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Dun Laoghaire Rathdown Drug and Alcohol Task Force (DLR-‐‑DATF) Strategy 2016/18 (Draft) January, 2016. Document to be finalised by DATF during March-‐‑May, 2016 Comments, suggestions, etc: [email protected]
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CONTENTS
• INTRODUCTION
• SECTION 1 -‐‑ CONTEXT
• SECTION 2 -‐‑ REVIEW PROCESS SUMMARY
• SECTION 2 -‐‑ REVIEW PROCESS SUMMARY
• APPENDIX 1 – DLR PROFILE
• APPENDIX 2 – MAP 1: DLR RELATIVE DEPRIVATION, 2011
• APPENDIX 3 – FIGURE : CLASSIFICATION OF SMALL AREAS ACCORDING TO LEVELSD OF AFLUENCE / DISADVANTAGE
• APPENDIX 4 – TABLE 1: SELECT RELEVANT DLR PROFILE DATA
• APPENDIX 5 – FIGURES 2 & 3: TREATMENT TYPES, 2004, 2008, 2012, 2016 (PROJECTED)
• APPENDIX 6 – MAP 2: DLR CLUSTERING TREATMENT DEMAND (ALCOHOL & DRUGS), 2013
• APPENDIX 7 – MAP 3: SOUTHSIDE PARTNERSHIP, TARGET NEIGHBOURHOODS
• APPENDIX 8 – FIGURES 4-‐‑65: PERCENTAGE YEAR ON YEAR IN(DE)CREASE IN ALL CRIMES AND CONTROLLED DRUGS D]CRIMES, 2004-‐‑14.
• APPENDIX 9 – PROGRAMME SUMMARIES
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INTRODUCTION Arising from changes in the nature of substance misuse problems (see section 1 below, Context), and also taking into account the Government’s decision, October 2013, to include alcohol in the remit of Local Drug Task Forces (now Drug and Alcohol Task Forces), the DLR-‐‑DATF1 decided to undertake a review and to put into place a new strategy. A review process was developed through 2014-‐‑15, which is summarised in Section 2 below, and a new Strategy 2016/17 has been adopted. Meanwhile the Government has initiated a Review of the National Drug Strategy, 2009-‐‑16. This latter review has only commenced and it is doubtful that the shape and content of the next strategy will become apparent until the latter half of 2016; it is likely the DLR-‐‑DATF, like others, will have an opportunity to make submissions into the process. These latter developments notwithstanding, the DLR-‐‑DATF considers it best to continue in accordance with the outcomes from its own, internal review process, to adopt these as priorities for 2016-‐‑17, and to adjust as appropriate when the new national strategy is published. The DLR-‐‑DATF Strategy 2016/17 consists of twenty-‐‑one actions which are organised under three programme themes, and three capacity building headings, and these are outlined in Section 3 below. Individual project summaries, as they relate to projects that are recommended for funding, are included in Appendix 9 – summary of programmes.
1 “DLR-‐‑DATF” is interchanged with “TF” , “the DATF” and “the Task Force” in this document.
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SECTION 1: CONTEXT This section draws from secondary data sources to draw attention to emerging trends and developments, relating to substance misuse in DLR. A full data outline is included in Appendix 1: DLR Profile Summary of relevant data • NDTRS national figures illustrate an increase in numbers entering treatment for alcohol and drugs over the period, 2004-‐‑13 – an annual average increase of 4.6%, from 9,945 to 15,808; the increase is accounted for primarily by treatment for alcohol and non-‐‑opiate drugs; indeed treatment cases for opiate drugs in Dublin (city and county), where this problem was most particularly pronounced right through the 1990s, has decreased quite significantly.
• While DLR mirrors the Dublin picture, it shows a slight increase in treatment for opiates over the period, and an average annual increase of 9.3% for alcohol and drugs, from 172 in 2004 to 384 in 2013, which is more than twice the national average annual increase.
• Assuming an annual trend of similar average annual increases, 2014-‐‑16, opiate treatment demand in 2016 will represent less than 25% of the overall demand on treatment services in DLR; the greatest level of demand will be in relation to alcohol, in excess of 40% of the work is expected to be in this area and a further 20% each is expected to be in the respective areas of cannabis and other drugs.
• When NDTRS data is co-‐‑related with Pobal area/geographical data, two clear clusters of treatment demand in Dun Laoghaire and Ballybrack / Loughlinstown are evident, with a more spread-‐‑out pattern in Dundrum/Sandyford/Ballyogan – the general pattern corresponds closely with Southside Partnership’s socio-‐‑economic targeting of small neighbourhoods.
• There is little or no treatment demand in Stillorgan, North Blackrock, Dundrum/Clonskeagh, South Dun Laoghaire, Killiney and Dalkey – this is not to say there is no treatment
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requirement, but that from what is known from NDTRS data, it is low.
• Persons from DLR who attend for methadone treatment (531 in 2014) attend mainly clinics or GPs, they are predominantly male and they are ageing out, and their number has decreased slightly over 2013; it is also reported that 25% of persons on the Central Treatment List have been in treatment for 10 years or more; these features are evident across DLR, national and regional (DML) figures.
• NDRDI data for DLR show 5 deaths for 2011, 11 for 2012 and 13 deaths for 2013. The figure of 13 deaths for 2013 is slightly less than the average of 13.8 over the ten-‐‑year period, 2004-‐‑13.
• Between 2003, and 2013 there was an increase of 30% in offences for controlled drugs DMR-‐‑Eastern (Dun Laoghaire, Blackrock, Cabinteely and Dundrum), representing an increase of 1% in offences for sale or supply, and 38% in offences for possession for personal use. The corresponding Dublin and national figures show overall respective increases of 114% and 66%.
• Between 2008, when figures were highest, and 2013, there was a 44% decrease in offences for controlled drugs in DMR-‐‑Eastern, representing a 30% decrease in offences for sale or supply and a 47% decrease for offences for possession for personal use. The corresponding Dublin and national figures show respective decreases 36% and 34%.
Conclusion In general both treatment and control data signify a fall-‐‑off in opiate problems, in recent years. However, in planning for 2016 and beyond it is clear there is an increased demand for treatments for alcohol, cannabis and other non-‐‑opiate drugs, especially among younger persons, many of whom are from neighbourhoods and families that previously experienced serious drug problems, and continue to do so. These developments constitute a major challenge for the Task Force in developing a strategic response, especially taking into account that there is only a limited role for established medical treatments for non-‐‑opiate drugs, with professional psycho-‐‑social programmes
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widely considered to be most relevant and efficacious intervention; meanwhile the need to develop appropriate socio-‐‑medical services and other supports for elderly methadone users will arise.
