D U M F R I E S AN D G A L L O W A Y

1. D U M F R I E S AN D G A L L O W A Y ChYPSS Integrated Substances Service

2. EARLY INTERVENTION The provision of early intervention services in rural areas for children and young people up to 18 years of age with/at risk of developing substance misuse problems

3. WHO ARE WE?

4. DUMFRIES & GALLOWAY ChYPSS/INTEGRATED SUBSTANCES SERVICE (Council/NHS/Aberlour)

5. ChYPSS Children & Young People’s Substances Service • Funding from Changing Children’s Services Fund 2002 • Remit: to set up, recruit/train specialist staff, develop model • of specialist substance misuse integrated working with: • * children with substance misuse problems • * children at risk of developing substance misuse problems • Multi-agency staff recruited/trained 2003 – full/part-time - • * social work, mental health, education, family/parenting, admin • * sessional staff to facilitate group work/activities & outreach • Evaluate project – evaluation by PiE completed January 2005

6. WHERE ARE WE NOW? • Agreement to develop a multi-agency integrated D & G wide • multi-disciplinary service with a single service manager • Integration of local authority, health and voluntary sector • Manager appointed September 2005 • In process of integrating the three existing service providers • for YP with SM problems – • CASUMS/ChYPSS and Aberlour (CRANNOG SM) • provide equity of access and service provision across D & G “YOUNG PEOPLE’S INTEGRATED SUBSTANCES SERVICE”

7. “A child’s world should be a secure and loving place created through the parents’/carers’ capacity to provide safety, emotional warmth, stimulation, guidance boundaries and stability” (Kroll & Taylor 2003)

8. What should we be providing for young people (up to 18 years) who have, are at risk of developing, substance misuse problems? • “Improve the range & quality of substance services for young • people, particularly under 16’s” • Develop “integrated services to assist early intervention” • with young people “particularly those with serious & • sustained substance misuse problems” • “A multi-disciplinary approach” is vital. “Young people’s • problems do not respect professional boundaries” • (SDF 1999)

9. “Substances services for children & young people should be separate from those of adults” (SCODA 1990) Services should be multi-agency, multi-disciplinary, in order to provide Early Intervention holistic services “from infancy to young adulthood” (Bancroft et al 2004)

10. HOW DOES RURALITY AFFECT THE PROVISION OF EARLY INTERVENTION SUBSTANCE MISUSE SERVICES TO CHILDREN & YOUNG PEOPLE UP TO 18 YEARS?

11. Population Stranraer - 11,348 Dumfries – 32,136 Annan – 8,930 Newton Stewart – 4,600 WEST EAST

12. Dumfries and Galloway extends to 2,380 square miles • Population in 2001 census = 147,765 • DUMFRIES (32,136 approx), STRANRAER (11,348), ANNAN (8,930) • Sparse population = other towns and villages = under 5,000 pop. • Of 60,000 people employed = 15,000 with Local Authority/NHS • Unemployment is below the Scottish average (0.5% average) • Dumfries and Galloway has low wage economy( 9% - Scot/17% -UK av.) • Shortage of skills in D & G, young people move away to work • High percentage of the population depend on benefits

13. ISSUES OF RURALITY AND YOUNG PEOPLE • Isolation and/or exclusion • Limited opportunities and low pay • Limited, or lack of, facilities that YP want to access • Inequity of and access to service provision • Restriction of choice • Poor transport • Marginalisation and disempowerment • Difficulties in accessing confidential services • YP in rural areas are more vulnerable to substance misuse • Misuse of alcohol (at an early age) is prevalent • (alcohol misuse in D & G = “endemic”& “above national average”) • Growth rate of problematic SM is “higher” in some rural areas • YP gathering on the streets is seen as anti-social behaviour • (www.countryside.gov.uk 2005)

14. “Hidden Harm”, “Getting Our Priorities Right”, “It’s Everyone’s Job to make sure I’m Alright” etc These documents emphasise the need for partnership working, in RURAL areas this absolutely vital if we are to be able to provide equitable bio-psycho-social services to our young people FOR EXAMPLE – we need to develop an interface between children’s/adult services re: Hidden Harm and developing the “Whole Family Approach”

