Planning and Provision of Drug Misuse Services

Services for Young People - Key Messages

Summary of key findings of the Health Advisory Service report
Children and Young People: Substance Misuse Services

The Health Advisory Service thematic review of substance misuse services for children and young people found a lack of dedicated services for young people who misuse substances. What services there were operated outside any strategic framework, and therefore in isolation from other services. Young people were often referred to inappropriate adult services for treatment.

The review recommended that:

• commissioners should clarify definitions of 'young' to ensure services are available for all age groups and are appropriate, with the aim of preventing young people falling through the 'gaps' in services;
• commissioning strategies are developed for young people;
• there should be a balance between education, prevention, care and therapeutic interventions for young people;
• commissioners need to make clear contractual arrangements that stipulate dedicated services for young people, particularly for assessment and treatment;
• services for young people should be located in an appropriate environment and open at times when young people can access them eg after school hours. Services should also be geared to specific needs eg young women, young people from an ethnic minority background. Services should be well publicised and user friendly and should accept self-referrals;
• staff working with young people require training which should be resourced and co-ordinated at local level, and have multi-agency participation; and
• adequate systems of support and supervision for staff should be in place.

Summary of key findings of an evaluation of a Young People's programme in England

The evaluations suggest that commissioners should pay careful attention to improving needs assessment, co-ordinating referral systems and developing appropriate services to respond to the needs identified. Particular attention should be paid to examining the needs of young people known or believed to be at risk of drug misuse who are in the care of local authorities, in contact with criminal justice agencies or living in inner-cities or economically deprived areas. Drug treatment and care interventions delivered away from traditional healthcare settings (for example, children's homes, homeless centres, courts, schools) may successfully engage some young people with drugs problems.

• It is important not to assume there is, or is not, a drug misuse problem.
  Clear identification of local needs and how these are to be addressed can save time and resources. However, needs assessment should not delay addressing identified problem misuse.
• "Recreational" or occasional misuse of drugs may not be perceived as a "problem" for many young people: primary prevention initiatives require careful development to succeed in dissuading young people from drugs.
• Interventions should be planned and integrated with other services rather than opportunistically provided. Commissioners should promote closer working between specialist drugs services and child and adolescent health services and with other young people's agencies to ensure interventions are likely to be relevant to their needs.
• Determine clearly what needs to be done: projects (eg outreach to communities and organisations) which essentially provide information or deliver primary prevention messages can help meet young people's desire for good quality advice and can reach large numbers. However, young people may not necessarily want any more from such services nor keep in touch.
• Whilst young people can be trained to provide information to their peers, it is not yet possible to determine whether such approaches are more or less effective than other approaches.
• Projects which have a geographical or locality focus, targeting smaller manageable groups (eg in residential settings, courts or discrete areas) may be more successful than those which adopt a "scattergun" approach.
• The views of young people and their parents should be taken into account at all stages, including policies on confidentiality and consent.
• Community diversion programmes (eg outdoor pursuits, alternative recreational group activities) may not attract those with significant drug misuse problems.
• Established agencies may fare better with their target audience: projects which rely on intermediaries or referring agencies to "broker" contact with young people may be less successful: clear working agreements may help overcome this
  problem.