Violence is a disease – and it can be curedBy treating violence as a public health issue, Scotland’s Violence Reduction Unit (VRU) broke ranks from the conventional law and order model to create a proactive multi-agency approach that has clear lessons for those tackling the anti-social behavior. Mark Cantrell took a look at the initiative for the September 2012 edition of Housing
“The sin is ignorance,” said Detective Chief Superintendent John Carnochan; a phrase that perhaps cuts both ways as we contemplate the malignancy of violence and anti social behaviour (ASB). As a society, we can bang on about law and order, take a macho stance and demand tougher penalties, but as Carnochan pointed out, it takes us no further forward.
At the end of the day, the criminal justice system can only mop up the mess, not resolve its root causes; that’s society’s job but all too often, society shrugs it off as somebody else’s problem, or retreats with the defeatist perception that violence will always be with us. This isn’t a view that’s finding favour north of the border: attitudes can and must change.
Using the image of an iceberg, he said: “The top end, the bit that we see, is where most of us work. We chip away at that – new legislation, new laws, lock more people up – but it doesn’t make a blind bit of difference to the size of the iceberg. It just keeps bobbing up a little. if we want to shrink that iceberg, we need to raise the temperature of the water. And that’s the big stuff. That’s stuff like equality. The societies in the world that are the least violent are the most equal.”
And challenging social inequalities and deprivation is not something that the police, or the courts, or the prison service is geared up to do. Carnochan is co-director of the Scottish Violence Reduction Unit (VRU) and since 2005 it has been leading efforts to actively demonstrate that there is nothing inevitable about violence. In June he was in Manchester to take this message to delegates at the CIH conference; that he was speaking in the session on ‘housing as a determinant of public health’ ought to indicate that he’s not your average tough-talking copper.
“Violence is a public health issue. It’s not a criminal justice issue,” he said. “We’re the service of last resort. If you leave it to us, we’re really good at it: check your prisons, they’re full. [It costs] £42,000 a year for someone in jail, and I don’t come cheap either. We’re an expensive outfit, and we’re the last resort – but we seem to be taken as the first resort all the time.”
Strathclyde Police established the VRU with the explicit aim of tackling all forms of violence, especially knife crime and the carrying of weapons by young men in and around Glasgow. In April 2006, the unit’s remit was extended across Scotland to create a national centre of expertise on tackling violent crime. One crucial aspect to its approach is that it doesn’t work alone – it can’t work alone – to tackle the problems of violence, which are said to be chronic in Scotland.
“We think of deterrence; we think about prevention,” Carnochan added.
The organisation took its lead from the World Health Organisation’s (WHO) report on violence and health published in 2002 and adopted the public health model. The aims are to reduce violent crime and behavior by “working with partner agencies to achieve long-term societal and attitudinal change”. Enforcement – the criminal justice side of things – isn’t abandoned, but the VRU seeks out best practice to develop solutions to the issues. in a sense, the public health approach treats violence as akin to a disease.
“Violence is an infection that has crept through society to the extent that it is viewed today in much the same way as the common cold – something that is both incurable and inevitable,” the organisation says on its website. it takes the view that there is nothing inevitable or incurable about it.
Karyn McCluskey, co-director of the VRU, provided the impetus for its inception, having moved from the West Mercia force to Strathclyde in 2002, she told Housing she was “absolutely shocked by the level of anti-social behaviour and violence”. The traditional methods, to her mind, just weren’t working, and so she took three weeks holiday and spent it writing a report arguing for a different approach.
“This is not just a policing problem. If everybody thinks that this is up to the police then we are never going to help them, we’re never going to solve it,” she said. “We’ll put loads of people in jail, that’s great, but you have to jail those you’re afraid of, not those you’re mad at, and you have to do something different.”
