An effective local public health response to child sexual exploitation

Today sees the launch of a two part resource for local public health leaders outlining how public health can support prevention and intervention of child sexual exploitation (CSE).

Part one of the resource is a framework designed by Public Health England (PHE) to support local leaders to address CSE. The second part of the resource is a CSE literature review commissioned by PHE and carried out by researchers at the International Centre. The literature review provides a high level summary of the UK research evidence around the issue of CSE, through the lens of what an effective local public health response to the issue might look like.

In today’s blog, Joanne Walker, one of the researchers who carried out the review, outlines some of the learning for Public Health from the CSE literature.

A public health response to CSE

CSE holds clear implications for the health and wellbeing of children and young people. This is both in terms of the impacts of the abuse itself and in terms of its frequent connections to wider health and wellbeing concerns. CSE can result in a range of physical, sexual and mental health difficulties and research also illustrates links between CSE and higher rates of youth offending, risk of forced marriage, involvement in adult sex work and poor educational prospects, amongst other things.

Public Health can play an important role in the response to CSE. A public health approach could enhance both individual and population-wide resilience to CSE and associated vulnerabilities, and protect and improve children and young people’s health and wellbeing through both preventative and responsive initiatives.

In addition, Public Health can contribute to the disruption and prosecution of offenders in a number of different ways. Changing public attitudes around CSE, for example, could contribute to a reduction in incidence and/or higher rates of reporting and identification. Public health also has an important role to play in considering the needs of children and young people who engage in criminal justice processes as victims or witnesses.

Local response

Public Health can proactively contribute to a holistic and multi-agency response to CSE through the work of local authority Directors of Public Health and that of health and wellbeing board partners. Some of the ways Public Health can respond to CSE in local areas include:

Providing leadership

Public health can provide leadership within the preventative domain, and in ensuring appropriate recovery and reintegration for victims. This can be achieved both through improvements to CSE frameworks and through more general improvements to the range of health issues and services that intersect with it. These include:

• school nursing services,
• public mental health services,
• alcohol and drug misuse services,
• health visiting,
• sexual health and reproductive services, and
• public health aspects of the promotion of community safety, violence prevention and response. This includes supporting schools and colleges to deliver comprehensive sex and relationships education.

Joint Health and Wellbeing Strategies (JHWSs), in particular, offer an opportunity to develop a holistic strategic response to CSE with clear outcomes that will, in turn, inform local commissioning of services for victims and perpetrators.

Developing the CSE evidence-base

The evidence base indicates that different local authority areas may have different profiles of CSE, highlighting the consequent necessity of CSE strategies and commissioning arrangements being based on an accurate and comprehensive mapping of the local manifestation of the issue. The inclusion of CSE in Joint Strategic Needs Assessments (JSNAs), as is currently the case in some local authority areas, offers an effective mechanism for facilitating this.

Contributing operationally to local responses to CSE

Current commissioning arrangements offer an opportunity to develop a needs-informed locally-responsive service landscape. For example, local public health commissions can consider how the range of services that fall under the Director of Public Health’s commissioning responsibilities can complement one another to tackle CSE.

Directors of Public Health can also support the protection of children and young people, and the disruption and prosecution of perpetrators, through their role in licencing. Directors could consider, for example, the ways in which in their position as ‘responsible authorities’ under the 2003 Licencing Act enables them to promote public health interests relating to CSE. They could also consider ways in which they can work with local authority partners^[1] to effectively use local licencing laws to disrupt CSE.

Finally, by providing a holistic response to CSE a public health approach could address the inequalities, vulnerabilities and broader social detriments that can impact on health and wellbeing in children and young people. They could also go some way to disrupting perpetrators and address the consequent vulnerabilities and inequalities that can result from CSE.

If you would like more information about this work please contact joanne.walker@beds.ac.uk. Public Health England have also written a blog about the publications, which can be found here.

[1] Including police, fire service, health and safety, environmental health, child protection services, trading standards, planning, and the licensing authority.