The World Health organisation defines youth violence as: “violence that occurs among individuals aged 10-29 years who are unrelated and who may or may not know each other and takes place outside the home”¹.  Declaring youth violence a global issue². The effects of which are considerable; causing increased smoking, drug, and alcohol use, and impacting physical and mental health³. The UK Government has reported a steady rise in violence⁴, with ever-increasing policies designed to guide a response^5–7.

The young people who are victims or perpetrators of violence are marginalized and vulnerable⁸ and more likely to have experienced neglecting and abusive caregiving, face significant social challenges (such as a lower socioeconomic status), a weak educational attachment, and more exposure to violence⁹. They become socially, economically, and culturally cut off from mainstream society making them vulnerable to exploitation and violence¹⁰. Thus, youth violence is a public health concern¹¹, however, no single public health approach seems to provide a clear or definitive path to youth violence prevention. Often the voice of the young person can be lost amongst the top-down, paternalistic policies, and prescribed interventions¹².

Giving young people a voice

As part of a master’s program, Danielle Cawdell, a Highly Specialist Speech and Language Therapist at the Royal Wolverhampton NHS Trust, interviewed a group of young people who were receiving support from a violence Intervention Team. This research aimed to understand young people’s experience of support. The initiative has been framed and funded by the political shift away from a purely youth justice approach to a public health and child protection one.

The young people interviewed expressed a conflict about how much autonomy they had in relation to their involvement in violence and the inequalities that sit outside of their control.

They spoke emotively about the negative influence of social media. Reporting that social media was important for staying in communication with peers but negative in terms of developing a sense of individuality.

“Don’t fall into the whole social media thing and feel like you have to impress people”

They often described themselves as “bad” and “wrong”. One young person talked extensively about their experience of being labelled as “troubled” and how they lived up to this.

“Going into high school I had a fight and they was like labelled me straight away, ok, she’s one ya got to watch out for and having that label, I thought ya know what, they’ve already labelled me as one of the troubled kids I’m just gonna prove them right,”

Another described themselves as “becoming a bad person”:

“They’d just be like freaked out on me and like change what I was doing, cos I was becoming a bad person”.

Another described how they would feel proud of doing something good:

“Every paramedic looks like a good person but like me myself it would just make me feel really proud that I’ve helped someone like prevent them from dying, that I’ve done something good”

Young people who come into a violence prevention service may have very disempowering perceptions of themselves that have led to strong emotive responses to people they perceive as having more power than them; often reporting they “hate the police” and they “hate teachers” and regularly experiencing the feeling of being judged:

“I used to go to the doctors, it was like they was judging me, so I would just close up”

“Even with my social worker, sometimes I feel like I can talk to her but even then, I feel like she is judging me”

One young person talks about being “forced to do stuff”, suggesting powerlessness, a power imbalance and exploitation.

The key notion of public health is that good health comes from the population and filters to the individual, no one individual can transverse the impact of the collective experience, inequality, and poor conditions that impact their health¹³. An example of violence intervention aimed at the individual level was experienced positively by the young people included in this study. Such programs cannot negate the impact of health determinants that sit outside of the individual. Public health approaches to youth violence need to include the voice of the young people they are targeted at, otherwise, it is a missed opportunity to co-produce effective approaches from the population to the individual level.

To read more about this study please contact Danielle Cawdell d.cawdell@nhs.net

References

1. The World Health Organisation. Global Status Report on Violence Prevention.; 2014. https://www.cambridge.org/core/product/identifier/S0007125000277040/type/journal_article
2. World Health Organization. Preventing youth violence: an overview of the evidence. WHO Libr. Published online 2015:100. https://bit.ly/2IYPQLx
3. Bonell C, Fletcher A, Jamal F, Aveyard P, Markham W. Where next with theory and research on how the school environment influences young people’s substance use? Heal Place. 2016;40:91-97. doi:10.1016/j.healthplace.2016.05.006
4. Local Government Association. Youth Justice Resource Pack.; 2018. Accessed June 17, 2022. https://www.local.gov.uk/publications/youth-justice-resource-pack
5. Home Office (UK). Criminal Exploitation of Children and Vulnerable Adults: County Lines Guidance.; 2020. Accessed June 17, 2022. https://www.gov.uk/government/publications/criminal-exploitation-of-children-and-vulnerable-adults-county-lines
6. Home Office UK. Serious Violence Strategy.; 2018. Accessed June 17, 2022. https://www.gov.uk/government/publications/serious-violence-strategy
7. Government HM. Ending Gang Violence and Exploitation.; 2016. Accessed June 17, 2022. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/491699/Ending_gang_violence_and_Exploitation_FINAL.pdf
8. Tyler K. Shining a light into the shadows: The hidden health needs of juveniles in detention. Altern Law J. 2015;40(2):101-104. doi:10.1177/1037969X1504000208
9. Farrington DP, Ttofi MM, Piquero AR. Risk, promotive, and protective factors in youth offending: Results from the Cambridge study in delinquent development. J Crim Justice. 2016;45:63-70. doi:10.1016/j.jcrimjus.2016.02.014
10. Gunter A. Race, Gangs and Youth Violence: Policy, Prevention and Policing.; 2017.
11. Neville FG, Goodall CA, Gavine AJ, Williams DJ, Donnelly PD. Public health, youth violence, and perpetrator well-being. Peace Confl. 2015;21(3):322-333. doi:10.1037/pac0000081
12. Barnert ES, Perry R, Azzi VF, et al. Incarcerated youths’ perspectives on protective factors and risk factors for Juvenile offending: A qualitative analysis. Am J Public Health. 2015;105(7):1365-1371. doi:10.2105/AJPH.2014.302228
13. Rayner, G. and Lang T. Ecological public health. Heal people, places planet. Published online 2012:617.