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SECTION 2: REVIEW PROCESS SUMMARY The process for developing and agreeing a new strategy commenced at a facilitated TF meeting in March 2014, following which it was decided to compile an interim workplan, based on existing activities, and to commission an external consultant to provide assistance in a review process, and in developing a new strategy. The consultant, Murtagh & Partners (M&P), undertook an initial scoping survey of funded projects’ resources and capacities, taking account of the workplan’s initial draft, and also provided an interim feedback report for the September 2014 Task Force meeting; a more intensive assessment was then undertaken, based on LDTF1 forms, and the consultant also provided assistance in analysing the NDTRS data – as per Section 1 above -‐‑ taking into account area / geographical data, as provided by Pobal’s analysis of Census of Ireland figures. Further feedback was conducted at November 2014 TF meeting and through this consultative/feedback process the following issues emerged: • The multiple needs of persons who have long histories of addiction, taking particular account of implications of ageing process, and the need to ensure a coordinated socio-‐‑medical response to this group.
• The adequacy of outreach and an intake system for persons presenting for first-‐‑time treatment, taking into account that persons with non-‐‑opiate and/or alcohol problems will not necessarily present as readily as those with opiate problems.
• Intensifying and coordinating responses to families with pervasive addictions, with specific focus on improving outcomes for vulnerable children, many of whom, it was reported, have themselves become involved in substance misuse, thereby prolonging the cycle of addiction.
• Providing a new service response for persons who are under 18 years – at both community and specialist levels.
• Developing contextualised research on the local drug problem, taking account that many current patterns of drug and alcohol behaviour have not been adequately studied or documented.
• Renewing and revitalising the Task Force itself, with particular attention to developing community ownership and engagement, and taking into account the issue of alcohol and non-‐‑opiate drugs.
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M&P’s report was circulated during January 2015, inviting comments from both TF members and funded projects. Meanwhile the TF drafted a Framework Document for moving forward and this document – which incorporated the main findings from Murtagh’s review -‐‑ was approved at the February 2015 TF meeting -‐‑ and referred to below as Review Framework Document (RFD). RFD – main findings The RFD underlined that all projects required some operational change to improve impact on drugs/alcohol, especially taking DPU evaluative criteria into account. It was evident that some projects, especially T&R projects had a clear focus on drugs and alcohol and their frontline experience in this field was important for moving forward. However, the data pointed to the need to address issues around reach and coverage of T&R projects, and also around collaboration between the two key voluntary agency services. Not all other projects were seen as having direct impact on targeted interventions to address drugs and alcohol, save in a general sense, and it was considered some would be unlikely to meet the essential criteria for successful individual evaluation. Altogether, RFD identified eleven projects funded, as follows:
• Treatment & Rehabilitation: two projects with 69% of the total budget
• Education & Prevention: (6 projects -‐‑ 19%) • Family support activities: straddle Treatment & Rehabilitation and Education & Prevention, with the result the actual spend on family support is unspecified.
• Coordination & Capacity-‐‑building: (3 projects -‐‑ 12%). TREATMENT AND REHABILITATION (T&R) The funding breakdown for these projects highlights the priority given to T&R. However, it was clear that T&R requires better focusing and attention to evidence and that a more cohesive arrangement between the two main funded agencies was required. Furthermore, NDTRS data underlined there are three clustered areas of service demand, one of which -‐‑ south-‐‑east -‐‑ does not have a visible service presence. RFD highlighted the need to intensify service provision in targeted disadvantaged areas within these hubs, even if this was undertaken on an outreach basis, using existing facilities as a base with arrangements for reaching out through community and
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family support services, as appropriate. This latter approach could also help to make services more accessible and relevant to local need. Taking account the TF’s geographic size, existing locations and facilities, and the relatively low funding base, the RFD suggested a consolidation of T&R service provision, with a focus on a tightly managed model of treatment/intervention, utilising keyworker/case management, with particular attention to pragmatic therapies such as CBT and CRA. It suggested this approach would help improve management and supervision, and reporting on progress. Keyworking / case management was seen as providing a quick response to crisis and formal presentations, with attention to early assessment, the preparation of a care plan/pathway followed by frontloaded intervention, with a reduced commitment as a client moves to continual care and eventual exit. It was considered that keyworking / case management would provide T&R services with a clear identity, thereby ensuring more service users are attracted to the service, that the interventions are more effective and that successful exit from services and integration into community and/or mainstream services would be more speedy. EDUCATION AND PREVENTION The RFD provided mixed reports on education/prevention provision, suggesting it should be further along the curve of risk and specificity of intervention. It makes the point that as regular T&R attendees age-‐‑out there is a need to pay more attention to the needs of younger, high-‐‑risk and experimenting drug users. It also suggests that targeted interventions for young people were needed, alongside appropriate one-‐‑to-‐‑one, brief therapies and harm reduction. RFD suggests that case management / keyworking approach for youth prevention, could be developed, combining outreach, befriending, and referral into one-‐‑to-‐‑one services, and developing a close, collaborative working relationship between keyworkers at this level and others working in a similar manner with families and adults. FAMILY SUPPORT ACTIVITIES Family intervention and support was seen as straddling two domains: in one, family members mobilise to support members’ treatment, in which case the intervention is potentially linked into the system of adult treatment; in the other the focus is on individuals
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negatively impacted by family members’ serious substance misuse, and where other child and family welfare issues arise – in which case the application of intense, family and child welfare practices may be required. RFD argued there are variable skillsets within funded projects in relation to these interventions and that most of the assigned funding is too low, and /or unspecified to achieve any real, meaningful benefits. It suggests the main gap is in the second domain and that priority needs to be given to supporting those service providers who can promote specialist skills development and an effective integration with relevant Tusla, HSE and other specialist services, utilising a case management/keyworking approach COORDINATION AND CAPACITY BUILDING DLR-‐‑DATF is one of at least three DATFs that, arising from public service employment restrictions, do not currently have a HSE employee as coordinator. In this case the DATF is hosted through Southside Partnership in a joint coordination/development capacity; the hosting is likely to remain in place until such time there is a change in government policy on employment restrictions; obviously this is an issue in which the DATF has only limited influence. Given the requirement that Task Forces be coordinated, the associated costs did not form part of the review. However, the RFD suggests there is a need to establish clearer lines of accountability with respect to individual projects back to the Task Force, and obviously these will need to be mediated through the Coordinator. A single, integrated data reporting and monitoring system across all projects is advocated. Southside Training, with a focus on training and other supports, is seen as offering an important back-‐‑up to the TF’s coordinating and capacity-‐‑building component. The reviewer welcomed Southside’s changed focus, in terms of supporting the implementation of the review outcomes and in terms of training relevant personnel with new and emerging skill requirements. Recommendations The RFD’s main recommendation was to shift the focus from recommending funding to individual projects to recommending specific programmes (as illustrated below) which could involve projects individually or in partnership. This alternative model, has an emphasis, on the one hand, on developing more effective
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coordination and capacity-‐‑building, while on the other, it focuses on targeting, direct interventions, monitoring, performance and accountability. The coordination / capacity-‐‑building role should be as a step-‐‑back from the main intervention programmes, but more engagement in planning, developing and ensuring their implementation, especially through use of evaluation and monitoring tools., and also having an emphasis on developing once-‐‑off initiatives, as the need requires.
