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Using public health principles to reduce violence in London?

Hello, my name is Corinne Clarkson and I joined the NHS Violence Reduction programme last summer as a public health specialist after 15 years as a community midwife most recently working with families traumatised by their experiences of domestic, sexual, wartime, torture and trafficking related violence. In clinical practice I saw how the impact ripples spread from each experience of violence through people’s mental health, intimate relationships, family functioning and expectations of the world. Trauma and violence are intertwined with each able to cause the other – and I am proud to now work on a programme which aims to break that cycle and reduce violence in our city.

Public health is the art and science of tackling complex issues using the information and resources we have available to treat, reduce and prevent a problem in a particular community or group. Much focus has been given to reducing serious youth violence in London but if we are serious about preventing it from happening, we need to know what causes violence and how we can address those underlying issues – this is the core principle of a public health approach.

Violence prevention (who.int)

Hard data such as that available through the ISTV, ECDS and Safer Stats dashboards will help tell us part of the story – where, when and what acts of violence occur in order to target services where there is most need; but many experiences of violence go unreported – absorbed into hearts, minds and relationships without ever becoming a statistic. We can also make use of a growing body of research about factors that increase risk or protect people against violence – decent homes, loving families, good schools, living wage jobs and cohesive communities offer everyone opportunities to live safer, happier lives.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/828228/CAPRICORN_resource.pdf (adapted to diagram form by Manchester VRU)

Hearing the voices of those who experience violence in their homes, communities, social and work lives provides us with essential insight into the causes of violence. London’s young people are smart, talented and vocal – in workshops hosted by Peer Power as part of the NHS Vanguards Community Mental Health pilot projects they spoke of their social and mental health being damaged by exclusion, displacement, poor housing and differential access to education, support services and job opportunities in a city so affected by inequality, racism and class division that it makes violence seem normal.

They tell us that they don’t feel cared about by the society they live in and find it difficult to trust and use health services – our role as their NHS is to make time to bridge that gap, develop our skills to provide trauma informed care, test and evaluate effective mental health interventions and amplify their voices calling for meaningful change to the social determinants of violence.

I look forward to working with the NHS London Violence Reduction Programme to shape the ways in which the principles of Public Health can support violence reduction.

Corrine Clark

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