Women and girls at risk. Evidence across the life course.

The purpose of this review is to inform a new cross-sector strategic alliance focused on women and girls with complex needs. It reviews the evidence base for the underlying hypotheses of the initiative: • There are groups of women and girls with similar clusters of extreme vulnerabilities in very damaging circumstances and systems. • For some women the trajectories towards these highly damaging outcomes appear to be driven by unaddressed or unresolved trauma (defined broadly to include abuse, neglect, exploitation and disrupted attachment). Other risk factors, such as personality type, genetics and family history, may also play a role. • Girls may begin to exhibit the behavioural manifestations of this early experience in different ways from boys in adolescence (which is also when service responses begin to differ). • Some women have been failed as children and as adults by the services meant to protect them, to support their resilience and to assist their recovery. • There are opportunities to address these issues and support women and girls by taking a ‘life course’ approach, looking holistically at a structural, social and cultural context. The review is based on a search of a broad range of evidence sources including: published research, theoretical literature, data available on UK government websites and ‘grey literature’ such as organisational reports and websites. The parameters of the search strategy have been literature published in the English language since 2000, supplemented by a selective review of significant literature since 1980 (identified primarily through citations).The review has explored available research and other sources of data on the characteristics and risk factors of women or adolescent girls who experience negative outcomes, including those: • In contact with the criminal justice system as adults or young women • Experiencing homelessness • Involved in prostitution or sexual exploitation • Experiencing severe mental health problems • With serious drugs and/or alcohol problems. We consider the relationship between these outcomes and the prevalence or accumulation of negative and abusive experiences across the life course, including physical abuse, sexual abuse, neglect, disrupted or poor attachments, domestic violence, negative school experiences and being in care, highlighting differential impacts by gender. We also review the available evidence on the characteristics of interventions that succeed in interrupting these pathways, and increase resilience and the possibility of recovery at different points of the life course, for example drug and alcohol and mental health interventions, education and training, maternity and parenting provision, and housing and criminal justice responses