Abstract
Background:
Youth violence and knife crime is increasing dramatically, so much so it has been described as a global epidemic. The social, economic and political forces fuelling this rise mean that minority groups are particularly affected.
Aim:
This paper reviews the literature primarily from a UK perspective, and illustrates the disparate factors that are influencing the rise in youth violence and knife crime and illustrates the complexities of integrating the perspectives of different disciplines into coherent intervention strategies.
Method:
We conducted a systematic review of the literature that explores both the causes of increasing youth violence and knife crime as well as some of the interventions that have attempted to deal with the problem.
Results:
A complex interplay of social, economic, mental health and political factors underpin the increase in youth violence and knife crime. An uneasy tension exists between a traditional criminal justice system-based approach based upon deterrence and punishment, and a more liberal preventative model focusing on adolescent mental health. None of the interventions thus far have been particularly effective.
Conclusion:
Youth violence and knife crime is a global social issue that causes untold suffering to individuals, families and communities as well as fear that reverberates through society. Interventions have often been devised through the lens of particular disciplines or ideologies. Integrating these perspectives into a coherent approach that is actually effective demands greater co-operation, dialogue and mutual understanding between disciplines and agencies, as well as a robust framework for the evidence-based assessment of outcomes.
The importance and impact of youth violence is increasingly being recognised internationally, described by some as a global pandemic and a priority for the United Nations. Young people and their families are affected both directly and indirectly by the consequences of violence and crime.
In the UK, youth violence – knife crime in particular – is on the increase and has resulted in the deaths of many young people. A significant number of those affected are from ethnic minority groups. Multiple agencies have formulated interventions which have had little impact in reduction and management of violence among the youngsters.
The Mayor of London’s Violence Reduction Unit brings together specialists from health, police, local government, probation and community organisations to tackle violent crime and the underlying causes of violent crime (Wieshmann et al., 2020).
There is also the Mayor of London’s Knife Crime Strategy (Mayor’s Office for Policing and Crime [MOPAC], 2017) which is a key intervention strategy implemented to curb knife crime through a multi-agency approach, and the NHS Long Term Plan, which points out in its priorities the importance of young people’s mental health (Cheater, 2019; NHS, 2019)
A multi-agency approach in line with the policy measures has since been adopted, with the setting up of units like the Westminster Integrated Gangs Unit (Westminster Integrated Gangs Unit, 2019; Young Westminster Foundation, 2021) and the Islington Integrated Gangs Unit Team (Greer et al., 2019; Patel, 2019). These initiatives indicate that there is willingness at policy level to address the problem of youth violence and mental health, but there remain major challenges.
Youth violence and knife crime research has explored gang culture, community violence, criminal justice and mental health to name a few (Bradshaw, 2013; Coid et al., 2013; Gorman-Smith & Tolan, 1998; Grimshaw, 2009; Grimshaw & Ford, 2018; Harding, 2020; Kelly, 2000; Kerig et al., 2016; Phillips et al., 2003; Silvestri, 2009).
Gang culture has been the main driver of knife crime and youth violence (Coid et al., 2013; Frisby-Osman & Wood, 2020; Greer et al., 2019; Harding, 2020; Kerig et al., 2016; Mcdaniel, 2012; Mediacom Real World Insight, 2016; MOPAC, 2017; Sethi et al., 2010; Shepherd, 2017). However, this appears to be changing as other reasons such as control, agency and ‘fitting in’ become increasingly prevalent (Harding, 2020; Palasinski & Riggs, 2012).
The relationship between youth violence and knife crime has been studied extensively (Ardino, 2012; Bradshaw, 2013; Coid et al., 2013; Frisby-Osman & Wood, 2020; Kerig et al., 2016; Grimshaw, 2009; Grimshaw & Ford, 2018; Holt et al., 2019; Sethi et al., 2010; Stephen, 2009). Mental health challenges have been shown to be related to or are said to be experienced by youth who commit, are victims of, or live in a community rife with youth violence (Ardino, 2012; Coid et al., 2013; Gorman-Smith & Tolan, 1998; Harding, 2020; Kerig et al., 2016; Palasinski & Riggs, 2012).
