Drug prevention for vulnerable young people - Nacro

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POLICY AND RESEARCH CONTEXTPolicy and research contextThe intention to establish Health Action Zones (HAZs) wasannounced in June 1997. HAZs formed a central part ofthe new health policy in the late 1990s and were also partof a wider family of area-based regeneration initiatives(eg New Deal for Communities) aimed at tackling socialexclusion and modernising public services. They wereintended to act as ‘trailblazers’ in developing innovativesolutions to reducing health inequalities, leading the wayfor other areas to follow.It was in this context of tackling health inequalities andsocial exclusion through innovation and modernisationthat the Department of Health and the Home Office setup in 1998 a programme to provide, through HAZs,pump-priming funding for innovative drug preventionprojects targeted at ‘vulnerable’ young people. Four ofthe seven projects evaluated were funded in this way,with the remaining three funded by the ManchesterSalford Trafford HAZs Young Person’s Programme.The broad objectives of the HAZ drug prevention fundingwere:• to build up the capacity of long-term, sustainable drugprevention services (rather than short-term projects)• to give a boost to preventive work with groups ofyoung people at high risk of drug misuse• to give central government an insight into theeffectiveness of joint planning and funding of drugprevention services• to provide local agencies with an opportunity to takeadvantage of the knowledge and experience of HomeOffice DPI staff throughout the country• to give an impetus to foster the development of jointworking, planning and fundingAll of this was in the context of the government’s ten-yearnational strategy aim ‘to help young people resist drugmisuse in order to achieve their full potential in society’.In terms of research, the evidence base for prevention isstill fairly weak. The following points summarise inoutline some key aspects of the current state ofknowledge: 1• Traditional, information-based approaches (includinguse of mass media) have been shown not to delay orreduce initial drug use. They may have a role in harmreduction, although evidence on this is slim at themoment.• Interactive and peer approaches appear to show somepromise in terms of delaying onset and/or reducinglevels of use, although the (limited) evidence suggeststhat impact is likely to be modest.• Multi-method approaches, tailored to local needs, havepotential.• Inter-agency working and involving parents andcommunities are also important.The changing picture of young people’s drug use (notably,a significant rise in lifetime rates of illicit drug tryingtogether with a drop in the age of first use 2 ) suggeststhat some different approaches to prevention need to beadded to the repertoire of interventions. For example,there is growing evidence that a number of groups thatfall under the umbrella term of ‘social exclusion’ (younghomeless, offenders, care-leavers, school excludees andso on) have particularly high drug prevalence rates andare especially ‘vulnerable’ to developing drug problems(Lloyd, 1998; Goulden and Sondhi, 2001; Wincup et al.,2003; Ward et al., 2003; Hammersley et al., 2003).Targeting interventions at these ‘vulnerable’ groups maybecome an important part of prevention strategies. 3Similarly, given the wide extent of drug-trying amongstteenagers, 4 aiming interventions at reducing harm and/orlevels of use may be a more effective focus than aimingat stopping drug initiation. This implies also sometargeting of efforts and resources at problem drug useand at the drugs most associated with problem use. Thisevaluation focused on attempts within the ManchesterSalford Trafford HAZ to develop some new interventionsof these kinds. It makes a contribution to building up theevidence base for effective prevention work withvulnerable young people for the early 21st century.The drugs prevention projectsin Manchester Salford TraffordHAZThe seven drugs prevention projects for vulnerableyoung people in the Manchester Salford Trafford HAZ thatwere the focus for our evaluation were:• The Anti Rust Mentoring Project A project thatinvolved volunteers from the community working inpartnership with local schools to provide alternativelearning environments (in this case horticulture) forsecondary school-aged children with learning,behavioural and social/emotional difficulties.page 2
Drug prevention for vulnerable young people• Kick Start in Old Trafford A volunteer-based projectoffering sporting opportunities to local young people,including those referred by the Youth Offending Team(YOT). A substance misuse worker from a partnerproject in the area provided specialist training to thevolunteers and worker in this already thriving localproject.• Kick It This project was run by Manchester CityFootball in the Community and involved project staffworking in a mentoring capacity with disaffectedyoung people of secondary school age to deliverjointly drugs education to young people in primaryschools.• Peer Education Network This project was run by theCommunity Work Unit at the University of Manchesterand provided training and support to ten communitybasedpeer education projects within Manchester,Salford and Trafford. The concept of a Peer EducationNetwork provided an opportunity to explore differentways of supporting, enabling and organising peerapproaches to drug prevention.• Early Intervention Projects in Manchester andSalford Run by Lifeline, a street agency with itsheadquarters in central Manchester. Lifeline’s workincludes drop-in services, information and advice,needle exchanges and counselling for drug users. Theaims of these projects were to provide an earlyintervention service for young people at risk ofdeveloping drug problems by establishing a networkof service providers, taking referrals and developing arange of appropriate interventions. The project staffalso delivered training and information to localschools, youth workers and other local agenciesworking with young people.• Trafford Substance Misuse Service This was aresearch project for truanting and excluded youngpeople, the aim of which was to examine theresources and opportunities within Trafford fordeveloping more appropriate educational provisionfor young people at Year 10 or 11 who were excludedor self-excluding from mainstream education.The continuum of preventionThe concept of prevention and, more specifically, drugprevention was a critical and fundamental one for thisevaluation. The question of what prevention is – andindeed whether it is a useful term at all – has been a coretheme throughout the work.There are, of course, a number of definitions of drugprevention. The Advisory Council on the Misuse of Drugshas stated in several influential reports that there are twoelements of prevention:1 reducing the risk of an individual engaging in drugmisuse2 reducing the harm associated with drug misuse(ACMD, 1984:4)Another similar definition uses the idea of primary andsecondary prevention, where the former is concernedwith preventing drug-taking in the first place and thelatter with preventing the harms that may be caused tousers or others by drug use.There is then some consensus in the field about whatdrug prevention is and what it seeks to do but it wasapparent during the conduct of this evaluation that atleast within Manchester, Salford and Trafford it is acontested concept around which there is a vigorousdebate.A useful framework for looking at this issue is the idea ofa continuum of prevention. At one end of the continuum,there is drug-focused work, which, to use the terms ofone of the definitions described above, can involve bothprimary prevention (eg drug education in schools) orsecondary prevention (eg advice about safer injecting). Atthe other end, there is generic prevention work, whichhas no drug-specific or drug-focused content (egdiversionary activities). The value of the notion of acontinuum is that it cuts across the split betweenprimary and secondary prevention and focuses attentionon some of the key strategic issues about the purposes,funding, location and targeting of prevention.Generic approachesThe projects in our study employing a generic preventionapproach did not have a drug focus, or indeednecessarily any drug content to interventions at all, butinstead aimed to address ‘risk factors’ for problem druguse. For example, the gardening mentoring project inSalford took referrals from a local secondary school ofpupils who were starting to have behavioural and/orattendance difficulties. Participation in horticulturalactivities and support from an adult mentor aimed tohelp re-engagement with education as well as equippingthe young people with a range of basic skills that mightincrease their future employability. If successful, thiswould then reduce some of the ‘risk factors’ for thedevelopment of problem drug use.page 3
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Drug prevention for vulnerable young people - Nacro

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