Repeat violence in Scotland: a qualitative approach

7. The cumulative impacts of repeat violence

Key points

- The impacts and effects of repeat violence on participants' health and their help-seeking strategies are difficult to disentangle from cumulative experiences of trauma and harm.

- Participants disclosed a range of physical and mental health problems with profound and sometimes permanent consequences. A number had received diagnoses for complex PTSD, but an even greater amount described trauma responses. For some this resulted in social withdrawal and feelings of isolation; others described hypervigilance and emotional reactivity. These reactions negatively impacted personal relationships and social networks.

- Strategies for coping with trauma included regular binge or heavy drinking, drug use, fighting, and self-harm. Preference for informal dispute resolutions sometimes escalated conflict, leading to further violent victimisation.

- Grassroots support services were valued for their community connections and emphasis on holistic response. Smaller, locally based organisations were seen to offer more individualised support, with an emphasis on building longer-term relationships of trust. Lived experience gave workers credibility, alongside the experience and skills to engage people who are distrustful of more formal sources of support.

Overview

Previous chapters have developed an understanding of repeat violence as a dynamic process, rather than a series of stand-alone or successive incidents, embedded within and informed by a context of intersecting interpersonal and structural harms. Building on this understanding, this final findings chapter explores the impacts and effects of repeat violence alongside intersecting forms of harm, showing the cumulative consequences of these experiences on participants' health and well-being, and their help-seeking strategies. It begins by highlighting the broad-ranging impacts of repeat violence on participants' physical and mental health and their personal relationships, illuminating trauma responses and triggers alongside coping mechanisms which expose participants to further harm. Lack of trust and a preference for self-reliance have significant impacts on people's help-seeking strategies, and the chapter concludes by examining participants' preference for informal resolutions and community-based based support.

The impacts of repeat violence

Just as it is difficult to untangle different forms of repeat violence, from one another and from the wider circumstances in which they emerge, it is difficult to untangle the impacts of repeat violence. As previously indicated, the pervasiveness of violence in many of our participants' lives meant that it was often minimised, accepted as an inevitable consequence of 'lifestyle', or overshadowed by other more pressing concerns related to poverty, addiction and homelessness. Within our 'unsettled lives' and 'mutual violence' groups, participants viewed the spaces they inhabited as generally unsafe and the people they encountered as generally untrustworthy – but as we saw previously this was linked to early childhood experiences of neglect and abuse, negative (or neglectful) contact with state systems of support, alongside cultural injunctions to 'stand up yourself' and 'no grassing', not simply direct experiences of interpersonal physical violent victimisation. That acknowledged, participants identified the following impacts of repeat violence during our discussions.

Deteriorating physical and mental health

In our 'unsettled lives' and 'mutual violence' groups, participants recounted a range of acute injuries and long-term health conditions linked to specific incidents of violence. This included (but was not limited to): broken teeth, broken bones, scars, facial disfigurement, nerve damage, sight loss, pregnancy loss, infertility, mobility impairments and coordination problems, traumatic brain injury, cognitive impairment, problems with memory and concentration, and chronic pain:

One put a knife to my throat. I managed to get away from him but when I ran, I ran up an embankment and banged my head and ended up with a detached retina which they couldn't do nothing about. (53-year-old man, West Town)

She slashed me when I was pregnant, a couple of weeks back, and I ended up miscarrying because of all the stress and that. (44-year-old woman, West Town)

But the hole in my head, the back of my head. […] I'm scarred for life with that. I don't know, it's about two and a half inch across the back of my head and I hadn't done nothing. […] I'm scarred for it. It's stupid. It's like getting my hair cut- Getting my hair cut, it doesn't cut right and every time I get it done it's like, that bastard done that to me. (37-year-old man, East Town)

I've got numbness in my full cheek now, so I've got nerve damage and sometimes it twitches and that and all, I've got like a nerve in my face [that] will twitch. (24-year-old man, West Urban)

These problems impacted participants' lives considerably, affecting their ability to work or have children, for example, or providing a constant visual reminder of violent victimisation (with facial scars marking them out as 'deviant' or 'dangerous').