The case management / keyworking approach to intervention was recommended across following three domains:
• Treatment & Rehabilitation (T&R), • Family Intervention & Support (FI&S) and • Youth Prevention programme (YPP).
A one team, or alternatively, well-‐‑constructed cross-‐‑project partnerships, was recommended, as well as more emphasis on common skillsets, clear communication, use of technology – as appropriate – contributing to better cohesion and congruence.
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Whether within a single project or partnership model it was recommended that the three programmes incorporate:
• a common assessment tool adaptable and appropriate to each target group
• the use of individual and family plans • integrated case management approach • a common suite of interventions – brief interventions, harm reduction interventions, and family support interventions;
• exit strategies for service users to appropriate ‘step down’ services and facilities and family support and other peer-‐‑support networks.
In moving this process forward, the RFD recommended that the TF not be over prescriptive, but rather it should adopt a clear programme focus, that is should set broad parameters and leave it to existing projects to decide whether or not to submit proposals, and whether or not these should be single or multi-‐‑agency partnerships. Moving forward In adopting this approach, existing projects were invited to submit proposals for 2016 under three programme headings, as above, and a review panel was appointed to assess these. The panel deliberated in July 2015 and submitted recommendations to the TF, which were considered at its August 2015 meeting and submitted its recommendations to the HSE and ETB. Both HSE and ETB agreed to support the recommendations during September/October, following which the Coordinator has negotiated with projects, and with other key stakeholders, to draft a Strategy, 2016/17 for both implementing these specific proposals, and for developing the TF’s other work in the field of education & prevention and in responding to the issue of alcohol. The Strategy 2016/17 is due to be signed off at the January 2016 TF meeting, and it will allow for adaptation with respect the new national strategy, when it is published.
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SECTION 3: DLR-‐‑DATF STRATEGY 2016/18 The DLR-‐‑DATF Strategy 2016/18 consists of twenty-‐‑one actions which are organised under three programme themes, and three capacity building headings; these are summarised graphically below, and in the following table. Individual project outlines are included in Appendix 9 – Programme outlines, as appropriate.
Thema&c(Programmes(Capacity(Building(
A.(Engagement(To#engage#targeted#neighbourhoods,#groups#and#their#members#in#the#Strategy#
B.(Leadership(To#resource##community#6based#organisa7ons#to#lead,#develop##and#implement#key#ini7a7ves#
C.(Integra&on(To#support#and#develop#Inter6agency#collabora7on#and##Integra7on#across#all#ac7vi7es#
Theme 1 Substance misuse
prevention
Theme 2 Treatment,
rehabilitation & family support
Theme 3 Research,
coordination & development
To#reduce#the#incidence#and#prevalence#of#substance#misuse#in#local#communi5es#
To#develop#and#operate#interven5ons##for#individuals#and#families#directly#affected#by#substance#misuse###
To#research#emerging#issues#and#needs,#and#to##develop,#coordinate#and#evaluate#the#work#of#the#Task#Force##
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Theme 1 To reduce the incidence and prevalence of substance misuse in local communities No. Action Lead Funding
1 NDS 2
To engage in Local Policing Fora and to seek to have these extended into communities/areas not currently included, as appropriate
Coord / Admin Support (CAS)
Interim Funding (IF)/HSE
2 NDS 28
To promote and develop a social media campaign and a dedicated website page in relation to the issue of alcohol in society
CAS / Southside Partnership (SP)
IF/HSE Dormant accounts (DA)
3 NDS 28, 29,30, 31
To identify and support vulnerable, at-‐‑risk youth (such as out-‐‑of-‐‑school, unemployed, homeless, members of minority groups, etc), to secure and allocate funding to assist in the implementation of evidence-‐‑based substance misuse prevention programmes, including lifeskills, strengthening families, as appropriate, and to encourage participation in mainstream educational and youth service programmes. (ETB/P&E)
Prevention & Education Project (P&E)
Young peoples facilities & services fund YPFSF / ETB
4 NDS 28, 29
To research models of good practice for alcohol policies for sports, education and other relevant youth bodies and to roll out a pilot scheme whereby these bodies incorporate and develop these policies
CAS / SP IF / HSE DA
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Theme 2 To develop and operate interventions for individuals and families who are directly affected by substance misuse. No. Action Lead Funding
status 5 NDS 32, 33 40, 41 42, 43 44
To support and strengthen addiction assessment (including for under 18s), and keyworker services for persons with substance misuse problems, and their families, through resourcing Community Addiction Team (CAT) to provide a county-‐‑wide, community service (Appendix )
CAT IF/HSE IF/ETB (training & programme supports, via SCTN)
6 NDS 41, 29, 30
To support and strengthen support services for children affected by parental substance misuse through resourcing Barnardos and Mounttown Neighbourhood Youth & Family Project to provide a child-‐‑specific service for families affected by substance misuse (Appendix ).
B’dos MNYFP
IF/HSE IF/ETB (training & programme supports, via SCTN)
7 NDS 36, 37 38
To develop a dedicated intervention programme for high-‐‑risk persons under 18 years with substance misuse issues, through resourcing Mounttown Neighbourhood Youth & Family Project and Ballyogan Family Resource Centre to establish and operate the service Appendix.
MNYFP B’gan FRC
IF/HSE IF / ETB IF/ETB (training & programme supports, via SCTN)
8 NDS 44
To improve the reach of service providers into most vulnerable communities and groups and to develop new referral pathways for persons and families who are affected by substance misuse problems.
CAT B’dos MNYFP B’ogan FRC
IF/HSE IF / ETB
9 NDS 49
To develop a framework (using Logic Model) for developing specific aims and outcome measures and for monitoring and evaluation, to complete (i) a TF-‐‑designed data sheet for each participant, (ii) and where appropriate, to collect additional information for HRB-‐‑NDTRS data returns,
CAT B’dos MNYFP B’ogan FRC
IF/HSE IF / ETB IF/ETB (training & programme supports, via SCTN)
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Theme 3 To research emerging issues and needs, and to develop, coordinate and evaluate the work of the Task Force No. Action Lead Funding
status 10 NDS 49
To design relevant data instruments for service participants, and outcome measures for project evaluations, and to gather, analyse and report on data
CAS IF/HSE
11 NDS 49, 50
To undertake secondary analysis and reporting on data from other sources, including: All-‐‑Island Research Observatory -‐‑ Profiles on Dun Laoghaire / Rathdown National Drug Treatment Reporting System (NDTRS)) National Drug-‐‑Related Deaths Index (NDRDI) Central Methadone List (CML) CSO – recorded crime statistics
CAS IF/HSE
12 NDS 62
To coordinate and support the ongoing operation of the DLR-‐‑DATF with meeting facilities, website maintenance, administrative and other supports, as appropriate.
