The causes are numerous and complex, but it is the scale and the age of those involved that alarms adults on the frontline

With a metallic creak, the door to one of Birmingham’s “weapons surrender bins” opened to reveal a plethora of blades, from kitchen knives to karambits, claw-shaped knives commonly used in south-east Asian martial arts which have lately featured in some computer games.

It was a collection that had been building in the windswept car park of a church in the Hockley area of the city before being unlocked last week.

Despite being dismissed by some as a PR stunt, the container is one of a network of 12 in the West Midlands that is be expanded as part of a range of measures in a region that has experienced the biggest increase in knife crime outside of London.

Facebook Twitter Pinterest Jaydon Washington James, 16, was killed on Saturday. Photograph: West Midlands police/PA

The fatal stabbing in Coventry on Saturday of 16-year-old Jaydon Washington James – killed, according to his sister, because of his postcode – brought the number of teenagers and younger children killed by knives in the West Midlands police force area to six this year, more per capita than in London and a 40-year high.

A previous spike came in 2013 when four people under-20 were fatally stabbed.

The five of those killed so far this year were from a black and minority ethnic background, the youngest 8 and 11.

“We are alarmed by the sheer number and we are alarmed by the ages of those involved,” said Katie Wright, an A&E consultant and co-lead of children’s emergency department at Birmingham’s Heartlands hospital, as she gestured towards an entrance door where people who have been stabbed are regularly dumped by those who would prefer not to attract the police attention that comes with calling for an ambulance.

Recent patients have included an 11-year-old who has been carrying a knife because he felt unsafe in his area, says Wright. She added that Heartlands’ location in an area with “massive” levels of deprivation resulted in minors frequently coming to A&E because of alcohol and drug problems, events at home and self-harm.

“Very often they are the ones who we see further down the line presenting with stab injuries,” said Wright, who likened the violence to a contagious disease that should be treated as a public health problem.

Chest, back and face wounds account for the vast majority of cases – sometimes seemingly carried out because of myths about those parts of the body being non-fatal places to stab – although medics also see life-changing abdominal wounds.

Like others working on the frontline of dealing withknife crime in the West Midlands, Wright was quick to point to poverty as one of the factors behind the rise.

Facebook Twitter Pinterest Katie Wright, A&E consultant at Birmingham’s Heartlands hospital, has been alarmed by the scale of knife crime and the age of those involved. Photograph: Linda Nylind/The Guardian

Although a landmark 2017 report on gangs and violence in the West Midlands (pdf) concluded it was difficult to explain the increase in both gun and knife crimes in recent years, it listed a mosaic of reasons cited by police, community groups, former gang members and others.

They included the emergences of a “new generation of gangsters” known for spontaneous acts of violence, the role of social media and music, mental health issues and what some referred to as the “father deficit”. Above all, perhaps, there was the impact of government austerity measures that resulted in the West Midlands experiencing some the steepest cuts in funding for youth work.

In Wolverhampton, the budget for youth services shrank by 86% between 2014-2017. Catch22 is a youth organisation that runs a “violence reduction team” aimed at supporting and rehabilitating young people inside or on the fringes of gangs. Its caseworkers said it has had a dramatic increase in referrals in the past 18 months, with the youngest person it recently helped being only seven years old.

Funded from the budget of the West Midlands police and crime commissioner (PCC), the team’s three caseworkers are working with 80 young people but could “easily” double that, given the right resources.

Out of a group of five of its young clients who answered questions from the Guardian passed on by Catch22, four said they carry or had carried a knife.

One, who carried a knife for protection, said: “You could probably try and calm the situation in some areas, but in other areas it isn’t possible, because people are revenging what’s already happened.”

Another said: “I don’t carry a knife, but, yes, someone’s tried to stab me. We need youth clubs, in every area.”

Former gang members who now mentor the young express surprise that carrying a knife has become common place among a new generation. Two mentors, who work in different parts of the West Midlands, spoke of a “desensitisation” towards violence, in some cases citing the role of computer games. They also emphasised deprivation as a factor and one over-riding catalyst: fear.

“It’s the age of people who are involved which is the biggest shock to me,” said James Gwilt, who served a prison sentence for arms offences. He compared his mentoring of at-risk young people to feeling like he was “continually trying to extinguish fires popping up everywhere”.

Gwilt adds: “Families are fracturing. Poverty has always been here but now it really feels like a generation are having upbringings without any love. When me and my friends were in that life we still had good upbringings. Nan was in the kitchen preparing a meal. Now she’s probably on Facebook.”

Simeon Moore was once affiliated to a Birmingham gang known as the Johnson Crew. He bemoaned the absence of more male mentors from communities affected by knife crime and the lack of backing.

“It’s also about the aunties, the uncles, the cousins. We literally need teams of people out on the streets and in the schools,” he said.

Moore’s words echoed one of the key criticisms of the 2017 report on gangs and violence in the region. It said there were no examples of genuine “power-sharing” between communities and the statutory, private and voluntary sectors in the West Midlands.

The office of David Jamieson, the PCC for the West Midlands, said community organisations were included in an implementation group overseeing a raft of initiatives ranging from the knife bins to funding for campaigns in schools. His office also part-funds Redthread’s youth violence intervention programme in collaboration with doctors such as Wright. The pilot scheme places youth workers in A&E departments across the Midlands to provide “tailored” support for young people at risk of youth violence or exploitation.

Police cuts are cited as one of the backdrops to the rise in violent crime by Jamieson and Pat McFadden, one of a number of Midlands MPs who have been pressing the Home Office on the issue and led a Commons debate on the matter this month. West Midlands police has lost a quarter of its officers (about 2,000) in recent years.

Both also point to local authorities cuts that have led to the provision of youth services in the West Midlands coming to, in Jamieson’s words, a standstill.

Another factor is causing particular concern to Jamieson: the “off-rolling” of pupils by schools, which he said was deliberate in order to enhance overall exam results.

“These are very often the children who find themselves involved in knife-related crime. Some of the nastiest episodes we have seen have almost always involved children from this group. They are being failed by some of the very institutions that are supposed to be one of their first and foremost supports,” Jamieson added.

Facebook Twitter Pinterest Det Supt Ian Parnall, of West Midlands police, says the reasons behind knife crime are so complex that it is difficult to tailor a response. Photograph: Linda Nylind/The Guardian

Det Supt Ian Parnell is the West Midlands police’s lead officer on knife crime. He said the force was recording between 250 and 280 knife-related offences a month and that this had followed a “worrying” increase in recent years.

“It’s incredibly complex as you don’t have one particular crime you can focus on,” said Parnell. “It might be related to gang issues, school issues, the night-time economy or domestic violence. It also tends to involve young males of all races and backgrounds, so it’s difficult to tailor a response to such a broad spectrum of people.”

While focused on “listening” to young people, he said stop and search had a role, provided it was based on firm intelligence and in consultation with communities. The said the West Midlands was in a good position on this, there was still a “battle” about the tactic’s future.

He added: “One idea I would like to explore is around ‘safe routes’. What can we do in partnership with the community and schools to reduce the fear and reduce after school violence and the propensity to carry knives.”