Journal of Adolescent Health and Welfare

Volume 8 - No 1 - Spring 1995

Special Feature Youth and Violence

Letter from the editor -

Dear Colleagues,

Welcome to Volume eight.

Youth Support is continuing to go from strength to strength. We have expanded our ‘Animal Therapy’ and pet shop project and the publications section has grown new titles fall into two broad groups - ‘scientific’ publications and general titles published in aid of the charity. Coming up - Italian Cookery and children’s mini books.

This edition includes the report of our 1993 meeting on Youth and Violence.

Dates for the following months - the International meeting in Vancouver in March - Our Ecology minded ‘Rhino Charge’ for children March 17th - Pet Day on April 1st which launches our appeal for funds to construct a new leisure area for our residents - and our tenth meeting at the RSM in October - please join us!

Best wishes,

Diana Birch

Director Youth Support

“Animal Therapy”

‘Animal Therapy’ is the buzz term at Youth Support these days. No, we are not sitting ducks and chickens on a couch and analysing their neuroses about being eaten by the local fox .. as one of our young helpers thought?! But Ducks, Chickens, Rabbits and even a pig do

figure as ‘staff members’ nowadays. Many of our abused patients relate better to animals than to fellow human beings, they trust animals and feel needed when a young animal is totally dependant on them for survival. The main articles in this issue deal with young offenders and violent youth. One Such young man was released from custody to come to us. His inner rage and fury might still have been felt towards society but his furry charges would never have realised the depth of his hurt and anger as he hand reared a litter of rabbits abandoned by their mother.A fourteen year old girl kept three orphaned babies inside her blouse so that they could hear her

heart beat and not feel alone ...they survived against the odds. Our youth survive against the odds. They have been pushed from pillar to post and been to several residential placements before coming to us, abused in their families, rejected by carers and further harmed by ‘the system’.  Kate keeps herself busy in our pet shop or tidying up the mini farm while Betsy the Vietnamese pig keeps her mind off drugs by chewing her shoe laces. Younger children learn how to groom the Chinchillas build houses for the Hamsters and Fancy rats.Imagine the delight of our city kids when Henrietta laid us her first eggs! Animal therapists do group work too - with every group member having a therapist sitting on their lap. Self Esteem is something they are good at - lots of non conditional positive regard! Stroking a warm cuddly bundle is an excellent stress reducing activity for someone who has just been screaming down the phone at their social worker or trashed their room in a frustrated rage.

“Warm Fuzzies” - A Special Kind of Refuge

The success  of our ‘mini farm’ and Animal Therapy led Youth Support to expand the animal theme to a pet shop. This project gives more scope for the concept of animal strokes and provides the forum for many other activities. Young people have work experience;lessons in accounting, ecology, animal care, stock taking and ordering, window dressing and also have a craft session producing items for sale. There is a children’s corner and petting area, sand pit complete with dinosaur models and the terrapins swim in a Fred Flintstone tank.. Our rabbits and fuzzy friends must be the tamest in Europe .. stroked and groomed almost non stop by our young customers who are encouraged to stay as long as they like - no purchase required!

Claude Steiner, a disciple of Eric Berne and one of the early transactional analysis therapists, wrote the original ‘Warm Fuzzy Tale” with the theme of strokes  given freely and unconditionally in the form of warm fuzzy creatures. We thus named our shop project “Warm Fuzzies”.

Part of the project plan was to invite groups of children, youth with disabilities and the local autism group for example to visit and enjoy the animals - we did not plan one of the most valuable aspects of “Warm Fuzzies” - the refuge. Without any prompting a group of deprived children have made it their special refuge, they wait for us to open up and stay until closing time, doing anything they can to help, but mainly wanting to get warm and safe and sometimes talk about their problems.in a way which they may never do elsewhere - they trust the animals, we look after the animals with them, so they trust us.    “Warm Fuzzies” is bringing a little bit of warmth, love and safety into the lives of London Youth.

Youth Support Forum on Adolescent Health and Welfare

8th Annual Meeting 21st October 1993

Young People and Violence

Transcript of the proceedings.

Introduction - Dr Diana Birch - Director Youth Support

Welcome to our meeting and it is great to see so many young people joining us tonight - both from our residential unit and from colleges and schools.

There has been a lot of controversey around young people and Violence and it is widely reported in various guises in the media. An excellent book ‘Deadly Consequences’ has recently been produced in the States by Dr Prothrow-Stith a member of Society Adolescent Medicine. This sets the scene well in terms of the American experience, perhaps we should begin by looking at some of the statistics which are quoted there. Looking at the relative problems in various parts of the world the USA is way ahead regarding homicide rates for young men, and the lowest is Austria. I find it horrific when I attend meetings in the USA they talk about gun deaths in schools, including Junior schools. Guns removed from 5 year olds trying to shoot their teachers. A survey in Los Angeles showing 4 out of 5 high school population had witnessed a death; how many of us have seen a dead body? For American youngsters this is no big deal. I argue with colleagues in States - if one of our young people turns on us we may get a black eye or at worst a stab wound but we will not get shot. So why on earth are they allowed to have guns? The gun lobby is very powerful.In the USA there were 8,000 hand gun deaths 2yrs ago as opposed to 8 in UK and 5 in Austria.In proportion Scotland has higher rate of murder for boys than England Ireland.

Comparative risks. USA white females risk of being murdered is 1:500 if male double black female rises to 1:100: black male 1:25. In proportion black boy in USA is 20 times more likely to be slain than a white girl. What of victims & aggressors? They tend to be similar people. In prevention it is no use suggesting social changes because two people raised same neighbourhood with same problems are as likely to be victims as aggressors. An aggressor is likely to be a young male of similar race from a violent home; who is depressed and abuses alcohol or drugs.

