether different picture emerging, because they saw this problem 10 years ago and decided to make a difference by dealing with complex living systems, rather than tinkering clumsily with mechanistic thinking. So it is high time that England ate some humble pie and learnt from our Celtic friends.

 

Scotland, unlike the English, are not delaying on taking a serious approach to Adverse Childhood Experiences, hoping to become the first fully trauma informed nation in the world. They have taken a public health, holistic approach to the knife crime problems in Glasgow and then spread the learning across the nation, rather than making devastating cuts to their PH budgets. What they have done isn’t rocket science – it’s plain, public health common sense. They have chosen not to criminalise, label and stigmatise young people (something the hostile environment rhetoric seems to do). They have refused to see it as a race problem – because it isn’t (but some in our press in particular, and some members of the government have stirred up this nonsense anyway) and they have invested in early and effective youth intervention programmes, amongst other things.

 

One of things my work has taught me to do, is suspend my judgements of those who we would automatically and ordinarily point the finger at, the supposed perpetrators of a crime, and really listen to the truth. The truth here is complex and I’m not saying that people who commit violent acts do not need to face the consequences of their actions. They do. But what I am saying is that we need restorative justice in our communities that breaks this horrendous cycle. We also need to recognise that there has been terrible violence done to our most vulnerable children and young people across England by a series of political decisions. The government has failed those it should have protected. In my line of work, those kind of errors would lead to massive learning events and the dismissal of those who had failed in their leadership. Perhaps people have such little faith in the political system we have because there is seemingly such little accountability. Now is not the time for silly political defence of failure. Now is the time for humility, repentance and a genuine turning of the hearts of the fathers and mothers in the nation to the rising generation, far too many of whom are no longer with us.

 

 

 

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Our Nation’s Biggest Public Health Problem

The subject of this blog is sensitive and difficult. It may stir up some difficult issues or memories for you, as you read. If this happens, then please take time to seek the help you need. I believe this blog and ones to follow might be some of the most important I have written to date.

 

UnknownI am currently reading a phenomenal book, sent to me in the post, by a dear friend of mine, who is a trained counsellor and knowing the work I do, felt that I should read it also. The book is called “The Body Keeps the Score” by the eminent Psychiatrist, Bessel Van Der Kolk. In my humble opinion, it should be compulsory reading for every person training in any of the clinical specialities, including public health and for those working in education. The book focusses on the detailed research and work done by Van Der Kolk and others at Harvard over the last 30 years in the whole area of Complex Post Traumatic Stress Disorder (CPTSD), or “Disorders of Extreme Stress, Not Otherwise Specified” (DESNOS). It is not a part of our vocabulary, unfortunately, because even now, after a huge evidence base and many studies, there still remains no such psychiatric diagnosis. However, it is a hidden epidemic affecting huge numbers of our population and is the root of many of our major public health issues. So what causes this problem and just how wide spread is it? The evidence shows so strongly that the cause of CPTSD or DESNOS is Adverse Childhood Experiences, which we more starkly call Child Abuse.

 

Child abuse falls into four main categories: Physical abuse, Sexual Abuse, Verbal Abuse and Emotional abuse – usually in the form of neglect. 10% of children suffer regular verbal abuse. 25% suffer regular physical abuse. 28% of women and 16% of men have suffered sexual abuse. 16% regularly watch domestic violence. 87% of all those who suffer one type of abuse, are also abused in other ways. Each of these forms of abuseUnknown lead to major health problems later in life and studies are showing that it is not just mental health issues (many of which lead to inappropriate diagnoses like Borderline Personality Disorder or Bipolar Disorder and ineffective treatments) but also major physical health problems. Those who have been abused are twice as likely than others to develop cancer and four times as likely to have emphysema. The more difficult a person’s experiences, the higher the chance of developing heart, liver or lung disease at an early earlier age with much higher chances of taking more health risks with smoking, becoming overweight or having multiple sexual partners. There is good evidence to suggest a link with autoimmune diseases, such a lupus, and other complex conditions like chronic pain, chronic fatigue and fibromyalgia. The body cannot be separated from the mind and literally keeps the score of the internalised turmoil. So, even if the abuse happens before memories are formed, or our minds manage to forget or block out what has happened, the body simply cannot forget and sometime and in someway, the damage will show itself. Studies show that the overall cost of this appalling reality far exceed those of cancer or heart disease. In fact, eradicating child abuse would cut depression rates by over 50%, alcoholism by 66% and suicide, IV drug use and domestic violence by 75%. Antidepressants and antipsychotics are now some of our largest prescribing costs. We know this, but are doing very little about it. Perhaps it feels too big. Perhaps we don’t want to face the demons involved. Instead, we are numbing the problem, trying desperately to get people to be just functional enough to keep on serving the needs of our economic system, but we are not facing up to or dealing with this horrific problem, nor its true cost.

 

What can be done in the face of such evil? How can we develop aimages culture of compassion and restorative justice in which we can find a new way through for humanity? It isn’t getting any better. It is just as widespread and far reaching in its consequences as it was a generation ago. Is it possible for us to face up to the startling reality we face? Van der Kolk offers much hope, but it is not within the gift of the health service and social services to tackle this alone. If we are to take this issue seriously, we must embrace what Bessel refers to (at the end of chapter 2) as four fundamental truths:

 

  1. Our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring wellbeing.
  2. Language gives us the power to change ourselves and others by communicating our experiences, helping us to define what we know and to find a common sense of meaning.
  3. We have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through simple activities such as breathing, moving and touching – (learning to be present in our own bodies is a vital way of separating out the memories of the past which can overwhelm us at times).
  4. We can change social conditions to create environments in which children and adults can feel safe and where they can thrive.

images-1People can be healed of trauma. We need this at both an individual and corporate level. We have become so focussed on saving money, on quick fixes to ensure the NHS and Social Care System can survive, but we are ignoring the root cause of many of our ill health issues. If we are willing to face up to the truth of child abuse in our society and its long lasting and far reaching impact on overall health and wellbeing, then we might just be able to find a way through to healing and restoration of what has become an extremely broken society. In the blogs that follow, I will look at some of the ways we might find a way through this crisis of epidemic proportions. One thing we must face straight away is that we are spending our resources in the wrong places and are focussing our attention in the wrong areas. We must protect our children and help people learn how to be good parents. We must strengthen our school teachers and sense of community. We must invest in the first five years of life far more than we are doing so currently, especially those key first 12 months of bonding and attachment. Together, if we want to, with love, care, bravery and determination, we can change the future. There is hope. There is healing. Our systems are not yet designed to cope with this, but we must speak the unspeakable, break the silence and face up to the truth. The truth will set us free and enable us to develop the kind of wellbeing that every human being should be able to live within.

 

 

 

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