6457 Hospital navigators: an evaluation of a youth-focused, violence reduction project in a major UK city

Objectives Hospital Navigator programs support children and young people (CYP) who present to hospitals with injuries resulting from violence. Dedicated case workers, 'Navigators' work with CYP to create personalised support plans, offer mentorship, and facilitate access to services and resources. Navigators working alongside the NHS are an important resource in safeguarding CYP and preventing the cycle of crime and reinjury.¹ Our evaluation of one program commissioned in a UK city had two aims. Firstly to assess mental wellbeing and the risk profile of participants before and after Navigator contact and secondly to compare the demographic details of CYP referred to the service with those of all CYP presenting to hospital as a result of violence related injury. Methods A pre and post assessment was completed by all CYP who accepted Navigator referral. The assessment used a Likert-type scale and the short version of the Warwick- Edinburgh Mental Wellbeing Scale (SWEMWBS) which is designed to measure wellbeing, and provides insight into levels of depression.² A local tool was used to evaluate risk. Demographic data of CYP referred to Navigators was compared with healthcare data sourced from the same hospitals where Navigators operated, specifically looking at CYP aged 10 to 25 years with a violence related injury. Results Comparison of pre and post assessment SWEMWBS scores indicated that CYP who engaged with Navigators had an overall reduction of 23% for probable clinical depression (30% to 7%).There was a significant improvement across all indicators of risk, particularly the risk of harm from others. The percent of participants whose risk was reduced for each indicator can be seen in figure 1. The gender of referrals into the Navigators project reflected CYP who attended an Emergency Department (ED) due to assault (referral group 75% male, ED attendance data 72% male). However, the age of CYP referred differed from overall ED attendances. Figure 2 depicts that younger teens are over-represented in Navigator referrals, whilst those aged over 18 are under-represented. Conclusion This evaluation demonstrated that Navigator involvement with at-risk CYP had a positive impact on mental health and overall wellbeing. Navigators are important in hospitals to support vulnerable young people and prevent further harm and the cycle of violence. The under-representation of people aged 18–25 in Navigator referrals needs further exploration. This may have been influenced by the division of healthcare into adult and paediatric services or the different processes and thresholds for safeguarding children and adults. References Are ED-based violence intervention programmes effective in reducing revictimisation and perpetration in victims of violence? A systematic review, James Brice and Adrian Boyle, 17 June 2020 Neha Shah, et al. Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS): performance in a clinical sample in relation to PHQ-9 and GAD-7, 24 November 2021.