Taking a public health approach to violence in Tower Hamlets: a needs assessment

Abstract Background The rise in knife crime in London, UK, and Tower Hamlets, London, UK, has led to calls to implement a public health approach to violence reduction, focusing on both prevention and violence as safeguarding and mental health issues. As part of this approach, we aimed to evaluate whether a Joint Strategic Needs Assessment (JSNA) is better for understanding the violence in Tower Hamlets and support the development of local violence reduction strategies. Methods Multiagency safeguarding meetings and a thematic review of serious youth violence in Tower Hamlets identified two types of violence requiring JSNAs. These were violence in those younger than 25 years outside of the family (among peers, school settings, street-based settings and gangs) and family violence (between parents, siblings, and intergenerational). Alongside standard JSNA methods, these JSNAs analysed anonymised local datasets on violence and safeguarding from the police, National Health Service, and local authority for demographic, time, and location trends and spatially mapped the results. This analysis was used to identify and understand patterns and risk factors for violence. Findings There are time trends for violence in those younger than 16 years, with peaks on weekdays related to school closure. Violence occurs later in the evening for young people aged 16–24 years. Higher levels of mental health problems were identified for children under youth justice compared with the general child population (20% vs 10%). Family violence was predominantly due to partners, parents, and siblings, and nearly 40% of victims were younger than 25 years old. The Crime Survey of England and Wales estimates that 38% of violent crime is reported to the police, allowing the under-reporting of violence in Tower Hamlets to be determined. The cost of violence in the borough was estimated to be over £100 million per year. Interpretation Violence is a substantial public health issue. These JSNAs have improved the understanding of patterns of violence, and the importance of safeguarding and mental health in violence prevention. They have influenced the priorities of local services working with families and young people and developed evidenced recommendations for the strategy for young people who are vulnerable to violence. Funding None.