Hurt People Hurt People: Lessons From Chicago's Violence Epidemic →

It was a snowy December evening in Chicago's Westside and I was wrapped up in layers with lovely warm heat blowing in my face as I sat in a big black SUV. I was, however, about to have an experience that would open my eyes to the reality of life on the streets of Chicago; a reality that has included nearly 60 shootings, many fatal, over the Christmas weekend.

I'd spent the afternoon with the Ceasefire team at UCAN; a Chicago based organisation who believe that youth who have suffered trauma can become our future leaders. UCAN serve over 10,000 at risk young people and operate the Cure Violence 'violence interruption' model in the Westside area of Chicago. The Westside is home to communities where violence is endemic, touches everyone and spreads like a contagious disease. The Cure Violence model, pioneered by Dr Gary Slutkin MD, proposes that violence will spread unless interrupted by culturally competent, trained outreach workers who can reduce the likelihood of retaliation through conflict resolution, offer effective, trauma informed support to those most at risk and mobilise communities to change the norms of violence.

My afternoon with UCAN started with me looking in awe at the huge oil painting in the lobby by artist Gerald Griffin. The painting depicts a young Black boy in simple clothes and trainers standing against a backdrop of debris and wreckage but with a pose of strength and defiance. The painting is titled 'Still Standing' and is described as representing 'the power of the will, the resiliency of the spirit and the anomaly of Black people'. This picture really does speak a thousand words.

Talking with Norman Livingston Kerr, Vice President of Violence Intervention at UCAN, was my next stop and another thought provoking experience. Norman speaks powerfully and eloquently about what growing up in Chicago is really like, particularly for young Black men. He talks of communities focussed on surviving not thriving, of hopelessness, racism, segregation and of a poverty of hope not just wealth. He also talks of the emotional trauma running through these communities like infected blood running through veins, carrying hurt and acting as a carrier for infectious community violence. Norman and his team understand these communities. They understand the violence. Many of them have lived it.

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It is the deep lived experience and the community credibility of the Violence Interrupters, alongside high quality training and support which makes them effective. This became evident in the planning meeting I attended, where the team don't rely on referrals to know where violence may occur. They know. The sensitivity of what was discussed isn't for a blog but I was so impressed with how the team pooled their extensive knowledge of what's going on across their patch; worked out where to focus and decided on what violence reduction strategies to implement that day.

Then it was time for me to hit the streets. I've lived and worked with violence for many years and so I wasn't as scared as I probably should've been; you don't get many white women walking through the Westside communities after dark and I didn't expect (or warrant) to be made to feel welcome. Thankfully, the UCAN team made me feel incredibly welcome and safe despite the area we were about to walk through.

Getting out of the nice warm cars and into the freezing night air (it was about -10!) was a shock to the system but so was the whole experience. It was surreal to be walking through streets plagued with violence, the day after a shooting left a 54 year old man fighting for his life after he was shot in the head whilst driving through the neighbourhood. The team, all in distinctive yellow hats to identify them as Violence Interrupters, immediately start shouting as soon as we leave our vehicles. They shout at the top of their lungs 'Ceasefire!' and I'm left wondering is this just an announcement as to who they are or a plea not to shoot at us as we walk through these eerie streets?

We all carry postcards and bumper stickers urging the community to use their influence and for conflicts to be handled without violence. We put them through letter boxes and on people's doors but more importantly we stopped and talked with people.

Before long, a man came over to talk to us; he looked broken. He explained that he was a close relative of the man that had been shot the day before and that the family were struggling to comprehend why he had been shot as well as questioning how they were going to cope. The team rallied round him, offering comfort and exploring what support could be offered. Sadly the 54 year old died in hospital a few days later.

The UCAN team, as well as other teams delivering the Cure Violence model, know that the prevention of further violence is far from just a law enforcement issue. It is acknowledged that the police have a job to do but that does not concern the Violence Interrupters; they work entirely independently and so maintain the confidence of the community, who are at the heart of the issue and the solutions.

The Cure Violence model works, some would say much more so than incarceration where according to the National Institute of Justice, recidivism sits at about 77%.The Cure Violence model actually reduces violence; in some areas by up to 70%.

