I wrote this about 18 months ago. Still very current, so I share again…
Post-Traumatic Stress Disorder & Gang Violence
As a way of introduction to this piece, please watch the following link below…
Nothing is being said about the possible, and probable, cases of Post Traumatic Stress Disorder (PTSD) arising out of the impact of gang violence in certain inner cities. PTSD is not just a probability experienced by young people active in gangs, but also people living in those areas trying to go about their everyday business and lives. Notwithstanding the assault on mental health and well-being of young people not involved in gang violence, as well as on mothers, fathers, other family members and friends of those killed and/or assaulted: all inadvertently becoming victims of gang violence themselves.
As a mother of two black men and grandsons, their safety is a daily concern for me, especially when they are out and about in the world. That concern had already been there, though more centred around my fears of possible- and some would say probable- run ins with the law, and other ‘powers that be discriminatory systems.’ Additionally I myself can struggle with anxiety, so this ongoing climate of youth violence oftentimes compounds my own anxiety, which must also be the case for those already living with mental health concerns at this time. Therefore, one does not need to be affiliated to gangs to be affected by it and feel terrorised by it living in these kind of inner city war zones.
Then there is the direct trauma experienced when witnessing a young person being harmed and/or losing their life, as well as the mental health assault of Bereavement when a young person and adults experience the loss of lives of friends and loved ones. As is already known, Bereavement has its own special effects and process of recovery, which is far from easy. And I can put money on it that out of those impacted, in whatever fashion, very few is in receipt of counselling, therefore ends up dragging all that unprocessed and therefore unresolved trauma into adulthood, and across generations. And so the devastation goes on.
Then there is ‘Complex Trauma’ which is very debilitating, let alone when it too is added into the mix of gang violence. A type of trauma that still has not received the recognition due. This kind of trauma comes from having experienced abuse during ones childhood; in this situation the trauma very much shapes you, whether you believe it does or not. And it shapes you deeply and physiologically when the abuse is experienced at the hands of family friends and/or loved ones themselves, the very people who are meant to be there to love, cherish, teach and protect you. I think this is where the saying, “Better the devil you know” comes from. This kind of early ongoing and personality shaping Complex Trauma is also less straight forward- though far from impossible- to treat.
It is indeed a very sad reality that it is not the ‘stranger’ who oftentimes presents the danger to children: the threat is on the doorstep and in children’s homes. The danger is in the place the child is meant to feel the safest. It is of no surprise, to me anyway, that for some children gangs can come to feel more like home: more like a place where they feel protected and can finally gain some sense of belonging…
Now let us take a look at some statistics:
Over 51, 000 children in England were identified as needing protection from abuse in 2017, (The National Society for the Prevention of Cruelty to Children (NSPCC); 90% of sexually abused children were abused by someone they knew, (The National Association for People Abused in Childhood (NAPAC); 1 in 4 adults, males and females, would have experienced some form of sexual abuse by the time they are 18 years old: 1 in 4 girls and 1 in 8 boys, (One In Four).
And to further make mention, there is no hierarchy in child abuse: neglect, physical, sexual, emotional, verbal, bullying and online abuse, are all forms of child abuse and are equally damaging in and of themselves. And in particular regard to mental health, 1 in 4 people will experience a mental health problem in any given year, and 1 in 10 young people will experience mental health problem, which oftentimes gets mistaken for run of the mill ‘teenage angst.’
Then there is the tendency for young black males aged 18-25 years old to be diagnosed with a psychotic mental health disorder, which is suspicious on the one hand because the statistic is marked and unchanging, but is of no surprise on the other hand when we seriously consider all the variables I am bringing to attention here. To me it is not rocket science why people from the black communities in general do not access counselling and other types of preventative service provisions and instead mostly presents at crisis points, and are over-represented in youth juvenile systems, prisons, social services, mental hospitals, and so on.
And in regards to the impact on the economy, in a study carried out in England in 2010, it was found that alone, mental illness cost the economy £105.2 billion. In spite of this figure mental illness is still under recognised and under treated in primary care.
Let us now take a look at physical health and well-being. The Adverse Childhood Experience (ACE) Study, (Retrieved 25 March 2014, is a research study conducted by Kaiser Permanente health maintenance organisation and Centres for Disease Control and Prevention), well documents Adverse Childhood Experiences on adult physical health. The types of childhood trauma associated with adult high risk health behaviours such as smoking, alcohol and drug abuse, promiscuity, and severe obesity, and correlated with ill-health including depression, heart disease, cancer, chronic lung disease and shortened life span, are physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect, mother treated violently, household substance abuse, household mental illness, parental separation or divorce and an incarcerated household member.