“.... I find trying to survive in this world very hard but when there is violence on the street it makes surviving even harder. I think about how many innocent people get killed on the street every day, I think about kids getting killed at young ages, I think about the elderly people who have no one to do things for them; I think about the fear that they have each time they come out of their homes; I think about how some old people have to stay locked up in their homes becasue they fear to stay inside and they are even more afraid to come out.  I don’t think that life should be this way.

I think about all these different gangs that are out on the streets trying to take over different turfs which don’t even belong to any of them. Every day we hear of someone who has been shot or stabbed. Why can’t those young kids understand that they are also a part of this human race?  Each day when I come home from school I stay indoors until the next morning when it’s time to go to school again. It’s getting so it’s not even safe to stay inside your own home. When I leave school in the afternoon, I try to find a safe way home, but there’s no safe way, no matter which way you come, there is always that fear inside.   I wish everyone could stick together as brothers and sisters. I wish the time would come when people could walk the streets without the fear of being robbed stabbed and shot or just being plain molested.   Tomorrow is another day and I wonder what it will bring, but deep down inside I know it will be another day of trying to find a safe route from school, seeing the kids on the streets trying to be bad, seeing some old person living in fear; seeing the police cars with their lights flashing and their sirens on, seeing the ambulances coming and going and seeing the youth of America being shot down and killed before they even have a chance to live...” prize winning essay by Mukiya Adams-17

That is America... Things tend to happen much the same way here after a while. Our own papers show youth committing violent crime. We can discuss that.

Martin Davis - Probation Service, Representing the Howard League for Penal Reform.

Crime in Britain is endemic. Surveys show a 49% rise in crime commited in UK 1981-1991. Police arrest figures have risen 96%. People report more crime now. Home Office figures look at trends and more reliably show 49% rise. We are looking mainly at young people in the reported crime group. Older people may be more involved in offences which are not street offences, more sophisticated and less obvious.    Violent crime is also endemic here and USA. Causal theories are difficult. Cultural? Is it a case of delinquency drifting into good behaviour and back? The state of the economy does influence the property offender. Also has a bearing on violent offender though not to same proportion.   Violence is endemic. Home office Janus survey found that of all known male offenders born in UK in 1953 1:8 have violence conviction so there is clear link between people who commit general offences and violent crime. Ten years later, the 1963 births produced a higher 1:5 figure for people committing one or more violent offences. In the case of property offences circumstances affect motivation to steal but in case of violent crime one must consider that they are in some way committed to a culture of violence. People do not come into the system labelled violent. Someone may be arrested for a property offence and whilst being processed is found to be involved in violence. The system does not deal with the violence but deals with the presenting case e.g. burglary. Police have their problem, Probation Service and lawyers have problems, but nobody comes to them presenting violence with chance to directly intervene Violence is only discovered later because of the situation. Supervising them is quite difficult. Coming further down, to the less serious offenders, mainly domestic, we may not see them at all. Lesser violent people are cautioned on first offence so do not enter the system. Do we deal with them through Social Services? The Home Secretary specifically targetted young violent people. “Juvenile crime generates strong emotions” people feel frightened and threatened, I do. “..Arrogant groups of young hoodlums who should be locked up - taken through Courts set up to deal with the particular menace of the young offender”.He stated that prison works so he has the power to introduce lock up procedures He also looked at developments leading to a tougher legalistic approach to criminals. There is a swing from welfare towards justice, punishment, imprisonment for violent offender The Criminal Justice Act 1991 and 1993 Act are penal  - punishment not welfare.

Dr Aggerey Burke - Consultant Psychiatrist - St George’s Hospital

I wish to share my experiences both from the clinical frame and from the framework of some of my findings on carers, usually mothers sometimes fathers and children.   A little background - The Children’s Act is the first piece of legislation trying to get into culture and race and religion. However it gets into this field in a confused way, resources to put it into force are not there, Lawyers make money but children do not get better and things are not improved. However, having identified the subject in law allows some of us to be less vocal perhaps and more pragmatic. It is 20 years since I said that the Afro- Caribbean population merits considerations in their own right.I am Afro-Caribbean, Jamaican.My colleagues in psychiatry are horrified by my interventions, they think I have gone too far and the reality is that there are only 4 West Indian psychiatrists in the country.

In the frame of the last speaker and in the context of the present society what we have to consider is that when we go to the criminal justice system, the courts or prisons in London fully half of those deemed violent are Afro Caribbean in secure units or Broadmoor it is a quarter.When I visit such institutions I am amused that they do not know whether I am visiting as a professional or escaping because that is the reality of such institutions. In the particular context of young people in violence and children in care my work does bring me closely involved with parents of such children most of whom are young.

Going back to the clinical frame, we work in the context of looking at dynamic relationships and ones childhood experiences with blocks to normal development of an emotional kind and reflections on adolescents..

Mental disorders are primarily the outcome of childhood experiences and blocks to development. The idea that schizophrenia is an entity we would debate because it has as yet not been flagged up in an accurate way.We would say that clinically there is syndrome which looks like schizophrenia which has no stated aetiology. We see it. More often we see a condition which does not come out of the blue, which is entirely understandable in the context of development. In it’s extreme form it is noted to be disturbance. Persons depicting this form of behaviour are seen to be disturbed and to be disturbing and most often they are young. Why should it be that the Afro Caribbean population may have more on the street disturbed than white middle class population, or Asian?  We find that in the care system,in the child care population, prison population and dangerous violent young population most are drawn from the Afro Caribbean London population. This reflects the social reality of London and we need not doubt this. In clinical practice we are involved in exercise of psychotherapeutic management of disturbed person presenting in adolescence with adjustment disorders - nobody to turn to. Syndrome found most often is sadness, fear, hatred, anger, constituting confused emotions - emotions that cannot be balanced; and in it’s extreme form it is fury. Extreme and confused emotions are mixed with extreme and confused thoughts in the most extreme and confused persons.

