Chapter 1: Introduction
This report describes and evaluates four projects within the Partnership Drugs Initiative. Two of the projects are designed to intervene with young people who are engaged in substance misuse, one provides support for young carers from families in which a parent is misusing drugs or alcohol and one seeks to reduce the impact of parents' drug use upon their children. The purpose of the report is 1) to describe and assess the impact of the four projects upon their various client groups and 2) to review what we can learn from them.
The importance of meeting the needs of young people who are vulnerable because of their own substance misuse or that of others has been highlighted in a number of key policy documents in Scotland including Scotland's drug strategy 'Tackling Drugs in Scotland: Action in Partnership' (1999) and 'Getting Our Priorities Right' (2003). While the former addresses issues associated with young people's own substance misuse, the latter provides guidance for services working with families affected by parental drug use.
In recent years there has been an expanding body of research within the UK that has shed light on the needs and circumstances of these young people and informed the development of services designed to meet their needs. The misuse of drugs or alcohol by young people can result in a number of negative outcomes including; involvement in criminal or anti-social activities; family disruption; poor school attendance and performance; and psychological and physical harm (Velleman et al 1993, Drug Prevention Advisory Service 1999, Scottish Executive 2001, McKeganey and Beaton 2001). Young people who are involved in substance misuse are also likely to have a range of other underlying problems (Burniston et al 2002). We also know that parental substance misuse can cause substantial harm to their children including; physical and emotional neglect; exposure to the use of drugs by parents or other adults; exposure to parents' criminal activities; physical or sexual abuse; the assumption by the child of 'parental' responsibilities; poor performance in school and social isolation (Harbin and Murphy 2000, Alison 2000, McKeganey et al 2002, ACMD 2003, Kroll and Taylor 2003, Barnard and Barlow 2003, Barnard and McKeganey 2004). There is also evidence that children in these families are at greater risk of becoming involved in substance misuse themselves (Hawkins et al 1992).
While there are a growing number of projects throughout the UK to assist these young people, few of them have been subjected to any form of systematic evaluation. We therefore know very little about how effective they are and what works best and under what circumstances. The evidence we do have is almost entirely based on research carried out in North America. This provides tentative support for the importance of the following as far as successful interventions with substance misusing young people are concerned; the presence of clear aims and objectives; the use of experienced and well-trained staff; a high degree of staff continuity; programmes that are of medium or long term duration; and holistic approaches that address the young person's substance misuse in the context of an attempt to also assist them in improving their life skills and ability to cope with difficulties (Elliott et al 2002).
In the last five years there has been a marked increase in services targeted at vulnerable young people in Scotland. Many of these services have been set up as part of the Partnership Drugs Initiative ( PDI). This is a funding programme that promotes voluntary sector work with children and young people affected by substance misuse. The PDI is funded by three groups; the Lloyds TSB Foundation for Scotland; the Scottish Executive; and Atlantic Philanthropies, a U.S. based charitable trust. Current projects funded by this initiative are targeted on such groups as pre-teen drug users, children growing up in families affected by parental drug use, and those who are developing problem behaviours, including drug and alcohol misuse, in their mid teens.
While it would obviously be preferable to develop services on the basis of clear evidence of what works, the urgency of meeting the needs of young people has meant that, in many instances, services have had to be developed in advance of that evidence being available. This means, however, that there is a particular need to carry out a rigorous programme of work evaluating the range of services that have been developed to meet the needs of vulnerable young people in Scotland. The purpose of the present research was to contribute to that process by describing and evaluating a number of the projects within the Partnership Drugs Initiative. The aims of the research were as follows:
- To identify approaches effective at improving outcomes for young people affected by drug misuse through an evaluation of projects funded by the Lloyds TSB Partnership Drugs Initiative.
- To develop a clear and detailed descriptive profile of each project and the interventions that they deliver.
- To provide an analysis of the differences and similarities between projects delivering similar interventions and/or working with the same client group.
- To develop existing learning about effective approaches with those client groups covered by the Partnership Drugs Initiative.
- To assess the effectiveness of innovative approaches to tackling difficulties in dealing with this client group; e.g. use of outreach services.
- To assess how successful projects have been in pursuing a client centred approach and the impact that such an approach has had on their activities.
The first stage of the research was completed in April 2004 with the publication of a report which profiled 17 of these projects and identified and discussed a number of important themes regarding their operation (McIntosh et al 2004). The present report presents the results of the second stage of the research: the case study evaluation of four of these projects. The four projects included in this part of the study were:
- the Reiver and Perth and Kinross Connect projects both of which seek to intervene with young people who are misusing drugs or alcohol
- the Aberlour Edinburgh Outreach Project which aims to reduce the impact of parents' drug use upon their children
- the East Ayrshire Substance Misuse Family Support Project which provides support for young carers from families in which a parent is misusing drugs or alcohol.
This element of the research had two components. The first of these was a process evaluation which was designed to provide detailed information on the operation of the four projects. The methods used in this component include, 1) in-depth interviews with project staff members and with workers in partner or referring organisations, 2) the observation of selected aspects of the projects' work and, 3) the analysis of relevant documentation. The second element of this part of the research was an outcome evaluation. This was designed to measure clients' progress over time by means of repeat interviews and an analysis of their case records. Collateral interviews were also conducted with individuals who knew the clients well and were able to comment upon any progress they felt they had made as a result of their contact with the project. The Multi Centre Research Ethics Committee provided ethical approval for the research.
The research was a collaborative exercise. The outcome evaluation was carried out by the Centre for Drug Misuse Research at the University of Glasgow and the National Centre for Social Research Scotland. The process evaluation was conducted by the Centre for Social Marketing at the University of Stirling.