Key to the impact of the UCAN team and the Cure Violence model, is that community outreach is just one element of intervention and that all the support offered is trauma-informed. This means that all staff are trained to recognise the impacts of emotional trauma and to respond sensitively and supportively when it manifests in those being supported. The UCAN outreach team includes culturally competent trained

clinicians able to respond there and then to those in crisis and to offer ongoing support where needed.

The wider UCAN team includes school based mentoring, therapeutic day schools, therapeutic housing provision, mother and baby units, youth leadership development and training for professionals.

We know that hurt people hurt people and so, in my opinion, this therapeutic approach to healing these hurts is essential to violence prevention and reduction. My work with a range of Chicago based not-for-profit organisations, including the Primo Centre for Women and Children will continue in 2017 and will include events to bring best practice in trauma-informed care (TIC) from Chicago to the UK.

The Trauma of Community Violence

It was just an average Thursday evening; I had been rushing between meetings and wasn't long home, I was kicking off my shoes and chatting to a friend on the phone, laughing about an ongoing joke.

That's when I heard the first gun shot. A shotgun being fired by balaclaved boys as they chased their target. I later learned they fired a shot not only into the back of another young adult but also into a 16 year school boy who was simply in the wrong place at the wrong time.

Living on a south London estate, this wasn't the first gunshot I've ever heard but it was the closest. Scarily close. People talk about a gunshot sounding like a car backfiring or like a firework, but it really doesn't. It sounds like a gun and when it is outside your home, it's frightening.

What happened next, whilst necessary, was also scary. Armed police quickly descended on the estate, Territorial Support Group vans speeding down the narrow streets and armed officers piling out of vehicles onto the street as mothers and their children scattered, running for cover.

The following minutes and hours saw the landing of the Air Ambulance, another assault on the senses, and uniformed police and medics arrive trying to offer lifesaving first aid to the two young men who had been shot whilst also trying to establish what had happened.

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Over the next 24 hours we saw our community become a crime scene, whole areas cordoned off and scenes of crime officers scavenging through bins after police dogs had been set to work hunting for forensic evidence. However, before long, the crime scene tape was pulled down and the police disappeared. This is when the community are left, in shock, traumatised and confused, to figure out for themselves what to do next.

For the media, and the police, the event was over. The investigation to identify the gunmen continued behind closed doors and resources went into the estates where retaliation was expected. But what happened to everyone that had their lives upturned by this life threatening experience?

My mind was so focused on the 16 year old, due to start his GCSEs the following week. Thankfully his injuries were not life threatening and he was expected to be back at school before long. But is that the end of it for him? Of course not. Nor is it the end for the other young man, critically injured, or his family who desperately awaited updates on the outcome of complex surgery to save his life.

It's also not the end for the community; a community who are still in pain and traumatised by the fatal shooting of an 18 year old boy on the same street less than a year before. This pain is palpable, it's in the air and on the faces of those you talk to on the street and in the locally convened community meetings to discuss possible solutions to this senseless violence.

What saddens me is that there is such public outcry for more policing resource to respond to this community violence, and a call from many just to lock these children and young people up, but so little understanding of the need for resources to respond to the trauma of these tragic incidents. What also seems to be missed is that the solutions also exist in these communities; if they had they right access to resources and support.

You may notice that I have not used the 'g' word, and it is that word 'gangs' that I feel so often distorts the reality for communities in public consciousness. I'm not suggesting that this shooting was not gang related but to me this is only one aspect of violence that ricochets through the lives of the young, the old and everyone in between.

As Temi Mwale so powerfully wrote in her recent explanation of the rebrand of her organisation, 4Front Project, violence is not limited to the sensationalist media reporting of gang conflict but is endemic in the worlds of young people and communities. Not only is this violence endemic, I believe it is also pandemic. But what does this mean?

What I am talking about is violence that spreads through communities like a disease unless it is identified and interrupted and communities given the resources to properly heal from its effects.

This goes way beyond the healing of the physical wounds and needs to look at the emotional, psychological and spiritual healing of those impacted. By spiritual I don't mean religion, I mean rebuilding the faith that things can get better and that there is hope despite the lack of proof of this possibility offered by politicians and policy makers.

