The 
Isle of Wight 
Young People’s
Substance Misuse 

Needs Assessment 

2010/11

		

Contents										Page

Overview	3	
1.	IOW Strategic Joint Needs Assessment 2008 – 2011	4
	
2.	IOW  Young People Substance Misuse	5
	
3.	NDTMS data from 2008/09	8
	
4.	Youth Offending Team SM Worker Report	10
	
5.	Service User Consultation Questionnaire	11
	
6.	Children’s Trust Consultation 	22	
7.	Education and Basic Drug Awareness Delivery	27
	
8.	What do Young People say?	29
	
9.	What the Team say 	30
	
10.	Catch 22
	32	
11.	Treatment Bulls eye and Treatment Pathway 2008/09
	35	

YPSM Needs Assessment data 2010/11

Overview:

This year’s Needs Assessment has been undertaken by a virtual expert group in light of the IOW DAT being without a Commissioning Manager since July 2009.  Contributions have been provided by the DAT partnership and there is an analysis from the data provided by the NDTMS. The report has been developed with support from the previous DAAT Commissioner, working in a consultancy role.

A major issue for the Young People Substance Misuses Agency – Get Sorted – in 2010/11 and beyond is the proposed reduction in funding. In previous years additional funding has been provided by the DAAT through the Adult Treatment Budget to support the service and whilst it is anticipated that this will continue the direct funding through the NTA is projected to reduce in 2010/11 and again in 2011/12 as a result of the linkage of funding to the Child Well-Being Index (CWI). Initial indications are that the CWI does not accurately reflect the position on the Isle of Wight; the following is quoted from the Summary Report produced in January 2009 on the CWI:
“The CWI represents the first attempt to create a small area index exclusively for children in England. Unlike the Index of Multiple Deprivation (IMD) the CWI was restricted by the availability of data as many datasets are not disaggregated by age group. Data on children is largely collected through surveys which are not robust enough to be broken down to small area level.”

The Island scores poorly on the IMD with the current ranking (2007) of 134th out of 354 (1 being the worst) – on data published by Hampshire County Council, the island is rated for CWI as 265th out of 354 (1 being the best) however for the funding on an Authority/County formula is rated 132nd (1 being the worst) 

Investigations are ongoing regarding the CWI and the allocation using this budget and representations will be made to the NTA. The immediate impact is the possibility of a reduction in staffing at the YPSM agency and a need to confine activities to the core work, leading to the likely cessation of education work for Young People and Professionals.  

1.   Taken from the Isle of Wight Strategic Partnership Joint Strategic Needs Assessment (JSNA) 2009

1	Isle of Wight Population 1998 to 2007

1.1     The 2001 resident population of the Isle of Wight was 132,731 with a 48:52 male/female split. This represented 1.7% of the population of the SE region. Mid-year estimates (MYEs) published by the Office for National Statistics indicate a population of 139,482 in 2007 – a 5.1% growth on 2001. The projected population of the IW for 2009 is 142,500. 

1.2   The Island’s population is not ethnically diverse with only 1,763 persons of non-white background recorded by the Census. This represents 1.3% of the population as against 4.9% for the SE and 8.7% across England and Wales. The ethnic minority population is mainly concentrated in Ryde and within the prison population in Parkhurst ward. 

1.3     Over the next ten years (2009 – 2018) it is anticipated that if the birth rate continues to follow current patterns:
•	The population aged 0 – 19 will decrease as a proportion of the total population, from 21.6% to 20.4%.
•	The working age population (aged 20 – 64) will decrease as a proportion of the total population, from 55.4% to 53%.
•	The population aged 65+ will grow as a proportion of the total population, from 23.2% to 26.8%.
•	The estimated number of people living with dementia will increase from 2,500 to 3,600.

1.4     The Isle of Wight school age population is lower than that of the South East and the national average. It only grew by 3% between 1995 and 2005, compared to the working age population growing by 16%.

1.5.	The island falls within the 40% most deprived local authorities in England (126th from 354) and is within the most deprived quartile of local authorities in the South East region. Approximately 1 in 5 island children live in poverty (equivalent to about 200 classrooms). Poverty is one of the most significant barriers to achievement and wellbeing in children and young people.

2.	
Isle of Wight Young People Substance Misuse Profiles

2.1	The estimates in the charts below show an ambiguous picture with overlapping confidence intervals which cast doubt on their statistical significance. They appear to indicate that the Island has 1.5 more of these children per 1,000 (7.0) than is the case in the South East as a whole (5.5). They are diminishing as a percentage of all age problem drug users.

2.2	Alcohol specific Hospital Admissions amongst Under 18s 
National Indicator:
NI 39 – Rate of Hospital admission per 100,000 for alcohol related harm
NI 70ª – Reduce numbers of emergency hospital admissions caused by alcohol and substance misuse related incidents for children and young people per 100,000 population

The North West Public Health Observatory (NWPHO), the lead public health observatory in England for alcohol misuse, has published nationally comparative data by Local Authority for 'persons aged under 18 admitted to hospital due to alcohol specific conditions - crude rate per 100,000 population.' 

This data (shown below) has demonstrated that the Isle of Wight's admission rate on this indicator has consistently been significantly higher than the England and South East Region average, and one of the highest Local Authority rates in England (ranking 353 out of 354). This data informed the adoption of a local target (NI70a) in the Island's Local Area Agreement (LAA) to reduce the rate of alcohol-specific admissions amongst young people. The NWPHO target definition has informed the local definition of NI70a. This target is not directly comparable with the NWPHO indicator, which counts each person admitted only once, however many times they are admitted, whereas the Island target counts each admission, including repeat admissions by the same person.

