There were 132 killings in London in 2018, many involving young people.  So far this year, 119 people in London have been killed. Each untimely death involved a human being with hopes and aspirations for the future.  Police and hospitals are in the frontline, tasked with catching perpetrators, saving lives and comforting distraught families of victims.

St Giles Trust is a charity working with people experiencing serious and chronic disadvantage to help them overcome barriers and progress their lives.  Our high profile SOS Project works with young people involved in or at risk of gang exploitation and the serious violence that comes with it.

Public Health Approaches

As politicians realise that enforcement alone will not tackle serious violence, they are exploring approaches rooted in public health and prevention.  This is a welcome move.  In 2005, Glasgow established a Violence Reduction Unit involving a partnership of health, social services, education and police to tackle the root causes.  Over a decade, the city more than halved the number of homicides.

For some years, homelessness and health professionals have worked together to tackle the health inequalities faced by homeless people.  St Giles Trust was involved in such a service with King’s College Hospital in 2003.  Now we are using a similar approach in tackling serious violence.

In 2015, we were approached by the Royal London Hospital to work with them on a project offering support to young victims who had been admitted to the hospital’s major trauma centre as a result of serious violence. The Consultant Trauma Surgeon, Dr Martin Griffiths, was dismayed at the way in which many of the young stab victims whose lives he had saved in theatre were soon back in hospital, as a result of returning to their previous lifestyles once discharged.

Our SOS caseworkers are embedded in the hospital’s major trauma centre to offer intensive support to young patients. They offer mentoring, advocacy and assessment of the young person’s risk factors, addressing any that may suggest a return to gangs and violence. Typically, these involve helping with housing, relocation, employment and training.  It is based on a successful US model which offers hospital-based interventions in trauma rather than A&E – a setting where it is often easier to engage meaningfully with patients. They intervene at a point when young people are very receptive to change, given that most have recently seen their lives flash before their eyes.

Cultural Competence

St Giles Trust’s approach has a secret weapon which is favoured by Dr Griffiths. He calls it ‘cultural competence’.  The SOS Project uses professionally trained individuals with direct, personal experience of the situations their young clients are in.  The team have themselves experienced prison, gang-involvement and offending.  They are highly credible role models to the young people and know the issues first-hand. As such, they are best-placed to help young people move away from risk and do whatever needs to happen to help them achieve it.

Last year, the team helped 162 young people and there has been a marked reduction in the number of hospital re-admissions amongst those supported.  An emerging feature over the last year has been an increase in the number of young victims who are involved in ‘county lines’ whereby young people are exploited by criminal gangs into transporting drugs to other towns by ‘plugging’ them inside their bodies.

County lines involvement places young people at enormous risk through making them vulnerable to assault and through the health risks involved with plugging.  Sadly, many end up in hospital.  However, a stay offers the young person respite from the dangerous and stressful life they are leading and also provides a crucial opportunity for intervention and change.

Saving Lives

17-year old ‘K’ came into contact with St Giles Trust when recovering from near fatal wounds she had sustained when she tried to stop working for a county line gang.  She needed to relocate for her own safety.   Her St Giles Trust caseworker found her somewhere to live, helped her get settled in and offered her care and support as needed. She remains incredibly vulnerable having undergone such a traumatic event.

Tackling the complex causes of serious violence requires a joined-up, well-resourced approach involving those at grassroots, alongside policy makers.  Hospitals and other health providers will continue to play a vital part to play.  The good news is such work makes a real difference to people’s lives and our society.

Evan Jones



Photo by Jimmy Chang on Unsplash.

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