A Need to Belong

REPORT

A need to belong

What leads girls to join gangs

Lorraine Khan, Helena Brice, Anna Saunders & Andrew Plumtree

to youth in females 9.5 gangs Girls of likely more with women young studies 7.0 Boys in in Boys gangs homelessness conflict, in gangs. involved average with compared 3.7 Female Female entrants

family health, difficulties identified in many also 2.9 Average number of vulnerabilities vulnerabilities of number Average per person General justice youth entrant justice entrants and over double the number of the number of double and over entrants justice screened. being other females of vulnerabilities young a factors risk the more that found We of their chance the greater accumulates, person identified as being factors risk Major generally were gangs to links with women Young other females than likely more times four report poor to System Justice Youth the entering and peers. their families with relationships or misuse substance imprisonment, Parental linked particularly were health poor mental in our in their children membership gang to histories such with women young with sample, times five to three around being These other females. than in gangs be involved more times four nearly also were women young Evidence from point of arrest data arrest of point from Evidence identified 80 Our database 8,029 of the sample from associations gang 15. was age and their mean people young factors risk 28 different for screened were They poor of histories including issues and health mental and victimisation. in gangs involved women young On average, and health of risk greater a threefold had social describe experiences of membership in terms in terms membership of experiences describe and compensatory an alternative providing of abuse sexual of A history structure. family was connections. gang or with violence in involved to likely more were roles. female devalue that severe childhood behavioural problems and problems behavioural childhood severe health ill mental to exposure health, mental poor maternal of in the home and experience violence trauma and disengagement aspiration academic low school with or gang-involved antisocial with association victimisation or and peer rejection peers in their or marginalised unsafe feeling neighbourhood and social inequalities high income influences Executive summary Executive Risk factors for gang affiliation gang for factors Risk of range a wide highlights literature Existing of members become to females for factors risk These include: gangs. • • • • • • identify sensitivity a particular studies Many family poor quality to girls on the part of driver a as bonds and social attachments Girls affiliation. gang for A small minority of young people is involved involved is people young of minority A small of the subject are they but in the UK in gangs This concern. and political public considerable in gang- a rise reports of by been prompted has gang between links about fear violence, related about 2011 riots, and concern and the activity women. young of exploitation the sexual national limited however, still, is There health of and pattern on the scale information young by experienced factors risk and social in the UK; and gangs with associated people girls by faced the risks about known is still less women. and young comprehensive a of the result report is This on girls literature international of review data of and an analysis in gangs involved people young 8,000 than more for collected of point youth developed 37 newly from in England. initiatives screening health arrest 18 10 to on primarily focused was Screening 2011 August between place and took olds year 2012. and November

Centre for Mental Health REPORT A need to belong 2 Centre for Mental Health REPORT A need to belong likely to have a sibling involved in antisocial Effective interventions behaviour than other girls being screened. We found that the vast majority of girls involved Our data show clear links between experiences in gangs were willing to be screened and of victimisation (such as sexual abuse, responded to offers of support. Nine out of witnessing or experiencing domestic violence) ten of those who were offered further support and gang association. Young women involved stayed in touch with the services they were in gangs were three times more likely to be offered. Around a quarter were supported identified as victims of sexual abuse compared back into education while 1 in 5 was referred with other young women being screened. They to physical health services and counselling were around three times more likely to witness services and 5% were supported into housing. violence and to experience physical abuse and A small minority were referred into evidence- neglect in their homes and about four times based family interventions such as Multi more likely to disclose being bullied than other Systemic Therapy and Functional Family Therapy females in the sample. which have good track records in improving Gang-involved young women were around three outcomes for young women involved in or four times more likely to have histories of offending or violence. running away, poor educational performance The reasons young women join gangs overlap and exclusion from school than the average in some instances with those of male peers, but female youth justice entrant. They were also they can also be quite different. This means that more than five times more likely than other efforts to prevent or address gang association young women screened through this initiative to among females need to be gender-specific. be involved in sexually risky or sexually harmful behaviour (although without more detailed Preventive measures need to tackle multiple qualitative investigation, it is unclear whether risk factors, for example to support secure sexually risky behaviour is a precursor to, or a attachment in early years, to reduce consequence of, gang involvement). maltreatment and neglect, to promote positive parenting techniques, to strengthen girls’ self- We found clear evidence of the psychological esteem and to respond quickly to the first signs vulnerability of gang-involved young women. of mental ill health among children. Just over a quarter were identified by workers as having a suspected diagnosable mental And programmes working with gang health problem. 30% were also identified members need to be sensitive to the specific as self-harming or at risk of suicide. 30% requirements of young women, for example to also identified having sleeping or eating foster respectful, collaborative and empowering problems. Finally, nearly 40% of girls with relationships to strengthen self esteem, to gang associations showed signs of behavioural provide safe housing and to offer positive problems before the age of twelve. These early female role models. behavioural problems represent one of the most common childhood mental health problems with particularly damaging implications for children’s life chances. Young women linked to gangs were three times more likely than other females in this sample to be identified with signs of early persistent conduct problems.

3 the practice. that ensure should on gender-specific YOTs and the Home Office Board Justice Youth statutory duty on the Secretary of State to to State of Secretary on the duty statutory translates inequalities health local reduce local and measurable meaningful into action. prioritise should institutions Academic effective into and development research women young of the needs to responses in gangs. involved Violence Prevention Unit should continue continue should Unit Prevention Violence training tools, produce to work and extend services youth for and initiatives materials and work should services and probation YOTs sector voluntary with partnership in close create to gangs with working services for and services spaces and safe engaging women. young vulnerable highly The Government NHS England should commission point of of point commission should England NHS which services and diversion liaison arrest the and recognise gender-sensitive are on membership gang of impact deleterious outcomes. and social health children’s The 10. 8. 9. 6. 7. All services in regular contact with young young with contact in regular services All recognise should families and people of impact and undermining the toxic prolonged and factors risk both multiple healthy children’s for risk to exposure development. young and girls with in contact services All dialogue open a routinely should women whether and how about people young with in their activity gang by affected are they communities. responsibility with authorities local All Needs Strategic Joint conducting for identify the number should Assessments activity in gang involved women young of multi- and develop it of risk at or who are risks. these address to strategies agency and justice education care, social Health, gang recognise all should commissioners particularly for a marker as membership young for outcomes negative pervasive collective and take and communities people prevent on prevalence, data gather action to to involved who are those and support risk safely. exit actively should Boards Safeguarding Local prevalence local and review monitor and activity on gang information membership. Recommendations 1. 2. 3. 4. 5.

Centre for Mental Health REPORT A need to belong 4 Centre for Mental Health REPORT A need to belong Introduction

Over the last decade, there has been growing More recently, the vulnerability of young interest in the small minority of young people women linked with gangs has been further involved in gangs in the UK. There are concerns underlined through the Home Office’s Violent over increasingly young gang members (The and Youth Crime Prevention Unit’s working Centre for Social Justice, 2009); reports of a rise group on Women, Girls and Gangs and through in gang-related violence; about links between the on-going investigation by the Office of gang activity and the 2011 riots (Home Office, the Children’s Commissioner for England, 2011) and general concern about the impact of highlighting the safeguarding risks faced gang-related activity on offending, communities, by gang-associated young women primarily the sexual exploitation of young women and on through experiences of violent victimisation and young people’s general welfare and wellbeing. sexual exploitation (OCC, 2012).

