Background: Prisoners are at increased risk of poor mental health and self-harming behaviours, with suicide being the leading cause of death in custody. Adverse childhood experiences (ACEs) such as child maltreatment are strong predictors of poor mental health and wellbeing yet despite high levels of ACEs in offender populations, relatively few studies have explored the relationships between ACEs and prisoners' mental health and wellbeing. We conducted an ACE survey with 468 male adult prisoners in a Welsh prison who were not currently considered to be at risk of self-harm and suicide and explored relationships between ACEs, lifetime mental illness diagnosis, self-harm (lifetime and lifetime in prison) or suicide attempt (lifetime and lifetime in prison), and current low mental wellbeing. Results: Most participants (84.2%) had suffered at least one ACE and 45.5% had suffered ≥4 ACEs. Prevalence of lifetime mental illness diagnosis, self-harm (lifetime and lifetime in prison) or suicide attempt (lifetime and lifetime in prison), and current low mental wellbeing increased with exposure to ACEs. For example, 2.7% of those with no ACEs reported lifetime self-harm or suicide attempt in prison compared with 31.0% (self-harm in prison) and 18.3% (suicide attempt in prison) of those with ≥4 ACEs. Compared with participants with no ACEs, those with ≥4 ACEs were four times more likely to report lifetime mental illness diagnosis and suicide attempt, and over 10 times more likely to report lifetime self-harm than those with no ACEs. Independent of lifetime mental illness diagnosis, selfharm or suicide attempt, participants with ≥4 ACEs were almost three times more likely to have current low mental wellbeing than those with no ACEs.

In the UK, demand for the police has changed, with the majority of calls now vulnerability-related. Police safeguarding notifications (N=3,466) over a one-year period for a local authority in Wales were matched to social care records. Over half (57.5%) of notifications were referred to social services and only 4.8% received social service input (e.g. social worker intervention). Over a third of individuals had repeat notifications in the study year. Findings evidence high levels of police-identified vulnerability and an imbalance in vulnerability-related risk thresholds across agencies. Furthermore, some individuals require more appropriate action to mitigate the risk of future safeguarding notifications.

Preventing and mitigating the life-long harms associated with childhood adversity is a clear international priority. Many organisations are striving for long-term, sustainable solutions to improve the wellbeing of populations. As International trends for crime decline and demand related to vulnerability (i.e. child maltreatment and domestic violence) increases, it is essential that the police respond using an early intervention approach to break intergenerational cycles of violence.The research aimed to understand the current system for the response to vulnerability by a police force in Wales, UK. Objectives included understanding police perceptions on their ability to respond to vulnerability and identifying the current protocols for the management of vulnerability by the police and associated agencies.In October 2016 – January 2017, mixed methods research was conducted with a police force in Wales. Over 370 hours of operational policing was observed, 27 interviews and seven focus groups were conducted with police staff. Police safeguarding referral data for a 12 month period was also analysed to ascertain the scale of vulnerability.The police encounter high levels of vulnerability related demand, with over 60 000 safeguarding referrals submitted in a 12 month period. Staff held diverse levels of understanding on vulnerability and the effects of childhood adversity or trauma. A varied capacity and opportunity to assess and respond to vulnerability was also reported. Challenges included cross-organisational working, highlighting the need for a shared understanding across services.Traditional policing methods, training and systems need to adopt to this scale and type of demand. A range of recommendations have been developed to ensure policing can be more effective in preventing problems before they escalate. Policy implications include how police are trained, ensuring they respond to vulnerable individuals in a trauma-informed way. Implications of the findings for partnership working will be examined.

Experts from across the globe have warned of the adverse consequences of COVID-19 lockdown and physical distancing restrictions on violence in the home, with the United Nations describing it as a shadow pandemic. This social innovation narra-tive explores how a public health approach to violence prevention is implemented in Wales during the COVID-19 pandemic by the multi-agency Wales Violence Prevention Unit. The article highlights early trends in monitoring data on the impact of COVID-19 restrictions on violence, including likely increases in domestic and sexual violence and abuse, concerns over the safety of children and young people, both online and in the home, and increased reporting of elder abuse. The article supports the notion of a shadow pandemic, emphasizing the lack of data that routinely measures violence in the home and online that disproportionately affects women, children, and older people, as well as vulnerable and minority populations. This renders these forms of violence much less “visible” to policy-makers in comparison with violence in public spaces, but they are of no less public health significance. Through sharing this narrative and early findings, we call for increased focus on the develop-ment of new data collection methods and violence prevention programs during the COVID-19 pandemic and in the future.

Across the United Kingdom, vulnerability is the biggest area of demand for police. However, evidence demonstrates that some forces may not be equipped to respond to the volume and nature of this demand. Beyond their statutory duties, operational police are often unaware of how to best respond to vulnerability within their roles. For many police officers and staff, there is limited training available to develop the skills needed to provide frontline support to vulnerable individuals and to signpost and refer to agencies who can provide the appropriate needs-based services. The Early Action Together (E.A.T.) program is delivering transformational change across Wales to support police and partners who wish to adopt a whole-systems response to vulnerability that enables early intervention and prevention. Drawing on the evidence around Adverse Childhood Experiences (ACEs) and the impact these early experiences can have on life outcomes, training is delivered to police and partners to embed ACE- and trauma-informed approaches into everyday practice. Evaluation of the training is already evidencing some key benefits of using this approach, with officers identifying and applying rootcause understanding of crime and harm and developing public understanding of existing early intervention assets and pathways of support in their local area. However, careful consideration and planning are required to ensure that these approaches continue to be embedded beyond the life of the program.