15. Staff should be “aware of the factors that can increase a young person’s vulnerability to developing substance misuse”(EIU 2002) Staff in universal/Tier 1 & 2 services should be appropriately trained to screen and assess for indicators of substances (including alcohol). This is particularly important in RURAL areas where staff and services are spread thinly across regions such as Dumfries & Galloway

16. Protected low number caseloads are essential to ensure intense and regular sessions with young people (and their families) • This is a challenge in RURAL areas because of • difficulties in recruiting, training and retaining • appropriately qualified specialist staff • Large rural areas to cover between visiting young • service users has impact on caseload/numbers of • young people who are supported by the service

17. What do we mean by Early Intervention and Substance Misuse? • Provision of appropriate services early in a person’s life that lowers risk, increases resilience and reduces the chances of problematic substance misuse (and other problems) • developing later in the child’s or adult’s life • Provision of appropriate services early in the history of the use/misuse of the substance/s

18. Recognition of importance of Early Intervention “Pro-active and preventative” service delivery is recommended by 21st Century Social Work – COSLA Task Group. * The need to work proactively with other agencies such as education & community services is emphasised * “There is no doubt working to prevent significant cases emerging through early intervention offers potential long-term benefits” * However, the Task Group recognises that this requires “significant resource commitments” The resource implications for proactive, preventative and Early Intervention service delivery in RURAL areas are even more significant

19. HOW DOES ChYPSS/INTEGRATED SUBSTANCES SERVICE PROVIDE EARLY INTERVENTION?

20. Stakeholders described ChYPSS as “highly regarded” because of • “its proactive, imaginative and targeted work with • children & young people and its ability to offer • Early Intervention” • They reported that ChYPSS had • “a reputation for being very good at identifying families • at risk” • (Partners in Evaluation 2005) This has created enormous demands on staff who both carry caseloads as well as plan, develop and often facilitate various initiatives across wide expanses of RURAL areas

21. Some examples of Early Intervention in Rural areas • VIPers’ Transitional Group work Programme • Lunch-time school Drop-in • Outreach work • “How to Drug Proof Your Kids” • Working with children living in households where substance • misuse is a problem (parental/carer, sibling, others misuse)

22. VIPers – Very Important People’s Groups

23. Outline Eight primary seven pupils Sessions (2 hours) over a 6 to 8 week period P7 April-June Summer activities-Linked to Summer School S1September-December S2 January-March ASDAN accreditation Aim To enable the young people involved in the project to engage confidently with adults and their peers on a co-operative basis

24. Lunch-time Drop-in • 4 x times weekly for 45 minutes @ lunch-time • Co-coordinated by ChYPSS but partnership planned/facilitated • Unstructured Drop-in but with agreed Ground Rules, membership • Provision of free fruit and water • Activities = computer access/computer games, table/board games, • arts & crafts, themed activities, substance-related quizzes, etc. • Opportunities to just sit and chat, drop-in and out • Break-out area for one-to-ones, for distressed, angry pupils, etc • Pupils say Drop-in is “safe”, “bully-free”, “friendly”, “a laugh”, etc • Staff identify a high number of vulnerable, at risk pupils

25. OUTREACH • Sessional work with YMCA, Community Learning and Development (youth work) • Summer school/summer programme work • Work in other secondary school in Wigtownshire • Meeting young people WHERE they are and where they WANT to meet • Community activities with service users • Home visits • Mentoring service

26. “HOW TO DRUG PROOF YOUR KIDS”

27. The overall Goal of the programme To educate and empower parents with skills that will enable them to steer their children away from the harmful use of drugs Six 2 hour group work sessions outlined below Session 1: DRUGS! Just how bad is it? Session 2: Why kids take drugs Session 3: How to educate kids to make good choices Session 4: Prevention tools for parents Session 5: Learning to intervene and where to get help Session 6: A parent’s guide to handling relapses

28. Working with children living in households where substance misuse is a problem • Engagement and relationship-building • Holistic core assessment and action planning • Opportunities to express/deal with their feelings • Reducing risks, building confidence, life-skills, resilience, etc • Keeping/developing appropriate links with their parent/carers • Working/sharing information with other agencies, parents/carers • Working jointly and in partnership with relevant services/agencies • Reducing isolation/overwhelming responsibilities • Providing some respite and fun HELPING THEM RECLAIM THEIR CHILDHOOD