My psychiatric colleagues insist in saying that anyone who adds a little Marihuana and a little crack in that disturbed state and happens to be black confused or otherwise will be called schizophrenic. We say nonsense. Indeed in my hospital clinical setting most of the people I see with these symptoms are white and we do not call them schizophrenic but “messed up people”. So we identify two syndromes, messed up woman and messed up man.Syndromes appear consistently & strikingly in adolescents. Features of messed up syndrome easy to find; confusing emotions, confusing thoughts about “Does anyone love me” “I am not wanted, I have been dumped,... I know it’s true but I hope to God it isn’t”.Such people at their most extreme form of disturbed thoughts and emotions show extreme forms of behaviour which to us become disturbing.

Case example, Someone brought up in a household with two alcoholic parents directly abusing each other and thus indirectly the child - since a child witnessing such parental abuse is indirectly abused by the process.In addition - both parents indiscriminately without reason beating and chastising the child who thus also suffers direct abuse and who also suffers that other form of abuse identified and flagged by Social Workers as neglect, seen often as children being left alone in their room or their house,  but experienced by the child as being unwanted and unloved. It is this undeclared abuse which is in later form presents as disturbed behaviour into adulthood. What we find is that people have to tranquillise their disturbed feelings, with marijuana, crack, alcohol. They use relationships in an interesting way, if they cut themselves with a razor, this gets rid of some of the feeling of having been abused and their arousal comes down, and if they give someone a good beating to someone it also reduces the feeling. So there is some energy involved in going down the road and mugging etc. - there is some reality to that feeling. A youngster presented to us with cutting and overdosing, when dealing with the issues we found real abuse of every description and sexual abuse at the level of torture. Continuous, consistent and harsh abuse leaves the mind distorted and disturbed. This youngster comes to the stage of wanting to replace himself or herself by having children who would have a better deal. What better scenario for continued abuse.

In my clinical practice we have the question of where does violence really start and what are the predictive factors for children to be returned to their mothers or fathers in circumstances of neglect or abuse? I have a sample which is mixed, some mothers, some fathers, some parents, child care situations - about 250 cases to analyse. What we see is that people who enter the care system from Social Services context come from poor environments, financially poor from high rise council estates, half being single, and from backgrounds where 66% of their parents are separated. Most are on income support, most live life of hand to mouth. They are poor people. If government curses them it is not a godly act. Some come from households where no mother, maybe no mother for part of their childhood. We are looking at people who are deprived, about one fifth of aggression between parents. These young parents have been brought up in care, three quarters felt unwanted during their own upbringing. Social workers cannot fill the gaps left by the lack of being wanted by their parents - One quarter ran away from home and fully two thirds tell you they were not close to their parents. We have people who had a lot of difficulties in childhood physically abused; linking information of mothers saying it was really hell as a child, so if you want to help me don’t crucify me. What happens in the mothering context? I am trying to find out what is really going on. 20% inflict NAI on their little ones. One third had been abused by their spouse. We have households where bones are being broken, some children die couple perhaps had mothers murdered. We have an abusing set up resulting from situations of early life and people tell you housing conditions are bad, there is constant worry and inability to get on with family members. From a Psychiatric point of view, fully half of these households are severely disturbed,children led to drug abuse, alcohol abuse or extreme aggression and only one third come to me for assessment with psychiatric illness of a serious kind. Other two thirds not at all. So what does this mean?  Are we looking at a situation in which young people who become carers and parents of future generations are themselves receiving deprivation and abuse by having their children taken away by social services? Being seen by those children as dumping them - being set up in the same situation once again? Most are black.

Is it a solution or do we then have into courts and prisons a generation of people who have been in care? That is how it looks to me. I have been reflecting on these issues, and one thing which struck me was how frequently in this population persons had lost a child. One in three had a child taken away into care system before coming to me. Not only deprived but depraved in the sense of being tortured by a system with no mercy, saving children but in the end the children have to get it in the neck just like you.

Questions and Discussion

Peter Blewett Warwick Park School- What are your criteria You say that only a third of your cases have real psychiatric illness? Given that it is really very difficult to get people who have even serious problems to be seen by a psychiatrist?

A.B.  We are guided by the mental health act. If you cannot sleep and you are off sex and your appetite is bad -  you may be mentally ill; if you have delusions - then you are mentally ill. The department of Health when asked for a definition left it up to a psychiatrist to fit people he deals with into syndromes. Americans have taken it further by identifying all possible syndromes, so anxiety syndrome, post traumatic stress disorder etc. Whole range. Essentially what the psychiatrist says and to answer question there is confusion between disturbance which may have high levels of aggression and murderous feelings for example and mental illness. Most takes off as concept when person is out of contact with reality. That’s when it takes off. Carers assessed by capacity to look after children, when is it a treatable condition like depression or schizophrenia and when is disturbance identifiable and treatable? I use tranquillisers and control methods. We are really in a complex field at the moment as to how something to do with childhood experiences is incorporated into the language of psychiatry - there is a split at the moment, counselling services are growing, social workers do most of the psychotherapy. Other services are systematically withdrawn borstal services, prison services, and division exists between counselling services and people who may be dangerous. The concept is a pragmatic issue, to do with resources and not really philosophical issues.

Student Warwick Park School - I have heard disturbing stories about over prescribing of drugs for mental illness - can you comment on that?