It is likely that youth violence causes mental health challenges, such as trauma, anxiety, depression, hopelessness and emotional desensitisation (Kennedy & Ceballo, 2016; Mcdaniel, 2012). Youth violence itself may be seen as a symptom of structural factors that play a role in mental ill-health among certain groups (Birch et al., 2020; Bowling, 2007; Cunneen, 2020; Gorman-Smith & Tolan, 1998; Greer et al., 2019; Kelly, 2000; Merton, 1938; Phillips et al., 2003) and there is a possible cause and effect relationship between youth violence and mental health challenges (Grimshaw & Ford, 2018; Sethi et al., 2010).
Knife crime as a specific form of youth violence is a topical issue in communities in the United Kingdom (UK). In England and Wales, in 2019 there was a 7% increase in number of offenses involving knives and sharp instruments (Shaw, 2020).
The number of people who died due to knife related incidents has increased in recent years. In 2017–2018, 285 people were killed. This was the highest figure since 1946, with one in four of these being men aged between 18 and 24 (Office for National Statistics [ONS], 2019). Incidentally, hospital admissions for knife assault increased by 8% (Shaw, 2020; NHS Digital, 2019; ONS, 2019). Within the statistics of knife assaults, 186 young people are reported to have died due to knife crime in 2019 and a staggering two thirds of these were reported to be from the Black, African and Ethnic Minority (BAME) community. These statistics further present a need to examine the phenomenon behind the high incidence of knife crime/youth violence among BAME youth.
It is unclear how this relationship is understood or interpreted in the current responses and interventions to BAME youth; partly because there is a lack of understanding of the BAME community, and partly because of a lack of clarity around mental health impacts on violence, and a lack of mental health resources for young BAME adults involved in youth violence and knife crime (Farrington et al., 2017; Frisby-Osman & Wood, 2020; Greer et al., 2019). The mental health needs of BAME youth involved in youth violence are multi-faceted and the dynamics involved in responding to these needs demands further study.
Although of late there has been a discussion in not using BAME as a term, instead using ethnic minorities, we use this in order to make sense of the literature which has used this term.
Bame communities in the UK
BAME communities in the United Kingdom make up an estimated 14% of the total population (ONS, 2019) and are composed of Asian ethnic groups, Black ethnic groups, Mixed-Multiple ethnic groups and other ethnic groups (ONS, 2019). A majority of BAME communities have higher levels of poverty and unemployment, more incidence of violent crime (street crime) in general, less participation in the political and social spaces and less access to or engagement with mental health services.
As previously highlighted, the prevalence of mental health issues in young people in general who are exposed to violence has been well evidenced (Bradshaw, 2013; Coid et al., 2013; Duke et al., 2011; Frisby-Osman & Wood, 2020; Grimshaw & Ford, 2018; Kerig et al., 2016).
In the UK, serious violent crimes are of increasing concern. In London, young people of BAME background are disproportionately affected by youth violence. The Mayor’s Office for Policing and Crime (MOPAC) report states that people of BAME communities are more likely to live in areas where youth violence is more prevalent, and that 50% of the population in the top 10 most vulnerable areas in London were members of BAME communities, with individuals living within these areas three times more likely to be a victim of knife crime (MOPAC, 2018).
As a result, fear and concerns for safety in public spaces may arise amongst the youths. This positionality highlights the need to explore the factors behind the high incidence of youth violence and knife crime in the BAME youth. The increasing rate of knife crime among BAME youths is attributed to gang culture (Densley et al., 2020), which is defined as a group of youths who have some organisational structure and whose members are involved in illegal activities (Esbensen, 2001). In the UK gang culture is characterised by knife crime, with some scholars coining it as knife crime ‘epidemic’ (Squires, 2009). Young people of BAME background are said to be more likely to be exposed, affected and traumatised by youth violence, knife crime and gang culture than any other minority group (Stephen, 2009). This study seeks to critically explore the contextual factors amongst BAME youths which provide possible grounds for the formation and thriving of gangs and fostering of youth violence and knife crime.
