On a cold spring morning last week, I went to Homerton hospital, in Hackney, East London, to meet Franklyn Addo, a youth worker whose job is to appear at the bedsides of young people, mainly boys, who have been stabbed, shot, or otherwise violently assaulted, and to persuade them to change their lives. Addo, who is twenty-five, has cropped hair, a wisp of beard, and wore a gray sweater with a security pass on a red lanyard. Redthread, the non-governmental organization that he works for, places youth workers in hospitals across London and the Midlands, and runs programs that help young people navigate the health-care system. The organization is named for the ball of string that Ariadne gave to Theseus to guide him out of the Labyrinth, after he had slain the Minotaur.
Violence among young people in London is at its highest level in a decade. I met Addo in the hospital café, where he ordered a sausage sandwich. “This is our second office,” he said, indicating tables occupied by couples with newborn babies and older people with walkers, passing the time. Addo grew up less than a mile from the hospital, on the Pembury Estate, a housing project that, in the summer of 2011, was an epicenter of the London riots, which were sparked by a police killing and rapidly ran out of control. That fall, Addo enrolled at the London School of Economics, to study sociology. He joined Redthread after watching its videos online. “All my friends are investment bankers and such,” Addo said, of his classmates. “I just felt compelled to do something. A lot of us are being forced to reckon with our realities rather than be individualistic.”
Addo’s actual office is in the emergency room. He meets patients when they come through the door. “Seeing them from as early as possible helps you remain etched in their memory,” he told me. If someone isn’t fully conscious, Addo will introduce himself anyway. Redthread workers are often present in the resuscitation room, where penetrating-trauma injuries tripled in some London hospitals between 2010 and 2017. “It was called the ‘resurrection room’ by a young person the other day,” Addo said.
Around half of the patients whom Addo works with are under eighteen. He accompanies them to CT scans, to check for organ damage, and interprets what the doctors and nurses are saying. “They can’t take, you know, reams of time to explain,” Addo said. Often he finds himself mediating between distressed family members and medical staff. “There’s a lot of dynamics to manage,” he said. He is also looking for what educators call a “teachable moment”—a chance to encourage the victim to see his injury as an opportunity to get some professional help. Sometimes the moment comes; often it doesn’t. Addo has been based at Homerton for almost two years. Some of his patients have been admitted several times. “What we will do is be persistent,” he said. “We will have the same conversation. It’s just not tiring of trying with these young people.”
There are occasions for hope. Earlier in the week, Addo had received a message on Twitter that a teen-ager had been wounded in the neighborhood. “I can’t be too specific,” Addo said, describing the message. “Basically, ‘Someone might have come to your hospital. Can you check it out?’ ” It was the first time that he had been alerted to a patient by the local community rather than by the police, or by emergency personnel. “That was lovely,” Addo said. It was around 8 P.M. He wasn’t working that night, but he headed to the emergency room anyway. When he arrived, the patient had already been discharged into police custody. Addo found out that he had also been removed from London, for his safety. But, a couple of days later, Addo was able to arrange a meeting. “I met with him eighty miles from here,” Addo said. “We managed to engage, and now we will be able to offer support that could genuinely change his life’s trajectory.”
Embedding youth workers in emergency rooms is one of the most visible—and intuitive—elements of the recent attempt to recast knife crime in London as a public-health crisis. This past September, Sadiq Khan, London’s mayor, set up a Violence Reduction Unit at City Hall to coördinate initiatives run by the police, schools, the National Health Service, and local authorities into a long-term, citywide campaign. The V.R.U. is based on an effort in Scotland, begun in 2005, that has helped to cut the homicide rate there in half. On April 1st, Prime Minister Theresa May took a rare break from the all-consuming work of Brexit to host a summit, during which she commended the public-health approach to reducing knife crime. “We cannot simply arrest ourselves out of this problem,” she said. The government has proposed imposing a legal duty on teachers and nurses to report young people whom they suspect of carrying knives.
In truth, London is caught in the confluence of two immensely complex phenomena, neither of which is obvious or easy to solve. One is an alarming, general rise in knife crime across the country. Between 2011 and 2018, the number of crimes involving a “sharp instrument” recorded by the police in England and Wales rose by almost a quarter. Rapes that involved a knife increased by sixty-nine per cent. Fatal stabbings are at their highest level since Home Office records began, in 1946. Almost eighty per cent of people caught in possession of a knife are adults.