2.3	Because the number of admissions each year at Local Authority level is relatively small, NWPHO combines data for 3-year periods to increase the robustness and meaningfulness of the rate calculations. The data shown is based on 178 admissions in the 3-year period 

2.4     The key points over the period shown are: 
• There were an average of 60 admissions of under-18 IW residents each year for alcohol-specific conditions (excluding repeat admissions). 

• The IW admission rates for Persons, Males and Females were consistently significantly higher than the England and South-East regional averages, and among the worst of all Local Authorities in England. 

• The IW admission rate was consistently higher among Females than among Males, reflecting the national and regional pattern. 

Figure 2: Isle of Wight LAA Indicator NI70a : Alcohol specific hospital admissions among Young people aged Under-18 (Ref D, 02302) 	

	
2.5        Figure 2 shows IW data by quarter for the year 2008-09 for the NI70a target, the first year in which this target was in operation. The data shows that there were 44 alcohol specific admissions of under-18s over the whole year, including repeat admissions - performance exceeded the targets set both for 2008-09 and for 2009-10. However, the small number of admissions involved means that this reduction could have happened by chance and might not be the start of a true downward trend.
 
2.6      We still do not have a clear understanding of why the Isle of Wight alcohol-specific hospital admission rate among under-18s has been so high compared with the national and regional average. Contributory factors could include: 
•  Problem alcohol use among young people in the community 
• Hospital admission policies and decision-making around the admission of young people who   presented at A&E having consumed excess alcohol. 

2.7	Work continued in 2009/10 to address this issue, including the appointment of a Specialist Alcohol Nurse in the A&E Department. It is hoped that the lower number of admissions in 2008-09 could be the start of a downward trend but it is not yet clear whether this will be the case. With the resignation of the SAN in November 2009 (to take up duties elsewhere within the local PCT) it is considered unlikely that this role will be re-advertised with funding being used elsewhere to tackle alcohol problems

2.8	The table below shows the Activity across all ages; of the 187 who were offered appointments, 30 were aged under 19 (16%); an additional 15 Young People were dealt with by a brief intervention within A&E. This figure does not, however, provide a true reflection of the problem within A&E as a significant number - possibly half – were not referred to the Alcohol Nurse Specialist. 

A&E Nurse Activity Summary (all Ages):

Month	Appointments  offered total	Number of attendances total	DNA total	Cancelled/ Rebooked total	
May	44	29	12	3	
June	30	8	17	5	
July	18	6	7	5	
August	29	7	15	7	
September	16	2	12	2	
October	50	4	45	1	

3.	NDTMS data (2008/2009)

3.1	From the 2008/09 Treatment Bullseye Data:

3.1.1.	The number of young people in treatment has been consistent throughout the past two years with the gender split remaining around 50:50 although a gradual increase in females has been noted. In the year there was a slight majority of females (52%)

3.1.2.	There is 100% White ethnicity, with compares to a SE Regional percentage of BME service users at 4%.  This is not, however, entirely unexpected taking into consideration the ethnic breakdown of the IOW residents where White British makes up 96.8% (2001 Census); this percentage was reduced from 99.3%.in the previous Census in 1991.  It does, however, identify that there are some pockets of ethnicity e.g. the Polish community – where there is a lack of current penetration

3.1.3.	For young people aged 15 – 24 years there has been a slight decrease in the percentage in effective treatment and known to treatment. Only 3 of the 108 YP in treatment during the year had been in treatment for over 12 months

3.1.4.	The age range profile showed a preponderance of YP aged 15 and over, although there were 11 YP aged 13 and under as at 30/9/2008. The breakdown is given in Table 3 

3.1.5.	The main drugs of choice remain alcohol (54%) and cannabis (41%); Stimulants (1% and Other (5%) make up the remainder of Main drugs. No injecting drug users were known to the service with all YP in treatment advising that they had “never injected”.

3.2	From the 2008/09 Treatment pathway:      

3.2.1	  YPSM services have had a significant decrease (108 in 2008/9 against 76 in 2007/8) of referrals mostly from the criminal justice service which may be explained by a vacancy in the SM YOT post for a period of three months.

3.2.2	  The number of referral sources has been widened although this is not reflected in the NDTMS data which indicates that only 5 referrals were received in the period for the sectors that are targeted by the NTA and reported on within the “Green Reports” (e.g. 20% of referrals should come from Looked After Children (LAC) Services and Children’s and Families Services (CFS) – in 2008/9 only 5% came from these areas). Discussions have been held with Children’s Services and it has been identified that the use of the Common Assessment Framework (CAF) and the relevant Panel review of Service Users will distort number e.g. the referral source will indicate Education Services however the individual may have involvement with LAC and/or CFS.    

3.2.3	  NDTMS data also indicates that the service did not refer any young person into adult drug treatment services during 2008/9 however this is known to be incorrect. Further investigations have identified the following figures for 2008/9:
1.	A manual review of the Data Entry Tool (DET) utilised by Get Sorted to upload data to NDTMS identified 3 individuals where the Discharge Reason was “Treatment Completed – referred to Adult Treatment Agency”; this was not picked up by the NDTMS system 
2.	During this period there was a Transition Worker post within the co-located Adult Treatment provider – Cranstoun – and 17 Service Users aged 19+ were reported on the NDTMS as clients of this Adult Service; these clients all originated from the Young People’s services as referrals and clients. To ensure that details were retained for reporting purposes (aged over 19, they would not have been picked up using a YP data system) they were inputted onto the Adult Data System; this could be a gap in understanding of the system or a gap in the reporting mechanisms 

4.	
Youth Offending Team SM Role:

4.1	The role of the substance misuse worker role was changed to include Tier 2 brief interventions for young people being assessed for alcohol and substance misuse within the YOT; and a clear referral pathway to Get Sorted is in place for Tier 3 interventions; as well as developing an Alcohol Arrest & Referral pilot.  

