Working with Gangs and Youth Violence in London

I was born in rural Zimbabwe, I moved from Zimbabwe to the UK when I was 20, at a time when the HIV/AIDS pandemic was wreaking havoc in Sub-Sahara Africa; we lost many breadwinners, many children were orphaned. I worked as a hospital cleaner in Scotland, later becoming a health care assistant in London.

I am dyslexic, I grew up in the shadows of stigma and exclusion. I trained as mental health nurse at City and Bartholomew’s School of Nursing. I worked in Accident and Emergency Department in St Mary’s Hospital in (London) in the Psychiatric Liaison Team for many years. I studied Public Health and Gender Violence at the London School of Tropical Hygiene and Tropical Medicine, later carrying out research on the Friendship Bench Model (Friendship Bench, 2019) a culturally adjusted stepped care model for people living and exposed to HIV in Zimbabwe. I worked as Mental Health Adviser for the charity, Africans United Against Child Abuse, the charity was formed on the background of the Victoria Climbe case (AFRUCA) I gained critical safeguarding experience in socio-cultural issues affecting African families such as Female Genital Mutilation (FGM) human trafficking, child chastisement and witchcraft branding.

In 2013 I worked as Clinical Nurse Specialist for a specialist unit under the office Boris Johnson was Major of London at that time. My role specialist and unique role provided innovative mental health interventions for young people and families who were highly exposed or affected by gang culture, youth violence and exploitation, a role a truly loved and exhaled in.

Many of the cases that I looked after in IGU were from minority backgrounds. The most presenting mental health cases were anxiety, depression, self-harm, suicidal ideation, high level substance misuses in both girls and boys. Trauma was associated with post stabbings or shootings and general fears of knife crime particularly in the school area and the neighbourhood that the adolescent live in. Other interventions included supporting adolescents affected by stab injuries, and infections from stab wounds, social anxiety self-harm in young girls, suicides associated with gang activity, head injuries were associated with high risk behaviours such as riding motorbikes whilst intoxicated by drugs, poor parental physical health, mental health and poor health seeking behaviours. Alcohol addiction or misuse was rare in this population

Our mental health interventions used screening and assessment tools, we engaged with adolescents in manners that mirrored their lifestyles. These methods included contacts in youth clubs, prisons, police custody, home from mainstream education, some of the were attending Pupil Referral Units and some had stopped going to school due to anxieties associated with violence and exploitation. Many young people who are affected by knife crime or are in gangs are not able to attend clinics because they are not able to move across different areas and postcodes due to substantial fears for their own safety.

The specialist unit that I worked, in collaboration a wide range of multi-agencies and the Mayor of London’s Youth Reduction Strategy team were uniquely equipped to identifies and screen young people who are particularly vulnerable and refer those with existing mental health disorders such as learning difficulties, dyslexia, autism, anxiety and depression associated with to violence.

Traditional mental health services usually stigmatise these communities as ‘Hard to Reach’ and they are often marked and stigmatised as families with as families with a ‘poor history of engagement with services’. Some young people, particularly those who have a both diagnosed and undiagnosed learning difficulties, autism, or attention deficit hyperactivity disorder, and those with poor literacy skills are not able to read appointment letters or adhere to appointments. Their concentration levels and lifestyles may not align with the structures of formal mental health services such as CAMHS. Parental mental health needs and poverty were prominent and undertreated.

I have been honoured to work with such diverse agencies all of whom care deeply about the plight of our young people who are highly exposed and affected by violence, many of whom are from BAME backgrounds

In January 2020 I returned to the frontline and worked as a psychiatric liaison nurse during the COVID19 pandemic.

Dorcas Gwata