We are still at an early stage of understanding There is still, however, limited national what drives gang enrolment in the UK and the information on the scale and pattern of health characteristics of those involved. After the and social risk factors experienced by young recent riots, attempts were made to understand people associated with gangs in the UK; less the young people who were prosecuted (a still is known about the risks based on gender. minority of whom had gang associations). Analysis revealed that they came from This report aims to add to the body of communities with entrenched and worsening knowledge on girls with gang associations in poverty, had much higher than average the UK. It draws on a database of over 8,000 educational statements of need and inflated under 18 year olds screened at the point of indicators of family hardship (DofE, 2011). arrest for a range of health, educational and social vulnerabilities. Some of these risk factors (such as histories of maltreatment, exposure to harsh and inconsistent parenting, Definition of gang membership early behavioural problems, school failure, etc) are associated with a range of persistent When referring to gangs, we will use the inequalities over the course of these young definition by the Centre for Social Justice people’s lives (The Centre for Community Child (2009), describing a gang as: Health, 2000; Fergusson et al., 2005), affecting A relatively durable, predominantly multiple cross-sector budgets (Centre for Mental street-based group of young people Health, 2009). Numerous studies show that who (1) see themselves (and are seen risk factors also have a multiplicative effect: the by others) as a discernible group, (2) more risk factors present in a child’s life, the engage in a range of criminal activity and more likely they are to have poor behavioural violence, (3) identify with or lay claim and mental health outcomes, including conduct over territory, (4) have some form of problems, anti-social behaviour and convictions identifying structural feature, and (5) are (Rowe & Farrington, 1997; Appleyard et al., in conflict with other, similar, gangs. 2005; Murray et al., 2010). International literature generally Prevalence of gang membership identifies gang membership as an important factor influencing youth crime, Gang membership is still a fairly rare and identifies higher crime rates among occurrence among young people. Accurate both female and male members (Gover estimates are challenging because of a lack et al., 2009; Haymoz & Gatti, 2010; of standardised definitions used in studies Weerman, 2012). (Schram & Gaines, 2008; Petersen et al.,

5 She described for driver a particular separated. had What we know about gang affiliation affiliation gang about know we What in the UK and around organise generally In the UK, gangs geographical postcodes, identify particular with territories drug-dealing on occasions, or, are gangs most , 2006). Although al. et (Sharp activity settings, urban larger with associated & Pitts, them (Pearce beyond be extending may been linked has association 2011). Higher gang and marginalisation facing communities with populations with as well as poor opportunities deprivation social of higher levels experiencing 1998). High income & Deschanes, (Esbenson own) on its poverty than (rather inequalities been identified as have Health, of (Department in communities violence 2012). and her parents conflict family between one of and Crime The British , 2006) reported al. et affiliations. A 13 year old girl was referred by the police for screening. She was bullied at school and was and was school at bullied She was screening. for police the by referred was girl old year A 13 was but infection transmitted a sexually about worries revealed She non-attender. a frequent described also but boyfriend old year a 19 had on; she this passed have who might unclear members. its some of with active sexually and was gang local a of ‘on the edge’ being was Her background from attention of the majority attracting brothers her two ‘invisible’; as in the family women part of being that but ‘worthfeeling anything’; not She described father. her now-distant feeling valued She also important. her feel men) made over power her sexual (and a gang her boyfriend. and by the gang by for’ and ‘cared protected (particularly behaviour her daughter’s about concerns long-term mother described Danielle’s men), and older with activity sexual and possible late out staying school, at disruptive being meet to failed her daughter But times. a number of services social help from for asked had her offending. of because attention the police’s to came and only support for the threshold her understanding listening, Danielle, with relationship a positive developed The worker the practical, solve to collaboratively working whilst her, and empowering perspective months a few Within in her life. barriers creating problems and aspirational psychological and moved education re-entered her boyfriend, with the relationship ended had Danielle re-offend. She did not the gang. from away whole-system of been a lack had there that felt the worker case, this of an overview Taking and escalating began factors when risk girl this with engagement and proactive commitment She explained: adolescence. she approached as school at multiplying more together work to interests in everyone’s it’s but remit… different a had ‘Everyone in is children these with and working engaging that the fact up to wake need to we closely; term. in the longer interests common everyone’s Danielle 2001), regional variations in gang activity and activity in gang variations 2001), regional 2009). & Burman, (Lauderdale trends changing frequently is membership Furthermore, gang and gang-surveillance if (particularly covert in communities increase activities suppression jeopardises membership of disclosure or if a to lead can and this safety) people’s young people young on the part of reluctance general discuss to 6% around of in the UK rates gang-membership age. of years 10 and 19 between aged those for prevalence international of studies However, suggesting variations wide to point rates rates membership fluctuating communities and sometimes countries different 2012). (Weerman, Justice Survey (Sharp Justice

Centre for Mental Health REPORT A need to belong 6 Centre for Mental Health REPORT A need to belong There is also some evidence of gun-enabled with half the males in one study claiming that gang members and victims becoming younger; female members were ‘possessions’ but two in 1998, most gang-involved men were in thirds of female gang members vehemently their mid to late 20s (Stelfox, 1998); within a disputing this view (Moore, 1991). decade, Bullock and Tilley (2002), for example, Over the years, studies have observed noted a fairly stable pattern of membership at increasing female involvement in gangs and every age from 12 to 25 years in Manchester. heterogeneity in the roles they adopt (Esbensen Furthermore, official data on hospital treatment et al., 1997; Esbenson & Deschanes, 1998; for gun and knife crime victims noted a pattern Thornberry et al., 2003; Archer & Grascia, of increasingly younger victims with an 89% 2005; National Gang Intelligence Center, 2009; increase in the number of under 16 year olds The Centre for Social Justice, 2009) including admitted to hospital in the case of serious stab some studies recording increasing parity in the wounds (The Centre for Social Justice, 2009). prevalence of male and female acts of violence (Wang, 2000). Regardless of these shifts, there Young women and gangs is still overwhelming evidence in the literature suggesting the exploitation, vulnerability and International and UK studies generally report victimisation of women affiliated with gangs a predominance of male gang membership (Archer & Grascia, 2005; Vigil, 2008; Young, (Esbenson & Deschanes, 1998; The Centre for 2009; Office of the Children’s Commissioner, Social Justice, 2009). Females represent roughly 2012). one-third of all youth gang members during early adolescence in US research (Esbensen et al., 1997); however, young women tend to exit gangs at earlier ages than males (Thornberry et al., 2003). Historically, girls have remained relatively ‘invisible’ in gang literature for a variety of reasons including: • a predominant research focus on male gang activity; • violence, offending and gang membership being regarded as quintessentially male behaviour running counter to traditional notions of femininity; and • limited police attention paid to female gang membership. Early studies described young women adopting fairly prescribed and stereotypical gender-specific marginal, sex-object, passive, nurturing or victim roles, rather than adopting equal responsibilities to male gang members, perpetrating violent acts or assuming active leadership roles (Archer & Grascia, 2005; Lauderdale & Burman, 2009). On occasions, alternative descriptions emerge of ‘tomboy’, hyper-masculine or fearless female gang members (Archer & Grascia, 2005). Differences have been noted between male and female perceptions of the power relationships in gangs

of common & Grascia, (Archer in the associated 2005; & Grascia, (Archer carers most the second factors further were identified as distant identified as Weaker attachments to school and academic and academic school to attachments Weaker , 2002). al. et (Wingood performance under of levels lower generally with in areas Living & Deschanes, (Esbenson education parental 1998). in gang member involved a family Having , 2008) al. et (Chesney-Lind activity 2005). were peer relationships drivers, After family Just involvement. gang female to often linked reported women being young of a third over either being peer pressure; through enrolled membership gang in’ to or ‘beat intimidated sophisticated more by ‘groomed’ or sexually partners gang-involved belonging & Krienert, of Fleisher 2004). A sense was join to decisions female underpinning driver Wang, 1998; & Deschanes, (Esbenson gangs 2000). a offered gangs said also women young Some neighbourhoods hostile from security of degree 2005). High levels & Grascia, (Archer being associated with respite or protection or protection respite with associated being 1998; (Miller, relationships family abusive from been seen also has 2000). Membership Wang, of attention the attract to a mechanism as emotionally availability or cannabis activity gang local in communities risk factors for both male and female gang gang and female both male for factors risk , 1999, 2001). Experiences al. et (Hill enrolment poor social discrimination, marginalisation, of serious drive also inequality and income trust (Esbenson behaviour and gang-related violence 2010; & Aitken, 1998; Elgar & Deschanes, 2012). Marginalisation Health, of Department of feature a particular are and discrimination for particularly lives, women’s young some or highly ethnic and minority black from those & Deschanes, (Esbenson communities deprived 1998). Other significant included: enrolment gang with literature • • •

not identified Snethen & Juvenile chances. and life 2008). Girls Vigil, was affiliation gang progress the highlighted and lifetime identified have of (Office etc.) has gender-specific understanding 2000; (Wang, members gang female studies of 2005; & Grascia, (Archer Health and social circumstances of young women in gangs women of young circumstances and social Health Numerous increase which factors risk developmental and in in gangs involvement of the likelihood focused so far have these of most violence; factors risk These members. gang on male birth (e.g. before even children affect can use alcohol smoking, depression, maternal pregnancy during Justice and Delinquency Prevention, n.d.) and n.d.) Prevention, and Delinquency Justice 1) Table (see domains of a range span generally children’s influencing the between be an association to seems There young by experienced factors risk number of Hill example, for membership; and gang people or seven to exposed youth that (1998) noted be thirteen observed to were factors risk more embedded and become join to likely more times , 2001). However, al. et Hill (also in gangs of likelihood increased routes to gang involvement. Based on the Based involvement. gang to routes 1 draws Table analysis, literature Centre’s on female-specific learning evolving together factors. risk of importance just dependent on a simple multiplication of of multiplication on a simple dependent just which to extent on the dependent also but risk, developmental broad six all spanned risks these a majority example, 1. For Table in domains who the girls 40% of and the boys (61%) of domains risk all across risk elevated exhibited in one study membership reported gang , 2003). al. (Thornberry et on gang- US) literature (mainly A growing females affiliated were more likely to describe experiences experiences describe to likely more were an providing of in terms membership of structure family and compensatory alternative & Deschanes, 1996; Esbenson (Molidor, 2008). A Puymbroeck, Van Snethen & 1998; in many common was abuse sexual of history studies membership gang 2008); Puymbroeck, Van problems at home as a motivator for for a motivator home as at problems involvement Social risk factors risk Social half Over