4.2	The initial development of the arrest and referral pilot included meetings with police and partner agencies; attendance at reprimand and final warning clinics offered once a week and attendance by young people and parents. As a result of this an average of 1 – 2 young people per week were seen. Statistically since July – November there have been a total of 4 young people engaging with brief interventions from the offer. More recent figures indicate that there were only 2 arrests for alcohol related crimes for the month of October for young people. It is reported that from 1 April 2009 there have been a total of 44 offences that factor in alcohol in the crime. As of July – November 2009 with the post holder in place there have been a total of 14 arrests of young people with alcohol present.

4.3	What is working well is the CAP (Community Alcohol Program) currently working with young people and their families in a pilot area on the island and communicating engagement back to the YOT and partner agencies.  Partner agencies are communicating well and appropriate referrals to Get Sorted are filtering through, although there has been a drop in Tier 3 referrals from the YOT.  There is the possibility that early interventions are impacting this with raising the police presence in targeted areas around the island as well as the availability of the Get Sorted service that young people can access throughout the schools, through the internet and directly on the telephone.

4.4	The SM YOT Worker has participated in networking meetings to meet partner agencies to raise the profile of their role and has been included for input with the CAF panel which includes meeting directly with once of the locality coordinators to explore the gaps in services and risks to young people on the streets

4.5	Since July 09 they have participated in extensive training with the YOT and Get Sorted and is continuing with their professional development.  The worker has had contact with 56 clients ranging from statistical information gathering to counseling and tier 2/3 engagement.   19 of those clients are current.   They have had 3 YOT cases 2 being referral orders and 1 an action plan order. They have also written 2 panel reports and 2 ROSH reports.  

4.6	In terms of future development for this post the recommendation of the Service Lead and input from the YOT is to have a dedicated Tier 3 substance misuse role linked to the YOT due to strategic changes in the service and impending funding cuts from the NTA.  While the Arrest & Referral Pilot was a good idea it is recommended that the limited resources of one post holder could be utilized more effectively as a full time Tier 3 Substance Misuse worker.

4.7	Other areas of improvement are to develop and offer group work to young people and ensure that close links and supervision are maintained with the Get Sorted Team. Continue to expand knowledge of other services and link in young people with positive activities and other agencies who could contribute to improving outcomes.

5.	
Service User Consultation 

5.1.	Historically specific substance misuse consultation events do not attract young people on the IOW, and we have therefore focussed on integrating the information sharing. This involved promotion of the service and consultation with Young People by going out to where they are or taking part in other Young Person’s events and activities.

5.2.	A Questionnaire was developed and shared with key partners and used at the various events, and with existing service users. These were completed at a number of events as below:

Big Day Out – Children and Families Annual Event			30%
Outreach along Ryde Seafront					50%
Youth Rock Event							10%
Current Service Users						10%

5.3.	Get Sorted – Questionnaire October 2009 Analysis of Results 

GENERAL 
•	95 valid questionnaires were received with respondents aged 19 and under (a further 12 forms were completed by over 19’s) 

Age of respondents 
91 people gave their ages (it was assumed that the 4 responses where no age was indicated did fall into the 19 and under range) 
•	Average age was 14.5 years
•	Median age was 13 years (22 responses) 
•	Distribution was as follows:

Not given 	10	11	12	13	14	15	16	17	18	19	
4	2	4	7	22	13	13	9	13	6	2	

Gender
90 people identified their gender 
•	41 (46%) of responses were male
•	49 (54% of responses were female 

QUESTION 1 – Are you aware of “Get Sorted” and What they do? 
95 valid responses
•	73% (69 respondents) knew of Get Sorted or had heard the name
•	Of these 37% (35) said Yes to the question and 36% (34) said “they had heard the name”
•	27% (26) people said “No” to the question 

Of those who responded, the age range of the positive and negative responses tends to reflect the overall range of respondents. However the “Yes” response is lower in the 13 year old range compared to overall response levels   

QUESTION 2 – How do you like to receive information?
All 95 respondents replied to this question, providing 194 responses across the various options provided – under the heading of “Other” several additional options were mentioned – Text (2); e-mail (2) and via mentor/counsellor (2)

There was no specific favourite option with the highest response being “online (23%) – a range of media and options therefore need to be used 

The split of responses was:
Option	% of total	Number	
Face to face	13%	26	
Poster	12%	24	
Fun events 	16%	32	
Online	23%	44	
TV/Radio	7%	13	
Friends/Families	7%	13	
Leaflets 	12%	24	
School Assemblies 	6%	12	
Other 	3%	6	

Further analysis was undertaken of several of the options, by age of respondent, to identify the level of responses against school tier e.g. High/Middle/Primary 

•	School Assemblies – of the 12 respondents, 3 were High School age (15-18) and 9 were Middle School age (10-14)
•	Fun Events – of the 32 respondents (making this the second most popular option),11 were of High School age (15-18), 18 were Middle School age (10-14) and 2 were Primary School age (10)
•	6 of the respondents answered Yes to both “Fun Events” and “School Assemblies”

QUESTION 3 – What would be the best location for you if you needed to access treatment by Get Sorted?
Again all 95 respondents answered this question, providing 112 responses; under the heading of “Other” there were 3 responses – 2 advised “college” and 1 “café” 

The most popular option with 50% of responses (56 respondents) was “In School” and the second most popular choice was “In another place” (Connexions was the suggested location) with 17% of responses (19). The option of “at Get Sorted premises” attracted 13% of respondents (14)       

The split was as follows: 
Option 	% of total 	Number 	
In School	50%	56	
In another location	17%	19	
At Home	9%	10	
At Get Sorted	13%	14	
By phone	9%	10	
Other	3%	3	