Participants across all groups identified emotional and mental health impacts relating to particular incidents of violent victimisation, including shock, fear, anger, and distress following the event, worsening with repeat violence. Emotional and mental health impacts could also often be long-lasting, with examples provided of flashbacks, nightmares, paranoia and avoidance:

It was like after the attack happened and I come out the hospital, I found myself- It was like flashbacks to the event because the way this certain person done it, he jumped out a car and I was just standing in the middle of the street and it was that quick, it just happened so quick. […] But paranoia set in, man. I think it was- Phew. I was just struggling to deal with simple things, going to the shop and that. (48-year-old man, West Urban)

I'm on SSRIs (selective serotonin reuptake inhibitors, i.e., antidepressants). They give you quite vivid nightmares and that was stopping me from getting to sleep at all. Because like many trauma things, I was getting very vivid flashbacks of the guy coming at me, me fighting him, and any time I would get a fright from behind, I was reliving it all. (36-year-old woman, West Urban)

Six participants said that they had attempted suicide as a result of their experience of repeat violence. In most cases, it was not simply victimisation that caused these participants to attempt suicide but difficulties with accessing support (see Chapter 6).

Social anxiety and withdrawal

Across all lived experience groups, participants expressed fear about visiting places they could potentially re-encounter their perpetrator and this was particularly problematic when the offence took place close to their home or accommodation. Side effects of this fear included social withdrawal, 'keeping yourself to yourself', avoiding leaving home (or, in the case of homeless accommodation, your room) or avoiding certain areas (e.g., the local shop, Town or Urban centre). In some cases, participants relocated, for example, giving up their tenancy in order to avoid further harm.

Emotional and mental health impacts specifically associated with experiences of repeat violence, sometimes diagnosed as complex PTSD, included depression, anxiety, and panic attacks:

I ended up paranoid, my anxiety and that went through the roof, and I ended up in the [Secure hospital]. That's where I ended up. […] I've got PTSD, my depression and my anxiety all came through all that sort of stuff, and I was basically paranoid. […] I'm always looking seeing if anybody coming from behind. And I'm like, my head's always going in a circle. (43-year-old man, West Town)

I get paranoid and scared walking about the town in dark places. I hate it. I take panic attacks and all that. I suffer severe depression through everything that's happened to us in the past. […] I can't sleep, I can't think right. (45-year-old man, West Urban)

For such participants, potentially unpredictable situations led to feelings of anxiety or paranoia related to a fear of attack. Young men in particular described how this limited their mobility to the local neighbourhood, which could in turn adversely affect leisure and employment opportunities:

It's just you're not comfortable in like crowded places or that. You're not comfortable in busy places, in places out of here cos there's a lot of chances that something might happen. You're on edge. You don't know what you're on edge for, but you are on edge. […] I just don't like being anywhere other than here. (19-year-old man, East Urban)

Some participants talked about fear and mistrust of particular groups within their community, including different ethnic groups or migrant groups. This sometimes resulted in hostility and violence. Others reported that 'you can't trust no one'.

Heightened feelings of insecurity and anxiety led some participants in the 'unsettled lives' and 'mutual violence' groups to carry weapons out of concern for personal safety, and several people we interviewed said they had dogs as a form of protection (as well as companionship):

Firearms was the last thing I was in for, but it wasn't a case of using it or anything like that. It was more protection for myself cos I wasn't from the area and my mental health was really bad and I was terrified. […] It never even had bullets in it. I didn't want bullets in it, I just wanted to make sure people stayed away from me and left me alone. […] But the way I live now, I've always got a big dog. I've had a lot of Pitbulls, American Pitbulls, I've got a big Belgian Shepherd just now, he's massive and he's like a really dangerous guard dog but he doesn't go out without a muzzle. (45-year-old man, West Urban)

Emotional reactivity and hypervigilance

Rather than withdrawing socially, or avoiding risky areas, some participants responded to the threat of violence head on. This could involve deliberately seeking out violent confrontations as means of discharging pent up emotions, or responding disproportionately to perceived slights or insults. When describing these scenarios, participants usually presented themselves as responding reasonably, though sometimes they acknowledged that certain situations 'triggered' them or that they had problems 'tolerating' unpleasant emotions. Either way, such outbursts were understood to have a protective function:

At parties, everyone has a laugh and winds people up. If someone takes the mickey out me, I would start over-thinking it and I'd be like- […] I started getting anxiety, thinking, 'They're taking the piss out of me, they're taking this piss out of me'. I wouldn't ever have a comeback or a joke back. I'd be like: [Motions squaring up] 'I'm becoming a victim I need to act', and then I'd act, you know, and it's stupid because, say this wee quiet guy, I'd just bang and explode. (39-year-old man, East Rural)

My brother and his girlfriend were fighting. I got a flashback of my mother and dad. I was in the middle of getting my carpet laid and there was a Stanley blade on the floor. I got the Stanley blade and stabbed my brother. (47-year-old woman, West Town)

It is important to understand such reactions as social and not just psychological, since they were socially learned and culturally transmitted. Participants who had difficulty walking away from violent encounters often made reference to notions of respect, reputation and in/justice, the need to stand up for yourself and protect vulnerable others, even if that meant 'taking a beating'. As previously discussed, this 'code' is linked to both the stress of living in deprived and violent circumstances and the sense of alienation associated with the failure of state systems.

Hypervigilance, an elevated emotional state of assessing potential threats, was another common theme, across different groups of participants, with references made to 'running on fear', 'like a tightly wound-up spring', 'looking over my shoulder constantly', or 'wing mirrors on all the time':

I'm always on my toes and like I always know my surroundings, if I go on a bus, I'll sit at the back of the bus so I can see – even before, this is before it happened to my face, just so I could see everything round about me. If I get on trains, I sit with my back in against a wall or in a corner so I can see everything. (24-year-old man, West Urban)

It's like you're on edge constant. […] Totally 100% aware of what's going on. […] It's like muscle memory, it's imprinted on your brain: 'Right, there's two guys behind me that are there. I need to go and sit in the corner, so I can see what everybody's doing and see when they start acting dodgy towards me'. And that's the mindset that you're always in. (27-year-old man, East Town)

This hypervigilant, threat-sensitive way of life was exhausting and participants sometimes talked about how they sought out violence, drugs and alcohol to break the tension:

I used to kind of harm myself to stop- to try and be like- to try and gain back control. So, it'd be like he'd be doing this to me, and I was completely out of control of my feelings and what he was doing and what the consequences would be. It was my home that we shared, and I kept thinking I'd get chucked out and all this type of stuff. But I just used to lock myself in the bathroom and I'd cut myself because I was like, 'I have to get control of this situation and I'd rather harm myself than him harm me'. (30-year-old woman, West Urban)

I drank a lot, took quite a lot of drugs. […] It wasn't recreational. I think I would have said it was at the time but looking back on that, that was a serious problem. But I don't think I recognised it at the time. I probably wouldn't even have said it was a coping mechanism at the time either. Again, you know, hindsight's a good thing because I can look at it detached now and go, 'Of course, that was a coping mechanism' and 'Of course, it's because I was feeling awful'. It was just oblivion basically. (32-year-old woman, West Urban)

These coping strategies often put people at greater risk of repeat victimisation, not to mention criminalisation. Some of the participants' more positive strategies for coping with repeat violence included writing, walking, meditation, yoga, and breathing exercises, often discovered as part of recovery support.

Personal relationships and social networks

Being emotionally reactive, alongside problems with substance use, made personal and intimate relationships challenging to maintain for some participants. Within interviews, participants often disclosed having difficulties forming emotional connections with other people, particularly in the context of intimate relationships, as well as problems getting along with people, discussed in terms of 'attachment issues' and 'trust issues'. This sometimes manifested itself in recurrent involvement in what were described as 'intense' or 'toxic' relationships, linked to a search for love and protection:

I was in homes from I was 11 till I was 17 and then when I left- I got thrown out the children's home and I started going out with a guy and that was my first sort of proper relationship. And it was quite- It was like- It was a completely controlling relationship. Like we took heroin together and at first it wasn't that bad, but it just got worse and worse over time. He used to beat me up, lock me in the house. But it was gradual, it was sort of gradual. I think I was always looking for somebody to look after me. I was looking at the wrong sort of people, I think. (38-year-old woman, West Urban)