Centre for Mental Health REPORT A need to belong 8 Centre for Mental Health REPORT A need to belong

Table 1: Risk factors for female gang involvement (and violence )

1. Individual/cognitive risk factors • Severe childhood behavioural problems including aggression (under 12 years old) • Pattern of attributing hostile intentions to others • Poorly developed problem solving skills • Low self esteem • Poor control over emotions • Risk seeking tendency • Mental health problems 2. Family risk factors • Poor maternal mental health • Experiences of maltreatment and victimisation, particularly • Exposure to violence in the home as a child • Experience of childhood trauma and prolonged life stressors • Harsh parenting • Low parental attachment and supervision of child • Pro-violent parental attitudes • Sibling anti-social behaviour • Gang-involved relatives • Family poverty 3. School risk factors • Low academic aspiration • Poor school achievement or motivation • School disengagement (truancy, expulsion etc.) 4. Peer risk factors • Association with anti-social/aggressive/ older male delinquent peers • Association with gang-involved peers/relatives • Rejection by peers or victimisation • Early sexual activity • High alcohol use • High cannabis use 5. Community risks • Feeling unsafe in neighbourhood • Low connectedness within neighbourhood • High levels of gang activity • Poor opportunities and marginalisation • Availability of drugs in neighbourhood • High crime neighbourhood

6. Societal risks • High income inequalities • Media influences which devalue female roles • Patriarchal, oppressive or gender abusive values • High economic dependence on males

and that

choices sexual high-risk a identified with are reflect higher rates including sexual Gang-related demands. Definition of sexual exploitation sexual of Definition are gangs with associated women Young violence sexual of risk high particularly at definitions Although and exploitation. of a sense receive only not in gangs girls sexual with compliance from belonging receive on occasions also but demands of levels reduce or aim to protection with complying by and threat intimidation sexual of sexual exploitation are contested, we we contested, are exploitation sexual of government’s on the previous build will describes definition which follows: as exploitation young and of children exploitation Sexual exploitative 18 involves under people relationships and contexts situations, person third a (or people young where (e.g. something receive persons) or alcohol, drugs, food, accommodation, as money) gifts, affection, cigarettes, others and/or of performing a result performing activities. on them, sexual the child/ exploiting those cases In all them over power have person young intellect, gender, age, their of virtue by or economic and/or strength physical Children, for (Department resources other 2009). Families, and Schools suggests literature specifically, More age often be same can exploitation and intimidation. violence , 2003) and three times more likely to binge binge to likely more times , 2003) and three in gangs women Young behaviours compromising health other of range and difficulties asthma, yeast infections, sexually transmitted transmitted sexually infections, yeast asthma, They pregnancies. premature and diseases sexual in early be involved to likely more are a monogamous have to likely less activity, broader than likely as twice around partner, et (Schalet drugs illicit use to populations youth al. these of Many their peers. with compared drink problems health , 2002). al. et (Wingood behaviour of patterns

which higher difficulties often a significant 2005) (Gooselin, abuse) behavioural , 2002; Chesney-Lind et , 2002; Chesney-Lind al. et is behaviour of a range as a history of running away running of a history school of in risk increase a fourfold expulsion in involvement of risk greater a fourfold fights activity sexual and risky early pregnancies teenage abuse in substance involvement in violence involvement offending. , 2008; Snethen & Van Puymbroeck, 2008; Puymbroeck, Van Snethen & , 2008; , 2006; Douglas & Plugge, 2006; Chesney- & Plugge, , 2006; Douglas Health risk factors risk Health on focused have studies many Although gang female for factors risk the emotional specifically more focused have few involvement, on mental health. Assumptions about mental mental about Assumptions health. on mental on broader often based are vulnerability health involved women young on available information in those (and particularly or crime violence in significantly have who often custody), internal people’s young and children of marker commonly most problems behavioural distress; in gangs females with in studies associated included: • • • • • • • • & Decker, Cyr St 1998; 1998; Miller, (Fleisher, 2003; Wingood al. , 2008) al. et Minnis and are more likely to self-harm or attempt or attempt self-harm to likely more and are Snethen & 2006; & Plugge, (Douglas suicide 2008). Puymbroeck, Van details in gangs women young on The literature exposure by characterised histories family Sexual and abuse. maltreatment violence, to 1996; Miller, theme (Moore, a common is abuse 2008) as Vigil, & Kreinert, 2004; 2001; Fleisher well levels of mental health problems than non- than problems health mental of levels depression, (e.g. peers female delinquent conduct ADHD, anxiety, separation self-harm, et 2005; Chitsabesan (Harrington, problems) al. young These 2008). , 2008; Fazell, al. Lind, et child of higher histories have in custody women (particularly trauma family chaotic escape to attempts seen as are Persistent trauma. out and blot backgrounds problematic

Centre for Mental Health REPORT A need to belong 10 Centre for Mental Health REPORT A need to belong Where our data came from - the screening sites

This report analyses data on young people with Gang-associated young women gang associations from a database set up to support 37 newly developed point of arrest 80 young women were identified with gang health screening initiatives in England in August associations in this sample of 8,029. In keeping 2011. Screening was focused primarily on 10 to with the general literature on gangs, young 18 year olds. women in this sample were around two thirds less likely to be gang affiliated than young In total, 8,029 young people were screened. men (Curry & Decker, 1998); girls in gangs The majority of them were at an early stage of were 1% of the total Youth Justice entrant involvement with the Youth Justice System (YJS). group compared with the 3% who were male. These prevalence rates are lower than other UK sources which note self-reported prevalence Limitations of this data rates of 6% (Sharp et al., 2006). The mean A number of qualifications and limitations age of young women identified with gang should be borne in mind when considering this associations was 15, but their ages ranged from data and the conclusions drawn. One of the 11 to 17 years. challenges of establishing a national network of point of arrest schemes was that sites used very different screening tools. There are other factors Regional distribution that may have affected the accuracy of the data. The twelve London sites were the most densely These include: urban areas, whereas most of the other sites • the absence of short, reliable screening were in medium-sized cities or large towns. A tools, particularly for neuro-developmental small minority were in rural areas. Surprisingly, problems for under 16 year olds during early a city in a largely rural area had one of the stages of data capture. highest rates of girls in gangs; London reported • a lack of access to multi-agency data on the next highest rate of prevalence per site. multiple risk factors. Sites in eastern England identified no girls in • poor awareness by screening staff of some gangs. risk factors and hidden disabilities. • variable rapid engagement skills Ethnic breakdown (encouraging disclosure) particularly where workers sought information about covert In London, the majority of gang-involved young risky behaviour. women were from Black and Minority Ethnic (BME) populations (55%) with around 20% of In some instances, it was also difficult to these young women being of Black Caribbean establish whether risk factors or health heritage; and the rest (45%) were from White difficulties were a precursor to gang British groups. The higher rate of female BME involvement or a consequence of membership. gang membership in London mirror the capital’s Despite these possible limitations, the data generally higher BME population. Northern on girls in gangs provides an indication of the sites recorded a predominance of White British multiplicity and pattern of need and particularly girls in gangs. The south east was most likely of this group’s relative vulnerability compared to identify the highest Traveller / Gypsy / Roma with other females entering the justice system. females involved in gangs.

