In this blog, Dr Helen Gleeson offers interesting insights on the needs of young people with a have a history of substance use who come into contact with the criminal justice system in the UK. Curious? Read on.

In the UK, many young people who come into contact with the criminal justice system have some history of substance use. Most of these young people will be ordered by the police or the courts to attend a mandatory substance use program as part of their sentence or caution. Unsurprisingly, it can be difficult to engage this group in a program that they are attending in order to avoid criminal sanctions (e.g. a custodial sentence). As part of the EPPIC (Exchanging Prevention practices on Polydrug use among youth In Criminal justice systems) project, research teams have been collecting qualitative interview data from young people and professionals in substance use intervention and criminal justice settings in six European countries (UK, Denmark, Germany, Italy, Poland, and Austria). In the UK, I was part of a research team that interviewed 38 young people and 25 professionals from youth offending teams (YOTs), community services, children’s services and third sector organisations who offer substance use services to young people both in and outside of the criminal justice system.

Over the course of these interviews it became clear that the young people being referred to substance use programs via the criminal justice system had complex, sometimes long ignored, needs that did not necessarily centre around their use of drugs. The participants talked about their experiences of bereavement, mental health difficulties, neglect, sexual abuse and parental alcohol and illicit drug use. Often these were issues they had not received previous support for. Some spoke about having visits from social workers who failed to intervene when they felt it was needed, or not receiving support from school authorities when they became aware of difficulties at home. Likewise, some young people who received support from child and adolescent mental health services (CAMHS) described their frustration of not being listened to and helped when the focus of the intervention was on their substance use rather than their mental health needs.

Increasing use of diversion for minor crimes (including many drug related crimes) for children and young people in the UK is welcomed across youth services. However, it was reported by some professionals that by the time a young person is referred to a YOT, their needs go beyond substance use intervention. As one practitioner noted, in the past young people would visit substance use services primarily for reducing substance use. Now it is more likely that young people come to substance use services with a range of, often complex and long-standing difficulties, of which substance use is just one.

What emerged from the research is a picture of a small group of young people who are referred to substance use services through their contact with the criminal justice system. For most, this occurs only after a prolonged period of need that has not been addressed by the various services around them who should be responsible for their care. However, the current responses to the needs of these young people have failed to consider how to prevent escalating difficulties in their lives. Those who lead substance use and youth offending teams need to be increasingly flexible in engaging young people who are referred to their services. The interviews with young people supported key factors that helped them engage with services noted by professionals and those who reported positive experiences of services identified similar elements of interventions that they felt had been helpful to them.

To explore how practitioners engage young people who do not visit substance use services voluntarily and may not agree they have a problem to be treated, we held four ‘solutions-focused’ practitioner workshops across England and Scotland. A total of 50 practitioners attended these workshops.

From the workshops, six key themes emerged on how to increase engagement of young people who likely had multiple previous negative experiences with statutory services:

1. Adopt a strengths-based approach – be open, don’t judge and look for positive and empowering ways for the young person to define their own goals.
2. Clarify ‘rules of engagement’ – be clear, consistent and transparent with young people, don’t promise things you can’t deliver and make sure they know what is expected of them from you.
3. Set goals collaboratively – make sure the young person has an active role in the goal setting process, ask what they want to achieve.
4. Offer practical support – often young people need help with housing or employment before they can address a substance use issue. Services should be prepared to provide support for these needs too.
5. Be flexible – practitioners need to be able to adapt their approach, meeting location and activities with young people who may be experiencing chaotic situations in their personal lives while attending their services.
6. Develop trusting, honest relationships – both young people and practitioners emphasised the importance of relationships in engaging with interventions and enabling genuine change in their lives.

Engaging young people, in a way that makes them feel heard is a challenge for practitioners offering substance use services within the criminal justice system. Findings from our project suggest that engaging young people in mandatory substance use services is an issue practitioners are responding to in broadly similar ways across the country. Giving young people the support they need while actively engaging them will result in more positive outcomes.

Acknowledgements: UK EPPIC project team: Professor Betsy Thom, Professor Karen Duke and Dr Rachel Herring, Drug and Alcohol Research Centre (DARC), Middlesex University, London, UK. Further information on the research work of DARC and EPPIC can be found here.

About the author:

Dr Helen Gleeson is a research assistant at Middlesex University, London in the Department of Mental Health & Social Work.  Her research interests include the experiences of young people in the criminal justice system and substance use and service responses within marginalised communities. Recent publications have focused on service provision for Black, Asian and minority ethnic (BAME) communities in need of alcohol and substance use support in the UK. You can follow her on Twitter @HelGleeson or email Helen at h.gleeson[at]mdx.ac.uk.

Disclaimer: This blog is drawn from the project 768162 / EPPIC which has received funding from the European Union’s Health Programme (2014-2020). The content of this blog represents the views of the authors only and is their sole responsibility; it cannot be considered to reflect the views of the European Commission and/or the Consumers, Health, Agriculture and Food Executive Agency or any other body of the European Union. The European Commission and the Agency do not accept any responsibility for use that may be made of the information it contains.