Alcohol, assault and licensed premises in inner-city areas
Monograph no. 45
It is widely recognised that data from the Emergency Department is a better measure of violence in the community than police statistics. But other data sources should also be used where possible. Cairns is a large regional centre in far north Queensland. Around one-quarter of injuries due to violence requiring treatment in the ED at Cairns Base Hospital can be linked with the Cairns late night entertainment precinct, a tiny area of less than one square kilometre in the inner city. Alcohol is involved in the overwhelming majority of injuries due to violence in Cairns generally. In this study, a surveillance system for incidents of person-to-person violence was developed and tried in the Cairns late night entertainment precinct.
In the ED, clinicians and triage nurses flagged incidents believed to have happened in the late night entertainment precinct, Queensland Police Service provided data on alcohol-related assaults occurring there, Cairns Regional Council CCTV camera room operators described incidents of concern and venue security reported incidents from registers on licensed premises. The combined results captured by the surveillance tool were consistent with local understandings and experiences and with the published evidence; i.e. they made sense. This makes the tool potentially useful for monitoring, surveillance and evaluating the effects of targeted intervention strategies if methodological shortcomings can be addressed. A methodologically rigorous and robust surveillance system would include at least i) a clear definition of the target area, ii) sound ways to repeatedly and comprehensively count and describe incidents of person-to-person violence in the target area, iii) sound ways of estimating the population exposed to the risk of violence for the target area and iv) strong local coalitions of stakeholders with the capacity to use such a surveillance system and to provide sustained support for intervention strategies. Importantly, the study was able to engage with the ED and QPS, but also with security providers and the Cairns Regional Council. The Cairns Regional Council’s closed circuit television (CCTV) system incorporates real-time communication links between camera room operators and security on-the-ground. Camera operators are proactive, efficiently directing street security to assault incidents intervening in 40% of assaults examined, limiting possible injury. The Cairns system appears to be unique in Queensland. Also, private security personnel, the guardians of patrons in the night-time economy, were shown to hold considerable potential to contribute to reducing alcohol-related harm and injury through improving strategic and operational good practices. To address alcohol-related violence in the night-time economy of a city like Cairns, the following strategies are feasible but depend on a robust supportive network of stakeholders that have an agreed focus.
- feedback of results as research or monitoring progresses along with information and education with specific local content,
- situational interventions to better manage groups of people on the streets, featuring educational activities by health and alcohol and drug agencies
- improved transport to enable quick and safe egress from the city,
- enhancing capacities to prevent incidents by enhancing security providers skills and improving practice,
- enhanced provision of brief intervention for people with alcohol problems,
- enhanced collaboration between agencies providing victim support services
- targeted joint operations between Liquor Licensing, Police and Emergency Services,
- support for more proactive prevention by venue-based management, venue-based environmental changes and increased focus on responsible service of alcohol,
- awareness-raising among youth by key agencies
- a supportive city-wide media strategy.