Acknowledgements We would like to thank all the Youth Justice Liaison and Diversion sites for their hard work in collaborating to establish and roll out point of arrest health screening in their local areas. 11 9 in 35 41 15 gangs in Girls gangs Girls 9.5 6 29 10 55 gangs Boys in Boys Boys in Boys gangs 7.0 4 3 13 81 Female Female entrants been identified in other has 3 1 Female Female entrants 3.7 11 86 youth

youth

General justice entrant justice relationships and social Victimisation between links strong relatively indicate The data sexual as (such victimisation of experiences domestic or experiencing witnessing abuse, women Young association. and gang violence) likely more times eight were in gangs involved the general than abuse sexual of victims be to likely more times and three entrant justice youth Both sexes were around four times more likely likely more times four around were Both sexes to YJS the entering people young other than activities. in such involved a sibling have more somewhat were women young These a have to screened being other girls than likely (Figure status looked-after or previous current likely as twice than more were they 2); however they (where plans protection be on child to the subject were but in their families remained also women These monitoring). continued of care been in foster have to likely as twice were or homeless. Maltreatment and reoffending for a precursor as studies (Smith & system the justice re-entry into strongly also is 1995; AIC, 2006). It Thornbury, early of the development with associated et, 2000; Jaffee al. et (Aguilar problems conduct negative multiple to link in turn 2005) which al., , 2005). al. et (Fergusson in adulthood outcomes

is Table 2: average number of vulnerabilities per capita vulnerabilities number of 2: average Table General entrant justice 2.9

and gang for conflict 7-12 13-18 19 + Table 3: distribution of vulnerabilities / risks (%) / risks vulnerabilities of 3: distribution Table of No. vulnerabilities 0-6 conflict family factors compared that family amplification’) with women Young times five to three were suggest difficulties Studies , 2008). The vulnerabilities of girls in gangs of girls in The vulnerabilities often associated with the development of severe severe of the development with often associated (INSRM, 2005) in children problems behavioural that indicate and our data association strong a relatively have violence in gangs. involvement girls’ with more likely to be involved in gangs than other than in gangs be involved to likely more backgrounds family challenging similar girls; of risk an increased with associated also are et (Chesney-Lind in crime involvement female al. histories of parental imprisonment, poor imprisonment, parental of histories substance parental health, mental parental and neglect misuse Family based vulnerabilities based Family 1 & 2) (Figures links strong reveal The data and girl’s dynamics family broader between gangs. with affiliation On average, young women involved in involved women young On average, of risk greater a threefold had gangs and social health entrants justice youth average with the double 2) and over Table (see of vulnerabilities number of screened. being other females that 3 shows Table Similarly, associations gang with girls as times three least at are other female as likely seven with present to entrants and or more vulnerabilities than likely more nine times exhibit to entrants general 28) (19 to very high numbers vulnerabilities. of young that (2001) suggested study Hill’s risk five than more with people 13 12 were 10 to of the age at membership in gang involved become to likely more times Chen youth. low-risk with compared activity a ‘snowballing’ described (2004) also al. et ‘risk phenomenon (called and abuse sexual as such experiences whereby substance away, running to led victimisation possible and then activity sexual early misuse, membership. gang

Centre for Mental Health REPORT A need to belong 12 Centre for Mental Health REPORT A need to belong

Figure 1: family-based risk factors and vulnerabilities % 60 55 Parental imprisonment 50 45 Family conflict 40 Neglect 35 Sibling involved in 30 anti-social behaviour 25 Parent with mental health or substance misuse problem 20 Physical abuse 15 10 Young carer 5 0 General youth Female Boys in Girls in justice entrant entrants gangs gangs

(The data for all figures are at the end of the report.)

Figure 2: child protection and safeguarding histories of those screened at point of arrest

% 30

25 Current looked after child status Previous looked after child status 20 On a child protection plan

15 Experience of foster care Homelessness 10

0 General youth Female Boys in Girls in justice entrant entrants gangs gangs

13 These seen often been have difficulties. health , 2002). al. et Poor relationships Poor Witnessing / experience experience / Witnessing in the home violence of Victim of bullying of Victim Victim of sexual abuse sexual of Victim , 2005) and al. et (3.9%) (Green mental youth Educational achievement Educational female for factors other risk (1999) noted Hill failure educational including initiation, gang In and aspiration. attachment academic and low 4) (see Figure in gangs women young our data, be under- to likely more times three over were entering other women than school performing at the YJS. and health mental Behaviour, wellbeing emotional problems behavioural and severe Persistent childhood common the most one of represent and behavioural problems affect more boys (7.5%) boys more affect problems behavioural girls than intimidation, bullying, persistent include signs lying, breaking, rule or aggression, fighting whereas low self-esteem appeared to protect protect to appeared self-esteem low whereas & (Esbenson gangs joining from males Gangs 1998). Deschanes, protection emotional, predominantly meet to (Wang, females for needs related and status 2000; Wingood gangs Girls in Girls over were gangs Boys in in gangs Female entrants Girls in gangs. General youth General justice entrant justice 5 0 % Figure 3: abuse, victimisation and social connectedness and gang involvement and gang connectedness and social victimisation 3: abuse, Figure 60 55 50 45 40 35 30 25 20 15 10 than other girls entering the system. They were were They the system. entering girls other than experience to likely more times three over also (see in their homes and neglect abuse physical more times four roughly were 3) and they Figure bullying. of experiences disclose to likely and bullying abuse of Whether experiences not is enrolment after gang or occur predate identify to tend studies US however, clear; sexual early for a precursor as abuse sexual (Moore, involvement gang to leading activity 2001). , 2001; Miller, al. et 1996; Joe-Laidler girls describe studies although Ironically, hostile from protection for in gangs enrolling and patriarchal or neighbourhoods, homes often and dynamics cultures gang abusive of their experiences and prolonged extended , 2002). al. et (Wingood and abuse victimisation here association stronger a much was There relationships social quality poorer between comparison in membership gang and female males with four times more likely to report poor peer to likely more times four the entering females to compared relationships research US mirrors This System. Justice Youth of levels low between links noted also which involvement; and gang in females self-esteem

Centre for Mental Health REPORT A need to belong 14 Centre for Mental Health REPORT A need to belong for Mental Health, 2009) being linked Figure 4: school performance more closely with identity formation, peer relationships and changes taking place in the % brain during adolescence (Steinberg, 2008). 60 Later-starting conduct problems generally 55 resolve themselves with age and as young 50 people adopt adult responsibilities. 45 Early behavioural problems are also a 40 significant risk factor for prolonged gang 35 involvement (Hill et al., 2001); those with early 30 aggressive traits (and anti-social peers) were 25 twice as likely to remain in gangs for more than one year. 20 15 Nearly 40% of girls in gangs in this database had signs of severe behavioural problems 10 before the age of twelve; roughly equivalent to 5 the proportion of boys in gangs (see Figure 5). 0 These data warrant further investigation given General youth Female Boys in Girls in that severe conduct problems are generally justice entrant entrants gangs gangs half as prevalent in females as in males in the Poor school performance general youth population (Green et al., 2005). Girls in gangs were also three times more School exclusion likely than other females in the sample to be identified with early conduct problems. cruelty toward animals, fire setting, running Childhood aggression is rarer in females. away from home, theft, truancy, and vandalism Female conduct problems present in more (Lahey et al., 1999; INSRM, 2005; NICE, 2013). Risk taking is also commonly associated with conduct problems linking to early substance Figure 5: behaviour problems before misuse, bulimia, crime, extreme sports, the age of 12 dangerous driving, harassment, involvement in % gangs. 40 Behavioural problems that emerge before the age of 12 result in some of the very 35 worst outcomes for children, such as lower life expectancy, poorer health, higher risk 30 of substance reliance and early promiscuity 25 and pregnancy (Loeber & Farrington, 2000; Fergusson et al., 2005; Rutter et al., 2006). 20 They also impose costs across a range of multi-agency budgets (Centre for Mental 15 Health, 2009). Furthermore, these children are at greater risk of every type of adult mental 10 illness and of suicide (Kim-Cohen et al., 2003; Fergusson et al., 2005; Rutter et al., 2006). On 5 the other hand, behavioural problems which emerge for the first time during adolescence 0 often have fewer long-lasting, damaging and General youth Female Boys in Girls in costly effects (Moffitt & Scott, 2008; Centre justice entrant entrants gangs gangs