A.B. You are black like me, so your question has particular meaning. I would say to you there are three elements to your question. I think first element is that white society is fearful of black people. Fearful for three reasons, slavery, black population disappointed about settlement in Britain, AC populations live in poor areas with hustling a part of life.  Second point is that there are very few Afro Caribbean professionals and we cannot all fight the services on our own, there is no one to reassure the black community. Those black professionals who may be able to do something about it are unable to. If half the children going into care are black, half the parents involved with social workers are black. Half people arrested in London are black, so there is something to see that blacks feel the police are against them. Half of the dangerous mental patients in London or Birmingham are black; if so, I am suggesting to you that they are handicapped substantially by having a situation where you know someone who goes through that process and start to believe it happens to black people.Although disturbance might not be mental illness it can be frightening and need intervention.Levels of arousal we see in Africans here are far higher than that seen in AC countries. What is feeding into that arousal I don’t known. I suspect those dumped in early life, rejected from 100 job applications and by society are angry. Does not matter if professional is black or white, we must bring down that anger.  Controlling angry syndrome is ten times more likely in black people

Dr Anthony Golding :- Why do you think that the pattern in the Asian Community is so different?

A.B. -Index of independence professional and commercial,of 100 Africans or Asians who have independence financially; we think Asians have 99% and AC 1% so we are comparing cheese and sand. Not like with like. The populations of AC came here with predominantly non professionals and not independent. In Jamaica the busineses were Syrians and mixed families more than black people. Guyana Indian business men. Coming to England, Asians had no problem about wanting to be British so no problem feeling British. No problem of slavery and no problem with British internalising their world. British do not believe Asians are dangerous. Slavery important point. Asians have not had same experience in migration and have been more successful keeping together family units against odds, AC strong mother has to work long hours. Asian didn’t do that in same way. Asians came here ten years later and did not subject themselves to the same tremendous long hours of work without support. British have never failed their duty to Asian children. Asians language and culture, racial views and attitudes retained. AC do not have separate language, no separate religion, and culture is British. So we have powerful differences which might determine violence emanating from people who say “What is going on? I try to get A levels and cannot move”

DB: Probably what you have said is a clue to the graphs put up at the beginning showing the vast differences between black and white rates of death and violence in the States.

Adam Hobbs - Guardian Angels

The group started in 1979 in New York - in the Bronx, the idea of a man who worked in MacDonalds as a late night supervisor. He was fed up with having to deal with victims of crime who would crawl in with bleedings noses at night and all he could give them was a cup of coffee. He wanted to do something more constructive. In fast food restaurants the typical people working there were young, partly from these groups we have been talking about youth who had not done well in life. He got a group of them who were going out and partying with the gangs and he gave them a dare to care about somebody else.He offered them a challenge that without weapons and assisted only by members of the same kind of age group they would help innocent travellers on what was a very dangerous subway network. He started with 13 people.14 years later New York has 400-500 members but still works on the same basis.It takes young people who could be gang members and gives them an alternative gang culture.It gives them a strong ‘family’ culture with strict rules, there are no drugs, no weapons The average time that people spend in the Angels is between six months and a year but for that short time they have been taken out of that scene. London we have slightly different group,it is not made up entirely of people who you would regard as potential gang members we have a cross section, kids who have come from schools where everyone carries weapons, knives, not guns-we don’t want to see a New York part 2 in London. Most young adolescents have an energy to release and unless you allow them an outlet for these tensions, there can be trouble. I am sure any of you who have been to New York will know that it has to be a very serious challenge - to go unarmed patrolling the streets is something else! In 14 years 5 members have been shot - two by police officers in New York who did not know who they were when they first started. Tragic really. But all of these people died in circumstances where any other sane person would not get involved so clearly young people who are involved take this very seriously to the extent that they are willing to lay down their lives.They would do that equally in any of the new York gangs which they could joined. Training is much improved. It used to be basic combat training, now we mix in first aid and things which these young people probably never get a chance to do They cannot afford lessons first aid or self defence but with us it is free. We are essentially a big family. There has been a lot of talk about the Guardian Angels - what we are accountable for and whether the police approve of what we do but the fact is that we operate within the law, and we take on youngsters some from good backgrounds with no ulterior motives for joining the group, and some who have nothing going for them and nothing to lose.This is something which gives them self worth. They might have been standing on street corners being jeered and despised. Now these people can have the public coming up to them and thanking them for caring,it is a big difference.

Adrian Lee - Young Conservatives

I must say in introduction - I was rung by our Vice Chairman and asked do you mind speaking to an organisation called Youth Support. Andrew has sent me on missions before where I had to defend myself from physical violence afterwards. I am glad to see its not that sort of meeting. I asked Piers Merchant MP for Beckenham where the organisation is based about it’s background and what it was, I was reassured when he told me that it was not an anarchist or Trotskyist organisation and he told me about the good work it does. My presentation is from view of an amateur politician really and I give my own opinions which will not always duplicate the Government view.  Youth problems - it is interesting in Sunday Telegraph this week Peregrine Worsthorne said Youth violence such as football hooliganism and racial attacks could be based on the breakdown of the class system. Class system in 1960s broken down too much. My own particular background is working class and I was brought up in appalling housing, I think that a meritocracy is an advantage to society when people have ability to be better educated we can move up notches. Individual personal freedom mostly of sexual sort was increased in 1960s. I approve generally but there has been a lack of understanding that there has to be responsibility attached to increasing liberty. The main conservative response to increasing violence is that the family is the main core group in society. Dr Burke said where there is no family there is a sense of aimlessness, sense of drift. And if you do not have that core group in society, frankly I think you are starting off on a very poor footing. Organisations such as this can ease the situation but where in certain council estates and among certain minorities even in certain parts of the indigenous population, family cores are breaking down and this is very concerning. How did this family breakdown occur? Extension of the welfare state into every area of life housing, health, education, social services took away dependency people usually had with their families and this broke down connections. No longer do we turn to family for support as the state does everything. Governments of all parties boasted increasing spending but this is a double edged sword. One example, council housing. In 50s and 60s altruistic motives accounted for slum clearance and tower blocks erected which have become worse slums than originals. Another innovation which I do not support is egalitarianism. I believe in a meritocracy when people can strive for their highest goals. Society as a social leveller is wrong, we should have opportunity to reach highest ambitions but the whole of the Labour Party comprehensive scheme was based on enforced equality. This should have been tackled by present government. Teaching is not equality but bringing everyone down to same level. Individuals should take responsibility for themselves and while not cutting off support to those in genuine need we must cut off support to most of society and return to home based support. This is where charities have role. Labour party think that charity is a bad name, looking at Victorian begging ‘thank you Guvnr’ .. we think charity is a very useful thing for people to be involved in and shows a caring society. The state does not help individuals to become participant in their community. Paternalism is known as no more than moderation of socialism, but literal meaning of term is individuals who have earned some money and are doing well in the world, helping by patronising -not condescending but helping financially (in a good sense) other members of society. Karl Marx would never have written Das Kapital if it had not been for the benevolent help of a capitalist. Charles Dickens wrote about paternalism not the state taking over every part of life.I do support tougher penalties, I and the Young Conservative and others in society are sickened by too many excuses to understand the criminal, too much emphasis on the criminal and not enough on the victim; we must come down hard on people who beat up old ladies etc. We are inflating figures of violence but ask your parents if the society they grew up in was less violent than the society we have today? Vast majority will tell you that it was.