I had attachment issues and that's the way I see it. When I was going into relationships, I was looking for somebody to bond to and then that impacted upon like when there was splits and stuff like that. (53-year-old man, West Town)

It gives you major trust issues. You can't really trust the people you love. (33-year-old-man, West Urban)

No matter what I went through in my life, all I really wanted was to be loved and cared for. (32-year-old man, West Urban)

The cumulative impact of repeated experiences of violence within the context of personal relationships – including the family, intimate partners, friends and community peers – contributed to a sense that the world is an unsafe place, where people are not to be trusted. This not only manifested in fears for one's own safety but fears for one's loved ones, which for some men resulted in controlling behaviour (of their intimate partners), chivalrous violence (in response to men's violence against women), and attempts to teach children (particularly sons) 'to look after themselves':

Terrified. Terrified that he's my boy, terrified that he's the same as me. Fucking used to think I'd be scared because people would want to get to him to get to me. Now I'm fucking scared that he's not going to back down from something that he should. […] I don't want my bairns to walk about being fucking hard because the next hard [guy]'s wanting to beat him to make his name. I don't want that, but I do want them to be able to protect themselves. (40-year-old man, East Town)

I was one of these ones like if my girlfriend didn't come home, I'd be like, 'Where is she? Where is she?' kind of thing. And it was a safety thing as well because I knew I wasn't safe when I was growing up and I knew- (PAUSE) what some women were enduring by being forced to go into prostitution and all the rest of it. (53-year-old man, West Town)

I would go and fight three fucking men that were trying to set about a bird. It doesn't stop me, it doesn't bother me, I'm not scared of you three, if you're fucking onto that bird and you're all coming at me instead and it's fucking shit that I don't agree with that. (40-year-old man, East Town)

They're not cheeky kids but they're not going to just sit there and take shite that they don't deserve. They'll stand their ground. My oldest son, he asked me advice on a bully. [I: What advice did you give him?] The only advice that a dad would give his son: get him on his own. So, the very next day, the kids' mum, sent me a video. (LAUGHS) So my wee boy approached the guy and put him straight, then took him round the corner and put him straight again (LAUGHS). I phoned him that night and I was like that, 'That's that guy, you've dealt with him, now he'll stay away from you, cos he'll know that you're not to be messed with and his pals will not come near you either cos you just got the big guy'. I told him that as well: the big guy, the one that causes it, the instigator, get him on his own. So, he got him on his own. (38-year-old man, West Urban)

Parents also recounted how they encouraged children to stay home, where they could keep an eye on them and 'keep them safe'. This exposed children and young people to other risks, including exposure to violence and abuse online.

Grassroots and informal responses

Continuing the theme of self-reliance, this section considers the cumulative impact of interpersonal and structural harms on participants' help-seeking strategies, exploring their preference for informal resolutions, community-based, and peer-led support. This is supplemented by a discussion of the value of local partnership working, a theme highlighted by several of our stakeholders. As discussed throughout the report, participants were generally unwilling to seek help from formal state agencies, partly because of the harms they had experienced at the hands of the state, and partly because of community norms linked to the criminal economy. Reluctance to engage with formal institutions was particularly prevalent amongst men, who often felt that they had to present as autonomous and capable to maintain their self-respect. Where women expressed reluctance, this was generally linked to past negative experience(s). Where support was accepted, it was usually in the context of community-based recovery groups, led by peer mentors with lived experience.

Informal resolutions

Many participants explained that they would prefer to deal with issues directly rather than report to the police or authorities. Particularly amongst our East Urban and East Town participants, who were not currently accessing services, there was an emphasis on 'sorting things out' yourself as a matter of respect:

It's more if somebody hits you, you don't go to the police, you go and batter them back. Just the way we were brought up. The police don't really give a fuck, so we were just brought up to defend ourselves. (24-year-old man, East Urban)

Like if you get assaulted, if you want to do something back about it, then you go and do it yourself, you don't bother going to the police. The police don't help people out. (36-year-old man, East Urban)

This reinforces much of the discussion from Chapter 3 regarding a culture of violence, rules around not grassing, and traditional models of masculinity, including fathers encouraging and rewarding violence as a form of self-defence. Dealing with conflict directly was viewed as more honourable than seeking state support, particularly where participants were concerned about maintaining their reputation and strong social bonds.

