On January 17th Mark Johnson wrote an article in the Guardian entitled "It's time to treat drug-addicted children as adults" although the article was itself about young people's rehab, the title does raise the issue of how we treat our young people when they access services. As those working in young people's drug treatment know, the outcomes the government look for are already those of adults. But, is it reasonable or even achievable to use same outcome measures for young people and adults in the UK?
The Drugscope document 'Young Peoples Drug and Alcohol Treatment at the Crossroads' recognised that over the last 10 to 12 years young people's drug treatment services have evolved from the adult style system that provided drug specific treatment, prescribing and health services to a wider system that better recognises the diverse needs of young people and their modes and developing patterns of drug use.
Most young people's services now offer services that are provided within multi-disciplinary teams, are not drug specific and recognise (and incorporate) emotional well being, mental health, family functioning systems, social inclusion, sexual health/relationships and knowledge of developmental stages of young people.
These adult treatment measuring tools used in the UK (NDTMS/TOP) do not reflect the diversity of work done in young people's services or the achievements or multiple changes achieved by young people within these services.
...expect substance misuse problems to increase during a periods of high recession and high youth unemployment.Young people's drug and alcohol treatment at the crossroads
They also don't reflect the nature of young people's drug use, which is often a fluctuating series of episodes that range from stable, chaotic, problematic, to episodes of reduced use, no use, back to chaotic etc, including a variety of drugs. Often this is as a result of the other issues going on for young people. Such as periods of sofa surfing, exam stresses, temporary family dysfunction etc. Whilst clearly this is the case with adults too, for young people these 'episodes' are often more regular and persistent, because, in part, it's a part of growing up.
Practitioners working with young people understood and were working with the emerging ACCE (Alcohol, Cannabis, Cocaine & Ecstasy) profile and the legal high phenomenon long before commissioners realised, and because of the already diverse way in which they were working were usually able to respond appropriately. Which in a sense renders the statistical data, published a year after the episodes as irrelevant, as the trends will develop and change again before they're even released.
These statistics are useful though, when viewed against the politics and economics. Currently, young people's services are gearing up for the possibility of a radical change in current trends due to the recession and unprecedented youth unemployment (and the persistent presence of cheap booze and cheaper drugs).
Therefore in recognition of the enormous changes in young people's services, is it time that we looked at a more reflective outcome measuring tool, than the inherited adult system of NDTMS and TOPS? What should it measure and how could it work to help young people?This Hot Topic was suggested and contributed to by Melody Treasure.