RCGP2019 - Youth stabbing ‘epidemic’ should be tackled as a public health hazard

  • UK Medical News
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By Rachel Pugh

Child victims of stabbings are presenting at hospital in Liverpool’s Alder Hey Children’s Hospital carrying knives themselves because of their knowledge that seeking treatment for their injuries makes them vulnerable to further attack.

This picture of youth violence in Merseyside was outlined at the Royal College of GP’s annual conference in Liverpool by a multidisciplinary team working in the city to tackle the issue. They emphasised the need for a public health approach to be taken to combat ‘an epidemic’ of attacks and to showcase the approaches being taken at Alder Hey.

Liverpool GP Dr Jane Robert, who leads for Liverpool CCG on mental health, said:” Youth violence and exploitation can affect any child. It has the potential to affect them wherever they live, and it has a devastating effect on their health and wellbeing and those around them.”

The impact is being felt at GP level, and she encouraged colleagues to be on the alert for cases. She described two cases she had seen as a GP - one of a teenager brutally scarred in a knife attack, who was terrified at the pressure he was under to retaliate, the other of a patient with shoulder injuries sustained working in a hospital A&E who described it as a battle zone.

By adopting a public health approach, Roberts said violence can be prevented. A range of different interventions throughout the life course can reduce individuals’ propensity for violence, lower the chances of those involved in violence being involved again and ensure that those affected by violence get the support they require.

Merseyside Police have been awarded £3.37m of government funding to work with public health specialists and local government partners to tackle violent crime. It follows the success of a similar model in Scotland, which saw the number of homicides fall by half in a decade. Violent crimes rose on Merseyside by more than a third in 2018.

A Youth Violence Health Partnership has been established made up of representatives from the CCG, local authority community safety, public health, the local NHS Health Provider, Police Education, the Youth Offending Service plus Third Sector organisations.

Alder Hey Children’s Hospital is taking an active role in tackling youth violence:

*  A youth violence worker started in post in September 2019

*  12 children are being supported by the post

*  Efforts are under way to introduce ‘navigator roles’ according to the Red Thread model (LINK)

*  Active role of Alder Hey Youth Forum.

A key to the success of a public health model is the participation of the youth forum at Alder Hey Hospital. This has increased the young people’s own sense of responsibility for their health. It has allowed them to develop greater confidence and leadership skills and has provided new role models for younger children. Links have also been built with other key youth forums such as the Police and Crime Commissioner and the NHS Youth forums.

Nationally, youth violence is a serious problem

*   13,000 13-24-year old’s were admitted to hospital as emergen cies after being assault ed in 2010/11 - one in seven involved a knife or sharp object.

*   Violence is estimated to cost the NHS £2.9 billion every year.

*   Exposure to violence as a child can increase risks of substance abuse, obesity and illnesses such as cancer and heart disease in later life. The total costs of violence to society are estimated at £29.9 billion per year.

  Violence especially as a child, makes individuals more likely to be involved in violence in later life.

*   Violence shows one of the strongest inequalities gradients with emergency hospital admission rates for violence being around five times higher in the most deprived communities than in the most affluent