As the days after the shooting unfolded and responses were considered by panels of professionals, what I was left with was a deep concern and sadness. This was centred not just on the needs of the immediate community but the wider network who were feeling the pain of what had happened and in particular the schools that were expected to respond to the trauma of the children who had witnessed or heard about the shooting of one of their fellow pupils.

A recent report by Catch 22 Dawes Unit 'Safer Schools: Keeping Gang Culture outside the Gates' generated much discussion on social media about the role of schools in responding to and dealing with violence. Sadly, what was missed in this report was the emotional impact of community violence on children and the role of schools to respond to this sensitively and appropriately.

I'm not suggesting that it is the role of teachers to provide therapeutic work to children arriving at school upset, confused and traumatised, but I am calling for consideration of the role of schools in providing high quality trauma informed care that doesn't leave violence at the gates. What I know from many years as a practitioner, manager and consultant is that schools are often the only safe haven for many children and the environment in which they will act out their pain.

Schools are well versed in building resilience in children, that is the ability to bounce back from difficult situations, but what is often missed is that many of these children have spent their whole lives bouncing back and are some of the most resilient children you could imagine. What they are is traumatised and the combination of resilience and trauma manifests in many different ways which is often misunderstood. For many children the impact is a deep mistrust of adults and professionals combined with a real struggle to regulate their emotions and behaviour.

I've been asked the question a thousand times 'how can someone just pull that trigger or put that knife in?' and to me it's not that hard to understand. Exposure to violence in all aspects of life, in the home, on TV, in the media, in the community both normalises and traumatises. When analysing what so many of the young men I have worked with have in common, it is an acceptance that violence is a natural part of life, often the only conflict management tool that has ever been modelled to them, combined with a disassociation from the expected emotions that accompany that violence.

I have recently written about the need for highly professional but credible practitioners to be able to respond to this trauma and here I call for the need for these professionals to be firmly embedded in the schools that are physically and emotionally holding so many of these children. There needs to be clear channels of communication between statutory agencies, such as the police, and schools to ensure that they are ready and prepared to respond to community incidents that will inevitably play out within school boundaries but that they also have the resources beyond the curriculum to play this vital role.

To pretend that children can just leave violence at the school gates is not just naïve but is a huge missed opportunity to intercept and interrupt the violence that will inevitably spread throughout schools and back into the community.

And so the cycle of violence continues.....

Trust Me..... →

Trust me, I'm a doctor. Well I'm not but trust me anyway.

Would you?

Would you trust someone with your physical health who had no medical training but who cared deeply?

What if you were really ill and needed real medical intervention? Would you want a skilled, experienced and well supervised doctor? Would you be happy with someone who had also been unwell, wanted you to get better but who had never successfully treated anyone before?

This seems like an unlikely scenario and an unlikely decision to have to make, but sadly it's the reality young people affected by crime and violence are regularly faced with in relation to their often complex needs and emotional wellbeing.

The depletion of resources within the voluntary and community sector to address community violence is of growing concern and is contributing to this reality. This lack of resource has also seen the boom of 'ex-offenders' and 'ex-gang members' taking up the role of mentor, coach, youth worker, outreach worker, mediator and youth practitioner but without the necessary support, development or supervision to practice safely or effectively. I personally don't like those labels and would rather think of individuals having lived experience of the issues they are trying to address.

Having lived experience and being an experienced and well trained practitioner are in no way mutually exclusive. In fact, it is my firm belief that a combination of both is essential to providing the highest quality and most impactful services for young people.

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However, creating services that have lived experience at the core, combined with the highest levels of professionalism and best practice are challenging and require real investment, time, effort and energy. They also require an underlying recognition that youth work is a career that should be respected and invested in, one that involves specialist skills, training and experience. It is also a career that isn't for everyone, despite their passion.

Don't get me wrong, I have yet to meet a highly effective youth practitioner who isn't passionate but this has to be the starting point and not the full offer. There must be a solid understanding of what makes good practice including boundaries, safe relationship building, quality assessments, risk planning, impactful interventions, successful advocacy, partnership, collaboration, information sharing, safeguarding, evaluation and self-care.

There is scope to cause real harm with a lack of knowledge or understanding of mechanisms for support, how to empower young people to make positive changes and how to help young people keep themselves safe.