One participant discussed the sense of solidarity in their community about how issues like housebreaking and theft were resolved or restored by contacting the local drug dealer, rather than the police:

If there was somebody who was the sort of main drug dealer in the area, you'd go to him and say, 'Listen, somebody keeps breaking into my fucking house, you're going to need to get them to stop it like or I will go to the police'. And that person would go, 'I'll sort that'. And before you knew it, the person's TV and whatever would be back at their doorstep with an apology. (Peer mentor, East Urban)

Some participants discussed how informal resolutions were imposed by peers or 'gangs' when they had been victimised. In the following excerpt, a participant describes being paid informal compensation by the person who stabbed him:

Know what he said? 'Here, stab me back'. I [was] only a wee guy and I'd not stabbed anybody. I was like that, 'I'm not stabbing you.' So [gang leader] comes in and goes, 'A hundred quid every stitch'. Fucking ended up 800 quid that day off him. (43-year-old man, West Town)

Of course, the availability of alternative resolutions as a restoration of conflict was not always regarded positively, particularly when people were on the receiving end of violent restitution for a perceived wrong or slight. In the next example, a participant explains that he was shot for stealing a local gang leader's car:

I looked in the glovebox and seen the ID and I was like, 'Oh no'. And he knew it was me right away because I was well known for it. He came to my mum's door with a shotgun in their hand and took me away and shot me in the leg. I thought he was going to murder me and all they were wanting was the ID back that was in the motor. I gave them it and they still shot me. (45-year-old man, West Urban)

The preceding examples demonstrate that much of the victimisation experienced by participants was hidden from formal channels, with people usually responding to victimhood directly without recourse to state agencies and actors. Of course, the major disadvantage of this approach was that it could result in a never-ending cycle of tit-for-tat retaliations, as described in Chapter 5.

Community-based support

Where support was accepted, it was usually in the context of community-based recovery groups. As previously discussed, most of the participants in our West Urban, West Town and Rural case study sites were accessed via prison throughcare support, addiction recovery support, homeless services or community cafés. They were unanimously positive about these services, citing the value of community connections and lived experience as well as the benefits of peer-led harm reduction. All of these services can be categorised as 'grassroots' community development approaches, insofar as they sought to tackle inequality, disadvantage and exclusion through participatory processes that encouraged discussion and ownership, including the employment of paid and volunteer peer support workers or 'mentors'.

The potential of community development as a means for violence prevention was recognised by a local authority manager in one of our West case study areas (picking up on the discussion of the value of community policing in Chapter 6):

Within a community-based setting, we could potentially prevent the incident from happening in the first place rather than reacting to an incident that's taken place thereafter. Because what you tend to find is that it tends to be from certain areas. So we could be in those areas, we could really work with those areas. To me, that just goes back to good community development work. It goes back to people having eyes and ears in that community and understanding where the pressure points are going to be. (Local authority manager, West Town)

Lived experience participants also highlighted the importance of local knowledge and relationships, emphasising the role played by peer mentors, who may work in a voluntary or paid capacity, and provide a wide range of practical help and support, including gathering information about local education and employment opportunities, helping with the completion of application forms, and accompanying participants to court appearances or meetings with service providers:

They've helped us with my house, they've helped us with my applications for my PIP, my money, they've helped me deal with all that, they've helped us with budgeting, they've helped us with food when I've not had it, they've helped us with- They've gave us every bit of support that I've needed. Counselling, they got us tied in with a counsellor. And now, [Name]'s asked me to open up a recovery meeting here cos she sees a lot – there's a lot of people see something in me that I'm only just now beginning to recognise. (38-year-old man, West Urban)

The community aspect of recovery groups and cafés was also emphasised, providing participants with a safe space to meet with people who have shared experiences, providing routine and stability and the opportunity to develop meaningful relationships and wider pro-social connections:

Aye, it's a good group, aye. I really enjoy it. You learn a lot about like trauma and all that stuff. Like, you learn that you're not the only one going through it and all that, know what I mean? It's just a good wee group, it gives you something to do. (31-year-old woman, Rural East)

Coming to the group, it helps me stay away from those kinds of people that's in town. And those people [in the group] have been through what I've been through, they've got the same kinds of experience. It's a good place to come and talk and you feel safe to be able to talk. (34-year-old man, West Urban)

Peer mentors and workers with lived experience generally had similar social and cultural backgrounds to the people they were supporting, often because they grew up in the same community. They were also likely to have similar experiences of repeat violence, drug use, criminalisation, and homelessness, which helped them to relate to the people they were supporting. This is illustrated by the following two excerpts from interviews with peer mentors:

I come from a violent background and taking drugs. That's all I've really known since I was maybe 16, 17, taking drink, drugs, whatever. Just ended up in and out of jail until I was about 30 odds. But that helps me in the work here to relate to people cos a lot of them know me from my old antics. […] A lot of the guys know me from the town and they know what I used to do and what I used to get up to. So they would try and maybe lean on me cos they know where I had came from and what I'm doing now to change my life. […] If you've lived experience, then guys can look and they can see: 'He's done it, you know, try and follow the things he's doing, just to keep yourself clean to start with and then you can start putting positive stuff in your life'. (Peer mentor, West Town)

The kind of things that I've been involved in, the kind of things that I've subjected other people to, the kind of things that I've been subjected to, were like a really long apprenticeship for doing the job that I do just now. I've got a fairly good insight when chatting away to people. […] I can definitely empathise with being a victim of violence, I can definitely empathise about hating yourself because you're just so angry at everybody. […] I can walk alongside them and use some of the more negative parts of my life as positives. (Peer mentor, East Urban)

Participants reflected on the value of workers with lived experience as follows, highlighting themes of trust and credibility:

You can't buy lived experience. You cannot buy that. The identification, the similarities. They've been through the same or similar to what I've been through and they're through it. So what advice can I take from them that I could use in my own journey, so I can get to where they are? (38-year-old man, West Urban)

[Worker 1] is from [District 1]. That got knocked down and that was a whole different world, that was a lot worse than all of here. And [Worker 2]'s from [District 2], that's another deprived area. So they both know what it's like. […] That's why [Worker 1] and [Worker 2] have the respect they've got cos they've been through it all what we've been through, they know what it's like. They understand our backgrounds. (19-year-old man, East Urban)

These excerpts also highlight how peer mentors can play an important role in supporting change, with part of their effectiveness coming from them being important role models for change and growth themselves. Shared experiences also gave peer mentors credibility to engage with people who are distrustful of more formal mechanisms of engagement, highlighting the importance of grassroots responses to repeat violence.

Peer support workers know what is going on in their local areas in terms of crime patterns and issues that people are coping with. They also understand how people with lived experience of trauma respond to potential threats, and therefore can read situations that are developing and work to de-escalate conflict. This is illustrated in the following excerpts:

Normal youth workers know how to work with normal bairns. [Worker 1] and [Worker 2] know how to work with bairns with behaviour, criminal backgrounds, might have a shorter fuse than normal bairns. [Worker 1] and [Worker 2] know how to work with that and that gets them respect. (19-year-old man, East Urban)

Literally half an hour ago, I was in a de-escalation situation with a gentleman downstairs just because he felt that he had been slighted in some way and his go-to is to ramp himself up to be the scariest person around. But if you have a wee chat and have a coffee, then you usually find that there's other things going on. (Peer mentor, Urban East)

Because they understand the wider challenges of issues like drug addiction and psychological trauma, peer mentors have the confidence to respond to situations using their own discretion, where possible keeping the people they work with away from the attention of the authorities. This is part of what distinguished them from national, government-funded organisations, however, several participants also emphasised how smaller, grassroots organisations would also 'go the extra mile':

They're more than youth workers like because, it's like youth workers do their job until they're finished, then they just chuck you out. But [Worker 1] and [Worker 2]'s more than that. They want to make sure you're alright, that you're going home with a full belly. […] They show you care and they talk to you more as in they're your friend or your family and not a youth worker who's above you. […] They don't forget about you. (20-year-old man, East Urban)