Martin Davis :  But how about the factor of the violence and people killed in the war?

AL:No sorry I am not talking of Adolf Hitler’s total.I am not in a debate,one second hang on..

MD: We must look at scientific data, statistics not this party political bias . because I would not dream of saying that during the conservative era 1981-1991 we have seen a 99% rise in violence. We are not supposed to be looking at party political issues here and that causes me some concern.

AL:I am sorry  that you are so concerned. May I just finish he interrupted me and I did not interrupt him and I would like to finish the point that he just made .Yes I am not making party political comments -average person in this country feels violence in society has increased, not dying on battlefields but inner city dwellers today who despite your pages of statistics believe society is becoming more violent and this is as much blame on labour as conservative.

DB On that note, to show we have no bias, I would like to draw your attention to the book which you have in your delegates pack, which is about life in Russia. And speaking as a Marxist I would like to say that when I used to be in Moscow before Perestroika, it was perfectly safe to walk the streets and to be on the subway and the Metro until 1 or 2am but now you take your life in your hands if you do so. I close my case!  We are not a political organisation - we like people to present different views.

Christopher Hickey - The Rainer Foundation

Rainer Foundation is a national charity based in South East London and founded in 1876. It was the original model for probation services. We currently run about 20 projects nation-wide for a variety of young people, 13 of which are directly for young offenders and a number of hostels in London for homeless people. Some hostels cater specially for young women. Regarding violence, a number of issues come to mind. We have heard a lot about rising crime figures and the newspapers do show the sorts of issues that concern us all but we should put it in perspective. One London Borough Lewisham in which we have project has a population of 19,000 school children aged 10-16 and of these the total arrested in a year is 492 and of those 51 were arrested for violence. In these terms the actual levels of violent crime that come to the notice of the police is not a very great problem.  Older teenagers and adults (17-25) are mostly responsible for rising figures. Violent crime tends to be committed by people of the same gender, same race, same circumstances so the concept of people wandering the streets waiting to prey on innocent people is far from the truth. They are assaulting each other in the course of their normal day rather than being the sinister figures lurking in the bushes preying on people. Going back to what DrBurke said. In our experience in Lewisham 62% of young people prosecuted for offences last year were black although black population of Lewisham is only 20%. This figure is of great concern; school children excluded for behavioural difficulties 65% of those in Lewisham are black. Why is such a high proportion in conflict with authority and society? I think there are links. There is some evidence from young black experience in school that there are cultural misunderstandings on behalf of white teachers in authority. Cultural norm in Afro Caribbean society is not to look at people when you are being told off, you look away and show submissive bending of head. Cultural norm in white society is to look people in the eye, look at teacher in face so indicating trust and openness; so this can lead to an escalating series of being pushed over the brink by being told ‘look at me when I’m talking to you!’ and raising head slightly, getting into further confrontation for being insolent further, original behaviour by this time being ignored, the teacher felt he was being disrespected and the young person could not be allowed to remain in the school because they had no respect for authority - although the young black people were showing normal cultural behaviour patterns demonstrating extreme respect for authority. Statistics help put into perspective what we talk about. Based on a study which ran over 3 years involving 150 young people in Southend.All were offenders referred to us as an alternative to custody. We looked at their life experiences to see if there were common factors. Average age 16, 95% male,75% convicted of offences of property, 25% offences of violence. 98% of them did not live with both natural parents so either had no experience of parents or had separation from one or both parents.Poor families 75% entirely dependant on income support and 92% experienced behaviour problems in school. 88% had not been to school 6 weeks prior to court date. Further 25% experienced death of close relative, 10% we knew had been sexually abused. They also had suffered physical abuse in sufficient numbers for us to record as a factor.  The previous speaker and others draw from statistics that the welfare state is creating these sort of people and that if we withdraw these supports, they will snap out of it and behave in a normal, decent law abiding way. But I draw on experience of 17 years working in this field; we have a system in social services whereby the care system is anything but a care system and that the duty of the state to provide young people with support fails them miserably. 40% of young people have been in care system one way or another. The average number of moves of young people in care is 12.They will be moved 12 times to different placements if they are in care for more than 6 months. If you are in care for more than six weeks you are likely to be in care until you are 18. This is creating a perpetual group of young people who are alienated and disaffected and are cut off from normal experiences of love care and support which we would all hope to experience at some point in our lives.In our society 10 years ago 1 million unemployed was unthinkable, we now have 4 million unemployed. We are creating a group of young people who are getting left further and further behind and are becoming increasingly desperate and turning to desperate measures to gain their place in society.

