Violence is a major public health issue that is linked with significant costs to health and social care as well as lost output associated with absence from work. Amongst victims, it is linked with an increased risk of health-damaging lifestyle behaviours such as smoking, alcohol and drug abuse. Violent crime can range from minor assaults (such as pushing and shoving), harassment and abuse (that result in no physical harm) through to wounding and homicide. It also includes sexual offences such as rape and sexual assault (Office for National Statistics, 2018).
The Serious Violence Strategy (Home Office, 2018) reports increases in some types of violent crime such as knife crime, gun crime and homicide at a national level since late 2014. It emphasises the importance of partnerships across different sectors such as education, health, housing and social services. In Derby, there were 20.3 violent offences per 1,000 population (n=5,190) in 2017/18. This needs analysis considers violence in its widest sense, and includes domestic violence, hospital admissions for violence and anti-social behaviour.
Research demonstrates that there is a clear link between childhood adversity and victimisation and criminality in adulthood. The evidence suggests that by targeting those most at risk of experiencing adversity in childhood and supporting people in the criminal justice system who have been affected by adverse childhood experiences, agencies can reduce re-offending and prevent intergenerational crime and victimisation (Scottish Government, 2012).
Unmet need and gaps
Reports suggest that 67% of the population have at least one adverse childhood experience (ACE). Those who experience 4 or more adverse childhood experiences are at a significantly greater risk of the following (Bellis et al 2012):
Local Council services are not designed to address violent crime per se but do seek to address the wider health and social inequalities experienced as a result of childhood adversity.
The Public Health nursing service delivers universal services to all children in the city aged 0 – 19 years alongside early intervention children’s social care services. These are ideally placed to identify children and families deemed to be at risk. Schools and exclusion units have a key role in identifying children experiencing trauma within the family home.
Children and adult safeguarding services are designed to adopt a multi-disciplinary approach to sharing risk information. They aim to bring together the key partners required to protect children and adults from harm.
Specialist Public Health services are also ideally placed to identify at-risk adults who access these services. Illicit drug use, problematic alcohol use and/or risky sexual behaviour in adulthood are often symptomatic of childhood trauma.