Transcript youth
Alcohol misuse, drugs, crime and disorder amongst the under-18s Professor Richard Hammersley Centre for Behavioural Aspects of Health and Disease Glasgow Caledonian University Tacking Alcohol Misuse Amongst Young People. Policy Spotlight Conference, London, November 2004 [email protected] References • Hammersley, R., Minkes, J., Reid, M., Oliver, A., Genova, A. & Raynor, P. (2004) Drug and alcohol projects for young offenders: The evaluation of development fund projects funded by the Youth Justice Board. London, Youth Justice Board. • Hammersley, R., Marsland, L. & Reid, M. (2003) Substance Use By Young Offenders: The Impact Of The Normalization Of Drug Use In The Early Years Of The 21st Century. Home Office Research Study 261, London, Home Office Research and Statistics Directorate. Both are available from the relevant websites Thanks to the Economic and Social Research Council, The Home Office and the Youth Justice Board for funding the work described here. [email protected] Outline • Review of causes of alcohol related disorder • Review of interventions • Survey of YOT clients’ substance use • Evaluation of Youth Justice Board substance projects • Further thoughts [email protected] Situational factors • Low tolerance to alcohol • Labelling of drunken (and adolescent) comportment • Public perceptions of al fresco drinking • Non-drinkers stay home and cause no trouble • Social funnelling from pub to club to take-away to taxi rank [email protected] Systemic factors • The “30 families who have the biggest problems” • Substance use problems are defined by adults – Parents – Schools – Other agencies • Children can become the focus for systemic problems • Alcohol or drugs can become the focus for complex personal and systemic problems [email protected] Current Interventions for young people • Too late too much • Focussed on the individual – Good for people with definite alcohol dependence – Require ‘psychological mindedness’ • Neglect the positive motives for drinking and drug use – – – – Maturity Confidence and sexuality Have a laugh Escape from life’s problems • Struggle with complex problems versus using evidence based practice • Issue of temporary misbehaviour versus permanent alcoholic condition [email protected] What works? • Early intensive, aggressive multidisciplinary interventions with the most problematic young people and their families • Motivational enhancement • Alcohol awareness – Which has knock-on benefits on drug awareness • Changing alcohol and drug norms – But beware of the persistent residue • Enforcing current alcohol laws – Sales to minors – Real price of alcohol relative to minors disposable income [email protected] Even big children are not small adults • Dependence is difficult to diagnose in the under 18s • Work with the under 16s almost always involves work with the family • Behaviours tolerated in adults may be much more harmful in children • Misbehaviour is not a rare part of adolescence – Don’t make temporary problems permanent! [email protected] Survey of Youth Offending Team Clients [email protected] Recent and lifetime use Used but not in last 4 weeks Used in last 4 weeks Methadone Heroin Crack cocaine Valium LSD Cocaine Solvents Temazepam Psilocybin mushrooms Poppers Amphetamines Ecstasy Tobacco Cannabis Alcohol 0 [email protected] 50 100 150 Number of respondents 200 250 300 Offence categories committed Sexual Fraud Taking (a vehicle) without owner’s consent (TWOC) Drug Violence Disorder Handling stolen goods Vandalism Theft 0 10 20 30 40 50 60 Percent of cohort [email protected] 70 80 90 100 Problems last 2 years My parents have divorced or separated I have self-harmed (cut or injured myself) I have been the victim of theft or robbery I have thought of suicide I have been homeless I have been seriously injured I have been beaten up I have broken up with a long-term boyfriend or girlfriend I have moved house or left home I have been depressed A close friend or family member has died 0 [email protected] 10 20 30 40 50 60 70 Percent of cohort 80 90 100 Service use and service involvement • GPs and Social Work were the most common services used • More than one-half of respondents had visited an A&E department during the previous two years. • More than one-tenth of the cohort felt they needed special help with education and/or getting a job and had not received any. • The quality of help received was generally felt to be low – over 40% said it had been only better than nothing or no use at all - except for help with getting a job. – Only half those who had received help for a drug or alcohol problem felt it had been useful. [email protected] Evaluation of Youth Justice Board Development fund projects • Generic staff can lack confidence and ability in identifying substance use problems, particularly alcohol problems • Services focus often on “drug dependence” rather than alcohol and cannabis • Need improvements in assessment • Need better interventions for non dependent adolescents • Need interventions that empower young people • Need sensitivity to systemic issues - young people, their families, schools and other agencies [email protected] Further thoughts • What are adult and child norms for drinking and drug use? – – – – Youth culture and segregation Just say ‘no’ says nothing The oxygen of publicity raises norms inappropriately Fear messages are popular but can be counter productive • Escape drinking (and drug use) • Cannabis and alcohol: Worse than the sum of the parts? • Early intervention without discrimination and labelling • Generational issues [email protected]