Vulnerable Biographies

Lesley GornallSheffield Hallam University

In Partnership with COMPASS

Overview

• ‘Evaluation Partnership’ • Broader context than project alone• Recognition of multiple vulnerabilities• Focus therefore on ‘Biographies’• Aim to identify and report chaotic

complexities• Aim to identify what works, and contextual or

systemic barriers to what works

Context – UNICEF 2007

State of UK Young People• “In its verdict on implementation of the Convention on the

Rights of the Child in the UK over the past five years, the Committee of international experts called for urgent legal and policy reforms. In some of its strongest criticisms to date it expressed concern about the “general climate of intolerance and negative public attitudes towards children”.

• The heavy hitting report includes over 120 recommendations for action needed to improve children’s lives, many of which made specific reference to children’s participation rights.”

• (Participation Works, posted 02.10.08, http://www.participationworks.org.uk/NewsBlogs/NewsArchi

ve/tabid/70/newsid618/425/Default.aspx)

Inequalities in Well Being

• 2010 Innocenti Report Card:

• UK is 19/24 on material well – being, 13/24 in Educational well – being, 11/24 in health well – being

• Overall performing below the OECD average for addressing child inequalities.

Identification of Need• National Treatment Agency Report 2010/11

1 The number of under-18s accessing specialist services for substance misuse in England fell to 21,955

2 The number of young people being treated primarily for Class A drugs, such as heroin and cocaine, continued to fall – to fewer than 800

3 Alcohol and cannabis remain by far the main substances for which under 18s access specialist services in England

4 More young people than ever are completing their therapy successfully – the figure has reached 75%

5 The number of young people dropping out of specialist services fell to an all-time low of just 13%.

However: Data is only collected from schools – the make up of those seekingtreatment is predominantly via Youth Justice, Looked After System or other referring agencies - working with non attenders, indications are that there is a significantly greater issue.

Recognised ApproachYoung people’s specialist substance misuse treatment is a care planned medical, psychosocial or specialist harm reduction intervention aimed at alleviating current harm caused by a young person’s substance misuse.” (NTA)

• Specialist services have two distinct roles:1. Supporting and enabling universal and targeted children’s

and youth services to respond to substance misuse issues2. Providing specialist substance misuse treatment to young

people and their families.

• The interventions offered can include, but are not limited to:- Psychosocial - Family- Specialist harm reduction- Pharmacological- Residential treatment for substance misuse

Choices Programme

• Self managed budget for predominantly Category 2 or 3 young people.

• Talking therapies, pscychosocial approaches focussed on life story

Evaluation Rationale

• Build on Life Story and Learning Journey so that young people are active participants.

• Recognise impact of biographical methods in Lifelong Learning contexts.

• Multi disciplinary team from Community Education/Social Pedagogy, Informal learning with young people and Socail Work (Mental Health)

Evaluation Design• Analysis of existing multiple vulnerability data to identify local

context, issues and lifestyle trends. • Open interviews with young people clearly outlining past and

current substance use, why they chose to try a particular substance, and overview of how they see their lifestory and future. Stage 2 interviews were designed to continue the lifestory approach assessing young people’s sense of future purpose. Changes in substance use were clearly identified.

• High sample size aiming for 20% of 250 participants in 5 areas – 3 London Boroughs, Coventry, and Hull – to clearly evidence rigour

• Informed consent was clarified and agreed, and researchers were very clear about their role, and number of visits.

Phase 1 Evaluation

• Home Office delays• 40 interviews completed, recorded

undergoing detailed analysis - 18% sample• Initial findings: Only 1 self – referral - Localised issues in terms of: Insecure Housing – HullYounger participants 10-12 Hull/ Coventry

Phase 1 Evaluation – Initial FindingsOverall picture of multiple issues and vulnerabilities: • Recurrence of effects of close family members’ substance misuse• Experience of suicide/suicide attempts – self and others• Insecure family contexts – breadth of family income• Mental health issues – often long undiagnosed, or with treatment

delays related to age, and access to Adolescent Mental Health Services

• Lifestyle choices, limited perceptions of risk and associated volume of substance used

• ‘Paranoia’ related to Cannabis use• High levels of risky sexual behaviour – from 14 onwards. • Insecure/chaotic living arrangements or care• Bright young people unchallenged in education • 4 of the sample have used ‘hard’ drugs• Sense of ‘isolation’

That said:

• Young people were articulate and aware of the issues facing them

• Significant progress had already been made in most cases, and the allocation of an individual budget to activities which interested them was seen as a positive

Phase 2• Pilot interviews completed – 8• Systemic issues related to access to courses, activities are slowing the

effectiveness of the programme. • Potential changes to the benefits system – particularly Housing Benefit

only available from 25 years old has the potential to put some young people at risk. 2 non attenders from this group were missing from Care, or had left Care to return home due to enforced changes in the Care Plan.

• Whilst most schools involved in this sample have been very supportive, and effective in negotiating outcomes for young people. Conflict in one case has resulted in the young person not attending, and is at risk of escalating her drug use.

• Of the 8 interviewed, 6 show visible signs of health improvements in the 10-12 weeks since the first interview. They report positive educational progress, improved and broader social lives, and sense of purpose.

Indicative Findings

• Harm reduction and talking therapies clearly beneficial

• Individualised, self managed approach has potential to support young people on exit from programmes.

• Clear issues in terms of availability of services, adult education classes for under – 18s, transfer between children and adult mental health services, care and housing issues, perceived irrelevance of education curriculum, and jobs.

Further Research

• Embedded into placement activity for our students:

• Focus on young people’s concept of ‘risk’ and lifestyle

• Link to work with COMPASS on risk• Impact of the reduction of universal youth

services for young people in the UK

References• Eastwood, P (2011) Statistics on Drug Misuse: England 2011, NATCEN• Eastwood, P. (2011) Statistics on Alcohol: England, 2011, NATCEN• Fuller, et al (2011) Smoking, drinking and drug use among young people in England in 2010,

NATCEN • Heath, S. et al (2009) Researching Young People’s Lives, Sage, London• Merrill, B & West, L (2009) Using Biographical methods in Social Research, Sage, London• National Institute for Clinical Excellence (2007) Drug Misuse: Psychosocial Interventions, NICE

Clinical Guideline 51, developed by the National Collaborating Centre for Mental Health• National Treatment Agency (2007) Getting to Grips with substance misuse treatments• Perry, A Ed.: (2009) Teenagers and Attachment, Worth Publishing, London• Youth Justice Board (2006) Systematic Review of Literature? • Innocenti Report Card 9 (2010) The Children Left Behind UNICEF• Innocenti Report Card 7 (2010) An Overview of Child Well Being in Rich Countries UNICEF• UN (2008) Concluding Observations for the UK from the UN Committee on the Rights of the

Child available from http://www.crae.org.uk/assets/files/Translation%20Concluding%20Observation

s%202008.pdf

Report Available Late September 2012

From: l.gornall@shu.ac.ukThank You for Listening