At the same time, serious youth violence in London—a broad definition that includes sexual offenses, gun-and-knife crime, and other forms of attacks—has risen by almost twenty per cent. There are communities and demographics in which these two problems merge. Around half of males injured by knife crimes, and half of the male perpetrators, are black and under the age of twenty-four. They also are more likely to be poor, excluded from school, and vulnerable to mental-health problems. If you focus on the weapon, you can miss everything else. Addo told me that knives were involved in only about twenty per cent of the cases he sees at Homerton. “We see all manner of mundane instruments used as weapons, from bricks on the street to poles to bottles in clubs. We have become fixated on knives, but it’s violence,” he said. “It is the desperation that causes you to weaponize anything around you.”
Part of the horror is how familiar all this is. A graph of knife crime in London over the past decade forms a “U.” It was high, then it fell, and since 2016 it has been rising fast again. The nightmare is recurring. Sophie Linden, the deputy mayor in charge of London’s new anti-violence strategy, set up a similar unit, in Hackney, nine years ago. It, too, was based on the Scottish model. “You can go round and round, and the real frustration is that, at moments like this, you get absolute focus,” she told me last month. “And then, after a year and two years, it peters out.” John Poyton, the chief executive of Redthread, set up its violence-intervention program in the emergency department of King’s College Hospital, in Lambeth, as a pilot scheme, in 2005. He thought that he might do it for a year. “We’ve got to actually get to grips with the fact that it’s not a recent phenomenon,” he told me. “It’s not even a ten-year phenomenon.”
Everyone has an explanation for the latest increase in violence, from public-spending cuts, which have led to the closing of around a hundred youth clubs in London and reduced mental-health services and police funding, to new forms of drug-dealing, which are increasingly reliant on minors, and the dizzying impact of social media, a chilling hip-hop variant known as drill, and London’s claustrophobic, fractious inequality. The newest theories, and their related fixes, are guaranteed the most attention, whatever their utility. Last month, the police erected airport-style metal detectors, known as “knife arches,” outside night clubs in London’s West End, to deter people carrying weapons. In January, two twenty-one-year-old rappers, Skengdo and A.M., were given nine-month suspended jail sentences for performing a song whose lyrics contravened a court order banning rhymes that describe “intrusions on to any other gang or group’s perceived territory,” or certain London postcodes. “It makes the police look like they’re doing something,” A.M. told the Guardian.
The concept of the teachable moment was popularized by Robert Havighurst, an educational theorist at the University of Chicago, in the early nineteen-fifties. “When the body is ripe, and society requires, and the self is ready to achieve a certain task, the teachable moment has come,” he wrote. The idea is predicated on a certain synchronicity between the mind of the student and the mind of the teacher, but the event itself is spontaneous. Pain and vulnerability can help. It can go wrong. Barack Obama used the phrase to describe the controversy that erupted after the Harvard professor Henry Louis Gates, Jr., was arrested while trying to enter his own house, in the summer of 2009.
“What I always say about teachable moments, that it’s hard to predict,” Addo told me in the hospital café. He recognizes that, for some of his patients, it is an achievement merely to have survived. “I empathize,” he said. “The first thing is a show of humanity.” Then Addo asks about their ambitions. “Subtle questions,” he said. “It’s just speaking through the potential outcomes, and making it real for them.” But not everyone who has had a terrible experience will have an awakening. One response to trauma is to be overwhelmed to the point of dullness. “They can also dissociate,” Addo told me, “and be resigned to, like, the massive structure.”
It is impossible to know whether London, now in the third year of its knife-crime emergency, is entering a teachable moment or whether it will succumb to dissociation. When I saw Linden, the deputy mayor, she told me that there were early signs that violence was stabilizing, but that it was too soon to tell. The risk of acknowledging that something is complicated and deep-rooted—the connotations of a public-health crisis—is to accept that it is also somehow inevitable or a part of city life. The challenge is to be deliberate and outraged at the same time. At the end of our conversation, I asked Addo what he was doing next. He looked at his watch. At lunchtime, he was due to see a young man who had been wounded and admitted to hospital a couple of weeks earlier. Now they were going to meet at a local dessert parlor. “I’m quite excited,” Addo said. “Honestly, every opportunity to interact is an opportunity to change the trajectory. It genuinely, genuinely feels like a sense of urgency.” He rose to go.