CAS IF/HSE
13 NDS 62
To operate and support a DLR-‐‑DATF Sub-‐‑committees, including: -‐‑ Substance Misuse Prevention Sub-‐‑Committee, with a specific focus on developing and implementing a County Alcohol Strategy.
-‐‑ Treatment & Rehabilitation Sub-‐‑Committee with a specific focus on identifying trends and the need for new treatment approaches and new target groups.
CAS IF/HSE
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14 NDS 32, 33 34
To research and develop proposals for psycho-‐‑social interventions and support services following key target groups in need: • persons with long-‐‑term substance misuse problems, especially in relation to provision of mental health care, elderly care, housing and welfare services, and services for parents of children in state care
• persons (children and families) whose lives are negatively affected by hidden harms arising from substance misuse
• young people who are at high-‐‑risk for substance misuse, requiring outreach support
CAS None yet
A. Engagement To engage targeted neighbourhoods, groups and their members in the Strategy No. Action Lead Funding
status 15 NDS 62
To engage with communities and to develop members’ capacities in relation to substance misuse and to facilitate community members’ participation in the operation of the DLR-‐‑DATF, including the participation of service users.
CAS IF/HSE IF/ETB (training & programme supports, via SCTN)
16 NDS 62
To engage communities in contributing to and developing a county-‐‑wide strategy aimed at reducing alcohol-‐‑related harms, and in particular to seek their involvement in developing community focus on alcohol events (DA / CDW)
CAS / SP IF/HSE DA / SP
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B. Leadership To resource community–based organisations to lead, develop and implement key initiatives No. Action Lead Funding
status 17 NDS 62
To provide community organisations who are involved with substance misuse with relevant programme supports and training in topics, such as leadership, community development, logic model
SP
IF/ETB IF/ETB (training & programme supports, via SCTN)
18 NDS 22
To recruit youth, sporting, educational and community bodies to participate in developing appropriate alcohol policies
CAS PW / SP
IF/HSE DA
C. Integration To support and develop inter-‐‑agency collaboration and integration across all activities No. Action Lead Funding
status 19 NDS 62
To operate and evaluate an Integrated Collaborative Practice course for persons working in substance misuse and family and child-‐‑related services
SP IF/ETB IF/ETB (training & programme supports, via SCTN)
20 NDS 62
To operate and support a DLR-‐‑DATF Interventions Coordinating Group with a specific focus on improving the coordination between substance misuse and relevant child and family services
CAS IF/HSE
21 NDS 62
To operate training initiatives for persons working on the front line of service provision in key intervention topics, such as keyworking/case management; community reinforcement approach, and multi-‐‑dimensional family therapies
SP IF / ETB IF/ETB (training & programme supports, via SCTN)
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APPENDIX 1 -‐‑ DLR PROFILE Dun Laoghaire Rathdown County lies between Dublin’s outer, southern suburbs and the Dublin/Wicklow Mountains and covers the electoral areas of Dundrum, Glencullen, Stillorgan, Blackrock, Dun Laoghaire and Ballybrack (pop. 206,000 approx.) Key socio-‐‑demographic features include the following:
§ Based on 2011 relative deprivation figures, it is the most affluent county in Ireland although it has significant internal differences in wealth and deprivation (see Appendix 2 -‐‑ Map 1).
§ Using relative deprivation index scores, several areas targeted for inclusion by Southside Partnership are classed as ‘marginally below average’ (8.4% of small areas – SAs), ‘disadvantaged’ (4.7% of SAs) or ‘very disadvantaged” (0.1% of SAs) (see Appendix 3 -‐‑ Figure 1) and of the 37 SAs classed as being ‘Disadvantaged ‘ and ‘Very Disadvantaged’, 19 experienced a negative shift in their relative position from 2006 -‐‑11: becoming increasingly excluded from more affluent areas, whose relative position improved during the recession.
§ The following specific characteristics are highlighted in the profile (Appendix 4 – Table 1)
§ DLR has the country’s highest 3rd level education participation: at 45% it is almost double the national rate; the rate of primary school only participation is relatively low at 8.1% (national figure is 15.2%), although in targeted disadvantaged areas it is 14.5%, which is higher than that in Dublin as a whole, at 13.4%. ) .
§ It has the lowest rate of population in the country within Social Class 5/6 – semi-‐‑skilled and unskilled -‐‑ which at 7% is half the national percentage of 14% .
§ Fifteen per cent of housing units in the DLR target areas are social housing, which compares to 6.6% for DLR county.
§ Although DLR has a less percentage of non-‐‑Irish nationals (12.2%), compared to national (13.0%) and Dublin (16.9%) percentages, target areas show higher percentage (13.3%) than national
§ DLR has the lowest rate ot population classed as Traveller (0.2%) compared to national (0.6%) and
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Dublin (0.5%) (Table 1) – target areas show higher percentage, with small number of isolated concentrations
§ The percentage of lone parents in target areas at 22.1% is higher than both national (18.3) and Dublin (20.8) and 6 points above the DLR county percentage.
§ It is clear that while DLR is a wealthy county, it has both areas and social groups of significant social disadvantage.
Demand for substance misuse treatment Currently data on treatment demand, 2004-‐‑13, for both alcohol and drugs, is available through the Health Research Board's National Documentation Centre on Drug Use (NDC) – the National Drug Treatment Reporting System (NDTRS). It refers to new treatments within a single year, and therefore may at times include persons previously treated. In recent years, trends in NDTRS treatment figures provide evidence of significant changes in the nature of drug problems. NDTRS shows that: NATIONAL • Between 2004-‐‑13, the number of treatments provided, nationally, for alcohol and drugs increased by 59.0% from 9,945 to 15,808: an annual average increase of 4.6%.
• Treatments for opiate problems increased by 34.3%, from 3,119 to 4,189: an annual average increase of 3.3%.
• Cannabis cases increased from 1,005 to 2,460 an increase of almost one and a half times (144.8%), over the period, with an average annual increase of 10.5% The corresponding changes for alcohol cases are 5,143 to 7,549, an increase of 46.8% over the period.
• Treatment of the category of other drugs (including cocaine, amphetamines, benzodiazepines, inhalants) rose from 678 in 2004 to 1,610 in 2013, an increase of 137.5% over the period and an average annual increase of 10.1%.
• During the period, 2004-‐‑2013, data of treatments for persons under 35 years show a slower increase, overall; the total number of treatments increased by 40.1% from 6,205 in 2004 to 8,695 in 2013, which is an average annual increase of 3.8%.
• Significantly, the number of opiate treatments for < 35 yrs opiate users decreased from 2,633 to 2,575 a decrease of 2.2% over the period and an annual average decrease of 0.2%.
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• Meanwhile, treatments for all other drug type register increases: cannabis (131.3%), alcohol (33.0%) and other drugs (108.6%).