15 , al. et further for non- than questions months , 2003; Archer , 2003; Archer al. et , 2002; Cepeda , 2002; Cepeda al. et six raises finding Running away Running / aggression Violence Drug misuse misuse Alcohol in sexually Involvement behaviour or harmful risky in the past This regular exposure to sexually degrading degrading sexually to exposure regular experiences; comply to threat under feeling women young from demands degrading or sexual with members; gang status, (perceived) for in return sex gain; or material protection rival by a weapon as used being rape sexual or for a punishment or as gangs gangs; within gratification up set or entrap to used being women young members. gang rival • • • • • 2001; Wingood (Miller, 2003; Schalet & Valdez, Beckett 2005; Firmin, 2011; & Grascia, 2012) in gangs girls violence, experiencing as well As other as violence use to likely as twice over were 6). Indeed, the (see Figure sample in this girls violence in involved women young number of men in this young for rates exceeds slightly sample. elevated of patterns Similar investigation. in other studies, been noted have aggression 3.6 times being females involved gang with or in three been involved have to likely more fights more

gangs Girls in Girls more likely more gangs Boys in times four over Female entrants just were times five over were 5 0 General youth General justice entrant justice in gangs in gangs sexual activity as a gateway or initiation into into or initiation a gateway as activity sexual partners; older via sometimes gangs, pregnancy; early of a higher risk non-monogamous with activity sexual with activity sexual as well as partners partners and serial multiple casual, consent); without (sometimes % Figure 6: risky behaviours 6: risky Figure 65 60 55 50 45 40 35 30 25 20 15 10 subtle ways, sometimes masked by depressive depressive by masked sometimes ways, subtle a later at manifesting and often symptoms pregnancy, activity, sexual in early stage 2005). Post- (INSRM, etc. truancy away, running with associated commonly is stress traumatic of histories to often linking disorder, conduct violence. sexual Girls likely to have histories of running away and and away running of histories have to likely from be excluded to likely as twice over were youth female the average with compared school just were They 6). (see Figure entrant justice to likely more times and three two between although drug use and drugs, alcohol misuse members. gang in male likely more was Girls risky in sexually be involved to other girls than on girls literature Broader behaviour. or harmful include: risks these that suggests in gangs • • •

Centre for Mental Health REPORT A need to belong 16 Centre for Mental Health REPORT A need to belong

Figure 7: mental health and emotional wellbeing % 30

25 Identified with suspected mental health diagnosis 20 Sleeping or eating problems Significant event affecting wellbeing (eg bereavement) 15 Suicide or self-harm risk 10

0 General youth Female Boys in Girls in justice entrant entrants gangs gangs affiliated females (Wingood et al., 2002). This is early starting behavioural problems had met perhaps not surprising in that the risk factors for diagnostic thresholds, suspected prevalence gang membership broadly overlap with those rates could approach 40%). 30% of girls in for violence (Mackenzie & Johnson, 2003). gangs were self-harmers or at risk of suicide, with two and a half times the risk of self-harm Our data provide no clues as to the relative of other girls. 30% of girls in gangs also have frequency or severity of aggression and violence sleeping or eating problems. Although on the in comparison with young males, and it has face of it these are physical symptoms, it is not been suggested that female aggression is uncommon for children and young people’s generally different in motivation (linked to emotional difficulties (such as depression, social ties), nature and severity than male anxiety or distress) to be displayed in this way. acts of violence (Putallaz & Bierman, 2004). For example, Campbell (1999) argued that for Younger people with emerging poor mental gang males, violence provides power whereas health or high risk factors for mental illness for gang females, violence has its root in fear often present with less clear-cut symptoms and survival; a protective response to their which make them much easier to miss. vulnerability (Bell, 2009). Disrespect, jealousy Furthermore, many professionals fear and accumulated tension may also prompt some unhelpfully stigmatising young people with women to behave violently (Cunningham, 2000; diagnostic labels. But delays in identification Kruttschnitt & Carbone-Lopez, 2006). prevent early intervention, can result in the multiplication of problems and undermine longer term prospects (Patel et al., 2007). There Other mental health problems is the strongest evidence that intervening early The Centre’s database highlights a wealth of has the best effect on a child’s quality of life; it other information pointing to the psychological can also reduce the burden of cost on a range of vulnerability of these young women (Figure 7). multi-sector budgets (Bonin et al., 2011). Just over a quarter of them have a suspected diagnosable mental health problem (and if

(Green Disorder ADHD or suspected with girls than as (such Hyperactivity in gangs difficulties girls difficulties and five sample in the same Learning disability Learning and communication Speech problems injury brain Acquired difficulty Developmental Deficit Attention of a previous identified with were women young spectrum and nearly seven times more likely to to likely more times seven and nearly spectrum hyperkinetic have young with compared females (ADHD) among screening arrest of 2008). Point (Fazell, males identified 10% of developmental rates to comparable roughly is which autism) in males found other females. of that times No study a US whereas trauma; head of history among ABI of high levels reasonably found ABI usually (15%). in custody women young and subsequent the head to trauma from results remain can Damage consciousness. of loss a sudden to then lead but years many for hidden High progress. developmental dip in a child’s men in young been seen in ABI have of levels of higher levels to linked settings, custodial suicide. of risk and increased violence , 2005). On the other hand, in custodial in custodial , 2005). On the other hand, al. et higher to point studies international samples levels

gangs Girls in Girls

identifies much are in the general gangs YJS Boys in (Bryan, 2007; has attention Again, 8). (Figure in the poor screening reflecting difficulties Female entrants identified in girls of a third identified around stages later & Bryan, 2009). Less 0 5 General youth General justice entrant justice frequently % Figure 8: Neuro-developmental difficulties 8: Neuro-developmental Figure previously 10 15 20 practices. 15% of young women had a learning a learning had women young 15% of practices. men young of 20% to opposed as disability YJS in the stages later at screening in gangs; has research. this in females to so far been paid Neuro-developmental less Levels of speech and communication problems, problems, and communication speech of Levels Injury Brain and Acquired disabilities learning one than lower appear sample (ABI) in this perhaps expect, would Neuro-developmental difficulties and difficulties Neuro-developmental health physical broader disability a learning having as people young (Harrington, 2005). and speech had in gangs girls these 3% of Only difficulties communication at screening males) (mainly people young 60% of around difficulties these experiencing Gregory under Boys boys. with compared population and a four around usually are old years 16 be on the autistic to likely more times half

Centre for Mental Health REPORT A need to belong 18 Centre for Mental Health REPORT A need to belong

Figure 9: physical health problems % 35

30 Dentistry problems

25 Eyesight problems Hearing problems 20 Diagnosable physical illness

15 Sexual health problems

0 General youth Female Boys in Girls in justice entrant entrants gangs gangs

Physical health problems This study found lower rates of physical health problems compared with previous YOT screening programmes (Bekaert, 2008). But the sites did not have a standardised screening system for routinely checking physical health needs. Nevertheless, in relative terms, young women in gangs had higher physical health needs in all areas in Figure 9. Girls in gangs were over three times more likely to have sexual health problems than other girls. Sexual health needs were particularly high in this sample, reflecting high levels of sexual risk-taking and pointing to possible experiences of sexual victimisation. Broader literature suggests that these young women experience a range of sexual health problems including higher levels of sexually transmitted infections (STIs), lower levels of condom use and higher teenage pregnancy rates (Miller, 2001; Cepeda & Valdez, 2003; Wingood et al., 2002; Minnis et al., 2008). In one study gang membership was identified as a risk marker increasing the probability of acquiring a STI (Cepeda & Valdez, 2003).

for costs just not significant save who are women young gang with identified women young

with of benefits demonstrated , 2010). , 2010). The children of the young women women young the of The children , 2010). interventions these associations were picked up at an early stage stage an early up at picked were associations the from and diverted away in their offending appropriate more towards system justice youth to services and social educational health, 10). (see Figure needs their multiple address has YJS the from away people young Diverting the risk decrease to in studies been shown those with compared furtherof reoffending et (Petrosino YJS the formal through processed al. , 2012) which have good good have , 2012) which al. et (Lee Therapy and outcomes in improving records track costs. and associated re-offending reducing an to referred was woman young One pregnant for Programme Visiting Home Nurse Intensive Partnerships) Nurse (Family parents teenage has which but rates arrest reduced of in terms mothers et (Eckenrode offspring female of those also al. be less to noted also are programmes in these themselves, parents teenage become to likely Many savings. multi-generational generating of time in comparison over purse the public for responses offending youth standard with , 2012). al. et (Lee custody) (particularly thirds Two issues and sensitive difficult on complex, works often alienated from other services and who may not trust adults easily. The young women are are women young The easily. adults trust not and who may other services from often alienated them and leave chances poor life to lead can that factors risk multiple to exposed frequently involvement as well men, as young with in relationships and exploitation abuse to vulnerable and work group experiential women young offers programme The Nia activity. in criminal support and positive resilience on developing focuses that support one-to-one intensive to women young enable to behaviour offending of patterns challenging alongside networks relationships. and safe healthy develop www.niaendingviolence.org.uk/young/index.php visit information, more For The Nia Safe Choices programme works in a number of London boroughs with young women women young with boroughs London in a number of works programme Choices Safe The Nia sexual include risks These culture. gang to in relation factors risk multiple who experience The project crime. violent in and involvement association gang and exploitation, violence pupil schools, as such agencies local by been referred who had women young with worked teams. care social and children’s teams offending youth units, referral Choices Safe The Nia Safe Choices programme - a gang-specific service - a gang-specific programme Choices Safe The Nia Engagement and services and Engagement Referral pathways for girls in gangs girls for pathways Referral women young vulnerable These highly support, general receive to likely most were and parenting misuse, substance for including a quarter support. were Around youth-related and in 5% of education into supported back 1 Around avoided. were exclusions instances services health physical to referred in 5 was and a further 5% were services and counselling of minority In a small housing. supported into into referred were women young these cases, as such interventions family evidence-based Family or Functional Therapy Multi-Systemic The majority of young women in gangs engaged engaged in gangs women young of The majority refused 3% only screening; arrest of point with a furtherwhile 11% then be screened to (Figure support subsequent from disengaged of patterns similar showed males Young 10). a hopeful presents this Overall, engagement. to people young of the willingness of picture the at screening health proactive to respond a the need for suggests also It arrest. of point approach outreach engaging intensively more vulnerable very number of very small a with disengage. who will people young