Panel Discussion - Diana Birch (Youth Support); Dr Aggerey Burke (Consultant Psychiatrist); Christopher Hickey (Rainer Foundation); Martin Davis (Howard League and Probation); Bennett Obong (Probation); Tony Machin(StCharles Centre);Adrian Lee (Young Conservatives); Joe Gherardi (AA); Adam Hobbs (Guardian Angels); Keith Thompson (Guardian Angels); Richard Stanton (NUT National Union of Teachers).

Q: What is the predominant race and gender of Guardian angels at the moment?

AH: Depends on city varies NY predominantly Hispanic some years ago. Young adolescents from Bronx, gang members, NY Angels seen as another gang, decided in NY not have women in group. We do not have problem in London. Not as many women as we would like in London and in terms of race we have Asian women, black men and women, oriental, all kinds.

KT: The London group is actually run by an Asian woman. In NY tended to respond best from same race group as area. We have good cross section here.

Q: How do you actually work?

AH: Basic principle is to act as a visual deterent. It doesn’t matter how small the traffic warden is, if he or she is standing there you are not going to park. Same principle as neighbourhood watch group.

KT: We are trained to deal with diffusing situations, first aid,basic principle is to act as visual deterrent. City of 10 million people we cannot be everywhere so certain areas targeted. Local communities phone us, and prompt us to send people.

Q:   How do you know your members do not take drugs

AH:If they are drunk or not in control are sent home. If a problem they will be “cut” from organisation. We take it seriously,members are searched for weapons.NY principles are adhered to.

Q:Group gives self worth to members,do you see yourselves filling gaps in police role?

AH:People say police should do more; ridiculous, politicians may say it is right of citizen to arrest and use force to prevent crime, it is a duty, quite frankly we should do something not pass buck. How can you expect anyone else to care.Response time of police is 7 minutes but neighbour would be quicker attending your house so it makes sense to look after each other. We spread this message. Group is multiracial. The Guardian Asians took basic principle to protect Asian community.This is a vigilante group.We are not Judge Dreads meting out punishment,we leave it to courts.Let people get home safety.

Louise:   Can anyone join?

AH:Anyone can join the group. We take people who have had criminal record, if you are 21 and at age 16 stole car but since clean record should be given second chance. No one is lifetime member, asked to leave group if not pulling weight. In London we get mix, some people have no self worth very poor, violent backgrounds friends of victim of crime, inspires them to join. Mix is good,unites different types.

Richard Stanton national union teachers

- focus on violence in classrooms.    Head teacher in Brixton. I wanted to focus on not statistics but schools should help children feel more valued and worthwhile in terms of giving them things they can achieve which give respect. They would then not need to turn to violent means to gain respect. Schools in their day to day policies in way they deal with young people and violence can influence them

Tony Machin (St Charles Centre):

I work for the Youth Treatment Service - one centre in Brentwood, and Birmingham. Secure accommodation for some of the most disturbed young people in the country. Bulk of residents are sentenced for very serious offences such as murder, attempted murder, rape, arson and similar violent offences and symptoms of major disturbance. We have 30 secure beds at each centre, providing care treatment and education for them.

Joe Gherardi AA:

I am an alcoholic. It is difficult in such a short space of time to describe an organisation which was founded in 1935 in Akron Ohio by two men helping each other through drinking problems to try to stay sober - and found that they could help each other by staying sober one day at a time. This has now grown to an international organisation with  between 1 and 2 million members now transforming many peoples life. Henry Kissinger was interviewed by David Frost - he said what single contribution had America left the world - he said AA. Can be of great assistance - main thing is to get person to AA meeting. Numbers are in phone book. Not many young people were members of AA 20 years ago but today unfortunately 2% of membership is under 25yrs old; possibly will grow in the next 10 years as more acceptance of alcoholism.

DB:  Relevance of AA here today is that so much violent crime is drink related and so many referrals from various channels to us underlying alcohol problem.

Bennett Obong:

I am a Youth and Community officer concerned about the development of young offender programmes. It is important specifically to look at issues relevant to young people’s behaviour.If we look at offending behaviour, we must also look at underlying factors such as peer group pressures, alcohol, health, effective use of leisure time, if you don’t look at whole picture cannot develop work. When young people come out of doing time pressures still exist outside so to reduce probability of return should take it all into account.

General Discussion

DB:  Tony - young offenders at your centre - The feeling we often get is that once someone starts offending will continue, and with regard to serious crimes i.e. murder - I think public has a recoil of horror about such a thing and perhaps even more so about young person committing such a crime rather than adult; what would you say was prognosis for this recurrence?

TM   Standard answer - it varies. Statistical evidence demonstrates that the most serious offences are rare - child murderers etc. are extremely rare so we cannot extrapolate from such a small sample. Most are the product of long-standing family affairs and not generalised to the rest of population. As someone died as result of actions of another, for murder life sentence mandatory for that offence. A small number of offenders commit offence out of the blue with no record of serious violence or disturbed behaviour. Tend to fall into that category.

At the other extreme individuals have demonstrated very disturbed behaviour from very young age and archetypal case is the child who was sent to child guidance at age 2, excluded from nursery aged 7, whole variety of residential placements, different schools and a sort of rake’s progress of general deterioration; in some of those individuals the problems they suffer from are so deep seated it is difficult to disentangle the causes and work with them. The essence of working is to try to get some understanding of the problem and agreement of the person about the nature of problem. I agree with need to condemn violent behaviour but we should make an attempt to understand it; this is not an excuse, simply an explanation of what happened. without that one cannot get a rational approach to the problem. Help identify causes that led up to behaviour they display, nature and interpretation, they may see their behaviour as absolutely justified whereas everyone else sees them as totally outrageous. How does that behaviour function for them what it does for them. Find other ways of getting the rewards which hitherto they got via violence, whether reduction in anxiety level or the contents of somebody else’s pocket

Dr Anthony Golding: I have found all this very interesting, but I find it very sad that just 20 yrs ago in this very building Sir Keith Joseph who was then the secretary of state talked about the subject of deprivation and I really wondered what kind of society will we have in another 20 years? more or less violent? And thinking about the schools, will there be more problems of violence and how can we reduce this?