DUBLIN CITY AND COUNTY • The treatment figures for Dublin (city and county) over the same period, 2004-‐‑13 show marked differences over the national figures, particularly figures for opiates; the total number of treatment cases increased by 50.3% from 3,294 to 4,951, an average annual increase of 4.6%.
• Treatments for opiates decreased from 2,446 in 2004 to 2,100 in 2013, a decrease of 14.1%, and annual average decrease of 1.7%
• Meanwhile cannabis, shows an annual average increase of 26.6% and an increase of 738.1% over the period, from 63 treatments in 2004 to 528 in 2013.
• The figures for under 35s mirror these trends, although more acutely for opiates: opiate treatments for this group decreased by 46.5% an average annual decrease of 6.7%.
• Total treatments for this group show only a marginal increase of less than 0.1%, although cannabis treatments increased by over six times (646.3%) from 63 treatments in 2004 to 470 in 2013.
DUN LAOGHAIRE RATHDOWN (DLR) • The treatment figures for DLR show an increase of 123.3% in total number of treatment cases between 2004-‐‑13, from 172 to 384, an average annual increase of 9.3%.
• The number of opiate treatments increased by 14.0%, from 107 to 122, an annual average increase of 1.5%.
• Cannabis cases increased from 6 to 46, an increase of nearly seven times (666.7%) and an average annual increase of 25.4%;
• The corresponding figures for alcohol are: an increase of 206.0% from 54 to 153, which is an annual average increase of 13.1%.
• The number of treatments for other drugs increased from 5 to 53, a nearly ten times increase (960.1%) over the period and an annual average increase of 30.0%.
• Treatments for under 35s increased from 102 to 190 over the period, an increase of 86% and an annual average increase of 7.2%.
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• Opiate treatments for this age group, reflecting trends in Dublin as a whole, show a 9% decrease over the period from 84 to 76, an annual average decrease of 1.1%.
• Cannabis treatments increased by over five times (533.3%) over the period, an average annual increase of 22.8%.
• Treatments for alcohol increased by exactly five times (500.0%) over the period, which is an annual average increase of 22.8%.
• Treatments for other drugs increased from 4 to 28, almost six times an increase of 6 times (600.0%) over the period, and an annual average increase of 24.1%.
COMMENTS • Assuming an annual trend of similar average increases, the level of treatment demand for 2016 is illustrated in Appendix 5 -‐‑ Figures 2 (all) and 3 (<35yrs).
• It can be seen that in DLR the level of opiate treatment demand will continue to decrease, and will represent less than 25% of the overall demand on services. The greatest level of demand will be in relation to alcohol, in excess of 40% of the work is expected to be in this area and a further 20% each is expected to be in the respective areas of cannabis and other drugs.
• Overall, the NDTRS figures illustrate an increase in numbers entering treatment for alcohol and drugs over the period, 2004-‐‑13, the increase is accounted for primarily by treatment for alcohol and non-‐‑opiate drugs
• Indeed treatment cases for opiate drugs in Dublin (city and county), where this problem was most particularly pronounced right through the 1990s, has decreased quite significantly.
• There are variations in the demand for treatment as viewed nationally and in Dublin: DLR mirrors the Dublin picture, although it shows a slight increase in treatment for opiates.
• What is most significant in planning for 2016 and beyond is the increased demand for treatments for alcohol, cannabis and other non-‐‑opiate drugs and it will be a major challenge for the Task Force in responding to these changes, especially taking into account that there is only a limited role for established medical treatments, with psycho-‐‑social programmes widely considered to be more relevant and efficacious.
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CO-‐‑RELATING NDTRS AND AREA DEMOGRAPHICS • Dun Laoghaire Rathdown has 69 Electoral Districts (EDs), which are the lowest level of aggregated data both from Census Of Ireland (COI), 2011 reports and HRB 2013 NDTRS data
• Thus, NDTRS and COI data lend to co-‐‑relational analysis • 496 treatment cases are of persons with an address in one of the 69 EDs in DLR; 33 EDs had five or more persons In treatment
• Cases were treated both in centres in DLR and other centres outside DLR and included both residential and day-‐‑attendance
• Figures also include persons in prison at time of treatment • From the data, It is clear that the distribution of persons seeking treatment across DLR is uneven, confined to 33 out of 69 EDs
• In ranking EDs 1-‐‑33 in terms of numbers in treatment per 1,000 pop, 25% (126) of persons treated are from EDs ranked 1-‐‑5, with a combined ED population of 16,000 (8% of DLR’s total population)
• 51% (253) of persons treated are from EDs ranked 1-‐‑16, with a combined ED population of 44,000 (13% of population)
• 71% (353) of persons treated are from EDs ranked 1-‐‑23, with a combined ED population of 91,000 (44% of population)
• Using Appendix 6 -‐‑ Map 2, two clear clusters in Dun Laoghaire and Ballybrack / Loughlinstown are evident, with a more spread-‐‑out cluster in Dundrum/Sandyford/Ballyogan – this clustering corresponds closely with Southside Partnership’s socio-‐‑economic targeting of small neighbourhoods (Appendix 7 – Map 3)
• There is little or no treatment demand in Stillorgan, North Blackrock, Dundrum/Clonskeagh, South Dun Laoghaire, Killiney and Dalkey – this is not to say there is no treatment requirement, but that from what we know it is low
• Comparable CTL ED data as per 1 b above is not made available, although it has been requested, on several occasions.
Central Methadone Treatment List The Central Methadone Treatment List is prepared by the HSE’s National Social Inclusion Office. The following are extracted from 2014 Central list data:
• During Jan-‐‑Dec, 2014, 531 (556 in 2013) individuals from the DLR area were treated with methadone and these constituted
24
4.8% (5.4%) of those treated nationally, 7.3% (7.7%) of those treated in Dublin city and county, and 10.6% of those treated in the HSE Dublin Mid-‐‑Leinster (DML) region (Dublin south of the Liffey, Kildare, Wicklow, Laois, Offaly).
• The corresponding figure for persons in-‐‑treatment at the end of Dec 2014 was 489 individuals, with respective national, Dublin and local percentages of 5.1% (5.6%), 7.4% (7.8%) and 10.2% (10.9%).
• 63% (59%) of persons in treatment in 2014, nationally, are 35 years or over; the corresponding regional figure for DML is 65% (60%), and the respective figure for DLR is 69% (62%); less than 4% (5%) of persons nationally are under the age of 25 years.
• If the above trends continue within five years (2020) almost 95% of persons in treatment will be over 25, with virtually nobody under 25
• 53% of persons from DLR in treatment attend clinics; the respective national and DML figures are 50% and 48% – there is no difference between these and 2013 figures
• 40% of persons from DLR in treatment attend GPs; the respective national and DML figures are 38% and 42% -‐‑ there is no difference between these and 2013 figures.
• Altogether, 90% (90%) of persons from DLR in treatment attend either clinics or GPs, with corresponding national and regional DML figures of 88% (85%) and 89% (87%).
