Tuesday, 9 August 2011

Seen but not heard – young people’s treatment issues

In June I spoke on young people’s treatment at the Drugs and Alcohol Today conference. It had been a while since I’d focused on young people’s issues. The new treatment agenda has been built around a vision of recovery that is more relevant to adults (for example, substitute prescribing and abstinence). It is this agenda to which a lot of DrugScope’s own policy work has been responding. I’d not registered some government initiatives, notably the Department for Education’s Positive for Youth programme, including a recently published ‘discussion paper’ on Preventing youth crime and substance misuse. Although, to be fair, it is not exactly prominent on the DfE website and some colleagues in children’s charities were not aware of it either.

In February 2010, we published Young people’s drug and alcohol treatment at the crossroads. Many of its recommendations are still pertinent. For example, we called on government to monitor the impact of funding changes on young people’s services with a focus on local variation; we also made the case for a national policy framework for young adults. But, equally, a lot has changed since then. The Department for Children, Schools and Families is no longer with us (and perceptions are that the Department for Education has a narrower policy focus), Every Child Matters is effectively gone and Public Service Agreements (PSAs) most definitely are. Above all, we are seeing local authority budgets being squeezed to an extent that was not envisaged then, along with a strong emphasis on localism and reducing the involvement of central government.

In December, the London Drug and Alcohol Network (LDAN), part of DrugScope, conducted a survey of young people’s treatment providers. We spoke to 18 London service providers; only three said their current funding situation was safe, and many anticipated substantial cuts. An article in the latest issue of DrugScope’s Druglink magazine shows that this issue has not gone away. Addaction have told DrugScope that some local authorities have imposed funding cuts on their young people’s services of up to 50 per cent.

It’s not all doom and gloom. A lot of the work young people’s services do could fit well with a more public health oriented approach to drug and alcohol issues, when treatment budgets are transferred to the new public health service and local Directors of Public Health. Concerns that the NTA has backed away from young people’s services may partly reflect the fact that much of what those services deliver is not treatment in the normal (or narrow) sense of that word; in financially austere times, it is perhaps understandable that an agency with a strong treatment focus would reconsider that investment. For better or worse, public health has a broader scope. There is also specific provision in the 2010 Drug Strategy for Directors of Public Health and Directors of Children Services to work together, pooling public health and early intervention budgets.

But this is a critical time for the development – indeed survival – of young people’s services. DrugScope will soon be meeting officials in the Department for Education as well as with colleagues at the National Children’s Bureau to ensure that the pressure is maintained. A clear and compelling narrative on young people’s services is currently lacking from government. Nor does there seem to be any mechanism for monitoring what is actually happening to these services on the ground. With the lives of some very vulnerable young people at stake, this cannot simply be a local matter for local people – not least, because with DfE estimates showing that £1 spent on young people’s treatment saves between £5 and £8 in subsequent costs, this is an issue with profound economic and social implications for us all.

Young People’s Drug and Alcohol Treatment at the Crossroads is available at: http://tiny.cc/YP-crossroads

Dr Marcus Roberts, Director of Policy and Membership


  1. Do keep up the pressure Marcus! I do believe the fluid nature of YP contact with services means the public health route should be a valid route for exploration. As Crossroads points out, YP engagement with services does not fit with an adult model - so at a time when adult services are changing it seems prudent to assess the shape and function of future YP services - based on need. With a bit of luck it may also highlight the need for transitional services, and plug the gap so many YP fall through when they reach 18.

  2. Lynn Bransby, NTA Head of Delivery11 August 2011 at 14:38

    I understand and share your concerns about the impact of budgetary pressures on young people's services generally, and the implications of this for drug and alcohol services, but I think it's a bit misleading - if not unfair - to talk about the NTA having "backed away" from young people's treatment. As you know, we have avoided any reduction in the £25m young people's Pooled Treatment Budget, and despite significant reductions in our own budget, we have agreed two additional posts to support work with young people in partnership with DfE.

  3. Marcus, thank you, a long overdue and welcome focus on Young Peoples Services
    DrugScope can be forgiven for taking its eye off the ball of policy in this area if only because you are in good company.
    The NTA backing off young people's services predates the current financial climate. The post of National Lead for young people was always marginalised within the organisation and now it’s been deleted young people's issues have been relegated to a responsibility of the Families Lead. I seriously doubt they have ever fully understood this complex area properly but let's hope that Lynn Branby's news of additional posts focussing on young people is the start of an upward curve that reverses this trend. In defence of the NTA though the root of the problem and the limiting narrative on young people goes back to before their origins. In 2000/2001 the Second National Plan came out of the Cabinet Office to support “Tackling Drugs to Build a Better Britain", the focus was on adult treatment and adult ways of doing things. It has the odd mention of young people's treatment but no detail before reverting to the theme of young people's services as Education and Prevention. We're early on here and laying foundations and the focus is on preventing young people becoming problematic adults, nothing about what to do with those that are already using problematically. Howard Parker and others work in the ‘90’s pointed the way to a much broader picture of the normalisation of recreational drug use with young heroin/ poly users falling through the safety net of services, the worry is they still are, even if their drug(s) of choice has changed with the times.
    The NTA came along shortly afterwards and inherited this “narrative” and little has changed since, their view of young people's treatment as a brief substance intervention with the mythical "mainstream services" doing everything else is limited and inaccurate.
    Young people's treatment moving into Public Health England could be seen as a backward step. High Focus Areas were a 2005 government initiative that was meant to speed up the mainstreaming of young people's strategy and commissioning into Children's Services/Partnerships, there are compelling arguments why Children's Services are a better home for young person's treatment than Public Health.
    A final point about the marginalisation of young people's services. When the old Home Office Drugs website was archived in April 2010 the young people's pages still carried the strap line from the updated Drug Strategy 2002 and were at least a full two years out of date, hardly an encouraging sign!!
    We desperately need fresh blood, a fresh debate and a fresh start with a few more/new people around the table. This year being the 10th Anniversary of the HAS Review would seem a good time and place to make a start – it’s just that no one’s noticed!

  4. Thanks for the info. Dealing with addiction can be hard and you should have an alcohol intervention for people you love when they need the extra help.