Richard Stanton: Well I would like to pick up the idea of condemning rather than understanding as well because I think that one of the most appalling statement from our prime Minster that I have ever heard - it seems that children are being made to realise the consequence of their family socio economic circumstances; far from notion put forward earlier that egalitarians are looking to equal levels down to another level, many people in education looking for opportunity for everyone to have a greater chance, giving those who start at disadvantage an equal opportunity as some of their more advantaged peers to catch up.  For instance, if you analyse 6/7r old tests in 1972 analysing looking from a socio economic basis, children taking tests showed dramatic differences in performance between children from higher socio economic groups than from lower; break down further into girls from higher se groups compared with boys from se groups even greater divide. Similarly looking at GCSE results staying on rates, all profoundly affected by se factors. What has been shown to clearly influence that and improve opportunities is nursery education. Current government resisted since Margaret Thatcher’s own call in 1974 for universal nursery education (said it was cheap investment) but ever since then successive governments have refused to make that investment despite the academic benefits and despite clear evidence of social benefits and cost benefits; latest results from USA shows that for every one dollar invested in nursery education - $4 saved in subsequent welfare payments, criminal activity costs etc. If you wanted to pick on one thing that would stop it being inevitable situation continues should introduce high quality nursery education tomorrow for all pre-school children.

DB: On that theme I would like to draw your attention to the article in the current issue of our journal titles “Deprivation, health and educational needs” which covers a number of those points.

Peter Blewett:   I would like to reassure the gentleman behind me - I started teaching career in a public school, where the pupils were upper class but many of the emotional needs of children were not met, they were sent to boarding school, often ridiculed and they then went on in life wearing this experience like a campaign medal. and I am now working in an inner city school where many of the children’s primary care needs are not met in Peckham and we try to cater for them in school. I have brought three pupils with me tonight, not boys, girls more articulate. You can share views with them. When I started there 9 years ago a lot of money was spent on pastoral care. Money is an issue. Budget of the school is 2.3 million, about 50p per year per child goes on pastoral care, the national curriculum costs £3.40 per year per child. My child’s ballet class costs me £3 per lesson - you get what you pay for. We continue to achieve exam good results, more girls than boys to university, and they have come through lessons where there has been major disruption, bullying, violence, children I have taught have committed murder, rape but nevertheless the vast majority will go on to achieve.

John Ryan:    Most agree that a male of whatever age or colour who is not preoccupied and not employed will be troublesome. If he is young he will be up to some mischief so however we look at situation there will be an increase in the problem if there is an increase in males being unemployed and with time on their hands. What I would like to ask panel is given problem of unemployment bringing low self esteem, there is small core - if you went to any area saying who is a nutter? people will tell you very quickly those who are extremely violent and don’t care a toss. Do you see these people and do you think there should be some form of containment of this very small minority who cause so much physical damage? I sometimes think magistrates do not perceive a nutter when they come across one, whereas anyone on the street in that area knows who they are.

A. Burke: How do we predict. Information comes from parents and teachers up to a certain age but later it is supposed to be part of that process of psychiatry. Say someone committed murder because of diminished responsibility it might be manslaughter. We are under terrific pressure in psychiatry to clean up the streets - but we may not have many indicators, sometimes our indicators are the acts themselves - diagnosing after the event. An indication of dangerous is a happening, rape, violence, serious crime. I am used to working with violent young people, it is nice to see someone from St Charles at this meeting, but it is not very useful when looking at early factors - how often do early factors predict other problems. The violence and abuse in the household, a lot of them have been abused. Many have been in care, have seen very violent parents, but many have not and there is the difficulty. Many young males who have been abused do not commit violent crime.

I am not so optimistic about the Peckham desert - I think it is a dry place. AN what it produces is a lot of males who will not be literate, who will not complete their school term. So there is a female population who will get on but there is a large sub-population who will not be employable and will need to fend for itself. That is a fertile group for looking at origins of violent crime but we must come back to looking at strategies of prevention. Let’s educate people in a broad sense. Let’s give people an opportunity to work. Then I think psychiatry would shift its ground because psychiatry would then not have to focus on deprived populations which are seen as dangerous.It is the deprived population whether black or white population, we define the target population as more deprived than us and so they are dangerous. I see the way ahead as education, life chances being improved and psychiatrists are less important in identification of dangerous behaviours disturbed behaviours.

Martin Davis: It’s a small group of people you are describing.

JR: Yes small but devastating

MD:They will end up in prison. I hate the fact that we have been politicising this issue but that fearsome group are totally unidentifiable by professional groups. I think we can be frightened by them into believing that we can do nothing with the rest of the group. The reality is that we have an awful lot of people who are grossly deprived.

Richard Stanton: I do think that the very disturbed people you describe are more or less a static number. They are always present in very small numbers. Unfortunately there is often a focus on them and it biases the way we look at all the others. The Jamie Bulger case took up a lot of media attention and diverted our attention from an 11 year old girl on trial for murder in Scotland. The means by which violence is perpetrated is changing. Now we see more weapons use which is glorified by the media.We are influenced by US culture.

Q: Can I bring up the question of violence in schools. I am a school doctor and I see that behavioural problems link with educational problems but I find it very frustrating that to get a child seen by an educational psychologist is very hard.You can pay for an assessment in private schools but in the state system, the resources are not there.