• The male:female ratio of DLR persons in treatment for 2014 is 71:29 (same as 2013), with national and regional DML respective ratios of 71:29 (70:30) and 68:32 (69:31).
• It is clear that persons from DLR attending methadone treatment (531 in 2014) attend mainly clinics or GPs, they are predominantly male and they are ageing out, and indeed it is also reported that 25% of persons on the Central Treatment List have been in treatment for 10 years or more. These features are evident across DLR, national and regional (DML) figures.
Controlled drug offences CSO Reported Crime databases provide information on reported drugs criminal offences 2003-‐‑2014 (note: due to a suspension of the recording system figures for 2014 were, at the time of compilation, estimated based on returns for Jan-‐‑June, 2014)
25
NATIONAL (ALL DISTRICTS) • Estimated controlled drug offences for 2014 are 15,826, a 3% increase over 2013 figure of 15,384
• Possession of drugs for sale or supply offences are estimated at 3,656 a 12% increase over 2013 at 3,265
• Possession of drugs for personal use is estimated at 11,066, a 1% decrease over 2013, at 11,195
• Between 2003, and 2013 there was an increase of 66% in offences for controlled drugs; representing a 41% increase in offences for sale or supply, and 73% in offences for possession for personal use
• Between 2008, when figures were at their highest, and 2013, there was a 34% decrease in offences for controlled drugs, representing a 24% decrease in offences for sale or supply and a 38% decrease for offences for possession for personal use
DMR (ALL DUBLIN METROPOLITAN DISTRICT) • Estimated controlled drug offences for 2014 are 7,196, a 11% increase over 2013 figure of 6,495
• Possession of drugs for sale or supply offences are estimated at 2,042 1,621 a 26% increase over 2013 at 1,621
• Possession of drugs for personal use is estimated at 4,618, a 2% increase over 2013, at 4,529
• Between 2003, and 2013 there was an increase of 114% in offences for controlled drugs; representing a 40% increase in offences for sale or supply, and 174% in offences for possession for personal use
• Between 2008, when figures were at their highest, and 2013, there was a 36% decrease in offences for controlled drugs, representing a 29% decrease in offences for sale or supply and a 39% decrease for offences for possession for personal use
EASTERN DMR (DUN LAOGHAIRE, BLACKROCK, CABINTEELY AND DUNDRUM) • Estimated controlled drug offences for 2014 are 302, a 33% decrease over 2013 figure of 451
• Possession of drugs for sale or supply offences are estimated at 60, a 27% decrease over 2013 at 82
• Possession of drugs for personal use is estimated at 226, a 35% decrease over 2013, at 347
• Between 2003, and 2013 there was an increase of 30% in offences for controlled drugs; representing an increase of 1%
26
in offences for sale or supply, and 38% in offences for possession for personal use
• Between 2008, when figures were highest, and 2013, there was a 44% decrease in offences for controlled drugs, representing a 30% decrease in offences for sale or supply and a 47% decrease for offences for
possession for personal use SUMMARY • Based on estimated figures, controlled drugs offences in Eastern DMR (DLR) decreased by 33% over 2013, compared to increases in Dublin and National levels; at all levels: National, DMR (Dublin) and Eastern (DLR), there has been a significant increase in controlled drugs offences over the period 2003-‐‑13 (see Appendix 8, Tables 4 -‐‑ 6)
• It is clear overall that there has been a reduction in the impact of controlled drugs on crime in general, particularly in DLR
Conclusion • Although DLR is an affluent county , it includes a number of small areas with high levels of social deprivation and whose relative socio-‐‑economic position has worsened in recent years during the recession
• These disadvantaged areas continue to experience drug-‐‑related problems, particularly arising from drug-‐‑related anti-‐‑social behaviour, under age drinking and complex family and child welfare issues – posing particular challenges in terms of developing professional capacities and interventions for improving child outcomes
• It is instructive, nonetheless that while there has been a general fall-‐‑off in controlled drugs offences nationally in recent years, that this fall-‐‑off is more pronounced in DLR
• The demand and use of drug treatment services within the county reflects developments at both national and regional (Dublin) levels., namely: • The socio-‐‑medical needs of long-‐‑term methadone users are increasing, although demand for opiate treatment is decreasing
• The demand for treatment of non-‐‑opiate drugs and alcohol continues to grow.
27
• There is no dedicated under 18s treatment service nor is there an appropriate outreach service for this group
28
10 11Social Inclusion Profile, 2011 All-Island Research Observatory
DúnLaoghaire
Monkstown
Blackrock
Booterstown
Churchtown
Columbanus
Dundrum
Ballinteer
Marlay Park
Stillorgan
UCD
Ticknock Hill
Sandyford Business District
Leopardstown
Cornelscourt
Kill of the Grange
Sallynoggin
Dalkey
Killiney
Cabinteeley
Carrickmines
Loughlinstown
Ballybrack
ShankillRathmichael
KiltiernanGlencullen
Stepaside
Ballyogan
Glasthule
KilcrossM50 M50
M11
N11
16
18
19
2117
201
2
13
15
14
12
3
411
5
6
7
10
8
9
Mounttown
Rosemount
Hillview
Balally
Nutgrove
Wyckham Point
.
Ordnance Survey Ireland Licence No. EN 0063512© Ordnance Survey Ireland/Government of IrelandData Source: Pobal HP Deprivation Index, AIROProduced by: All-Island Research Observatory (AIRO)Not to be reproduced without permission from AIRO.
Small Areas (SAs)Pobal HP Deprivation Index 2011
Extremely Disadvantaged
Very Disadvantaged
Disadvantaged
Marginally below Average
Marginally above Average
Affluent
Very Affluent
Extremely Affluent
Target Neighbourhoods
Pobal HP Deprivation IndexMap 1 Relative Deprivation, 2011
Figure 2 Relative Deprivation, 2011
0 136
64
185
360
110
40
50
100
150
200
250
300
350
400
# of
Sm
all A
reas
Source:(All+Island(Research(Observatory((AIRO)((2012)(A"Social"Inclusion"Profile"of"DúnLaoghaire6Rathdown."Blackrock,(Dublin:(Southside(Partnership.,(Map(1.
Appendix(2(* Map(1:(DLR(Relative(Deprivation,(2011
29
Appendix(3(* Figure(1:(classification(of(small(areas(according(to(
levels(of(affluence(/(disadvantage
Source:(All*Island(Research(Observatory((AIRO)((2012)(A"Social"Inclusion"Profile"of"Dún Laoghaire6Rathdown."Blackrock,(Dublin:(Southside(Partnership.(Figure(2.
30
National Dublin DLR DLR-targeted
Education-3rd-level
24.6 32.0 44.8 35.5
Education-primary-
15.2 13.4 8.1 14.5
Social-class-5/6
14.3 12.1 6.8 11.5
Social-housing
8.7 10.2 6.6 15.0
Non?national 13.0 16.9 12.3 13.3
Travellers 0.6 0.5 0.2 0.6
Lone-parents 18.3 20.8 15.8 22.1
Source:3All6Island3Research3Observatory3(AIRO)3(2012)3A"Social"Inclusion"Profile"of"Dún Laoghaire6Rathdown."Blackrock,3Dublin:3Southside3Partnership.3Figure32.
