A public health approach to violence

September 29, 2018 07:41 pm | Updated 07:41 pm IST

Police officers at the scene of a knife attack in Russell Square, London, in August 2016.

Police officers at the scene of a knife attack in Russell Square, London, in August 2016.

It was just over a decade ago that a 2005 UN report concluded that Scotland was the ‘most violent nation’ in the developed world, while a separate World Health Organization (WHO) study the same year found that Glasgow had the highest murder rate in Europe.

Long-standing concerns had already prompted the setting up of a Violence Reduction Unit within the Strathclyde Police Force (which covers Glasgow), which was given the remit of tackling all forms of violent behaviour, particularly focussed on knife crime. The project was eventually extended nationwide. The unit was particularly striking, being the first globally to formally adopt an approach advocated by the WHO, which had called for a public health approach to violence, in 2002. “Safety and security don’t just happen: they are the result of collective consensus and public investment,” wrote Nelson Mandela in the forward to the report. “We must address the roots of violence.”

The report elaborated on the perspective that violence was by and large preventable and had to be treated as such, and that tackling it could not be carried out successfully without recognition of its epidemic-like qualities: experiences of trauma and violence spawning further such acts. Initiatives varied and had to be linked to the specific circumstances of the communities or cities in question — from effective parenting and alcohol reduction initiatives to working with gangs.

Among the initiatives it pointed to was one adopted in the 1990s by Mayor of Colombia’s cartel-ridden city of Cali, where measures ranging from educational initiatives to safe recreational facilities for young people were brought in, leading to a 30% fall in homicide within a three-year period.

Since 2005, Glasgow’s rate of violent crime has fallen sharply. It began by drawing on ideas used to tackle gang violence in Boston in the 1990s, working with gang members to find sustainable alternative sources of livelihood, while pushing for an increase in punishment for knife-carrying. Other programmes included its “navigator” programme, which had people working in accident and emergency services departments of hospitals to help guide victims of violence and knife crime.

New strategy

The approach is now set to be tried in London, which has seen high rates of violence. Earlier this month, the capital saw its 100th homicide this year. London’s Labour Mayor Sadiq Khan has come under increasing pressure, and last week announced a bold new strategy that would adopt a “long-term public health approach” to violent crime, alongside enforcement work.

Like in Glasgow, London will have a Violence Reduction Unit, which will draw on specialists in health, police, youth services, mental health services and criminal justice.

“Enforcement alone cannot solve this problem... the ultimate aim is to divert young people away from criminal activity by supporting the vulnerable at an early stage and giving young Londoners better life opportunities,” said Mr. Khan.

The development has come in the wake of increased scepticism that a hard-line approach, which treated violence purely as a criminal matter, had limited success.

London’s challenge is immense: translating an approach that proved successful in a city the size of Glasgow (with a population of around 6,00,000) to a global metropolis of eight million will be far from straightforward. However, if successful, it could well provide a template for action well beyond the U.K.

Vidya Ram works for The Hindu and is based in London.

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