Knife crime: how nursing can help

Specialist nurse Dorcas Gwata explains the potential for nurses to prevent stabbings, stop the cycle of violence and help turn young lives around

This time last year, on 8 January, 14-year-old Jaden Moodie was knocked off his moped in East London, set upon by four youths and stabbed nine times. The fatal attack lasted seven seconds.

Known to police, Jaden had been dealing drugs for a gang called the Beaumont Crew. His convicted killer, 19-year-old Ayoub Majdouline, had been acting for a rival gang.

The story is tragic but all too common. Latest stats show knife crime offences are at a record high, up 7% to just over 44,000 in the 12 months to the end of June 2019.

Though Jaden’s murder was senseless, a deeper look into his and his attacker's backgrounds shows they were arguably failed by a society not set up to support them when they needed help most.

Ayoub was officially designated a “modern slave” by the National Crime Agency in 2018 amid concerns he was being groomed by more sophisticated adult offenders. His father, also a drug dealer, died in 2015 after being stabbed in his flat, which was then set on fire.

Jaden was vulnerable too. Excluded from school multiple times, he was moved from Nottingham to London in an attempt by his family to get him away from trouble.

There's a direct link between service cuts, social inequality and violent crime

These factors, RCN member Dorcas Gwata believes, play into the cycle of violence which is devastating thousands of families across the UK.

When asked what she feels is responsible for the spike in stabbings, she lists school exclusions, lack of mental health support and social media as key issues.

“We know young people affected by knife crime suffer from post-traumatic stress disorder,” she says. “They’re anxious and more likely to use drugs. If their mental health trauma is not addressed, they’re also more likely to continue carrying knives and be involved in further violence.

“News also travels fast online. If you’re angry with somebody and want to humiliate them, you can do that very quickly on social media. For someone with no emotional buffer, a social media post can be an invitation to war. Combine fast information with impulsive behaviours, and life becomes very dangerous for these young people.”

Dorcas is speaking from experience. As a specialist mental health nurse in Westminster’s Integrated Gangs Unit, she works alongside the police, social services, youth workers and former gang members to reach out to young people affected by knife crime.

Her aim is to create a safe space for young people to talk, encourage them out of drug dealing and into employment. In the face of austerity, however, the unit is facing an uphill struggle.

“There’s a direct link between service cuts, social inequality and violent crime,” says Dorcas. “Many young people I work with come from refugee families who have fled Syria, Somalia, Congo or Iraq to seek safety in the UK. Their parents are often dealing with pre-migratory trauma, while trying to adjust to life here. Tough choices have to be made and children can be left to find their own path. When there’s hard austerity, the vulnerable suffer most.”

For every young person involved in knife crime, there’s a story that explains their situation, Dorcas believes. Turning lives around is about understanding the full spectrum of their experience and adapting support to them.

They're just children looking for you to understand them

“Mainstream services aren’t designed for these young people,” says Dorcas. “They’re just not. Safety is a real concern for them so going from postcode A to postcode B to attend an appointment, or go to school, can be a real issue. We must mould ourselves around them and be innovative to reach out.

“For me, it means adjusting my working hours, meeting them where they want and using WhatsApp to set things up. I align my interventions to what they respond to, so just talking a lot of the time, as many of these young people can’t read or write well.

“My questions cover what you’d usually expect in clinic. The conversation goes something like this: How are you sleeping? I’m not sleeping. Why are you not sleeping? Because I’m scared. Why are you scared? Because my mate was stabbed last week, and they posted on social media to say I’m next.

“So, these young people are very open, when we are open. They’re just children looking for you to understand them. They want to be able to trust you and get reassurance that they’re going to be OK.”

Dorcas’s unit has had success, providing interventions at the right time, and steering young people onto a different track. But the service is stretched, and her role is unique.

There needs to be more multi-agency units across the UK, making the most of mental health nurses who can bring specialist skills to help prevent violent crime, Dorcas insists. 

“We have a lot of work to do to scale these services up,” she says. “I believe I’m the only nurse in the country doing this sort of work. It’s not enough. We need to keep young people safe in other cities too. I want what works for London to work for every child in the UK.” 

Having said that, Dorcas admits her role requires a sophisticated understanding of cultural issues and can be difficult to deal with. 

“There’s some graphic and unsettling stuff that you witness,” she says. “Seeing a young person with a stab or gunshot wound can feel uncomfortable. Supporting someone paralysed by fear, equally so. And being with a mother, who is relieved one son is still alive but worried about the next, can rock you to the core. 

I sleep better knowing that I’m part of change, that I’m doing something about it

“That’s why it’s so important for staff working with violence and trauma to have close clinical supervision, reflective practice and opportunities to step away from the frontline. They must have chance to focus on their personal and professional development as well as get support to process what they’ve been through.

“Team development is also crucial, so I’m very grateful to my manager who understands the strength and importance of teamwork, as well as my clinical supervisor who is always looking out for me.

“I’m grateful too for the young people I work with. Their vulnerability and resilience push me on. And I sleep better knowing that I’m part of change, that I’m doing something about it.

“When finally, you give a young person enough encouragement, support and confidence to enrol in college when they had previously been housebound for four months crippled with fear, that’s the difference you’re making. That’s what I do the job for.” 

About Dorcas

Dorcas is a Mary Seacole award scholar who has recently completed research into improving mental health interventions for young people from black and minority ethnic backgrounds affected by gang culture. She is due to publish a report of her findings soon. 

Dorcas leaves her current role this month but will continue to work with the RCN to help identify solutions to how nursing can help stop the cycle of violent youth crime. She is one of 17 case studies in an RCN report which demonstrates how nursing helps to achieve the United Nations sustainable development goals. This is being published as part of celebrations for International Year of the Nurse and Midwife. 

Could you be part of the conversation?

We’re keen to hear from RCN members involved in work to prevent youth violence and knife crime. It’s to help us get a better understanding of the issues in different parts of the UK so we can lobby the government to invest in preventative services.

This follows an emergency resolution at RCN Congress last year, in which members voted in favour of campaigning on the issue. To get involved email 

Words by Kim Scott

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