Further analysis was undertaken of several of the options, by age of respondent, to identify the level of responses against school tier e.g. High/Middle/Primary 
•	In School – of the 56 respondents, 22 were High School age (15-18), 31 were Middle School age (10-14); and 1 was of Primary School age (10) – the other 2 had not indicated their age 
•	At Get Sorted premises – of the 14 respondents, 7 were of High School age (15-18), 6 were Middle School age (11-14) and 1 was aged 19
•	In another location (e.g. Connexions) – of the 19 respondents, 11 were High School age (15-18), 4 were of Middle School age (11-14); 2 were aged 19 and 2 did not state their age

QUESTION 4 – How much Alcohol is a safe daily limit for an adult male? 
All 95 respondents answered this question; the correct answer was 4 units and 85% (80 respondents) gave the correct answer; 14% (13) stated 14 units, and 1% (1) stated 24 units
   
QUESTION 5 – How many units are in each drink? (a) pint of 4% lager; (b) ½ litre of vodka; (c) bottle of 12% wine? 
A – this answer received 81 valid responses (the correct answer is 1.8 units) 
•	Average of responses was 2.5 units 
•	The median response was 2 units (40 responses)
•	The highest figure given was 14 units; the lowest figure given was 1 unit 
B - this answer received 76 valid responses (the correct answer is 19/20 units) 
•	Average of responses was 8.8 units 
•	The median response was 10 units (9 responses)
•	The highest figure given was 40 units; the lowest figure given was 1 unit
C - this answer received 81 valid responses (the correct answer is 9 units) 
•	Average of responses was 9.1 units 
•	The median response was 10 units (11 responses)
•	The highest figure given was 60 units; the lowest figure given was 1 unit
This would indicate that the majority of respondents were okay with the strength of lager and wine but vastly underestimated the strength of vodka

QUESTION 6 – What is good safety advice to follow when planning to drink alcohol? (list as much as possible)     
There were 77 valid respondents and they provided a range of 141 comments, which were grouped as follows: 
Response 	% giving response 
(out of 77)	No giving option 
(max. 77)	
Don’t drive 	19%	15	
Watch for spiking 	14%	11	
Don’t drink too much/Know your limits 	65%	50	
Stay with friends 	17%	13	
Designate a driver	3%	2	
Drink water before/during 	8%	6	
Don’t mix drinks 	8%	6	
Eat (before or during) 	21%	16	
Pace yourself 	18%	14	
Don’t drink in front of YP	3%	2	
Don’t drink	8%	6	

QUESTION 7 – What drugs are you aware of on the IoW that you/friends have used?
There were 65 respondents to this question giving 187 responses

This data should not be taken literally as some of the responses indicated that the respondents were answering based on what drugs they knew about (i.e. have a knowledge of as a drug) and not that they were using it, or knew someone who did. 
Drug	% replying
(out of 65)	Number replying (Max. 65)	
Weed	72%	47	
Legal Highs e.g. Spaced E/MKAT/Beano’s	40%	26	
Cocaine	31%	20	
Ecstasy/MDMA	31%	20	
Cannabis	28%	18	
Nicotine/Tobacco	14%	9	
Heroin	12%	8	
Crack	12%	8	
Alcohol	9%	6	
Hash	6%	4	
Crystal Meth	6%	4	
Poppers	6%	4	
Ketamine	5%	3	
Acid	5%	3	
Speed	5%	3	
Mushrooms	2%	1	
Glue/tippex 	2%	1	

QUESTION 8 – What can be the side effects experienced due to using Cannabis?
76 valid responses were given providing 125 side effects; additionally one respondent stated “none” and 8 stated “Don’t Know”. The “Talk to Frank” campaign was specifically mentioned in 2 responses” 
•	42 respondents gave more than one side effect

The responses in order of frequency were:
Side Effect mentioned 	% advising of Side Effect (out of 76)	No. advising Side Effect (max. 76)	
Paranoia	43%	33	
Loss of Control/the “giggles”	20%	15	
Brain damage	18%	14	
Mood swings/depression	16%	12	
Memory loss	14%	11	
“Munchies”	14%	11	
Hearing voices/having hallucinations 	12%	9	
Sickness/vomiting	12%	9	
Don’t Know	11%	8	
Slow reactions	5%	4	
Large eyes	4%	3	
Blackouts	4%	3	
Erectile dysfunction	1%	1	
None	1%	1	

QUESTION 9 – What would you do if you could not wake your friend after he/she passed out through drink or drugs?
88 respondents answered this question giving 114 responses. Only 1 respondent answered that they would “leave them before they get blamed” but he/she also answered that they would call an ambulance. 
•	19 respondents advised they would call both ambulance and parent/carer
•	Of the 3 who said “other” this was in addition to another response and comprised “check if they are breathing” and “put in recovery position” (2 respondents)  

The number of respondents to each option was: 
Response	% of respondents  (out of 88)	No of respondents  (max. 88)	
Let them sleep it off	5%	4	
Make them sick	6%	5	
Phone for ambulance	89%	78	
Phone for parent/carer	26%	23	
Leave them before I get blamed	1%	1	
Other	3%	3	

QUESTION 10 – What is the worst punishment you could get for 
A.	Possession of Cannabis 
B.	Supplying Cannabis 
C.	Letting people smoke at your house

Information from the Home Office for these offences is: 

 “Current penalties related to cannabis
Penalties for supply, dealing, production and trafficking
The maximum penalty is 14 years imprisonment.
Penalties for possession
The maximum penalty is five years imprisonment.