One young man sticks in my mind, he was someone who had a history of violent offending and who had served a significant prison sentence. Months after his release he expressed real frustration at his own lack of progress which he attributed to his ongoing cannabis use which he relied on to sleep, eat and feel confident enough to engage with others. He had been identified as a young person who was 'hard to engage' due to his offending history and previous disengagement with statutory services. He was referred to a local provider of gang interventions as they were thought to be best placed to work with him as a 'gang member'. He explained to me that initially he rated the practitioner allocated to him and found him easy to relate to as he had a similar background. He was also motivated by the fact that the worker had made real changes in his own life and showed him that this was possible. However, the young person powerfully concluded that he had got into the position he was in by becoming an expert on the roads (experience of street and group offending), he didn't need to hear any more about that life but needed someone with expertise in a different life. He reflected that at no point was his cannabis use discussed despite openly buying and using it whilst with his worker and then mentioning the debts he was in. The young man had never flagged it as a problem but was secretly waiting and hoping to be challenged. He didn't understand how the worker could say he cared but then let him keep making the same mistakes with his money. He realised that what he wanted was someone that understood him but that looked at things differently, could teach him things he didn't know, introduce him to people he'd never meet; take him to places he'd never been. Ultimately someone who could put him on a different path and not reinforce the bubble he was used to existing in.

I don't underestimate the importance of lived experience as an engagement tool. I suspect we can all relate to the desire to be understood without explanation and to know you aren't being judged as someone has been in the same boat as you are, but again this must be the starting point not the full offer. I also don't underestimate the skills I previously listed and the example highlights the need for these skills in practice. However, with time, good training and high quality management these skills and experiences can be developed. Whilst the offering is less and less each year there is still availability of training through Local Safeguarding Children Boards that can offer access to credible yet free development for staff and volunteers and effective partnership development with specialist providers can often open up access to learning and development opportunities. In my experience it is the self-care element that is the most challenging.

Inevitably, with lived experience comes lived experience. This is stating the obvious but it seems so regularly overlooked. Personal, and often recent, experiences of physical, emotional or sexual violence or abuse, imprisonment or the loss and bereavement that come with violence all have a traumatic impact. This trauma must be addressed before it is appropriate to expect individuals to go on to safely engage others experiencing similar trauma.

Trauma is yet to be properly understood by many agencies working with young people and I am not going to write an in-depth analysis here. However, it must be understood that trauma presents in a variety of ways many of which are attributed to 'lifestyle' choices and not recognised to be the symptoms of underlying emotional turmoil. These include self-medication with drugs or alcohol, unhealthy or dysfunctional relationships, self-destructive behaviours, depression, mistrust of others, numbing of emotions and detachment and a normalisation of the violence that resulted in trauma.

When those experiencing trauma enter professional environments it is not uncommon for these symptoms to be repressed and hidden. However, with most repressed emotions and behaviours they have a tendency to leak and in this scenario that often means with the young people being supported. Where this exists with an absence or lack of clinical supervision and regular management supervision and support the harm caused to individuals and young people can be extreme.

The prevalence of practitioners with these presentations tells me we are getting something really wrong. Not the commitment to bring those with lived experience into the youth support workforce, as I've said I think this is essential and must be encouraged within the statutory as well as voluntary and community sector.

Our persistent failures lie in the lack of resources, support and investment in the individuals and communities affected by crime and violence and in the services that exist in these communities. There is power in showing young people different pathways, in having trusted and credible messengers from within communities showcasing the opportunities to do things differently, in having tangible evidence that the cycle can be broken. To do this means we have to see communities as part of the solution and not just the problem, we need to empower and develop individuals and communities to create lasting legacies of support and to recognise the mutual benefit for those giving and receiving support.

This investment must be more than one off cash injections and must involve building capacity and capability of grass roots organisations. This has to include the embedding of best practice, access to high quality, evidence based training and development, access to clinical supervision and group support networks, offers of specialist input from other sectors and agencies and the promotion of a spirit of collaboration.

This may seem like an unrealistic expectation in times of austerity but show me a community that has not seen a youth murder - each murder costs in excess of £1.5 million when all costs to the public purse are included. Just imagine what that investment of £1.5 million would look like if allocated to developing community resources and resilience and putting those with lived experience at the heart of solutions.

Just imagine!