Centre for Mental Health REPORT A need to belong 20 Centre for Mental Health REPORT A need to belong

Figure 10: Engagement of girls in gangs with the screening programme

4% 6% 6% Engaged with the intervention Screened but did not engage 11% Screened and put in touch with existing services Screened and no further action deemed necessary 73% Information provided but team unable to engage person for screening

Figure 11: Referral pathways for young women with gang associations entering the YJS

Placed in local authority care 5% Supported into housing 6% Other evidence-based interventions * 40% Supported into employment 5% Exclusion prevented 5% Support with education 24% ADHD services 0% Primary health care 19% Family Nurse Partnerships 1% Cognitive Behavioural Therapy 0% Psychological therapy (counselling) 18% Functional Family Therapy 3% Multi-Dimensional Treatment Fostering 1% Multisystemic Therapy 3% 0 5 10 15 20 25 30 35 40

* Other interventions include parenting, substance misuse, youth work support, gang and gender-specific support.

research on the Developing experiences adverse Council Scientific in neuro-scientific

improve healthy lifestyle choices; lifestyle healthy improve stress and toxic stress of the impact reduce intervening (i.e. development on children’s maternal with and effectively early substance parental address to depression, and maltreatment address to misuse, support in the home and to victimisation promoting techniques parenting positive wellbeing); children’s communication early healthy promote jump-start to and babies mothers between in the brain. activity electrical are thought to lead to biological disruptions disruptions biological to lead to thought are on occasions, with, development in brain birth. before occur to appearing damage prioritising of the importance suggests Research reduce to activity and multi-sector integrated and factors environmental health-compromising that relationships the protective strengthen to stress. toxic of effects the harmful mitigate therefore must chances life girls’ Promoting mothers expectant birth before providing begin to: support with 1. 2. 3. (National A lifetime approach: what works works what approach: A lifetime for outcomes better support to women? young vulnerable a risks, the highest with people young the For a across occurs risk of pattern stone stepping lifetime. child’s in infants architecture neural robust Building Advances early between links highlight increasingly adolescent and later experiences childhood behaviours threatening health taking, risk (Shonkoff problems health adult and chronic 2012). Early & Garner, on , 2005; Center al. et 2004; O’Connor Child, 2012) Shonkoff, 2012; Child, the Developing

young time.

of failure, to of sign (Heckman period of mature children to women young histories

and approaches. as programmes effective approaches at difficulties specific modify to very programmes support which a significant over of the importance reinforce the looks chapter levers educational difficulties, health final address difficult more Improving lives through gender-specific programmes gender-specific lives through Improving women and build on the strengths and gender- on the strengths build and women specific lifestyles. damaging change screening and intervention. some Although screening been have and programmes tools screening to and responsivity effectiveness for tested (Bell, not have many and needs, risk female focusing and programmes tools 2009). Many have membership and gang crime violence, on and do majority the male for been designed not gender-specific adopting While many factors motivating girls to join join to girls motivating factors many While there peers, male of those with overlap gangs this 2009). For (Bell, differences key also are include should interventions any reason, of record a proven (with both gender-neutral and outcomes) male as well as female improving gender-specific This for outcomes improving of chance the best with women. young group of very vulnerable this who join women young that suggest Studies undermine that risks multiple accumulate gangs their progress be may factors risk these some of Although missing be overlooked, can others hidden, cost-effective and early for opportunities vital risk early as problematic is This intervention. which patterns developmental create can factors get 2003). (Hertzman & Power, support evidence-based intervention using Early of escalation violence, prevent to essential is mental and physical offending , al. et , 2011; Lee al. , 2010; Bonin et al. et attention multi-sector a need for is There 2012). the first In particular, risks. these to problems behavioural early-starting persistent a broad over risks of and the accumulation critical be seen as should domains of range gang including outcomes poor for markers mobilise to a signal and therefore membership support. effective provide to services Our findings

Centre for Mental Health REPORT A need to belong 22 Centre for Mental Health REPORT A need to belong

Girls Circle: a promising US gang and gender-specific programme

Girls Circle is a strengths-based support group promoting safe and healthy decision making, positive protective connections and empowerment in girls aged 9–18. The approach recognises the importance of good quality relationships for young women’s psychological make-up determining their overall psychological health, self-image, and connections with others. The approach relies on growth-fostering relationships (or relational–cultural theory (RCT )) as a primary lever for supporting change. Girls Circle aims to provide experiences of safety in relationships and not only to reduce risk factors for delinquent behaviour but also to increase protective factors for resilience in adversity. The approach combines motivational interviewing, resiliency practices and skills training.

The programme consists of 8- to 12-sessions. In each session, typically held once weekly, a group of girls of similar age and development meet with a trained facilitator for either a 90- or 120-minute session. Within a structured six-step format, the girls take turns talking and listening to one another about their concerns and interests. Gender-specific themes and topics are introduced that relate to the girls’ lives, such as body image, goals, sexuality, drugs, alcohol, tobacco, competition, decision-making, friendships, setting personal boundaries, coping with stress, recognising abusive relationship patterns, assertiveness, and trusting oneself. Creative or directed activities such as role-playing, drama, poetry, and other creative projects link to these discussions.

A key component in the model is that one group member speaks at a time, with the expectation that other participants will listen attentively. This form of communication aims to increase empathy skills and mutual understanding among group members. A mother– daughter curriculum extends the Girls Circle model to address the mother–daughter relationship as girls enter and pass through adolescence.

It has been subjected to limited evaluation and is considered a ‘promising’ programme by the US Office of Juvenile justice and Delinquency Prevention model programme guide.

The importance of good quality attachment Reducing maltreatment As well as good quality parent-baby Our overarching findings suggest that poor communication, children also need to feel safe parenting, maltreatment, neglect and family and secure, usually gained through positive and victimisation have a detrimental impact on secure attachments. Being female is usually a young women’s development. Although some protective factor for crime, violence and gang stress is important to develop children’s membership. However, some research suggests resilience, extended experiences of stress or that poor quality child-parent attachment maltreatment have a particularly toxic effect on and severe environmental risk can increase children’s health and wellbeing (Center on the the chance of girls developing behavioural Developing Child, 2012; Shonkoff & Garner, problems, poorly regulated stress-response 2012). There is a growing call for multi-agency systems, aggression and risk taking (Del commitment to address all levels of child Giudicea, 2009). maltreatment (Shonkoff & Garner, 2012). Many schools and services that identify maltreatment describe current challenges in mobilising

poor factors of (Moffit benefits signs first problems very cross-budget risk or more five with the to behavioural early , 2008; NICE, 2013) but that that 2013) but , 2008; NICE, al. et Numerous teachers. were noted for females including reductions in reductions including females for noted were and a 63% rates and arrest pregnancy teenage compared graduations school in high increase groups. in comparison women young with child poor of signs the first to Responding health mental in advantages considerable are There early responding , 2007; Bonin al. et (Patel health mental child with important particularly is This , 2011). al. et persistent Pre-school interventions Pre-school demonstrate also initiatives Some pre-school children’s for improvements promising Pre-School Perry Scope The High outcomes. low from children targeted in the US programme backgrounds ethnic and minority black income taught The programme 2005). (Schweinhart, solving and problem planning of a range learning participatory active using competencies visits home regular and supported through by parenting evidence-based Simple 2008). Scott, years 11 3 to from children for programmes not in improvements result to been shown have parental also but outcomes in children’s only evidence is There 2013). (NICE, health mental with children with best work programmes that , 2007; al. et need (Hutchings of higher severity positive equally , 2010) and have al. et Reid and gender range age a broad across impact (de Graaf to well be implemented need to programmes Mental for (Centre results positive guarantee 2012). Health, and factors risk multiple of The importance problems behavioural risk multiple linking exists evidence Strong with events childhood and adverse factors health. mental problems/poor behavioural our expanded have studies Longitudinal rates with factors risk clustering of knowledge increasing problems behavioural severe of factor. risk accumulated each for exponentially boys In one study, were almost 11 times more likely to develop develop to likely more 11 times almost were