RS: I agree. We need an emphasis on resources for evaluating special needs and providing for them. The remedying of special needs and giving educational support is costly but pays high dividends and is well worth it. It is very important that school put their own house in order. When I first went to the school where I became headmaster there was a lot of violence. We had to change the whole ethos.People had to learn that violence was not a way of solving their problems and teach them alternative ways of getting what they wanted.Secondly you have to make sure that the curriculum is appropriate to the needs of the children in the school. Thirdly you look at the children’s special needs and provide as much support as you can. Then once you have an appropriate curriculum, an ethos which defined the way that the school ought to work and you provide individual support for children you begin to get a little bit of sanity into the set up as a whole. Then you can pick out individuals who are needing extra support. In the eighties there were more resources. Now it is much more difficult.

Aggerey Burke: A last comment on the care system. I think it is the basis for a lot of these problems. That is why we have doctors and teachers frustrated in not being able to provide for these children. We have a system which is taking the most disturbed children into care, into StCharles into crime into violence this is a progression.

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Staff responses to violence - How do we feel after a confrontation - Strategies for ‘defusing’ and coping.

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How do we cope with anger in the work situation?  Staff who come into contact with disturbed individuals and angry young people need constant support and reinforcement in order to be able to cope with the aftermath of anger. How do we ‘keep our cool’ in the face of the “rage” described by Dr Burke. How do we keep our perspective in detaching from the anger? How do we deal with the fear that inevitably comes with facing a possibly dangerous young person who is out of control.

I am often asked about self defence methods for staff - the principle of this is all wrong - certainly one should be aware of a few self preservation moves and perhaps one method of restraint - but essentially in the caring professions, this is not our role - that is the role of the police and staff should NEVER HESITATE to call for police aid. Heroism is entirely misplaced in the situation of a raging patient - even if you do feel sorry for them - self preservation and protection is the rule. Two quotes are worth repeating here -

“When confronted with a young man with a knife - I run like hell!”  ...

“It is laudable to help prevent someone from jumping out of the window - but at the last moment, LET GO! Don’t let them take you over the edge with you”.

Staff can easily feel that they have failed in some way when a confrontation goes out of control and it is important to keep two points foremost in our minds.

1. Not to take on misplaced responsibility. The ‘patient’ is responsible for their own actions.

2. Keep the ‘patient’ centre stage - ie it is THEIR problem - not yours.

Dealing with conflict was the theme of a recent staff workshop - the following comments arose ...

“....In a confrontation I feel inadequate and lost. Although I let them rant and rave as there is no point in arguing back while they are in full flow, I still feel I should know what to say to help them- as their anger I feel is a cry for help”... Anne

“... When anger is directed at me I feel vulnerable and afraid. I detach a certain part of myself whilst still aware of what is being said and done. I try not to let it get to me and usually talk it over with someone or let off steam out of work - i.e. have a long, hot bath!”

“... I have seen anger in many different ways, sometimes directed at other residents in the house and strong anger directed at the staff. It can be very disturbing to all, especially if you do not know the real cause of it. Only once have I been verbally attacked by strong anger. I knew no matter how hard I tried to calm or talk to her was useless. At that point she would not have heard or listened. .... So I let her finish and told her that if she wanted to talk, to come to me and then I left her. I did get an apology the next day. Anger can be caused by many things, lack of knowledge, fear, loneliness and the need of love ....” Rosa

Coping with our feelings before, during and after conflictive situations - Summary of a behavioural approach - presented to the staff workshop by Sheena Brown .

Miechenbaum advocates a “Self Talk” approach. This involves silently, in our own minds, saying to ourselves:-

1. “I know this person is getting angrier - but I’m going to stay calm.”    (Preparation; problem definition; supportive thought.)

2. “I’m doing OK”    “This isn’t about me” (Focus and reassurance)

3. “I’ve done all right. I’ve coped with the situation. I can go forward feeling OK.”  (Self reinforcement)

Novaco suggests a similar approach of self instruction:-

1. “This is going to upset me, but I know how to deal with it”  (Preparing for provocation).

2. “There’s no point getting upset”  (Impact and confrontation)

3. “My muscles are getting tight - try to relax”. (Coping with arousal).

4. “I handled that well.” (Reflection on the confrontation).

This approach has been adapted by others (e.g. Sanders 1984) for modification of marital violence and for an approach to child maltreatment (Barth et al 1983).

Barth et al suggest the use of imagery - picturing in the mind that one is a rubber wall that hurled items bounce off. Also relaxation e.g.- simply counting and breathing done silently e.g. - breathe in 1; breathe out 2; breathe in 3; breathe out 4; ......

Further reading -

Spence S “Social Skills training with Children and Adolescents” NFER London 1980

Miechenbaum D “Cognitive Behaviour Modification” Plenum, New York 1977.

Novaco RW “A Stress Inoculation Approach to Anger Management Training” American Journal of Community Psychology 5 327-46  1977

Barth et al “Self Control Training for Maltreating Parents” Child Welfare LXII 313-324 1983

NEWS      NEWS      NEWS      NEWS      NEWS      NEWS

SAM meeting is coming up in Vancouver March 23-25 1995 - with the IAAH meeting overlapping from 20-22 March (for details see last issue). Anyone in UK wishing to attend as part of YS group please contact office.

XXI International Congress on Paediatrics Cairo 10-15 September for information fax 202 354 2556

Violence in Society - the report of the Royal College of Physicians meeting  Edited by Pamela Taylor is available from the college - contact publications department 11 St Andrew’s Place Regent’s Park NW1 4LE.

International Association for Adolescent Psychiatry meeting Athens Greece July 5-8 1995. Information from Shelley Doctors Fax 212 873 3841.