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Pathways to Problems – Local Approaches

Pathways to Problems – Local Approaches. 14 September 2007 Caroline Mackie Deputy Child Health Commissioner. Policy Context (National Level). It’s Everyone’s Job to Make Sure I’m Alright Getting Our Priorities Right (2003) Hidden Harm (2004)

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Pathways to Problems – Local Approaches

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  1. Pathways to Problems – Local Approaches 14 September 2007 Caroline Mackie Deputy Child Health Commissioner

  2. Policy Context (National Level) • It’s Everyone’s Job to Make Sure I’m Alright • Getting Our Priorities Right (2003) • Hidden Harm (2004) • Mental Health of CYP: Framework for Promotion, Prevention & Care (2005) • Getting it Right for Every Child (2006) • Letter of Assurance (2006)

  3. Policy Context (National Level) • It’s Everyone’s Job to Make Sure I’m Alright • Getting Our Priorities Right (2003) • Hidden Harm (2004) • Mental Health of CYP: Framework for Promotion, Prevention & Care (2005) • Getting it Right for Every Child (2006) • Letter of Assurance (2006)

  4. What has this meant for Children& Young People in Tayside? • Work undertaken through Child Protection Committees and DAATs to implement National Policies and reflect this Agenda • Local policies and procedures developed in all three Local Authority areas to address GOPR • In NHS Tayside – Unborn Baby Protocol developed • – Review of child Protection • Feeding of recommendations from these policies into local planning process of Child Protection Committees and Integrated Children’s Services Plans

  5. What has this meant for Children& Young People in Tayside? (cont’d) • Improved Communication • Local CAMHS Group – Working towards objectives within Framework specifically identified as • Provision of CAMHS input into services for children and young people mis-using drugs and alcohol • Development of specialist CAMHS with members having training in both children and young people’s mental health + substance misuse issue

  6. What Services are Provided in Tayside? Variety of Services over tiers 1 - 3 • Tier 1: • Identify potential signs of substance misuse, provide brief advice, signpost to services • School nurse • Guidance teachers • Health promoting school partnership • Supportive discussion • Run campaigns • Information network

  7. What Services are Provided in Tayside? • Tier 2: • More focused services which cover drug and alcohol issues • Youth orientated • Offered by Practitioners with some drug/alcohol experience

  8. Tier 2: • Drop in General Services – eg Youth Enquiry Service with access to advice on substance misuse • Direct Access – offer drop in direct access to advice and info service for all ages including children and young people concerned about own or someone else’s drug or alcohol use. Can offer initial assessment, advice and information and referral on. For young people majority are referred on to other services – no under 16s have accessed this service to date. • Includem – dedicated to redressing the social exclusion ofthe most vulnerable young offenders and supporting the needs of young people who are experiencing a troubled transition to adulthood.   Tackle the social exclusion of young people at the greatest risk of offending to reduce the offending behaviour of the most excluded young people by offering packages of personal support and supervision.  What Services are Provided in Tayside?

  9. What Services are Provided in Tayside? • Tier 3: • Community based services • Comprehensive and intensive assessment and intervention programme • Deal with complex and sometimes multiple needs of children and young people • Diversionary approaches • Treatments

  10. What Services are Provided in Tayside? • Tier 3: • Children and young people’s Drugs and alcohol Service (Choice Project) • Partnership Approach with Social work and NHS Tayside • To provide service for primarily Looked After Children and Young people experiencing problems with drugs and/or alcohol misuse • Individually tailored programmes devised  • Consultancy/information source for parents, carers and key workers • Linked to choice Project (aimed at reducing or eliminating youth offending) • Nurse role filled by seconded worker from Dundee CHP • Service provided flexibly to suit young person’s needs (not 9 – 5pm)

  11. What Services are Provided in Tayside? • Tier 4: • Inpatient treatment programmes • Day Units • Residential rehabilitation • Secure Accommodation • Involvement with Tayside Substance Mis-Use Service

  12. Who Provides these Services? • Aberlour Outreach Dundee Under 12 and parents • Angus Carers Centre All ages • Barnardo’s Hopscotch Angus 5 – 16 • Barnardo’s Hopscotch P + K 5 – 16 • Dundee Educational Development Under 18 • Dundee Drug and Aids project 18 + usually although flexible • Dundee Drug and Alcohol Carers • Support Group All ages • Fairbridge Trust 13 –25 • Harm Reduction Service All ages • Includem Under 21 • Key To Change 12 – 17

  13. Who Provides these Services? • New Beginnings All pregnant women • Peer Education Under 18 • Phoenix Futures All ages • Tayside Police All ages • The Choice Project Under 18 • TCA Connect Angus Young people • TCA link up mentoring Angus • And Dundee Young people • TCA The Link project Under 18 • TCA The Web Angus Under 25 • TCA The Web Kinross Under 25 • TCA The Web Dundee Under 25 • Tayside Substance Misuse Service Primarily adult services but flexibility to see young people if required

  14. How are these Projects evaluated? • On the whole self evaluation • Occasionally external organisations evaluate – likely to become more common • Evaluated through funding provider – eg CCSF • Very little overview or comparison with other similar projects out with area • Varied feedback to inform the planning process?

  15. Future Plans • Development of brief interventions approach – • [GUM Children & Young People’s Clinic • Community Pharmacists] • Work towards early identification of substance misuse • Signposting on to other services • Identify repetitive behaviour • Screening and intervention (GUM) • Launch of strategic and operational framework for children and young people who put themselves at risk through their own behaviour and substance misuse operational framework (Dundee)

  16. Future Plans • Art Therapy bid being developed with TCA and NHS • Mental Health and substance misuse consultation as part of Delivering for Mental Health [Scottish Government document] • Ninewells currently analysing all alcohol related admissions – data available early 2008 • Perth & Kinross DAAT tendering for a post to support Looked after Young People 16 – 21

  17. Challenges • Evidence that Services address needs • Links with Community Justice Authority • Meaningful Evaluation • Collaborative Commissioning • Continuous Improvement

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