Young people in possession of cannabis
A young person found to be in possession of cannabis will be arrested and taken to a police station where they can receive a reprimand, final warning or charge depending on the seriousness of the offence.
Following one reprimand, any further offence will lead to a final warning or charge. Any further offence following a warning will normally result in criminal charges. After a final warning, the young offender must be referred to a Youth Offending Team to arrange a rehabilitation programme.
This police enforcement is consistent with the structured framework for early juvenile offending established under the Crime and Disorder Act 1998.
Adults in possession of cannabis
Anyone caught in possession of cannabis could be arrested.
Alternatively, police may:
•	issue a warning (primarily for first-time offenders) 
•	issue a penalty notice for disorder, with an on-the-spot fine of £80”
For allowing people to smoke Cannabis “the owners of premises who knowingly permit or suffer the smoking of cannabis are also subject to a maximum prison term on indictment of 14 years”.   
A – there were 69 valid answers split as follows:
•	Fine – 25% (17 respondents); no indication was given of the severity of the fine by any respondent
•	Imprisonment – 68% (47) 12 also gave a term of imprisonment; the highest was 10 years; lowest 6 months and the average 56 months  
•	Other – 7% (5); respondents stated caution or warning  

B – There were 68 valid answers split as follows:
•	Fine – 12% (8 respondents); no indication was given of the severity of a fine by any respondent
•	Imprisonment – 88% (60) 14 also gave a term of imprisonment; the highest was 15 years; lowest 36 months and the average 90 months   
•	Other – 0%  

C – There were 55 valid answers split as follows (the percentages are given against the 42 who advised of some punishment):
•	Fine – 33% (14 respondents); no indication was given of the severity of a fine by any respondent
•	Imprisonment – 45% (19); 8 also gave a term of imprisonment; the highest was 14 years; lowest 6 months and the average 70 months   
•	Other – 21%; respondents stated caution or warning 
•	A further 13 responses advised “nothing” or none” for the punishment 

QUESTION 11 – How bad would somebody’s use of drugs have to be before you got them some help, even if they did not want it? 
There were 72 valid responses and the highest answer given was “any use” or “not very bad”; against this 47% said “using every day” (18%) or noticeable effects/collapsed (29%) – the latter response appears to relate to alcohol use when indicating collapse
•	2 respondents appear to have misunderstood the question and answered “death” 

The ranges of responses given were: 

Response	% of respondents (out of 72) 	No. of respondents (max. 72)	
Any use/not very bad	38%	27	
Shouldn’t be taking drugs	3%	2	
Can’t make them get help	1%	1	
Don’t know	11%	8	
Noticeable effects/collapse	29%	21	
Using/smoking every day 	18%	13	
Death 	2%	2	

6.	
Children’s Trust Consultation 

6.1	A separate questionnaire was sent out to the membership of the “Be Healthy” sub-group of the Isle of Wight Children’s Trust – this was intended to serve a twofold purpose:
•	To identify the perception and profile of Get Sorted and Substance Misuse services for Young People amongst “professionals” 
•	To provide a “control” group for some of the questions raised in the Young People questionnaire 
  
6.2	Unfortunately it was not possible to allocate much notice to enable responses, however a total of 9 responses were received. The answers received have been analysed and detailed below; where appropriate an assessment has been made against the YP responses. 

6.3	Professionals  – Questionnaire October 2009 Analysis of results 

GENERAL 
When the Get Sorted Questionnaire was undertaken in October 2009, a Questionnaire was forwarded to representatives of the Childrens’ Trust, “Be Healthy” sub-group with a request to share this with their teams 
•	Whilst the level of responses was low at 9 responses, it is felt that there is some ability to make valid judgements regarding most issues. 
•	Also the responses for certain questions were analysed against the YP survey to obtain a comparison against YP’s responses and assess the knowledge across Professionals – this will assist in future contact with these teams
•	No demographic information was sought in this Questionnaire  

QUESTION 1 - aware are you aware of “Get Sorted” and what they do? 
All respondents answered this question – the split of responses was:
Aware of services and have referred within last 12 months	2	
Fully aware of services but not used in last 12 months	2	
Have seen their brochures and understand what they do	6	
Have a superficial understanding of what they do	1	
Have heard the  name	4	
No idea who they are or what they do	0	
•	Four respondents gave 2 responses to the question, and advised that they had seen brochures and knew the name of Get Sorted 
•	The positive response with no-one answering a lack of awareness of Get Sorted is encouraging given the anticipated responses expected some years ago. 

QUESTION 2 - What is the best way for you to receive information on Get Sorted?
A total of 26 responses were given as detailed below:  

Newsletter 	5	
Leaflets 	5	
Presentations at Team Meetings 	6	
On-line via Intranet 	6	
E-mail Newsletter 	0	
Other (please specify below)
•	Shadowing team members within Get Sorted 	4	

•	A range of options were requested indicating the variety of information sources that are needed to provide information
•	Several of the choices are by their nature labour-intensive and are likely to be undertaken on a more irregular basis 

QUESTION 3 – What would be the best location for a client if he/she needed to access treatment by Get Sorted?
•	There were 27 responses to this question:
At Get Sorted drop in premises (public access) 	7	
At School 	7	
At home 	2	
By phone 	2	
At another location e.g. Connexions 	9	
Other (please specify below)	0	

•	The most popular response was “At another location” followed by “At Get Sorted” and “At school”
•	The Chart below compares the responses between YP and Professionals and show a broadly similar level of responses to the various options 

QUESTION 4 – What drugs are you aware of on the Isle of Wight that Young People have used, or have access to?
There were only 5 responses to this question and therefore no significant analysis can be made against YP responses; the list of responses is given below for information 

Ketamine	4	
MDMA	4	
Cocaine	4	
Acid	4	
Cannabis	5	
Ecstasy	5	
Speed	5	
Base	4	
Heroin	1	
Cigarettes	1	
LSD	1	
Aerosol 	1	

QUESTION 5 – How much Alcohol is a safe daily limit for an adult male? 
7 out of 9 respondents answered this question and all were correct in their response of 4 units. 
•	The level of correct answers was higher than that of YP (who achieved a level of 85% correct responses) 

QUESTION 6 – How many units are in each drink? (a) pint of 4% lager; (b) ½ litre of vodka; (c) bottle of 12% wine? 

