- Redthread youth workers engage girls when they attend A&E and offer support in the community
- Two thirds of girls seen during the first year saw their risk of harm reduce and self-esteem improve
A 2013 report by the Centre for Mental Health highlighted how girls and young women are the most vulnerable group in the criminal justice system, with many showing evidence of being sexually abused and groomed by male gang members.
Shortly after the report was published, youth work charity Redthread appointed a dedicated girls and gangs worker for its Youth Violence Intervention Programme based at Kings College Hospital in south London.
This became the basis for the development of the charity's I Define Me project, part of Redthread's young women's service which is funded through the Tampon Tax Fund, Comic Relief and the government.
Launched in March 2017, I Define Me sees youth workers Jess Macdonald and Amy Masson support young women who attend Kings College and St George's Hospitals for reasons that suggest they are involved in a gang or have factors in their lives that put them at risk of being exploited.
The issues presented by the young women that the project works with include mental health, sexual assault, physical injuries, domestic violence and self harm. However, it may not always be obvious what the problem is when a young person turns up at the emergency department.
"We see a number of young women that come in with unexplained ‘abdominal pain' then they go on to disclose further when we have a conversation with them," explains senior youth worker Macdonald.
"Some young women we meet present in hospital because they have been harmed by someone, often someone they know well or know of. Sometimes the pressure of their life experiences builds up to the point of experiencing mental health breakdowns."
As is the case with Redthread's Youth Violence Intervention Programme, referrals to I Define Me come via clinical staff. Speed is of the essence, so as soon as the youth worker has been bleeped or called they try and speak to the young person. This meeting could take place on the hospital ward, in the emergency department waiting room or even the resuscitation bay. It is always between just the youth worker and young person.
Macdonald explains the reason for this urgency. "This moment of intense crisis, when the young person is nursing a serious injury in the daunting environment of a busy hospital, often alone, can be a catalyst for self-reflection and pursuing positive change - a ‘teachable moment'," she explains.
"If they agree to meet us in the hospital it shows that they are at least ready for a conversation. Through just one conversation we are able to complete safety planning, so if that's the only conversation we manage to have with them at least they have a plan for when they leave.
"However, overwhelmingly, young people do engage with our service and by meeting us in hospital they know they can always get in touch."
From this, further meetings can be arranged in the community enabling the youth workers to learn more about the circumstances a young person is living in and the risks posed to them.
Macdonald says that it can sometimes take months for a young woman to disclose her experiences, which is why the service works with young people for up to a year.
Conversations tend to focus on emotions, self-worth and self-esteem, sexual health and contraception, and mental health support.
"We do a lot of safety planning and support young women to access other agencies," she adds.
In the year to 31 May 2018, 102 young women were referred to the project with 73 receiving some form of "meaningful engagement". Out of 36 young people who received long-term support, 67 per cent saw their risk of further injury reduce and 83 per cent reported a rise in self-esteem.
Macdonald admits that while leaving a gang or risky situation may be the outcome the service would like to see "this is asking a young woman to change her entire life and leave everything behind".
"We have to be realistic that while we might recognise that a young woman is experiencing or at risk of harm, she may not acknowledge this - there is no better expert in a young woman's life than herself and this is at the heart of the support that we offer."