Clinical nurse specialist lauded for work with gang members

Clinical nurse specialist Dorcas Gwata was presented a Nursing Standard award for her work with young people involved in gangs in Westminster.

She won the award in the mental health category, recognising her innovative ways of engaging with this difficult to reach group.

Dorcas who is employed by for Central and North West London (CNWL) NHS Foundation Trust and Westminster Integrated Gangs Unit (IGU) works closely with St Mary’s Hospital where the hospital’s major trauma centre sees many young people involved in risky lifestyles. These young people often present with stab wounds or other injuries from fighting.

It can be a challenge to get these young people to engage. As one of her key strategies, Dorcas often uses their physical health needs as a way in to a mental health assessment, as is the case with her work at St Mary’s Hospital.

Dorcas works closely with specialist youth workers from Redthread, an organisation that has over nine years’ experience helping children and young people change their risky lifestyles. Together they provide a strong approach to connecting with the victims and perpetrators of violence at St Mary’s Hospital. They work with social services and community protection to support these individuals to make positive steps away from their current lifestyles.

Dorcas was hired following a Home Office Report in 2011, which showed significant unmet mental health needs in young people involved in gangs. As a clinical nurse specialist, she works to help improve the health of socially stigmatised, deprived young people associated with gangs.

Dorcas says: “Anxiety is a major problem. These young people need to carry knives from one part of the borough to another. And their high levels of substance misuse can escalate into untreated psychosis.

“Some have developmental problems such as learning disabilities, as well as health needs and substance misuse. Furthermore, they often have longstanding behavioural problems.

“Young girls carry particular risk factors - 20 per cent in Westminster are involved in gangs. They are at very high risk of sexual exploitation and, subsequently, self-harming.”

To help deal with the specific vulnerability of her young female clients, Dorcas refers young people to Jefferiss Wing, the world-renowned sexual health clinic at St Mary’s Hospital.

Dr Asif Rahman consultant in emergency medicine at Imperial College Healthcare NHS Trust and Dorcas’ colleague said: “In A&E we often see young people come in after having been involved in a serious violent incident, like being stabbed. These wounds are very often indicators of a much bigger problem, but it’s only the physical injuries I’m able to deal with.

“Having Dorcas and youth workers from Redthread to build relationships with these young people when they need it most has made real improvements in the lives of these individuals.

“Dorcas delivers a holistic approach to health, addressing these individuals’ mental health needs, family situation and peer relationships. And she does so using language that they can understand and relate to.

“She is very deserving of this award – she’s an invaluable member of our team and an asset to the community.”

Dorcas’ achievement was celebrated at a ceremony in the Savoy Hotel, London, on May 1 at the Nursing Standard’s Nurse of the Year 2015 event.

Dorcas said: “I’m incredibly honoured and grateful to receive this award. It will only reinforce my determination in supporting and advocating for these vulnerable young people.”

Her clinical supervisor Dr Tami Kramer said: “Dorcas’ outstanding knowledge and skills have secured her success in a difficult field.

“She has engaged with young people not primarily looking for help and are of often dismissive of their need for professional help”

Matt Watson, manager of the Integrated Gangs Unit said: “We are very fortunate to have Dorcas working with us in the IGU and proud of her hard won and well-deserved nursing award.

“Gang members and those involved in violence often present with mental health issues but accessing services has been almost impossible due to chaotic lifestyles and deep rooted lack of trust in professionals. Having Dorcas as part of the Unit has changed this.  Her flexibility, integrity and courage to work together to innovate to meet needs has seen Dorcas intervening with previously unreachable clients, often very influential in gangs in Westminster. She also provides invaluable consultation for team members that is improving practice and increasing capacity across the team. This has served to make real positive changes to individual and families affected by gangs and violence, lowering risk and improving communities.”