Approaches to youth violence, knife crime and mental health
There are two main approaches that have stood out in literature in addressing the problem of youth violence, knife crime and mental health; namely, the Criminal Justice Approach (CJA) and Public Health Approach (PHA). These two approaches are dynamic in their nature, and their convergence and divergence when it comes to youth violence, knife crime and mental health presents key foundational issues relevant to this study. This study reviews and critically analyses some of the literature around these approaches and assesses their application and relevance in relation to BAME youth.
The CJA stands out as the oldest and most common approach to the problem of crime in general, including youth violence and knife crime (Bowling, 2007; Bowling & Phillips, 2016; Caveney et al., 2020; Cunneen, 2006, 2020; Grimshaw & Ford, 2018; Holt et al., 2019; Keeling, 2017; Phillips et al., 2003; Shepherd, 2017; Silvestri, 2009). This approach covers various aspects of the criminal justice system including policing methods, for example, stop and search (Bowling, 2007), arresting, diversions, detentions and probation within the prison system (Bennett, 2013). The main focus of the CJA is said to be reactive and responsive to the criminal in relation to the crime committed, and over the years, the approach has somewhat succeeded in that respect (Grimshaw & Ford, 2018; Neville et al., 2015).
Until recently the CJA did not adequately address mental health in the context of youth violence and violent crimes (Gebo, 2016; Grimshaw, 2009; Grimshaw & Ford, 2018; Neville et al., 2015; Silvestri, 2009). The CJA had aligned its aims with forms of rehabilitation measures to deter re-offending (Neville et al., 2015). However, the CJA is criticised as falling short in its own aims as instead of reducing the number of arrests and re-offending, the rates of arrests and re-offending were said to actually increase (Grimshaw & Ford, 2018). Moreover, it has been criticised as failing to fully accommodate mental health aspects in its approach (Grimshaw & Ford, 2018; Neville et al., 2015; Stephen, 2009).
Grimshaw and Ford (2018, p. 10) suggest that knife crime and interpersonal violence tends to be conceptualised through the lens of criminal justice, defining individual acts of violence primarily as rational choices on the part of the perpetrator, devoid of wider social context. This focus solely on the criminal and the crime fails to take a more holistic approach to the milestones and mental health complexities of young offenders (Frisby-Osman & Wood, 2020; Grimshaw & Ford, 2018).
These shortcomings of the CJA therefore, specifically towards mental health, have to be associated with a Public Health Approach (PHA) in addressing youth violence and mental health. WHO advocates such an approach conceptualising the problem of youth violence and mental health (Frisby-Osman & Wood, 2020; Krug et al., 2002; Mcdaniel, 2012; Neville et al., 2015). The PHA is thus a population-based approach aimed at improving the health and safety of the population (Krug et al., 2002; Neville et al., 2015).
The focus of the PHA is more on preventative measures and behavioural change through interventions at multiple levels and with the involvement of multi-disciplinary stakeholders (Krug et al., 2002; Mercy et al., 2003; Neville et al., 2015). The stated multiple levels of intervention are: the Primary level, that is, preventing violence before it happens, the Secondary level, that is, immediate responses to incidence of violence to decrease prevalence after early signs of the problem and Tertiary level – that is, intervening once the violence problem is evident and causing harm (Bellis et al., 2012; Local Government Association, 2018; Neville et al., 2015). Multi-disciplinary stakeholders working within this framework would involve social workers, police, teachers, community and faith leaders and youth workers.
