Transcript: Reversing the trend: supporting people to reduce harmful drinking

Resource developed by Partnership Drugs Initiative (PDI) and Evaluation Support Scotland (ESS) with practitioners to help gather and disseminate evidence on the impact of preventative approaches for young people at risk of developing alcohol issues.

Podcast Episode: Reversing the trend: supporting people to reduce harmful drinking

Category: Substance misuse 


What follows is a transcription of the audio recording. Due to differences between spoken and written English, the transcript may contain quirks of grammar and syntax.

EW - Elaine Wilson

Reversing the Trend is a resource developed by Partnership Drugs Initiative and Evaluation Support Scotland with practioners that helps to demonstrate the impact of preventative approaches for young people at risk of developing alcohol issues. In this episode we hear from Elaine Wilson, Programme Manager for Partnership Drugs Initiative, a funding programme within Lloyds TSB Foundation for Scotland. Elaine tells us more about the projects funded and the approaches taken:

EW "Partnership Drugs Initiative - PDI as we call it - is a funding programme that supports children and young people affected by drugs and alcohol issues. It's a partnership between Lloyds TSB Foundation for Scotland, the Scottish Government with investment with the Robertson Trust at the moment. The programme has been established since 2001 and since that time we have awarded over £21m to charities across Scotland. The ethos of the programme is to support funded projects to self-evaluate so we get a better understanding on the impact of their work and impact directly for children and young people but also then to use that knowledge and understanding to influence policy and practice from a bottoms-up approach, so from practitioners directly - how can we ensure that gets to develop practice and inform policy?

Our approach is to work with funded projects, to help them to think about evaluation as the root of understanding reflective practice and how they then capture that knowledge and then share it with us and with others. We're outcome focused and we have been since 2001 and our outcomes have always been driven by the funded projects. From all this knowledge and learning it has helped us understand and acknowledge as a funder that the smaller steps, even if they're minute - so it could be someone just someone accessing a service are actually key to help make them more positive progressive change. Individuals need to take ownership of their own outcomes and all services and projects are there to be the supportive factor. And all approaches and models and method wouldn't work if wasn't for supportive and nurturing relationships between key service workers and practioners.

All of this knowledge and learning is contained within our PDI briefing paper called "Understanding What Makes a Good Project" and is available on our website. As I said, the PDI is a programme that focuses on alcohol and other substances and we've recognised from very early on that alcohol is a significant factor, both for families so many children and young people are living with parents who misuse alcohol and these are still a high number of children and young people that are hidden and we work closely with a number of projects who offer intensive family support and support for children who are living in those situations.

Many of those children and young people will be at risk of themselves developing alcohol issues which comes from the evidence base that's available and we would work with them, those projects as well, to help them understand how do you prevent those young people from following similar pathways to their parents. We also work with a number of projects who would be often seen as youth work or diversionary, offer preventative models either through group sessions, respite opportunities for young people, developing/delivering detached work or street work - a range of options, and their focus will often be on alcohol misuse. What they tell us is there is, as expected, is there is significant use of alcohol amongst some young people, high levels of binge drinking and often at the established and known times so they'd be looking at the weekends. Many projects have tried as well to think about providing support on Sundays or Mondays when there maybe is some fallout from young people who've been involved with risk taking behaviours or issues because of drinking over the weekend.

Many of the projects that we support that do preventative work use youth work principles to help them deliver the services. Youth work is all based on relationships, strong relationships with young people, which fits well with the ethos of the PDI and the learning we have gained over the 13 years of delivery. What they often will focus is how to help young people think about reducing risk-taking behaviours. Often those risk taking behaviours are risks that they wouldn't see as necessarily as risky taking behaviours when they are using alcohol, increasing awareness of alcohol, increasing awareness of alcohol knowledge, the impact of alcohol and also helping them think about the impact on others. And the other area they look at will be to think about how they can offer alternative positive options for young people, whether that's within their own service or other community activities or thinking about new peer groups or options to develop new interests.