That something was the shift towards the public health model; more holistic and pro-active, it takes in a whole host of considerations and agencies, to identify, isolate and intervene to address the factors that, well, breed the infection of violence and propagate it down the generations. By identifying risk factors, then preventative efforts can be put into place. In terms of violence, typical factors include: deprivation, poor parenting, education issues, and members of peer groups who are already engaged in violence.
“It allows us to look at things like primary prevention: parenting, early years, housing design, and a whole range of things like that,” McCluskey said. Secondary prevention then targets those who are at risk. Housing organisations and professionals are crucial allies, but interventions can also take place in what seem – at first glance – the unlikeliest of places.
“We do interventions in dental clinics now,” she added. “Because if I punch you in the face, the first things you’ll lose are your teeth.”
They found that dentists weren’t addressing the causes of these injuries. The VRU helped establish a charity Medics Against Violence, which has recruited around 300 consultants and dentists to push the anti-violence message. “Intervene at every teachable moment in someone’s life and they might be motivated to change,” McCluskey said.
Back to Carnochan and his hard-hitting presentation on gang violence, just one example of the VRU’s approach in action; in 2008 the VRU set up the Community Initiative to Reduce Violence (CIRV) in Glasgow’s east end. The initiative drew upon the best practice established in the United States to combat gang violence in cities such as Boston and Cincinnati. In Glasgow, the ‘diagnosis’ revealed 55 separate gangs that were “highly territorialised”, “obsessed with respect” and “resistant to change”. In effect, a life of violence was all they knew.
The process starts at an early age. As Carnochan explained, he put the question to Professor Richard Tremblay of Montreal University, a child psychiatrist, ‘how do young men learn to be violent?’ the answer was to turn the question on its head: how do we learn not to be violent?
“What we do in those early years, those first four years of life, are the most important and what we learn is to negotiate, to communicate, to compromise, to empathise, to problem solve, to resolve conflict, so that the violence option gets pushed down the menu, so it becomes the last resort. For lots of young men, they never learn these skills so the only option they have is aggression and violence. It’s not a deliberate thing, the sin is ignorance, they don’t know any better,” said Carnochan.
What this means, he added, is that they can learn. With the right approach, the interventions, education and support, they are capable of change, and that’s what CIRV is all about. The initiative involves a wide-range of partners working together, from the justice system, social work, housing, health services, education, and the community, and former gang members themselves, all working on a shared strategy to target at-risk gang members. It’s as much about prevention as it is about enforcement.
But there’s a flipside to this culture of sin and ignorance. “The world that we live in and operate in is all about professionals – we have silos. I’ve got a two-hour leadership lecture on gangs and I never mention a street gang once,” Carnochan said. “The gangs I speak about will be universities, it’ll be health, it’ll be education, it’ll be social work, it’ll be housing, it’ll be the police – those territorial gangs are the most corrosive, the most pernicious, and cause the most damage to our society than any street gang ever did – and we need to tackle that. Think beyond the profession, the job title. You’ll be a father, a son, a mother, a brother, an aunt, an uncle, a wife – you need to think of your whole self.”
There’s more to the VRU than gangs. In its latest phase it focused on weapons-related violence and alcohol-related violence, while later this year its next phase will be to tackle domestic abuse and violence against women. regardless of the particular focus of its overall mission to reduce violence, at the core of the VRU is the firm stance that violence is everybody’s problem, and so we all have to work together to solve it.
“We have to change public attitudes because it’s everybody’s issue. No one is safe until everybody is safe,” said McCluskey. “They can’t draw their curtains in Knightsbridge and just say ‘that’s the bad boys in Tower Hamlets or Mosside or Easterhouse’ – it’s everybody’s issue. And that’s what we’ve tried to do; you know when they point the finger and say what are the police doing about it? We say here’s what we’re doing; now there’s three fingers pointing back at you when you’re pointing at me – so what are you doing about it?”
This feature first appeared in the September 2012 edition of Housing magazine, and was subsequently republished on the Housing Excellence website, 16 October 2012.