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Effective Interventions Unit - Young people with, or at risk of developing, problematic substance misuse: A guide to assessment

Introduction

An effective assessment process is at the core of delivering effective treatment, care and support to individuals. The EIU produced guidance on assessment as part of 'Integrated Care for Drug Users: Principles and Practice' (EIU 2002) and went on to publish a 'Digest of Tools used in the Assessment Process and Core Data Sets' (EIU 2003). However, these materials deal with adults and we recognise that it may not be appropriate to apply assessment processes or tools that were developed for use with adults to young people.

There are important differences between the needs of young people and the needs of adults: for example, in terms of their vulnerability, the circumstances of their substance misuse, methods of use and perceptions of risk. These differences are described in more detail in the EIU guide 'Services for Young People with Problematic Drug Misuse: A Guide to Principles and Practice' (which can be downloaded at http://www.drugmisuse.isdscotland.org/eiu/pdfs/eiu_yptreat.pdf). This current guide to assessment for young people with, or at risk of developing, problematic substance misuse follows our commitment to undertake further work on assessment for young people in that guide.

This guide to assessment addresses young people's substance misuse, not just drug misuse. During the consultation work that we undertook as part of our evidence gathering, participants frequently reported that young people often had issues with both drugs and alcohol. Both are problematic for young people and are often inextricably linked.

There is wide agreement on the need for different levels of assessment although currently there are no common definitions. Consultation with practitioners and others on the content of this guide suggested that it should address 'the initial identification of substance related needs' (or initial assessment) and what might be involved in a more in-depth assessment.

The wider context: other work on assessment for young people

This guide needs to be placed within the context of wider work on assessment for children and young people being undertaken by the Scottish Executive and others.

Recent reports (such as 'For Scotland's Children' and the child protection review 'Its Everyone's Job to Make Sure I'm Alright') and Inquiries on children (Kennedy McFarlane and Caleb Ness) have highlighted deficiencies in assessment and information sharing. The Cabinet Delivery Group on Children and Young People has identified assessment and information sharing as one of its five priorities for action. The Scottish Executive (in partnership with other agencies) is undertaking a programme of work which will include the production of: a new integrated framework for the assessment of children and young people and guidance to support information sharing in children and young people's services. We refer to this work throughout this guide.

Colleagues within the Scottish Executive who are currently developing the all encompassing integrated assessment framework for children and young people have worked closely with the EIU to ensure that our evidence and this guide will support that wider initiative. While the focus of this guide is assessment for young people engaged in substance misuse, we have identified key principles and key elements of person-centred effective practice in engaging with young people, building relationships and managing an assessment which apply to all assessments involving young people.

Other national initiatives which address assessment include: the eCare children's stream which focuses on common assessment processes and data sharing; the 'Getting our Priorities Right: Good Practice Guidance for Working with Children and Families affected by Substance Misuse'; and 'Individuals in Transition: A Framework For Assessment and Information Sharing' developed by Careers Scotland in consultation with the Scottish Executive. The 'Looked After Children' materials developed by the Department of Health in England and now used by most Scottish local authorities provide a national framework for assessing the needs of children who are looked after. There is also the Education (Additional Support for Learning) (Scotland) Act which is expected to come into force in 2005, and the recent Children's Charter.

We have looked at work underway in England and Wales, and a separate initiative in Northern Ireland, on assessment and information sharing. This guide also draws heavily upon: 'First Steps in Identifying Young People's Substance Related Needs' (Home Office/Drugscope 2003) and 'Assessing young people's drug taking: Guidance for drug services' (Standing Conference on Drug Abuse, SCODA, 2000). We have then gone on to present case studies from the Scottish experience, where agencies and service providers have adapted the Drugscope and SCODA materials to meet their own needs.

The legal framework that exists for children and young people is also different to that for adults. The Children (Scotland) Act 1995, the United Nations Convention on the Rights of the Child 1989 and the Age of Legal Capacity Act (Scotland) 1991 are the three key pieces of legislation in relation to the care and welfare of children in Scotland. The child or young person's welfare is paramount. Children and young people's rights include the right to protection from abuse, neglect or exploitation and the right to be heard and to have their views taken into account. Those working with children and young people must ensure that their rights are upheld and that children and young people understand what their rights are. They also need to know who will champion their rights if they feel they are being ignored. In March 2004, the Scottish Executive published a Children's Charter, 'Protecting Children and Young People - The Charter' which sets out what children and young people need and what they expect to help protect them when they are in danger of being, or have already been, harmed by another person. The Executive also published the 'Framework for Standards', which is a means for translating the commitments made to children in the Charter into practice.

Methods

This guide is informed by:

• a Reference Group with representation from: the EIU, other Scottish Executive Departments, national agencies working with young people, Drug and Alcohol Action teams (DAATs) and local authorities, and services working with young people with substance misuse problems. Membership of the reference group is provided in Appendix 1.

• two practitioner consultation seminars (one in Stirling and one in Bishopton, by Glasgow) with a total of 90 participants ( Appendix 2). Consultation feedback is provided in Appendix 3.

• consultation with young people, via services working with young people, and examination of previous research on young people's assessment experiences.

• consultation with families on their experiences of assessment, via the Scottish Network of Families Affected by Drugs (SNFAD).

• case studies of assessment frameworks, processes and tools in use across services in Scotland. The guide also incorporates case studies on effective ways of engaging with young people and examples of practice for sharing information. The services who provided information for the case studies are listed at Appendix 4.

• visits to a number of agencies and individuals working with young people. A full list of these visits is at Appendix 5.

• consultation with colleagues in other departments/units of the Scottish Executive, and Careers Scotland, on wider work on assessment for young people currently being undertaken.

• an examination of assessment materials produced in England by the Home Office/Drugscope and by the Standing Conference on Drug Abuse (SCODA). The EIU also looked at the development of a national assessment framework for England and Wales (Department of Health and Welsh Assembly) and work underway to develop a national assessment framework in Ireland.

The potential audience for the guide is wide, ranging from generic services e.g. health, social care, criminal justice, through to specialist substance misuse services for young people. DAATs and partner agencies engaged in planning and commissioning of services should also find it useful since an effective assessment process is at the core of the planning and delivery of effective services. In particular, a robust assessment process delivered consistently across service providers should supply important data to inform future planning.

It is hoped that the layout of this guide will allow people to access information according to their varied needs and interests. It is also important to note that this guide limits its scope to assessment leading to the production of an agreed action plan. It does not extend to the issues that impact on the wider care planning process. Finally, it may be helpful to read this guide in conjunction with the EIU Guide to Services for Young People.

Note: In this guide there are many references to previous EIU documents: 'Integrated Care for Drug Users: Principles and Practice'; 'Services for Young People with Problematic Drug Misuse: A Guide to Principles and Practice'; and 'A Digest of Tools Used for Assessment and Core Data Sets'. As shorthand we will refer to them as:

Integrated Care for Drug Users
Guide to Services for Young People
Digest of Assessment Tools

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