Appendix3436 Table31:3Select,3relevant3DLR3profile3data
31
2004 2008 2012 2016
DLR*Opiates 62.2 52.2 34.8 23.8
DLR*Cannabis 3.5 1.0 10.6 16.9
DLR*Alcohol 31.4 39.8 44.7 41.4
DLR*Other 2.9 7.0 9.9 17.9
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
Fig$11.$Treatment$ types$ (DLR$5 all))$ as$%$of$ total:$2004,$2008,$2012,$(2016$5 projected)
DLR*Opiates DLR*Cannabis DLR*Alcohol DLR*Other
AppendixB5B– FigureB2:BTreatmentBtypesB(DLRB– All)BasB%BofBtotal:B2004,B2008,B2012B
andB2016B(projected)
2004 2008 2012 2016DLR*Opiates 82.4 66.5 42.4 25.9
DLR*Cannabis 5.9 21.8 15.8 24.7
DLR*Alcohol 7.8 1.8 28.8 30.6
DLR*Other 3.9 10.0 13.0 18.8
0.0
10.0
20.0
30.0
40.0
50.0
60.0
70.0
80.0
90.0
Fig$12.$Treatment$ types$ (DLR$<$ 35$yrs)$ as$%$of$total:$ 2004,$2008,$2012$(2016$D projected)
DLR*Opiates DLR*Cannabis DLR*Alcohol DLR*Other
AppendixB5B– FigureB3:BTreatmentBtypesB(DLRB* <35Byrs)BasB%BofBtotal:B2004,B2008,B2012,BandB2016B(projected).
32
Appendix(6(* Map(2:(DLR(Clustering(treatment(demand((alcohol(and(drugs),(2013
Source:(Based(on(ED(breakdown(of(figures(of(drug(and(alcohol(treatment(demand((figuresas(provided(by(HRB?NDTRS
33
45
Social Inclusion Profile, 2011A
ll-Island R
esearch Ob
servatory
Study Area
DúnLaoghaire
Monkstown
Blackrock
Booterstown
Churchtown
Columbanus
Dundrum
Ballinteer
Marlay Park
Stillorgan
UCD
Ticknock Hill
Sandyford Business District
Leopardstown
Cornelscourt
Kill of the Grange
Sallynoggin
Dalkey
Killiney
Cabinteeley
Carrickmines
Loughlinstown
Ballybrack
ShankillRathmichael
KiltiernanGlencullen
Stepaside
Ballyogan
Glasthule
KilcrossM50 M50
M11
N11
16
18
19
2117
201
213
15
14
12
3
411
5
6
7
10
8
9
Mounttown
Rosemount
Hillview
Balally
Nutgrove
Wyckham Point
.
Ordnance Survey Ireland Licence No. EN 0063512© Ordnance Survey Ireland/Government of IrelandData Source: CSO, AIROProduced by: All-Island Research Observatory (AIRO)Not to be reproduced without permission from AIRO.
Target Neighbourhoods
Appendix(7(* Map(3:(Southside(Partnership,(target(neighbourhoods
Source:(All+Island(Research(Observatory((AIRO)((2012)(A"Social"Inclusion"Profile"of"DúnLaoghaire6Rathdown."Blackrock,(Dublin:(Southside(Partnership.,(Map(1.
34
!20.0%
!10.0%
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
2004% 2005% 2006% 2007% 2008% 2009% 2010% 2011% 2012% 2013% 2014%
Percentage)year)on)year)in(de)crease)in)All)crimes)&)Controlled)drugs)crimes)(All)DMR)Divisions))
All%crimes% Controlled%drugs%
!20.0%
!10.0%
0.0%
10.0%
20.0%
30.0%
40.0%
2004% 2005% 2006% 2007% 2008% 2009% 2010% 2011% 2012% 2013% 2014%
Percentage)year)on)year)in(de)crease)in)All)crimes)&)Controlled)drugs)crimes)(Na8onal:)All)Divisions))
All%crimes% Controlled%drugs%
Appendix(8(– Figures(416:(Percentage(year(on(year(in(de)crease(in(All(crimes(&(Controlled(drugs(crimes,(2004114
Figure(6:DMR:(Eastern
Figure(5:All(Dublin:(DMR
Figure(4:National
!20.0%
!10.0%
0.0%
10.0%
20.0%
30.0%
40.0%
2004% 2005% 2006% 2007% 2008% 2009% 2010% 2011% 2012% 2013% 2014%
Percentage)year)on)year)in(de)crease)in)All)crimes)&)Controlled)drugs)crimes)(Na8onal:)All)Divisions))
All%crimes% Controlled%drugs%
!40.0%
!20.0%
0.0%
20.0%
40.0%
60.0%
80.0%
2004% 2005% 2006% 2007% 2008% 2009% 2010% 2011% 2012% 2013% 2014%
Percentage)year)on)year)in(de)crease)in)All)crimes)&)Controlled)drugs)crimes)(DMR:)Eastern))
All%crimes% Controlled%drugs%
60
40
20
0
%20
60
40
20
0
%20
40
20
0
%20
Source:(CSO(– Recorded(crime(databases((Figures((for(2014(are(an(estimate(based(on(Jan>June(figures)(
35
APPENDIX 9 – PROGRAMME OUTLINES
1. CAT -‐‑ T&R programme The T&R programme, based at Community Addiction Team (CAT), Sandyford, assesses and addresses the needs of adult substance misusers (normally aged 18+) in the DLR area. Typically the central , presenting issue of concern is that their drug/alcohol-‐‑using behaviour is impacting negatively on their individual development and well-‐‑being, and on social and family relations and also potentially undermining their participation in work, training or education, or in causing a dependency. The programme is structured around keyworking/case management and draws from established psycho-‐‑social therapies, assisting participants to assess and evaluate their situation and to prepare and implement customised care plans and bring about personal and behavioural change, dealing with their substance misuse and other related problems, overcoming addiction and preventing relapse. Typically programme participants include:
1 Persons not attending any programmes and who are seeking assistance, including assessment, in dealing with their substance misuse.
2 Persons attending other specialist drug programmes – e.g. methadone maintenance -‐‑ seeking additional assistance in rehabilitation, harm reduction, or relapse prevention.
3 Persons attending other health or social services and who seek assistance in dealing with the substance misuse dimension to other psycho-‐‑social issues.
