7.6 Mechanisms of early detection and signposting of young people facing health risks
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Policy framework
There is no overarching policy framework specifically for mechanisms of early detection and signposting of young people facing health risks. However, there are policy frameworks which include mechanisms of early detection and signposting which affect young people facing health risks.
Reducing Harm, Supporting Recovery
The national drug strategy for 2017-2025 is Reducing Harm, Supporting Recovery is a health-led response to drug and alcohol use in Ireland 2017-2025 (Department of Health and Healthy Ireland, 2017). While it is targeted at the general population, one of its objectives (1.2) is to ‘Prevent use of drugs and alcohol at a young age’. Actions include:
- To support the Social, Personal and Health Education (SPHE) by promoting effective communications between schools and Drug and Alcohol Task Forces
- To improve supports for young people at risk of early substance use by prioritising initiatives under the new DEIS programme [Delivering Equality of Opportunity in Schools, described in Chapter 6.1] to address early school leaving; and providing a continuum of support for young people encountering difficulty in mainstream education
- To facilitate increased use of school buildings, where feasible, for afterschool care and out-of-hours use to support local communities
- To improve services for young people at risk of substance misuse in socially and economically disadvantaged communities by developing a new scheme to provide targeted, appropriate and effective services
National Youth Strategy 2015-2020
The National Youth Strategy 2015-2020 sets out that DCEDIY will provide leadership at national level, to ensure that national policy joins with local implementation and with the implementation structures under Better Outcomes, Brighter Futures. The aim is to ensure quality services, focus on prevention and early intervention, improve collaboration and coordination, and improve access to quality information and supports. An action it set out was to enhance “effective prevention and early intervention through the reformed targeted youth programme as recommended in the Value for Money and Policy Review of Youth Programmes (2014), while ensuring a preventive focus in and across all other universal programmes and schemes within DCEDIY, which focus on the development of young people”. In 2020 this reformed targeted youth programme was launched as UBU - Your Place, Your Space (discussed in Chapter 7.4). The National Youth Strategy also set the target of “Developing efficient and user-friendly ways of collecting and analysing quantitative and qualitative data at local, regional and national level to inform service planning, delivery, assessment and continuous improvement.” To support implementation, the strategy stated that DCEDIY would establish a National Youth Strategy Lead Team, drawing from experience in DCEDIY and technical assistance from relevant experts, as required.
Stakeholders
The National Drugs Strategy names the following organisations as involved in achieving the actions in Objective 1.2, to ‘Prevent use of drugs and alcohol at a young age’:
- Department of Education
- Health Service Executive (HSE)
- The Child and Family Agency (TUSLA)
- Department of Housing, Local Government and Heritage
- Department of Health
- Department of Children, Equality, Disability, Integration and Youth (DCEDIY)
- Drug & Alcohol task force
The Child and Family Agency (Tusla) recommends that parents/guardians who are concerned about a teenager’s risky behaviour should ask their family doctor for a referral to a psychologist or other mental health professional, or they should speak with the child’s school counsellor.
Secondary schools must provide Social, Personal and Health Education (SPHE) during the junior cycle, and some provide SPHE in Transition Year (an optional year between the junior and senior cycles) and to a lesser extent, in the Leaving Certificate (established) (the non-vocational state examination curriculum at senior cycle). Schools may also choose to provide additional School-based life-skills training programmes.
Assessment Consultation Therapy Service is a small national specialised clinical service that provides multidisciplinary consultation, assessment and focused interventions to young people who have high risk behaviours associated with complex clinical needs. It also supports other professionals in their ongoing work with young people and their families.
Jigsaw is The National Centre for Youth Mental Health. Jigsaw is a multi-systemic early intervention and prevention model. In this context, it:
- Promotes positive mental health for young people by deploying strategies that target the whole population to enhance strengths, thereby reducing the risk of subsequent negative outcomes (e.g., community-level mental health awareness training);
- Utilizes universal prevention strategies designed to address risk factors in the whole population without attempting to discern which young people are at elevated risk (e.g., anti-stigma media campaigns and youth advocacy);
- Targets groups of young people at risk for developing mental health difficulties through selective prevention strategies (e.g., Youth Centred Practice training for front-line providers);
- Provides indicated early intervention/prevention supports and services for young people with mild / emerging mental health difficulties (e.g., brief interventions delivered through the Jigsaw Hub).
Jigsaw is described in further detail Chapter 7.5.
Youth Work Ireland’s launched the Detached Youth Work Programme in 2015. It is an outreach programme that engages with vulnerable and socially excluded young people and helps them connect with supports that will aid them in addressing their needs and achieves successful outcomes. While the target population for this programme may have needs in relation to issues as diverse as mental health, sexual health, and homelessness, most young people engaged struggle with substance misuse. Detached Youth Workers engage with young people on the street during key times when young people are involved in dangerous activities related to substance misuse.
Guidance to stakeholders
The National Drug Strategy includes the strategic action to promote a health promotion approach to addressing substance misuse. This is to be delivered in line with the Action Plan for Education a) Commencing and rolling out a national programme to support the implementation of the Wellbeing Guidelines to all primary and post-primary schools; and b) Developing Wellbeing Guidelines for Centres of Education and Training.
The Department of Education issued Guidelines for developing a School Substance Use Policy to all primary and post-primary schools.
The HSE’s Alcohol Programme published Alcohol and Drugs: A Parent’s Guide in 2018. It was written specifically for parents and includes insights directly from young people. The Guide has advice on topics such as getting the conversation started, how to stay close to your child and help them to resist pressure from their friends and the media, how to set boundaries and further practical advice and helpful tips. There are also several resources related to young people and alcohol for parents on the HSE’s website.
The HSE also run the website drugs.ie which offers free information and resources about substance misuse. It includes information specifically for parents/carers about young people.
Promoting Health in the Youth Sector – A Practice Manual is a manual which aims to introduce those working with young people to good practice in health promotion. It targets youth workers working in the area of health but is designed to be used by anyone working with young people with an understanding and appreciation of youth health.
A Mental Health Resource for Youth Workers and Volunteers (2011) was published by Jigsaw (previously Headstrong) in association with belongTo, Foróige and ReachOut.com. This resource helps youth workers and volunteers to understand more about mental health and how young people can best be supported.
Target groups
The National Drug Strategy’s targets include:
- the children of parents who misuse substances
- Young people leaving care and detention services, particularly from residential or hostel accommodation
- third level students
- Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI) young people
- those who have already started to use substances
- communities that are most impacted by socio-economic disadvantage, marginalisation, and exclusion
- those who have or who are at risk of early school leaving and/or not in employment, education or training aged 15-25 years
- migrant communities
Funding
Capital Public Health Expenditure on mental health has significantly increased from 25million euro in 2009 to 81million euro in 2019.
Over €38.7 million was made available in targeted funding in 2020 to form the basis of the UBU – Your Place, Your Space targeted youth funding scheme (discussed in Chapter 7.4).
In 2022 the Budget is set to increase by €1 billion for Covid-19 related measures. The health expenditure in Ireland for 2022 will increase 5.3% from 2021.