A – this answer received 7 valid responses (the correct answer is 1.8 units) 
•	Average of responses was 2.27 units 
•	The highest figure given was 3 units
•	the lowest figure given was 1.7 unit

•	The responses reflected a similar position to YP where the average was 2.5 units (although the range of answers given by YP was much higher – from 1 up to 40 units) 

B - this answer received 7 valid responses (the correct answer is 19/20 units) 
•	Average of responses was 12.6 units 
•	The highest figure given was 20 units
•	 the lowest figure given was 4 units

•	The Professionals as a whole performed in line with YP in underestimating the number of units in a ½ litre bottle of spirits. After eliminating the two correct respondents who gave a figure of 20 units, the remaining respondents gave values at 4 units (1) and 11 units (4).
•	Professionals performed badly against the Adults responses (received in the YP exercise) who gave responses closer to the correct value    

C - this answer received 7 valid responses (the correct answer is 9 units) 
•	Average of responses was 8.7 units 
•	The highest figure given was 12 units
•	the lowest figure given was 4 units

•	Again the response of Adults was reasonably in line with YP, where an average figure of 9 units was given (again, however, the range was much tighter, compared to YP responses ranging from 1 to 60 units) 

QUESTION 7 – What is good safety advice to follow when planning to drink alcohol? (list as much as possible) 
Only 2 respondents gave answers to this question, and the responses broadly mirrored those of YP. However both respondents gave a response of “Don’t take drugs and drink”, a response not used by 

QUESTION 8 – What can be some of the side effects experienced due to using Cannabis?
Again only 2 respondents answered however the range of side effects fits well with the current “Talk to Frank” advert campaign on television, with the stated effects mirroring those given in the advert:

QUESTION 9 – What is the worst punishment you could get for 
D.	Possession of Cannabis 
E.	Supplying Cannabis 
F.	Letting people smoke at your house

Information from the Home Office for these offences is: 

 “Current penalties related to cannabis
Penalties for supply, dealing, production and trafficking
The maximum penalty is 14 years imprisonment.
Penalties for possession
The maximum penalty is five years imprisonment.

For allowing people to smoke Cannabis “the owners of premises who knowingly permit or suffer the smoking of cannabis are also subject to a maximum prison term on indictment of 14 years”.   

The response level to these questions was relatively good with 7 people responses to the three questions within this subset; 

A – there were 7 valid answers split as follows:
•	Fine – 5 respondents; no indication was given of the severity of the fine by any respondent
•	Imprisonment – 1 respondent indicated this penalty with a correct term of 60 months (this respondent worked within the YOT); they had also advised a fine in addition to a prison term    
•	Other – 0 respondents   

•	The number indicating a fine was out of line with YP where 68% of respondents indicated a prison sentence with the average term of  56 months in line with the correct maximum term  

B – there were 7 valid answers split as follows:
•	Fine – 0 respondents
•	Imprisonment – 100%; 2 also gave a term of imprisonment; the highest was 14 years (the YOT worker); the other respondent advised a term of 8 months    
•	Other – 0 respondents   

•	Responses were broadly in line with YP – 88% indicated Prison 

C – there were 7 valid answers split as follows 
•	Fine – 2 respondents; no indication was given of the severity of a fine 
•	Imprisonment – 1; this response was from the YOT worker who gave a correct term of 168 and also advised of a fine 
•	Other – 5 respondents stated “none” 

•	The responses given by YP were more inclined to a penalty e.g. 33% stated a fine and 42% stated a prison sentenced; only 20% of the 55 YP respondents said “nothing” or “none” by way of a penalty    

     

7.	
Get Sorted Delivery of Basic Drug & Alcohol Awareness 2009
							
Date	Where		No.	Who	What		
14/02/08	Mayfield Middle	120	students	Solvent, harm reduction	
28/02/08	West Wight Middle school	26	Students	Solvent, harm reduction	
03/03/08	Riverside Ctr	78	Trading Stand.	Alcohol health risks, referral pathway, info on service	
19/03/08	IW College	30	Students	BD&A Awareness	
04/04/08	Eight Bells	25	0-16 Team	BDA/service/referrals	
15/05/08	IW College	8	Social Care Students	BDA	
29/05/08	Northwood House	15	PCSO	Alcohol awareness	
10/06/08	IW College	5	Staff	BD&A Awareness	
11/06/08	IW College	100	Students, professionals	Roadshow	
04/08/08	Foyer	20	Residents	Alcohol group	
07/08/08	IW College	17	Wigits	Alcohol	
17/09/08	Foyer	6	Residents	Alcohol group	
09/09/08	IW College	100	Students	Fresher’s Week	
10/09/08	Get Sorted	6	School Nurses	BDA/alcohol and referral pathway	
11/09/08	IW College	100	Students	Fresher’s Week	
16/09/08	IW College	100	Students	Fresher’s Week	
18/09/08	IW College	100	Students	Fresher’s Week	
25&26/09/08	Sandown High	400	Students/teachers	Alcohol/cannabis/ecstasy	
01/10/08	IW College	18	Students	BDA	
02/10/08	IW College	25	Students	BDA	
22/10/08	Salvation Army	19	4 adults
15 YP	Alcohol awareness	
12/11/08	IW College	5	Students	BDA	
02/12/08	Sandown High	414	Yr 10	Alcohol/cannabis awareness	
27/01/09	Children’s Services	34	Range of services	Awareness Session/referral
pathway	
28/01/09	The Foyer	12	Residents	Cannabis Awareness/referral pathway	
13/02/09	Mayfield Middle	92	Yr 7	Cannabis Awareness/ referral pathway	
11/03/09	Carisbrooke High School	300	Year 10	Alcohol Awareness workshop/referral pathway	
21/03/09	Gunville Methodist Church	20	Street Pastors	Day long Drugs Awareness/ referral pathway	
25/03/09	Lake Middle School	18	Teaching Staff	Drugs Awareness/referral
pathway	
02/04/09	Lake Middle	11	Parents/Carers	Drug Awareness/referral pathway session	
03/04/09	Lake Middle	124	Yr 8	Cannabis Awareness Workshop	
09/04/09 - 17	The Foyer	36	Residents	Ketamine Awareness/ group work and referral pathway	
21/04/09	Quay Arts	7	Foster Carers	Cannabis Workshop/referral pathway	
27/04/09	Wootton Primary 	9	Parents/Carers	Drug Awareness/referral pathway session	

