Dr Christine Goodall is head of Medics Against Violence (MAV). Recently she attended a World Health Organisation conference in Canada focused on violence prevention. Here she reveals the international interest being generated by Scotland's success in reducing violence.
I’m on a very small plane flying back from the World Health Organisation 8th Milestones meeting on Violence Prevention in Ottowa. These meetings bring together a range of experts on violence prevention from around the globe who spend a few days sharing their experiences, knowledge and plans to make the world a much safer place. You quite often pick up some good ideas at these meetings, you always leave feeling inspired, but you most definitely leave with a sense that we live in a very safe country. Scotland is a safe place to live.
The past few days have been spent hearing about elder abuse, violence against women and girls, homicide, gun-related violence, collective violence, youth violence and suicide all on a scale unheard of in Scotland. But they have also been spent hearing about ‘what works’ and what countries and organisations, who are often under resourced, have been able to put in place to tackle the problems they face, often with staggering results.
As part of a small Scottish contingent at the meeting this year there were two things we heard frequently as soon as it became apparent we were from Scotland. One was ‘we absolutely loved the Milestones meeting in Scotland’ and the other was ‘how did you do what you did in Scotland?’. They were referring to the huge drop in violence in Scotland over the past ten years and also more specifically to the reduction in gang related violence in Glasgow. Often when you are very close to an issue you can’t see the wood for the trees but the fact is countries around the world know about our violence reduction efforts in fact they are almost the stuff of legend, they look to us to see what they can take and use in their own countries. What happened in Scotland is special.
If you are not aware what did happen was that over about ten years from 2006 till now, the homicide rate and the incidence of serious violence in Scotland fell to its lowest level for 42 years. Alongside that Glasgow’s notorious and intergenerational territorial gang issue all but vanished and we lost our title as The Murder Capital of Europe. The biggest and most significant drop in violence was seen among our young people. Now you might challenge that by saying violence has reduced worldwide, and it has, but nowhere has seen the precipitous fall we have seen in Scotland.
So here’s a bit of insight into what I think happened. What Scotland did, led by the Scottish Violence Reduction Unit and by a government and a police force that let them get on with it, and supported them to do it, was to admit we had a problem, embrace the public health approach and bring people together to help tackle the problem. The net for ideas was cast globally. Red tape was banished or dealt with pretty quickly. Talking was replaced with doing. Anyone and everyone with a good idea and the passion to get off the ground was welcome.
The other thing that happened was that violence was tackled on all fronts, in schools, in communities, in hospitals, in prisons, in workplaces and by harnessing champions and partners in those arenas. You didn’t need to be an expert on violence you just had to be an expert on your own circumstances and in your own field and be able to see how you could use that expertise to tackle violence. We all had lived experience within our own fields, everything else could be learned on the job.
The recognition that this was a problem that affected everyone and one that anyone could help tackle was perhaps the smartest thing of all. Violence was made relevant and we all had a role. Telling medics that they have to speak to young people about violence because it’s the right thing to do will get some people on board, but telling them that they should speak to young people about violence because it will reduce ED attendances and hospital admissions, reduce injury and suffering, mean less emotional energy spent breaking bad news, save the NHS money, reduce the out of hours pressures on their younger colleagues, give them some time to develop their services and allow them to focus their expertise on the other patients on ever increasing waiting lists is a much more compelling argument. It is also an argument that wins over their managers.
The same was true for education, reducing violence increases attainment. For policing and the prison service reducing violence reduces the police workload and the prison population. Violence reduction was made to feel not only relevant, but necessary. Those involved started seeing results and that positive reinforcement made it all feel very worthwhile.
Obviously behind all that there was detail, organisation, planning and a whole lot of hard work. The detail is important but less so than the culture created because every city and country has to do what’s right for them and that might mean changing the detail a bit. We were also lucky we had people with vision and the absolute belief that we could do this. John Carnochan and Karyn McCluskey were those people for us and they left behind them a strong foundation and legacy as Scotland continues it's bid to reduce violence.
So in Scotland violence reduction has become a sort of movement with a lot of very passionate and committed people behind it, many of whom get involved on a voluntary basis. You’ll find them in the most unlikely places. We also have luck on our side, we are a small country and in a way that makes things easier, even if violence starts to go up a little we know we can bring it back down, we’ve done it once, we can do it again.