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6.10 Inter Agency Guidance on Working with Young People Who Use and Misuse Substances
This inter agency guidance document was originally written for and approved by the Worcestershire Safeguarding Children Board, but was adopted by the Safeguarding Children Boards in Herefordshire and Shropshire for the November 2009 update of the manual.

Contents

  1. Introduction
  2. Definitions
  3. Confidentiality
  4. Guidance for Professionals from all Agencies
  5. Guidance for Specialist Substance Misuse Workers

    References


1. Introduction

1.1 This guidance is for use by specialist substance misuse professionals, and for professionals from all safeguarding agencies. It is intended to help to safeguard young people from the harm caused by substance misuse and also to provide guidance to specialist substance misuse workers when they encounter a young person in need of safeguarding for whatever reason.
1.2 Research suggests that, by the age of 16, nearly half of all young people have tried an illegal drug and that the average age of first time use is decreasing, (Health Advisory Service 2001). Most professionals working with young people will encounter substance use to some degree and it is important that individual workers are able to respond appropriately to this.
1.3 The specialist multi-agency team addressing the substance misuse needs of young people under 19 in Herefordshire is DASH, in Shropshire is YPSMT and in Worcestershire is SPACE . They offer a comprehensive service of advice and guidance to non-specialist professionals as well as working directly with young people.
1.4 In working with young people who misuse substances, it can be difficult to ensure that they are safeguarded, when the risk to themselves may be entirely self-inflicted. Their families may be caring and protective, however the young person may choose to misuse substances.


2. Definitions

2.1

Substance

This includes tobacco, alcohol, volatile substances, prescribed medication, "over the counter" medication, and illicit substances e.g. cannabis, ecstasy, heroin.

2.2

 Clear distinctions between substance use and substance misuse are difficult to draw; however the following definitions are based on Health Advisory Service, The Substance of Young Needs Review 2001:

2.3

Substance Use

Substance use can be defined as the taking of substances in an experimental and/or recreational manner. It is acknowledged that harm may still occur through substance use, though it may not be immediately apparent.

2.4

Substance Misuse

Substance misuse can be defined as problematic and/or dependent use of substances. All substance misuse is potentially harmful - however, there are degrees of harm which require specific responses according to the presenting risks. 

2.5

Child in Need

A child is considered to be in need if he/she is unlikely to achieve or maintain, or to have the opportunity of achieving or maintaining, a reasonable standard of health or development without the provision of services, (Section 17, Children Act 1989)

2.6

Child in Need of Protection

A child in need is considered to be in "need of protection" if he/she is likely to suffer Significant Harm without the provision of services. (Children Act 1989)

2.7

Significant Harm

Harm is ill-treatment or the impairment of health and development. It is considered to be significant if the child's health and development fall significantly short of what could be expected of a similar child. This can be the result of deliberate abuse or of a failure to meet the needs of the child over a long period of time. (Children Act 1989)

2.8

Significant harm in relation to substance misuse

This arises when young person's substance misuse places them in a situation of risk. This misuse of substances will cause, or is likely to cause, the young person to fail significantly to maintain their health and development.


3. Confidentiality

3.1 Confidentiality is a means of providing young people with security and much needed support without the fear of reprisal. This is a more complex issue as the young people are engaging in what could be an illegal act, which is at the same time harmful and possibly life-threatening. Despite this, young people will need help and they may not engage with services if their confidentiality is not respected.
3.2 There are however circumstances when a professional should breach confidentiality, when there is an immediate concern for the safety of the young person or that of a third party. This could arise from information given by the young person, a member of the family or a third party. It is particularly important in safeguarding children that information given about family or home life, which might have safeguarding implications for siblings, is referred to the appropriate service. For further guidance see Information Sharing and Confidentiality.
3.3

SCODA (Standing Conference of Drug Abuse) (1999) suggest the following parameters as a guide to establish whether confidential information regarding a young person who is using substances should be disclosed:

  • The age and maturity of the child
  • The degree and seriousness of the substance misuse
  • Whether harm or risk is continuing or increasing
  • The general context in which substance use is set
3.4 Any breach of confidentiality should provide appropriate information but should not extend to other areas of the young person's present or past life that are not relevant to the situation.


