'Fingernails pulled off, stabbings and attempted suicide': Life for children involved in County Lines

Fingernails pulled off, multiple stabbings and attempted suicides are some of the situations children involved in county lines are experiencing - and it's on the rise.

New research into the criminal exploitation of children has revealed that more children and young people are being admitted to hospital after self-harming and attempting suicide, because of their involvement in county lines.

A report by the University of Nottingham's Rights Lab, led by Dr Ben Brewster, says health professionals are warning that young people are being forced into gangs through online exploitation and the use of explicit photos.


  • What is County Lines? 

County Lines is a system where drugs are transported from one area of the country to another, often across police and local authority boundaries, usually by children or vulnerable people who are coerced and controlled by gangs.


Here's what the research found:

  • Violence: Fingernails pulled off and multiple stabbings

Researchers have been looking at the impact of the coronavirus pandemic on the county lines drugs supply and how its affected children and young adults, who are groomed and exploited into dealing and supplying drugs.

Interviews with hospital A&E youth workers in the Midlands and the south of England have revealed a rise in violence, as well as shifts in the types of injuries and their severity. One participant reported an increase in the number of young males (aged 21 and under) attending A&E in the south of the country, who had been the victim of rape by heterosexual males in a gang context.

One youth worker described some of the injuries they had seen: “Fingernails pulled off, hair pulled out, even the stabbings… whereas before Covid-19 you may have seen one or two injuries on a young person, now they will be repeatedly stabbed. So we're talking five, six times is kind of an average amount of stab wounds.


  • Sexual exploitation: Grooming and pop-up brothels

The researchers say that males still represent the majority of A&E admissions in relation to violence with some as young as 13-years-old, however A&E professionals reported that injuries sustained by female victims in relation to County Lines activity were becoming more severe and sexual in nature.

One youth worker referred to the use of ‘gift girls’, describing the sexual exploitation of females by County Lines actors where victims are sexually exploited and passed around the wider network as a reward.

Online grooming featured consistently among interviewees, particularly involving females who were being coerced into taking and sharing explicit images of themselves.

While it was unclear whether this was linked to sexual or criminal exploitation, rising cases of self-harm in young females were attributed to this form of online activity.

One youth worker observed the existence of ‘pop-up brothels’ that were operated by organised crime groups, having not seen them prior to Covid-19. The victims, he said, were usually young British girls.

Credit: ITV News Central

  • Self-harm and mental health: High levels of suicide attempts and gang rape

While a general increase of self-harm and attempted suicide was reported across all genders, one youth worker specifically noted seeing rising cases of young males aged 17 to 19. A participant told researchers: “We've continued to see incredibly high levels of suicide attempts. What has increased with that is the reason for those suicide attempts being online exploitation and males and females being asked to send explicit photos.”

Professionals reported that this had become more noticeable in some County Lines, where the harbouring of indecent images was being used by the network as part of their coercive techniques to exert control over young people.

As well as online grooming and harm, perpetration-induced trauma and the feeling of being trapped in their exploitation were increasingly reported by young people in A&E as a reason for their deteriorating mental health. Another participant also identified suicide attempts linked with the occurrence of sexual violence within a gang context:

“One person who I met in A&E, he had been quite heavily involved in County Lines and he was in the hospital that night for trying to drink a litre of bleach. He said: ‘I just wanted to get out of it because this particular day, they was gang raping someone’ […] When he refused to get involved they beat him up and now they was after him because he wouldn't get involved in that gang rape”.

He said: “These latest findings are extremely concerning – taken together with the fact that professionals’ ability to identify signs of exploitation and safeguard vulnerable young people are being hindered by Covid-19 restrictions, it is a very alarming picture.

“One area that has seen some positive outcomes, is the privacy afforded by visiting restrictions in hospitals has meant that some young people have felt safe enough to disclose the circumstances of their injuries and experiences of exploitation. This is something that should be borne in mind when setting future policy and practice guidance.”


  • Lockdown: Car chases and road traffic accidents

The experts have found that there has been an increase in the number of injuries treated in A&E as a result of road traffic accidents, police car chases and vehicles being used as weapons by County Lines perpetrators in the south of England.

The research suggests this rise has been caused by increased movement of drugs on the roads since England’s first Covid-19 lockdown in March 2020, which has contributed to more young people being exploited through car theft.

This participant reported an increase in individuals selling their identities online, mainly through social media platforms such as Snapchat and Facebook for between £500 and £4,500.

Similar to the traditional County Lines model, those less likely to raise the suspicion of the authorities (i.e. ‘clean skins’) were deemed more desirable to the network and were offered more money. Once in receipt of the relevant documentation, organised crime groups reportedly began to take out loans, credit cards and car finance agreements in the victim’s name, liquidating the assets and using the money for illicit activity. The researchers say the difficulty in identifying the perpetrators of ID fraud has become a huge issue for law enforcement, while also having serious and long-term consequences for victims.


  • What are the next steps?

The Rights Lab researchers have put forward the following recommendations:

  • Face-to-face meetings with young people should resume as soon as possible.

  • Independent return home interviews should be completed in person within 48 hours, providing opportunity for people to be listened to, in order to understand why they went missing, and what harm they experienced.

  • Statutory services should incorporate diversionary schemes to reduce court backlogs and keep young people out of the criminal justice system to avoid their further exploitation.

  • All A&E departments in the UK should have youth workers in place to offer support to children and young people attending hospital with violence related injuries.

  • Criminal exploitation and County Lines training should be made a national requirement for those working with children, young people and vulnerable adults.


If you are, or think you might, sexually exploit or abuse a child or young person, or are a concerned parent, contact Stop it now!, a free helpline offering information, guidance and support.

People living in the UK and Ireland can call for free on  0808 1000 900 (Monday – Thursday 9am-9pm and Friday 9am-5pm), or use the online messaging service available 24 hours a day.

You can also call the NSPCC for information and advice on 0808 800 5000, email help@nspcc.org.uk or fill in the online form.