Most of the staff who are here are from [West Town], so there's that sort of grassroots feel about it. […] The likes of [National organisation 1] and [National organisation 2], a lot of the staff there are leaving [West Town] at 5 o'clock, at the end of the day, and they're going back to wherever they're from. That community connection's a wee bit lost with these larger organisations. (Mental health organisation manager, West Town)

In comparison with larger organisations, smaller services were also seen to be able to provide more of a personal service, because they were not bound by national standards or procedures.

Local partnership working

The importance of being able to be responsive to the needs of the local community was also raised by stakeholders working at a strategic level, who emphasised the importance of a partnership approach to tackling repeat violence. For example, stakeholders working in Rural and Town settings saw themselves as being at an advantage, insofar as the scale of the community permitted a service delivery model that reduced 'silo working' by bringing partners together, sometimes in the same office or other centrally-located community space. This permitted managers to get an overview of the issues affecting their area, and also to develop a detailed understanding of the issues facing particular individuals and groups:

I think there's a uniqueness about the nature of partnership working because we're such a small local authority. […] I'm based within the health and social care partnership and based within justice social work. So, I think there are some other agendas that I can bring to [community justice] in terms of particularly some of the journeys that service users will have been on. […] I'm embedded within a department where actually I still get that meta view but actually I get to hear stories of individuals. […] I've got colleagues who sit within a community safety setting and justice is part of their portfolio. But I get a real sense of taking it beyond that step of actually understanding why some people who're involved in justice are some of the most marginalised people within our community, the impact that trauma has, […] understanding the frequency of violence of certain individuals [is] because their family has a past, or the community in which they find themselves in. So I think I would maybe miss an awful lot if it wasn't for sitting in this department. (Local authority manager, West Town)

Co-located partnership service provision brought benefits for people accessing multiple services, innovatively reducing barriers by bringing services to individuals and marginalised communities. An example in one Rural community was using the primary school as a central hub for essential services, simultaneously hosting the local food and clothing banks, GP and nursing team, benefits and job centre representatives, and drug harm reduction workers while also co-opting the local fire station as a refuge site for people fleeing violence.

Picking up some of the points raised by lived experience participants in the last section, the following excerpt highlights the value of holistic models of service delivery, facilitated in this case by partnership working and co-location. It also reiterates the importance of community networks – and the contribution that small-scale, grassroots initiatives can make in fostering local connections, tackling stigma and addressing isolation:

Whether it's housing, or health, or benefits, or mental health, or addictions, everybody knows who everybody is in the area and that's been the beauty of having that co-located team and it doesn't matter what the front door is, you can come into the school to get health pointers or you can go to the women's group if you're scared about domestic violence. So no branding anything as: you come here for your mental health, you come here for your addiction support. You open the doors- Like: 'If you've got any issues, let us know what they are and we can organise that for you, we can sort that out for you'. (Local authority community development worker, West Rural)

Throughout these conversations, there was an emphasis on adopting an 'asset-based' or 'community development' model of working, involving and empowering local communities and disadvantaged groups. This way of working was often evidenced in our access negotiations, where we often had to present our research access request to an advisory group of service users who decided together whether to grant us permission to speak to people using their service.

Summary

This chapter has explored the impacts of repeat violence alongside intersecting experiences of structural exclusion and social harm, recognising the cumulative effects of trauma and harm across the life course. It began by highlighting the broad-ranging effects of repeat violence on participants' health, wellbeing, and feelings of connection to others, illuminating trauma responses and triggers, adverse impacts of justice interventions and support accessibility, and feeling threatened and unsafe in the world. Previous chapters indicated the impact of structural and cultural factors on whether or not people report further victimisation; the remainder of this chapter explored the impact on how they might seek or access support. Grassroots support services were valued for their community connections and emphasis on a holistic response to repeat violence. Lived experience gave workers credibility, alongside the experience and skills to engage people who are distrustful of more formal sources of support. Local partnership working and asset-based community development approaches were highlighted by stakeholders.