4. Guidance for Professionals from all Agencies

4.1 When working with young people, professionals from agencies should routinely check, using the Common Assessment Framework (CAF) (and, in Shropshire, the Substance Misuse Screening Tool), if there is a problem with substance misuse, particularly with vulnerable young people or those whose lifestyle might place them at risk of substance misuse. They need to gauge if the substance use is experimental or problematic. If the professional is unsure they can discuss with DASH (in Herefordshire), the YPSMT (in Shropshire) or SPACE(in Worcestershire).
4.2 Professionals working with families may become aware of a young person in that family using substances. If it is appropriate they may discuss this with the young person, to assess the extent of the substance use and whether the young person requires any help or advice. It may very well not be appropriate for the professional to discuss this with the young person and this decision must be made for each situation.
4.3 Any safeguarding professional, if they are concerned about the substance use of a young person can seek advice from DASH (in Herefordshire), the YPSMT (in Shropshire) or SPACE (in Worcestershire). This can be done confidentially, without disclosing the details of the particular young person.
4.4 If a young person wants help with their substance misuse they can be referred to DASH (in Herefordshire) the YPSMT (in Shropshire) or SPACE (in Worcestershire), without contacting their parents. They should however be encouraged to discuss their substance misuse with their parents. Advice is also available for Parents as to how they may access support.
4.5

Referral can be made to DASH (in Herefordshire), the YPSMT (in Shropshire) or SPACE (in Worcestershire) by telephone, ideally having completed the CAF and the Substance Misuse Screening Tool. If this has not been carried out then the referral can still be accepted and the specialist worker will complete a brief screening tool over the phone, to establish if a referral is appropriate. The young person will then be contacted about an assessment taking place.
4.6

In the situation where a safeguarding professional is concerned with a young person's substance misuse and the young person refuses to be referred to DASH, the YPSMT or SPACE, the relevant drug advisory service will support that professional in continuing to work with the young person to address their substance misuse. The safeguarding professional must continue to advocate a referral to DASH/ YPSMT or SPACE.
4.7

Once a referral to DASH/ YPSMT or SPACE has been made, it is possible that the DASH/ YPSMT or SPACE professional on hearing the extent of the substance misuse may feel that the young person is at risk of Significant Harm. If this is the case the referring professional will need to make a referral to Children and Young People's Services -see the Referrals Procedure. In some instances it will be the social worker making this referral. They will therefore need to re-assess the situation and take appropriate action to safeguard the young person.
4.8

In Shropshire, the referral will be made to Children and Young People's Services having regard to the Shropshire Drug and Alcohol Team Protocol 'Young People and Consent to Health Advisory Service Tiers 2, 3 and 4 Substance Misuse Interventions and Treatment (March 2007).
4.9 This referral to Children and Young People's Services can be made without gaining the consent of the parents or young person, but it is good practice to discuss with the parents if this will not put the young person at greater risk. For further guidance see Information Sharing and Confidentiality Procedure.
4.9

Any professional from any agency can discuss with a Duty Social Worker in Children and Young People's Services, a young person they are concerned about, to ascertain if a referral is appropriate.


5. Guidance for Specialist Substance Misuse Workers

5.1 In working with young people who misuse substances, the specialist workers will encounter young people who are Children in Need. This may be in relation to their substance misuse or for other reasons. In these situations the worker should discuss a referral to Children and Young People's Services with the parents and young person.
5.2 A young person who is receiving services from DASH/YPSMT or SPACE without their parents' knowledge may be assessed as needing additional support from Children and Young People's Services. In this situation a referral can be made to Children and Young People's Services without parental consent if the young person is able to give informed consent to this referral.
5.3 In situations where the young person is believed to be at risk of Significant Harm then the worker can make a referral to Children and Young People's Services as a matter of urgency, without gaining consent of the parents or the young person.
5.4 In working with young people and their families, the specialist workers may become aware of other children in the family who are Children in Need. This may be as a result of the young person's substance misuse or for other reasons. In these situations the worker should discuss with the family a referral to Children and Young People's Services. If the family is in agreement with the referral, a multi-agency referral should be completed and forwarded to to the relevant Children and Young People's Services - this will be the Referral and Assessment Team in Herefordshire, the area Multi Agency Team in Shropshire or the  Access Centre (in Worcestershire)
5.5 The specialist workers may on occasion become aware of children in a family, whom they believe to be at risk of Significant Harm. These children should be referred as a matter of urgency to Children and Young People's Services and this can be done without obtaining parental consent, if to do so would put the child at further risk. - see Referrals Procedure.


References

  • SCODA (Standing Conference of Drug Abuse) & The Children's Legal Centre (1999) Young People & Drugs Policy Guidance for Drug Interventions
  • Children's Legal Centre Working With Young People: Legal Responsibility and Liability
  • Health Advisory Service (1996) The Substance of Young Needs. HMSO
  • Health Advisory Service (2001) The Substance of Young Needs Review. HMSO
  • Working Together to Safeguard Children, 2010
  • Framework for the Assessment of Children in Need and their Families: Department of Health
  • What to do if you're worried a child is being abused, 2006

 

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