Having gathered up these very telling social facts, and with the emphasis on Control and Prevention, the authors also identifies trauma-informed and resilience-building practises based on the research that is being implanted in communities, education, public health departments, social services, faith –based organisations and criminal law in America. We too on these side of the world shores can benefit from drawing some important lessons of our own from pieces of research such as these, especially around control and prevention.
Indeed, Britain has started to make little headway, for example, in regards to domestic violence and abuse some lessons have be drawn from similar types of studies in Britain and are currently trying to be addressed in a primary care training and support programme called Identification and Referral to Improve Safety (IRIS, Ran by Queen Mary University of London, 2007-2010) IRIS is a collaboration between primary care and third sector organisations specialising in Domestic Violence and Abuse. A GP, on IRIS trained practise, has been quoted as saying:
“I’m now convinced that violence against women and children is a major public health problem with long-term consequences for women and their families. As an experienced GP, the whole project has been nothing short of transformational.”
And in regards to mental health and young black males being disproportionately diagnosed with psychosis, and as a community not accessing the more preventative services, I am aware of a piece of research that is currently being carried out by The Early Intervention City and Hackney Mental Health Team, in collaboration with a key player involved in a similar type of research carried out in America around this key issue.
So once again I say, more needs to be said, documented, and disseminated to all the key players in the Primary and Social Health Care fields – as well made available for the general population on the issue of PSTD. Also more need to be said and disseminated on Mental and Physical ill-health that surrounds and is also coming out of inner city gang violence, highlighting the social conditions that compounds these issues, namely poverty, discrimination, deprivation, racism, and Adverse Childhood Experience. Which brings to mind a quote:
“Hate yourself in the morning of your life, and by afternoon time you will be hating everyone else.”
In regards to treatment in the way of medication, yes it is not the sole source of help, but it absolutely has its place. It has its place when treating PTSD and other enduring Mental Health conditions, those that have become more ingrained, out of hand, and is havocking dire consequence on the person’s day to day life. But for true recovery, which by the way benefits the individual, the community, society and the economy on a whole, medication should be used in conjunction with therapy. With that combination oftentimes the need for medication lessens and can be weaned off from overtime. Once the trauma that has brought on the unbearable symptoms has been psychologically processed and satisfactorily physiologically regulated, one’s life can take a more productive and progressive turn, and head off in a happier and more wholesome life direction.
I have come to know quite a bit on this subject of PTSD and Mental Health, firstly from my own experiences, as well as in my work as a counsellor with women who have experienced historic and adult sexual and domestic violence. I have seen first-hand the impact of those traumas on mental health, well-being, relationships and self-esteem. To spell out more clearly, here are some of the symptoms of PTSD:
Sleep Disturbance like nightmares and difficulties in falling asleep and staying asleep; Flashbacks triggered by smells, associated memories, certain situations, almost anything; Intrusive Ruminating Thoughts that one feels that they cannot switch off from; Anxiety and Panic Attacks; Depression; Anger turned outward against others, and/or inwards resulting in violence towards oneself, e.g. Suicide, Self-Harm. Hyper vigilance, feeling always on edge, unable to relax; Paranoia, which in regards to gang violence can have some base in reality what with young people feeling unsafe in their communities, some feeling they need to carry guns and/or knives to protect themselves- or even Agoraphobia fearing venturing outdoors. Substance Abuse, Alcohol Abuse and Eating Disorders in an attempt at self and emotional regulation, as well as a way to self-medicate, numb and/or escape the pain. These PTSD symptoms and ways of coping are very real, as well as life-limiting.
In closing I am hoping at the end of this blog you can begin to see how very complex this issue of gang violence is and how very important it is that solutions to it come from all psycho-social angles. Let us not waste time splitting hairs about the cause and thinking our recommendations, in the way of solution, is the only one and best way forward. We have no time for score keeping and finger pointing: it is distracting and time wasting. We simply try everything and see which solutions works best.
This issue of gang violence and the immediate and far-reaching destruction it creates and leaves us with in its midst does not need knee jerk reactions and short-sighted opinions: it’s deep. It needs to be approached from the grass root up, then travel back down again to check out if what the grass root has said has been fully heard and taken into serious consideration. Then off we all go to implement, from the grass root up and back down again, monitoring and evaluating failures and successes.
This gang violence will be a slow, though steady and certain resolve, far from a ‘peanut throwing sprint,’ which has oftentimes been the case with issues such as these, hence why not much have changed, and steadily gets worse. What is being called for – across the human condition board, is a Life-Change, from us all. And we all need to consistently take care of matters from our own end, then any place else we able to offer help: no more, no less.
And bless you one & all; You who are already out there making a difference. A dark place in the world lights up because of your efforts, so do not underestimate the power and importance of your difference-making much needed contributions. United We Stand, divided We fall.
Peace & Love,