those the need as (such highlight study UK, 2013). time mothers (Gov this from first Parents Under Pressure, a home visiting visiting a home Under Pressure, Parents drug and with intervention parents for piloted being currently problems; alcohol the Prevention for Society the National by & (Dawe (NSPCC) Children to Cruelty of Harnett, 2007) home- an intensive the Baby, Minding help high- to seeking programme visiting risk with mental health or substance related related or substance health mental with relationships positive develop difficulties) with their baby; currently being piloted by by piloted being currently their baby; with , 2005) al. et (Slade the NSPCC parents A portfolio of evidence-based or evidence-based A portfolio of interventions promising programmes Preventitive very targeting programmes Some preventitive considerable shown have parents high-risk young for outcomes in improving promise Partnerships Nurse Family risk. at women and aim time over tested been robustly have years two over parents teenage empower to parent birth be the best (before and after) to promoting health develop be, to can they and solve problem and to styles parenting have Outcomes stressors. life family reduce in the US decades three over for been tracked benefits improved multiple produced and have for resources to respond not just to severity severity to just not respond to resources for maltreatment sustained to also but neglect of support to in order factors) risk (and multiple experiences. damaging in these reductions reductions including domains of a range across offending offspring and female in maternal a across costs intervention saves This levels. and is well implemented if budgets of range high with in the UK and expanded tested being risk are initiatives promising Other comparable improvements support to in the UK tested being drug, with struggling parents for in outcomes These problems. health and mental alcohol include: interventions • • support for anything other than the highest the highest than other anything for support Overall needs. protection child of threshold findings

Centre for Mental Health REPORT A need to belong 24 Centre for Mental Health REPORT A need to belong conduct disorder than those with none, while factors which sustain problematic behaviour) girls with five or more risk factors were 19 all have a good record of improving outcomes times more likely to develop severe behavioural for older vulnerable females and should be problems than those with no risk factors (Murray commissioned and used more extensively et al., 2010). Intervention at the earliest sign with young people at risk of crime and gang of sustained patterns of poor behaviour can involvement (Lee et al., 2012; NICE, 2013). prevent further disadvantages stacking up. However, experiences of risk are dynamic; Violence prevention programmes children may move in and out of as they mature, requiring those in routine contact with them Numerous international league tables have in schools and in other settings to be alert to sought to identify and draw together the most changes and to take prompt action to mobilise effective programmes for reducing youth engaging support when risks accrue. violence, aggression and broader behavioural problems (Lee et al., 2012; Office of Justice Programs, 2012; Blueprints for Healthy Youth School-based interventions to improve Development, 2012 - 2013; SRU, 2012). Since outcomes for high risk girls young men are at greater risk of involvement Studies further highlight the potentially in violent behaviour and criminality, most important contribution of schools in changing programmes have been designed with the the lives of vulnerable girls (and not just male majority in mind. A minority have been through academic attainment). There is good tested for impact on mixed gender populations. evidence from long-term studies of links Programmes designed exclusively for females between social and emotional wellbeing and are even rarer and the vast majority have not academic attainment (Masten & Coatsworth, been effectively evaluated (Zahn et al., 2008). 1998; Weissberg & Greenberg, 1998; Eisenberg, 2006; Guerra & Bradshaw, 2008). Gender-specific gang interventions The best school-based social and emotional interventions are noted to result in an 11% The majority of literature on girls in gangs shift in attainment levels (Durlak et al., 2011); advocates the importance of developing a essentially this means that a child who is 16th gender-informed treatment model to improve in the class in terms of attainment will move up outcomes. Studies suggest essential elements to 5th place. Programmes such as Promoting of effective programmes for girls include the Alternative Thinking Strategies (PATHS) in following: schools have a good record of preventing violence and offending (as well as a range of 1. Programmes should be provided in a safe other positive outcomes for girls’ wellbeing and and nurturing environment (including life chances) (SRU, 2012). single-sex space) conducive to therapeutic change; exiting gangs particularly relies on interventions that prioritise young women’s Conduct problems and older young people safety (e.g. risk assessing exit strategies and providing safe housing). An overview of the literature generally suggests that although we should intervene as early as 2. Programmes should include content which possible to prevent the escalation of risk factors reflects both the risk factors and the for gang involvement in a child’s life, it is also realities of their daily lives, including: never too late. Comprehensive programmes focusing on multiple risk factors such as • A multidisciplinary, comprehensive, multi-dimensional treatment fostering (MDTF) holistic and solutions-focused approach (for those young women requiring placement to addressing the multiplicity of girls’ outside their family home), functional family risks, strengths and experiences therapy (FFT) and multi-systemic therapy (MST (including physical and sexual health - an intensive therapeutic approach focused and risk taking, practical difficulties, on empowering families to address the risk parenting support, experiences of 25 then 2012). Referrers & Garner, Every system contact offers an opportunity to to an opportunity offers contact system Every in gangs girls for outcomes improve intervention requires early effective Finally, and children families touching services all as such services adult-oriented includes (this and probation health mental misuse, substance and children’s educational as well as work, and recognise with be familiar to services) poor for factors risk of the implications particularly 1) - Table (see outcomes female domains of a range span risks multiple where (Shonkoff to and pathways gateways referral need clear support. early mobilise

were women young and cultural home; they for find at influential didn’t the racial/ethnic they victimisation, aspirations, mental mental aspirations, victimisation, substance work, for preparation health, reliance). self-esteem, promoting interventions and self- behaviour assertive healthy against resilience build to reliance victimisation. future which interventions health mental for treatment incorporate potentially trauma. justice youth in disappointed most focused who only staff and probation and on on failures on enforcement, mistakes. critical are models role female Positive and development healthy girls’ to dissatisfying for often a proxy are should mentors relationships; family reflect to seeking females of backgrounds gangs. from away move Young women in the criminal justice justice in the criminal women Young as been described have system relationships positive for searching that , 2004; al. et 2003; Gaarder Sherman, 2000; Bloom & Covington, & McCallum, • • • • Programmes for females should foster foster should females for Programmes an as relationships and positive respectful when change promoting for lever important Relationships women. young with working particularly are evidence-based include should Programmes supporting the longer families with work with women young these of resilience term and interaction improving to attention the between both ways communication and the child. parent outreach prioritise should Interventions engagement. and maximise approaches and gang tactics engagement Marketing, and co- be creative need to pathways exit themselves. people young by produced both as a way in to risky activity and as a and as activity risky in to a way both as that: know we example, out. For way 3. 4. 5. (Gross 2001; Snethen, 2010; 2009; Board, Justice Youth 2011) & Ruddell, Scott Lynne

Centre for Mental Health REPORT A need to belong 26 Centre for Mental Health REPORT A need to belong Conclusion

This study identifies young women with gang Young women generally respond best to associations as a small but significantly programmes which are stylistically different vulnerable and troubled group compared to those designed for males; interventions to other young women entering the youth must address relevant aspects of these young justice system. Harsh or neglectful parenting, women’s experiences (such as trauma and maltreatment, victimisation and poor victimisation) as well as recognising the relationships appear to have a particular importance of positive relationships as leverage impact on their developmental vulnerability. for change. Furthermore, clustering risk factors spanning These young women were not difficult to engage multiple domains create a ‘toxic’ effect at the point of entering the youth justice system. increasing the likelihood of persistent We found examples from sites of positive behavioural difficulties - the most common outcomes being achieved when engaging and mental health problem faced by children. empowering multi agency support was wrapped Nearly half of young women with gang around them focusing on holistic care, safe associations on the Centre’s database were exit pathways and addressing the damaging noted with signs of behavioural problems before psychological legacy of prolonged victimisation. the age of 12. Early childhood behavioural However, data on referral outcomes still suggest problems are associated with an array of poor that only a small minority find their way to health and social prospects, particularly if evidence-based interventions with the best critical opportunities are missed to intervene chance of improving their long term outcomes early and if damaging childhood experiences (e.g. MST, FFT, MDTF). Anecdotal reports are are later amplified through later gang-related of patchy commissioning of these resources bullying and victimisation. (which although sometimes costly in the Our findings suggest that every system that short term, reap longer term benefits across touches the lives of families (including mothers a range of budgets). There is also evidence before and after pregnancy) offers opportunities that gender-specific programming is generally to identify the gender-specific risks undermining underdeveloped with insufficient investment as the (often intergenerational) prospects of these yet in robust evaluation of initiatives. Finally, young women, to strengthen and promote any action with these young women will also their lifelong healthy development and to save need to link with broader national and local multi-sector costs. Effective responses need activity to reduce health, social and income to recognise that these young women move in inequalities in communities. and out of risk across the years; where multiple risks emerge and escalate, evidence-based programmes together with gender-specific programmes should be mobilised.