7.1	The demand in High Schools has increased with young people accessing our service and while there is a designated worker for High Schools other key workers are adding presence at Sandown High School and Cowes High School to meet the demands. Requests for delivery of Basic Drugs Awareness continue to come in on a regular basis from High School and Middle Schools. Feedback from Middle Schools regarding drug and alcohol awareness is that they really find them beneficial and would like more. 

7.2	Input at the Isle of Wight College has included 20 weeks of open access/clinic/education with a minimum of engagement of 10 – 20 students each session. 1:1’s were also offered and referrals for those 19 and up were passed to adult services and in some cases the Young Person was introduced to the adult service by the key worker.  Harm reduction advice and safe messages were relayed consistently and students reported it was really helpful having someone to contact regularly. Tutors openly refer Young People into Get Sorted with their consent.

7.3	We also link up regularly with other generic services such as: Youth Services to provide support and information to young people, professionals and parents. We participated in special evens such as Wight 2B Heard; Awareness Day at the Hospital for staff; Question of Crime; Crime Stoppers; Road shows at Thompson House and Clatterford Centre; Band Night – a community partnership project in Church Litten Park.

8.	
What do Young People say?

8.1	Quotes from young people about accessing Get Sorted

7.1.1	'First I thought it isn't going to help, but it did, it helped me to get through the hard times and reduce my drinking.'
'Thanks for your help you have helped me to become a better person'
‘Thanks for making the difference and listening’.
‘I needed the safety net of knowing there would be somebody to talk to every week’.
‘I can control situations better now’.
‘I don’t have to go along with others, I can decide’.

8.2	In addition to young people in treatment we have offered 45 individual 1:1 harm reduction advice sessions to Young People, parents and carers.

8.3	Results from the YP Questionnaire suggest that continued education around the strength of different alcoholic drinks may be beneficial to minimize and address risk factors with Young People. Additionally it could be argued that Young People would benefit from accessing an open service to engage with support which is not currently available. 

8.4	Recommendations include Get Sorted being located with generic services such as Connexions supporting the national campaign ‘Your Welcome’ of an open access service. Additionally, it is suggested the team could be more efficient having clients/parents being able to drop in and schedule appointments at a central location.  Get Sorted would envision continuing to offer outreach to Young People who are complex and difficult to engage with.

Yvonne Price 
YPSM Lead and Team Manager

9.	
What the Team say:  GET SORTED YPSM PLANNING 2010/11

9.1	The team are concerned about the upcoming budget cut and the affects on delivery of the service as it a small team providing engagement to Young People across the island. Recommendations are to seek funding from other streams to secure a post currently vacant to maintain the continuity of the service provision and have appropriate coverage for annual leave and illness.

9.2	More resources are needed to improve and keep current the information on the web site for Young People and parents/carers to be able to access appropriate information and safety tips around alcohol and substance use. The possible use of the resources of the Performance and Contracts Manager within the DAAT to undertake this role on an ongoing basis will be investigated. 

9.3	STRATEGIC:

•	ALCOHOL – youth alcohol action plan/ PCSO/A&E posts
•	Crime- youth crime action plan/drug strategy
•	Supporting and Involving Carers
•	IOW Children and Young Peoples plan
•	Safeguarding Children – Hidden Harm
•	Your Welcome – charter mark- YP accessible service
•	Targeted Youth Support – local plan: Pan Pilot
•	CAF
•	DCSF Childrens Plan – Building brighter futures
•	CAMHs plan

9.4	Key achievements 2009/10

9.4.1.	Get Sorted is closing gaps with partner agencies by offer joint training, attending road shows and delivering information at team meetings and linking in with cross agency meetings.

•	Provided training to staff within HTP – a training provider for young people who historically have not attended school and are difficult to engage. In addition we have set up a clear referral pathway and links to engage with complex young people at their location; resulting in more successful attendance for engagement.
•	Developing a mentoring scheme for young people with complex needs to expand the care plan to meet their needs with a holistic approach. A project is underway and being explored in collaboration with the Hampton Trust.
•	Another development is a group activity project encompassing team building, self esteem and self awareness in conjunction with Challenge and Adventure; this will be delivered alongside the care plan with the young person to reduce/abstain with their substance misuse. 

9.4.2.	Confirmed agreements with Children’s Services to secure available clinics for young people and parents to access Get Sorted within three locality settings scheduled to be in place 2010.

9.4.3.	The Team is firmly embedded in the CAF process and participate in Lead Professional meetings regularly.

9.4.4.	Raising awareness of the team and offering current training to a range of professionals working with young people with two separate training days covering cannabis and alcohol. Well attended and received with positive feedback and improved links with services.  This is an area we would like to continue to model and have joint agency and partnership training to include the voluntary sector.

