Scotland’s relationship with violence has moved on

Dr Alastair Ireland has seen a lot in his 21 years at the Glasgow Royal Infirmary. “In my first ten years or so here, we would be dealing with stabbings on an almost daily basis, sometimes several times a day, and particularly weekends,” says the clinical director for emergency medicine for the north sector in Glasgow.

“On weekends on call, I tended to find that in the small hours of the morning, almost every weekend, I was ‘on’ with somebody who had sustained serious stab wounds usually requiring immediate resuscitative procedures in the department.”

Though not ceased entirely, the frequency of such incidents has declined dramatically against the backdrop of a transformed landscape in terms of violence. Serious assaults have plummeted 67 per cent in Scotland’s largest city in the last decade while offensive weapons are down nearly 75 per cent.

The gang-related violence that sparked the creation of the Violence Reduction Unit and the Strathclyde Police gangs’ taskforce has, by all accounts, diminished. “The profile of people who are victims of violence has changed as well in that it’s not so much youths involved in gang-related encounters but probably more deliberate, more targeted,” adds Ireland.

“When I say domestic violence, I don’t mean man versus women violence but [rather that] things are occurring amongst people who know each other and are deliberate. Generally, the frequency of sharp trauma as a result of assault has declined a lot and indeed, I think the night culture in Glasgow is much, much safer than it used to be too, for a variety of reasons.”

Alcohol remains a running thread, though. “What we’re still seeing is that the violence that is coming into hospital as injuries is still very strongly associated with alcohol, so although there is less of it, it is still the same association,” says Dr Christine Goodall, a senior lecturer and honorary consultant in oral surgery at the University of Glasgow, and one of three to found Medics Against Violence (MAV).

A recent trial at the Southern General sees so-called ‘violence brief interventions’ delivered to maxillofacial trauma patients alongside existing alcohol brief interventions, trying to help individuals understand that violence isn’t an acceptable part of society in Scotland anymore.

Seven years on from its launch, senior doctors behind MAV continue to visit secondary schools, though the focus has shifted away from knife carrying towards alcohol and messages around staying safe.

“Certainly in the schools, it has been quite a few years now since anybody said to me that they carry a knife and that used to be something that they would have said relatively often,” says Goodall.

A primary school programme delivered online is to be piloted this August before being made more widely available. The initiative will see pupils introduced to two fictional teenagers who have been injured as a result of violence and ask them to consider the story from various perspectives, including that of a police officer, doctor and journalist, to see where things could have been done differently.

It is domestic abuse, however, where much of Medics Against Violence’s focus – and indeed that of a number of other services – now lies. Compared to other forms of violence, the number of domestic abuse incidents recorded by police has risen 46 per cent in the past decade.

Against this backdrop, Police Scotland and the Crown Office have both embraced greater specialisation, while a government consultation on the law around domestic abuse is due to run until June 19.

Work previously undertaken with dentists, vets and GPs on how to spot the signs of domestic abuse and broach the subject of support has been extended further in the last year to firefighters and hairdressers.

The 350 or so dental and medical students enrolled each year at the University of Glasgow are all trained in how to deal with victims of domestic abuse, with other universities such as Dundee expressing an interest in following suit.

“There has been a general change and reduction in violence across the UK so that has been really positive,” says Goodall. “But you still get left with things that are not fixed, like domestic abuse. That is something that still really needs to be sorted out.”