Krug et al. (2002) stated that ‘Public health can benefit efforts in this area with its focus on prevention, scientific approach, potential to coordinate multidisciplinary and multisectoral efforts, and role in assuring the availability of services for victims. Public health complements existing approaches to violence, by focusing on changing the behavioural, social, and environmental factors that give rise to violence’. Although PHA has been used for the prevention of youth violence (Bellis et al., 2012; Bradshaw, 2013; Frisby-Osman & Wood, 2020; Grimshaw & Ford, 2018; Hughes et al., 2015; Local Government Association, 2018; Neville et al., 2015; Patel, 2019; Shrotri & Scantlebury, 2019) it still relies on enforcement, embedded in the CJA for support (Grimshaw & Ford, 2018).
The emphasis on crime prevention and mental health still makes it a relevant approach to addressing youth violence and mental health, as the PHA is not intended to undermine law enforcement but is there to support it in a dynamic way (Frisby-Osman & Wood, 2020; Krug et al., 2002). Furthermore, an ‘integration’ of the two approaches as proposed by some authors, for example, Gebo (2016) may prove beneficial for the ultimate goals of crime prevention and public safety. The relationship between PHA and the wellbeing of BAME youth needs closer integration (Robertson & Wainwright, 2020).
Many official reports and writers attest to the fact that BAME youths are overrepresented within the youth criminal justice system (Bowling, 2007; Bowling & Phillips, 2016; EHRC, 2016; Gavin, 2018; Holt et al., 2019; Keeling, 2017; Lammy, 2017; Mediacom Real World Insight, 2016; Phillips et al., 2003; Robertson & Wainwright, 2020). BAME youths are said to be more likely to be prosecuted than to be reprimanded or warned (EHRC, 2016) and they are more likely to be remanded in custody than White defendants (Bowling & Phillips, 2016; Cunneen, 2006, 2020; Holt et al., 2019)
Ethnic minority suspects were more likely to be viewed suspiciously by the police for non-behavioural reasons (Bowling, 2007; Cunneen, 2006; Keeling, 2017; Phillips et al., 2003; Smithson et al., 2013). The disproportionate criminalisation of BAME youths has affected trust between BAME youth and the criminal justice system (Bowling & Phillips, 2016; Mediacom Real World Insight, 2016).
In response to the lack of trust in law enforcement, police reforms that govern ‘fair use’ of police powers in stop and search were introduced amidst the agenda of mending community and police relations (Fanning & Michael, 2018; Caveney et al., 2020; Mediacom Real World Insight, 2016). The policing field take the view that these reforms ‘have resulted in overall decrease in incidence since 2008/9’ however, despite the claimed overall decrease it is argued that the ‘positive measures have failed to make any meaningful improvement’ (Bowling & Phillips, 2016).
It appears that disproportionality and discrimination against BAME youths in the Youth Criminal Justice System (YCJS) seems to be worsening and BAME youths are still assessed as high risk (Bowling & Phillips, 2016; Keeling, 2017; Mcneill & Wheller, 2019). As a result, the mistrust is increasing. Furthermore, it is argued that the damaged relationship between the BAME youth and criminal justice also impacts on other services which the BAME youth may perceive as aligned to the YCJS, including mental health services (Gleeson et al., 2019).
The negative narratives on BAME youth and their knock-on effects point to deeper issues which are structural in nature. These structural inequalities as a key aspect which cannot be ignored when assessing youth violence and mental health.
Footnotes
Acknowledgements
The inception and completion of this project would not have been possible without their support, I am incredibly grateful to them all. I am extremely grateful to all the participants who took part in this research, for their insight, energy, and their drive to shape solutions in our communities. I have been driven by an innate desire to give voice to vulnerable and underprivileged communities. To the young people I have worked with over the years, thank you for sharing your vulnerability with me, your resilience inspires me.
Authors’ note
This report has been completed as part of the Mary Seacole Leadership Award 2018–2019.
Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The project was funded by Health Education England in association with the Royal College of Midwives, Royal College of Nursing, Unison and Unite. The operation of the project was supported by the Westminster Integrated Gangs Unit and Central North West London Foundation Trust, Westminster Child and Adolescent Mental Health Services.