9.4.5.	Access to the diversionary fund and being able to offer a range of different activities/training for complex Young People to suit their needs with substance misuse issues has resulted in improved outcomes with measurable results and abstinence reported in some cases. Young People stated it gave them the chance to build their confidence being exposed to different opportunities; and gave them the confidence to continue to make positive changes with lifestyle choices. Some Young People have continued on and have found ways to maintain and become involved in voluntary programmes

9.4.6.	The system for Clinical Supervision has been re-established with the lead for the Southampton Young People Provider, and monthly clinical support sessions have been put in place from December 2009. Clinical Governance has been identified as a key area for future development and joint meetings with professionals from CAMHS, Children’s Services and the PCT are scheduled for early 2010 to take this forward    

9.5	Aftercare Provision

9.5.1	Support for individuals following treatment is essential and Get Sorted has developed links with accommodation, training and employer providers to ensure that referrals to appropriate agencies may be made. These links will be developed through 2010-11 and any gaps in support established and potential providers identified and resourced
•	On the accommodation front linkages are in place with Supporting People Providers and Mental Health
•	for employment and training links are in place with HTP (as discussed above) to provide training and work-placements in the hospitality sector
•	Strong links are also in place with Connexions   

9.5.2	Additional support is also available to assist Young People at risk with psychological issues and confidence building through the following:
•	Motivational support is available through a pilot programme with Challenge and Adventure around positive activities; self esteem; team building and group work 
•	Mentoring support provided through a contract with The Hampton Trust (an existing Provider based in Southampton) for individual one-to-one, tailored support 
•	Referrals to the Youth Trust for additional counselling support  

9.6	Areas for improvement
•	Improve links with Children Looked After Team for referral pathway
•	Continue to build upon the gap in services with CAMHS and identify issues of common concern from the Independent Review of CAMHS 
•	Develop on-line website locally to be more interactive for Young People/parents/carers. 
•	A gap in service provision identified around the Hidden Harm Agenda where young people have highlighted they would like to engage with someone around concerns of their parents drug or alcohol use. We have had 10 young people presenting to the service with requests.
•	Development of new guidelines for Youth Rehabilitation Order (YRO) and links with YOT to implement
•	Renew and develop Clinical Governance Procedures 

9.7	Priorities
•	Target training related to Hidden Harm
•	Continue to embed the CAF and links with localities satellites throughout the island
•	Research and develop training focusing on Legal Highs, due to the reported high incidents of admissions to the mental health ward and continued continuous reporting of young people with their increased use of ‘legal highs’. Whilst legalisation will make these illegal from December 2009, the expectation is that new Legal High’s will be developed to obviate this new classification 
•	Research potential funding for a dedicated Transition post to work across the DAAT Partnership to ensure care planning etc. is in place for any Young Person transitioning into Adult Services   

10.	
Family Work Project

•	Support young people aged 10-16 years
•	Work with young people who live or attend school in the East Bay area or central Newport
•	Early stages of experiencing personal or family difficulties 
•	Do not reach the threshold for statutory services
•	12 week intervention period 
•	Includes up to 4 family sessions
•	Meet with young people weekly 
•	Comprehensive assessment
•	Young people led, target focussed work
•	Solution focussed approach 
•	Support the young person and family  to address underlying issues
•	Encourage positive choices

Catch 22 works on the IOW in collaboration with the DAT and CDRP Partnership. This voluntary sector organisation was involved n the local Community Alcohol Partnership Initiative providing additional support to families.

10.1	The following monitoring Report shows:

•	127 young people supported (January 2008 to September 2009)
•	Young people primarily from Sandown, Shanklin, Ventnor and Lake area
•	Expanded into central Newport in September 2009
•	Continue to work with Police: Operation Dragon and C-12
•	CAF Panel

10.2	   Gender & Disability 									 

10.3	Presenting Difficulties

10.3.1	Social 
•	Making friends
•	Understanding eye contact, tone of voice, body language, 
•	Developing conversation skills 
•	Resolving conflict within peer relationships 
•	Peer influence and pressure

10.3.2	Emotional  
•	Managing anger, anxiety and sadness (especially related to bereavement or loss through parental divorce/split)
•	Learning to identify and understand emotions: expressing emotions verbally, ‘putting words and facial expressions to emotions’
•	Dealing with peer conflict and arguments
•	Low self esteem and confidence 

10.3.3	Family 
•	Parents/ young people understanding adolescent development
•	Negotiating and re-negotiating boundaries  
•	Communication difficulties: step-parents and blended families 
•	Addressing separation and loss resulting from parental relationship breakdown 
•	Impact of domestic violence

10.3.4	Parental
•	Strengthening parental listening skills 
•	Parental relationship difficulties 
•	Individual emotional problems of parents – childhood 
•	Impact of domestic violence 

10.3.5	School 
•	Truancy and lateness
•	Unrecognised or assessed learning difficulties
•	Lack of motivation for education 
•	Lack of direction regarding future goals 
•	Conflicts with particular teachers
•	Negative feelings about education, in particular emphasis of discipline over positive relationships 

In treatment now

In treatment over two years

  Not known to treatment 

10.	IOW YPSM bullseye 2008/09 in Treatment

General population
Female
BME groups
Under 15years

108

3

??

56 (52%)

1 (33%)

0 (0%)

0 (0%)

27 (25%)

0 (0%)

10.	IOW YPSM Treatment Map 2008/09 
Criminal Justice

Mental Health

Education

C&F services/ Targeted Youth Support

  27      (14)

5    (4)

Referrals

Treatment

E’s Up
(1)

(Total Discharge)

   Planned 
  discharges

Unplanned discharges

Referred on

1

41 (34)

27 (20)

 0 (0)

Get Sorted
Key – Get Sorted All referrals 
          (Get Sorted 15-18 referrals)

    5          
       (2)

Get Sorted (All)  68
Get Sorted 15 – 18 yrs (54) 

1     (0)

9                
      (6)

SM services

9              
       (7)

20    (17)

0

0

1   (0)

Health

Self and Family

Other

E’s Up
(Portsmouth) 

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