We recognised very early on when we started to deliver preventative work that it was really difficult to measure the impact and be able to answer some of the questions about what difference does prevention make. I think this is very topical just now because prevention is a key factor in Scotland in other areas of the UK where we are trying to look at how we can push everything downstream and especially in terms of financial pressures and budgetary constraints. But that said, when you are trying to measure prevention, it often is not seen as a high priority for funding because you cant measure hard outcomes, you cant be saying "we know that so many young people stop drinking or we know so many young people have now got those attainments in schools", so we needed to look at how we could address this issue and help our funded projects measure what was meaningful to them, what was the difference they were making and actually making it meaningful for young people as well.

So in 2012 the PDI worked with Evaluation Support Scotland to work with six of funded projects to help them understand and look how they could address some of those questions and we could start to think about how do we measure prevention but before we even got to that stage we wanted to ask ourselves what does prevention actually mean, what are trying to address, what are we trying to achieve as a result of this? So we tried to look at three key questions, the first was the role of youth work in prevention, the second was understanding what the outcomes could be and realistic outcomes, so knowing where you sit in spectrum of support for young people and what could be achievable with the work you where doing with them and then finally how go about measuring them and involving young people in that? So trying to help those young people get involved with that self-evaluation process and take more ownership and help then for the young people to be able to think more clearly about - yep I get that risk, yeah I understand where they are coming from, from this point of view.

As a result of all this work, we worked with these of projects over a 12 month period, there was a number of sessions with Evaluation Support Scotland where the groups discussed, quite strongly at times I think would be the point, about understanding what was youth work, what was prevention, what were the main risk factors? And I think what came out of that for us was the diversity of the sector, the diversity of what's available under prevention to support young people around alcohol issues and the diversity of youth work support. So within that spectrum of prevention we had projects who were offering a youth cafe in a rural community where the young people were often excluded other activities. They were seen as the kind of bad young people and in a very rural community that can be quite isolating, you can be stigmatised in your community so this youth cafe was the kind of haven for them and their youth work was a very low threshold approach about nurturing those young people, building relationships and having a quite a long term view so that young people came in and stayed with them for a long time, for a number of years right to through to projects that were often a preventative approach but they were in a small town where there was high issues of alcohol misuse and where young people themselves had significant issues around alcohol and their youth work approach to nurture those relationships, develop long-term support for these young people to address their own use and it was often through 1-2-1 support rather than a kind of informal group setting. So there was that spectrum of prevention that we were trying to address and I think diversity came across. But the groups all worked well together and I think it was good for them to challenge those questions, to produce what we've called Reversing the Trend.

Reversing the Trend is an online resource that looks to address the questions of prevention and youth work around alcohol and drug misuse for young people. As I said, there were six projects involved, all offering various approaches and each project committed to working with young people in their local areas to develop methods, resources and tools that would evaluate and understand the impact of the work and then be able to start to address if its made an impact towards reducing risks of alcohol misuse, helping young people increase awareness and looking at offering them alternative and diversionary opportunities. Each of those projects is detailed case study which has links to all the tools and methods that were used within that online resource that people can go in and pick up and use what they feel is appropriate.

Another one of the projects that was involved was The Junction, which is an Edinburgh based project, and they formed part of the North Edinburgh Alcohol Initiative Collaborative which offered a range of interventions and supports for young people from street work to awareness raising, to group settings, to 1-2-1 support and ABIs and the ABIs were delivered in both the detached element but also through 1-2-1 support and I think what we recognised from The Junction support, along with those other six projects, was understanding the importance, and I'll reinforce it again, about building the relationships with young people which was key and critical for all the work that was delivered. What they also highlighted to us was the awareness and understanding of the difference between providing advice to young people around risk as opposed to delivering an ABI so for us the advice and support around risk to young people would be things like if the workers were engaging with young people and talking to them about risks they would be saying things like making sure your mobile phone was charged if you were going to be out in the evening, if you were going to be drinking about ensuring that you didn't leave your friends. Quite sensible things but actually about starting to help young people think about those kind of parameters and the impact that alcohol could have if you don't have these kind of simple tools and methods for yourself to cope in those environments through to an ABI which is much structured conversation around alcohol misuse and how do you think about reducing and so on. So their work, in fact the Junctions work has contributed to the wider work in Scotland around young people and ABIs which is being led by the Scottish Government and we can provide, we have links to, that informationing that's been done by the Scottish Government for further reading.