childhood of sign and children for the first at interventions children’s Groups, Commissioning Seek to prevent poor outcomes poor outcomes prevent to Seek childhood healthy fostering by and intervening resilience development, for support mobilise to promptly families should objective shared A key distress. and the escalation prevent be to in girls. factors risk of multiplication responses and engaging early Provide gang into drawn women young to safely them exit helping membership gender-appropriate to access and gain and supporting their progress services housing, safe (e.g. recovery effective and engaging services health sexual etc). services health mental All sectors (including health) should should health) (including sectors All local to contribute proactively people young of understanding very the given gangs with associated these by faced risks high safeguarding people. young protocols sharing information Clear agencies all between be in place should and Emergency Accident (including support to services) health and sexual with associated people young with work gangs. • • • • Health, social care, education and justice and justice education care, social Health, gang recognise all should commissioners particularly for a marker as membership young for outcomes negative pervasive collective and take and communities people prevent on prevalence, data gather action to to involved who are those and support risk safely. exit Clinical and Crime and Police schools services, in jointly invest should Commissioners and gender- based evidence holistic, specific young people of all ages to prevent violence violence prevent to ages all of people young sector multi These membership. and gang should: interventions 4. etc) All services in regular contact with young young with contact in regular services All recognise should families and people of impact and undermining the toxic and prolonged factors risk both multiple healthy children’s for risk to exposure development. in contact services and professionals All teachers GPs, (e.g. children with need training and on-going professional professional and on-going need training understanding improve to development child supporting healthy in and practice in workers includes This development. of on adults mostly focused services age. working young and girls with in contact services All open a dialogue routinely should women whether and how about people young with in their activity gang by affected are they communities. Personal, workers, social workers, Youth workers (PSHE) Education and Health Social providers, sector voluntary in schools, are workers offending youth and health and issues these raise to well-placed all people young to support or offer signpost need it. when they responsibility with authorities local All Needs Strategic Joint conducting for identify should the number Assessments activity in gang involved women young of multi- and develop it of risk at or who are risks. these address to strategies agency of Directors Boards, Wellbeing and Health strategic Reduction and Crime Health Public systems information develop should groups information and analyse integrate which affecting on risks sources of a range from and communities, children families, in Joint intelligence shared this embedding Assessments. Needs Strategic Recommendations 1. 2. 3.

Centre for Mental Health REPORT A need to belong 28 Centre for Mental Health REPORT A need to belong 5. Local Safeguarding Boards should actively 8. YOTs and probation services should work monitor and review local prevalence in close partnership with voluntary sector information on gang activity and services working with gangs to create membership. engaging and safe spaces and services for highly vulnerable young women. Given their exceptionally high safeguarding 9. The Government should ensure that the risks, females in gangs warrant particular statutory duty on the Secretary of State to attention and monitoring from Safeguarding reduce local health inequalities translates Boards. Safeguarding Boards should also into meaningful and measurable local ensure that multi sector information sharing action. protocols are in place and work effectively to

support collaborative working to safeguard Studies have shown that inequality is more young people associated with gangs. important in predicting violence and gang 6. NHS England should commission point of membership than poverty itself. This is arrest liaison and diversion services which thought to be linked to factors such as poor are gender-sensitive and recognise the social trust and relationships in unequal deleterious impact of gang membership on societies. children’s health and social outcomes. 10. Academic institutions should prioritise

research and development into effective The National Operating Model for point responses to the needs of young women of arrest health screening and diversion involved in gangs. services must include gang membership as

a significant marker of multiple poor health, Current priorities for research include: social and safeguarding outcomes. • To develop gender-sensitive and Point of arrest liaison and diversion validated screening tools for young services should recognise that first contact women at risk of gang membership to with the police and with YOTs provide a help prompt schools, youth services and critical opportunity to identify both gang YOTs to respond early to risk. involvement and the multiple health and social risk factors underpinning • To develop programmatic knowledge membership. of what works for young women involved in gangs. This should include They also need a reliable and holistic solid evaluation of the broad impact health screening tool to help consistently, of initiatives with particular attention accurately and swiftly identify mental to the longer term economic benefits health, speech and language/ of interventions for young women. neurodevelopmental needs and behaviours The high degree of risk identified prompting fuller assessment when in these young women suggests necessary. No comprehensive screening scope for adapting/trialling an tool currently exists to support holistic intensive person-centred wraparound health screening. Any tool should also be programme (adopting models similar to child, gender and culturally sensitive. Multisystemic Therapy or Family Nurse Partnerships) specifically focusing 7. The Youth Justice Board and the Home Office on turning around the lives of gang- Violence Prevention Unit should continue associated women. and extend work to produce tools, training materials and initiatives for youth services • To crystallise the core components and YOTs on gender-specific practice. of what make any gender specific programmes work so that these can be effectively replicated in different communities.

29 28 59 5 60 43 26 33 13 10 18 15 28 20 10 53 26 36 19 in gangs in gangs in gangs Girls in gangs Girls Girls Girls 34 47 7 2 9 10 15 13 13 15 29 18 17 39 4 29 19 13 Boys in gangs Boys Boys in gangs Boys Boys in gangs Boys

8 5

Boys in gangs Boys 13 13 12 7 4 2 2 13 11 28 11 17 Female Female entrants

Female Female entrants 9 6 12 10 Percentage vulnerabilities Percentage 9 4 4 Female Female 11 11 entrants Female entrants Female 6 9 2 1 2 youth

10 20 youth

7 7 2 10 11 15 General justice entrant justice youth

youth

General justice entrant justice General justice entrant justice General justice entrant justice conflict Data for the figures Data for School exclusion School Poor school performance school Poor Poor relationships Poor bullying of Victim abuse sexual of Victim Witnessing / experience of of / experience Witnessing in the home violence Neglect in anti-social involved Sibling behaviour or health mental with Parent problem misuse substance abuse Physical carer Young Parental imprisonment Parental Family Current looked after child status after child looked Current Previous looked after child status after child looked Previous On a child protection plan protection On a child Experience of foster care foster of Experience Homelessness

Data for Figure 4: school performance (%) performance 4: school Figure for Data Data for Figure 3: abuse / victimisation / social connectedness (%) connectedness / social victimisation / 3: abuse Figure for Data Data for Figure 2: child protection and safeguarding histories histories and safeguarding protection 2: child Figure for Data (%) arrest of the point at screened those of Data for Figure 1: family based risk factors and vulnerabilities (%) vulnerabilities and factors risk based 1: family Figure for Data

Centre for Mental Health REPORT A need to belong 30 Centre for Mental Health REPORT A need to belong Data for Figure 5: Behaviour problems under the age of 12 years (%)

General youth justice entrant Female entrants Boys in gangs Girls in gangs 13 13 38 39

Data for Figure 6: risky behaviours

General youth Female Boys in Girls in justice entrant entrants gangs gangs Running away 5 8 17 35 Violence / aggression 20 23 53 62 Drug misuse 15 13 51 38 Alcohol misuse 10 16 25 39 Involvement in sexually risky or harmful behaviour 2 3 3 16

Data for Figure 7: Mental health and emotional wellbeing (%)

General youth Female Boys in Girls in justice entrant entrants gangs gangs Identified with susp[ected mental health diagnosis 9 11 24 26 Sleeping or eating problems 7 11 27 30 Significant event affecting wellbeing (such as 9 13 18 30 bereavement) Suicide or self-harm risk 6 12 10 30

Data for Figure 8: Neuro-developmental difficulties (%)

General youth Female Boys in Girls in justice entrant entrants gangs gangs Learning disability 7 6 20 15 Speech and communcation problems 4 2 11 3 Acquired brain injury 1 1 3 0 Developmental difficulty 3 2 11 10

Data for Figure 9: Physical health (%)

General youth Female Boys in gangs Girls in gangs justice entrant entrants Dentistry problems 2 2 9 9 Eyesight problems 2 3 2 9 Hearing problems 1 1 2 1 Diagnosable physical illness 2 3 2 4 Sexual health problems 4 9 9 31

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35 A need to belong

Published May 2013

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