4 Adult family members of persons whose substance misuse is impacting directly on their lives and welfare
The T&R programme commences with assessing the impact of substance misuse on persons referred, providing information and support through one-‐‑to-‐‑one intervention and through an engagement, as appropriate, with other close persons, for example, partners, friends, family members. The programme pays particular attention to linking referred persons into other treatment systems where this is indicated, such as methadone programmes, detox, AA, NA, and it also explores the need for other more specialised supports, where necessary; which might include housing, employment, education and psychology assessment. Through CAT the T&R programmes outreaches into local communities, social services, GPs and relevant medical centres, working closely with people within the context of their families and employer and other social networks, as appropriate, and with other locally based addiction services and programmes. Through CAT the programme brings empathy, professional judgement and a commitment to facilitating a change process in substance misuse behaviours and in participants social and emotional development and relationships.
36
Programme contact details: Geraldine Fitzpatrick Dun Laoghaire Rathdown Community Addiction Team Ltd Unit 8, Leopardstown Office Park, Burton Hall Ave Dublin 18 Phone: 01-‐‑2176140 Fax: 01-‐‑2176143 Mobile: 087 – 2789 678 [email protected] 2 Barnardos and MNYFP -‐‑ FI&S programme The FI&S programme based at Barnardos, Dun laoghaire (lead project) and at Mounttown Neighbourhood Youth and Family Project assesses and addresses the needs of family members – particularly children and young people -‐‑ whose lives are negatively affected by another member’s substance misuse; typically the central issue of concern is the impact of parental substance misuse and the programme works to ensure that issues and needs as they impact on children and other family members are not hidden, and are kept in focus. The programme’s primary purpose is to support parent / child relationships and to improve outcomes for children across different aspects of their lives, including their relationships, attachments, their living situation and their involvement in school and other socio-‐‑educational events and activities. Interventions focus on improving children’s social engagement and emotional development, encouraging them to explore feelings and experiences and to develop skills for improved self-‐‑regulation and for reducing inappropriate acting-‐‑out behaviour. The programme also seeks to prevent or reduce the likelihood that children become involved in substance misuse themselves, thus serving to break the cycle of addiction. Referrals into the service typically come from addiction projects, community agencies and statutory services such as schools, HSE and TUSLA. Intake involves an assessment and developing a family support plan, which is then monitored and reviewed on a regular basis. The assessment, which is continuous through the intervention, takes account of the following key domains:
• Living situation • Relationships/attachments • Social behaviour/participation • Health (physical and psychological) • Learning: education/employment • Identity, self-‐‑care and self-‐‑esteem
The support plan includes arrangements for review, updating and amending key aims as appropriate; it also includes planned step-‐‑down and integration with other local projects and services. Among the specific interventions within the care plan, the following are utilised, according to their relevance and appropriateness:
37
• Individual therapies: play therapy, psychotherapy • Individual supports: focus on managing emotions, problem solving,
improved self-‐‑image and self-‐‑esteem, and attendance at school/training. • Small group therapies: early years groups, Tús maith groups, resilience
groups • Parent-‐‑child supports: Marta meo; Partnership with parents -‐‑ home-‐‑
based support; infant matters, strengthening families •
During the early phase of assessment the programme involves 1-‐‑2 sessions per week; thereafter these can become less frequent, depending on the type of intervention involved. Individual programme duration is typically 6-‐‑18 months. The programme values participation and throughout children and parents are encouraged and supported to contribute to the assessment, the formulation of a care plan, care reviews and ongoing programe evaluation., thereby ensuring that the views of children and families are heard, and are taken on board; explanations / rights of appeal are provided in circumstances where limits on participation become necessary. Programme contact details: Mary Daly, Barnardos 14, Tivoli Terrace South Dun Laoghaire, Co. Dublin 01-‐‑284-‐‑2323 [email protected] Úna Kenny C/o Holy Family School Dunedin Park Monkstown Farm Dun Laoghaire Co. Dublin 01-‐‑230-‐‑4086 [email protected]
38
3. MNYFP and Ballyogan FRC and CAT -‐‑ YPP The Youth Prevention Programme (YPP) is operated by Mounttown Neighbourhood Youth and Family Project (lead) and Ballyogan Family Resource Centre; the Community Addiction team (CAT) provides an occasional addiction assessment service as required. The programme assesses and addresses the needs of young people (12-‐‑18 yrs) in the DLR area who are high risk, experimenting alcohol / drug users, helping them to facilitate a change process in their substance misuse behaviour and in their social and emotional development and relationships, taking account of their unique needs. The main target group is young people who misuse cannabis or alcohol; there is also groiwng concern about poly-‐‑drug use and young people using new drugs. There is a particular focus on targeting young people not engaged in tier 1-‐‑2 services, such as school, alternative education, youth or community services; young people who come from families where there are parental addiction issues; young people who present to services with multiple psycho-‐‑social issues; and also on young women, Travellers and members of minority groups. While the programme provides a response to young people who present with addictions it is more broadly concerned with problematic drug and alcohol misuse: the central issue of concern is whether their access to and use of drugs and alcohol is impacting on their abilities to participate in education, training or work, on their personal health and psychological and emotional development, their behaviour, and on their ability to form and/or sustain social and family relations. The programme receives both self-‐‑referrals and referrals from appropriate services such as HSE, TUSLA, youth services, Gardai, probation, schools and training centres, as appropriate. It assesses the impact of substance misuse on young people, providing information and support through one-‐‑to-‐‑one intervention and through an engagement with social networks, where these are appropriate. It pays particular attention to linking young people into youth and social development services and also explores the need for other services and specialised supports, where necessary; typically these could include housing, employment, education, psychology assessment, therapeutic services. The participating projects consider that embedding the programme in local communities is key to long-‐‑term success and in this regard an information / education service is developed in tandem with the programme’s other components. The programme has an emphasis on keyworking and the development and implementation of individually-‐‑agreed pathway plans for keyworker involvement, and for supporting young peoples’ access to other relevant community services and facilities. In this regard the programme draws from community reinforcement and cognitive behavioural therapies, however the level of formality with respect the use of these approaches varies, according to the young person’s needs and the appropriateness of formalised interventions. Typically, each young person is offered 12-‐‑16 individual keyworking sessions; additional supportive, groupwork is also provided to help achieve and sustain step-‐‑down goals. The desired outcomes for young participants on the programme are:
39
• Reduced substance misuse • Improved social, psychological and emotional functioning • Stronger support networks • Increased participation educational and/or social programmes • Improved access to other support services • A positive experience of the service and ability to seek other help as
required The programme values participation and throughout young people and their parents are encouraged and supported to contribute to the assessment, the formulation of a pathway plan, reviews and ongoing programe evaluation, thereby ensuring that the views of programme participants are heard, and are taken on board; explanations / rights of appeal are provided in circumstances where limits on participation become necessary. Programme contact details: Úna Kenny C/o Holy Family School Dunedin Park Monkstown Farm Dun Laoghaire Co. Dublin 01-‐‑230-‐‑4086 [email protected] Colette Farrington Ballyogan Family Resource Centre 41, Ballyogan Avenue Carrickmines Dublin 18 01 2953219 [email protected]