The Reversing the Trend online resource also kind of mapped out for us the pathway of risk for young people and how we would identify those young people that were high at risk of going down a pathway where they would potentially have alcohol issues or start to misusing alcohol on a more regular basis. Those risks were then highlighted as in how they then would impact on their lives and then into the wider world. So for example, you could be looking at young people where maybe their parents had misused alcohol, there was peer pressure on them to use, they had low confidence or low aspirations then that would then encourage them start taking risk taking behaviours, misusing alcohol. It would then potentially link onto the impact of education and then potentially on-going impact of costs to the health service and to education and schools and so on but this is much more detailed in the online resource.

Alongside that we also produced a logic model that actually working with the projects recognised what those small, keys steps to change would be for young people and then how they would all contribute toward community outcomes and then national outcomes. Now this is obviously specifically based on Scotland but the outcomes produced by the projects I think are transferrable across the board so they could be used in other sectors with people looking at how they could contribute those to their own, local areas or their own national picture. From all this, what we learnt was there's a number of protective factors to supporting young people and helping them in a preventative model. One was providing fostering, supporting, positive adult relationships. Now that could be with projects but it could also be parents, somebody else that they trust, so having those positive role models helping them to think about options, building their confidence, alongside that having those supportive, nurturing peer groups as well so you were friends were helping you with your confidence, boosting your confidence. Young people that were able to have aspirations so they could see their future and have options about what they wanted, whether that was short-term goals or long-term goals and also increased knowledge and the right knowledge that would enable them to think about reducing risk-taking behaviours.

So overall, from Reversing the Trend, which is free and is available on our website, we have learnt the diversity of prevention, the diversity of youth work in general which I think we already knew but I think that just helped encapsulate it and how all this has to fit in the wider structures and systems of support. So it can be one element in a pathway for young people. That the outcomes you are trying to achieve for young people, the difference they want to make for themselves can feel quite small and can not feel like they are a contributory factor but actually they'll be key and significant so having positive conversation or enabling young people to partake in group sessions can actually be a real stepping stone to help them progress and move on. And what we also learnt was, and helped the projects though, being very clear about where they were and how contributed to that bigger picture.

The Partnership Drugs Initiative continues to provide support towards to preventative approaches and support across Scotland to help young people look at reducing alcohol use. Another couple of examples we've funding in the last couple of years - we have just funded a project called Connect in Easy Ayrshire and that's a partnership with two voluntary organisations and the local football club where the main partners we are funding, Barnardos Connect, will work with young people through group work and 1-2-1 support but then they will offer options into diversionary activities that are being provided by the football club but all being provided Centrepoint which is the drama and arts group in the area. So that's giving that preventative approach of how do you support young people where there may be issue of alcohol misuse into more positive alternative options.

I think the key thing for that project for me is though, is the referrals from that are coming directly from A&E and the police. I know that this has been tried on a number of occasions before but I think what's positive about this is about all of the partners there are trying to look at how they can share data more effectively, try to join up systems, try to make it feel like a more opt-in support service for young people so they can get a bit of buy-in so we are looking forward to see what comes out of that. I think conversations to date from the referral partners have been really positive and I think there willingness to think about how can we make this work to make it seem more seamless in terms of a referral pathway for young people.

We've also been funding a project in Lanarkshire that delivers detached youth work, providing advice and support to young people. Again its all predominantly alcohol issues for young people, they've delivered detached work and tried to encourage and support young people to come in and access group activities or diversionary activities. What they've been learning in the last year is, actually what they have started to do because the detached youth workers are in the community, they're known, they feel non-threatening is that parents is that parents now are actually coming out and having conversations with the detached team. So the conversations will maybe be about their young people, about asking about their issues or alcohol use. But what they've now started to see actually that the parents will then start to raise questions about their own issues which I think is a really interesting engaging a wider family approach and we've also continued to think about how does prevention work in rural and more isolated communities.

We've just supported in April 2015 action for Children in the Western Isles which is looking at what building on their weekend support project to try and offer young people who would not go to traditional youth work services, offering them street work but also ensuring that they have space available at those weekends when young people can come in to a warm space, have a conversation, maybe get a bit of advice, support and then start to think how they could maybe progress them into other supports if required. Partnership Drug Initiative I has been going since 2001, we support a range of projects, wider than prevention. All the information that I have discussed today is available on our website.

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