Under the Influence Jeannette Leech Associate research in practice Councillor's and Trustees Seminar

About Under The Influence? part of the research in practice Change Project programme Literature review Group meetings a collaboration with the Cheshire Drug and Alcohol Action Team looking at the links between offending behaviour and alcohol use in young people aimed to produce an evidence-informed practical tool to equip professionals with confidence and knowledge to work with this group of young people more effectively Link to two key ECM outcomes - Make a Positive Contribution (reduce offending) and Be Healthy (reduce alcohol use)

Patterns of drinking Normalisation and acceptance of alcohol use by young people  75% of 11 to 15 year olds had tried alcohol  20% drank at least once a week Amount of alcohol drunk increased considerably in the 1990s (11-15 year olds who drink)  1990 average weekly consumption 5.3 units  1998 average weekly consumption 10 units More young people abstaining More heavy sessional (‘binge’) drinking  Commonly occurs in unsupervised locations

Motivations for drinking External  Social facilitation  Considered the norm in a peer group Internal  To cope with problems  Boredom relief  To gain a buzz

Patterns of drinking Normalisation and acceptance of alcohol use by young people  75% of 11 to 15 year olds had tried alcohol  20% drank at least once a week Amount of alcohol drunk increased considerably in the 1990s (11-15 year olds who drink)  1990 average weekly consumption 5.3 units  1998 average weekly consumption 10 units More young people abstaining More heavy sessional (‘binge’) drinking  Commonly occurs in unsupervised locations

Alcohol’s ‘continuum of influence’ Heavy sessional drinking better predictor of offending behaviour rather than average consumption Alcohol can lower inhibitions Or provide an excuse for intended behaviour Rural settings found higher number of nuisance-related incidents by young people who had been drinking Underage drinking tends to take place in unsupervised locations The ‘pick n mix’ theory

Taking account of age: late childhood to early adolescence Heavy drinking relatively rare Characterised by inexperience More likely to drink whatever is available and to do so outside or unsupervised Parental influence More likely to cite internal motivation for drinking Offending very rare  But those who do offend at higher risk of becoming persistent offender

Taking account of age: middle adolescence Key transitional period Those who drank at younger age may now start to drink more Many other young people drink for the first time Peer group influences becoming more important External reasons most often cited Offending increases year on year in middle adolescence  Gender gap in offending becomes more pronounced

Taking account of age: late adolescence Easier to acquire alcohol Transition to drinking independently in bars and clubs Control over alcohol use increases Drug use more prevalent Drinking by those not in education or work may increase and be spread out through the day  May also turn antisocial behaviour into offending behaviour Boys rather than girls more likely to report drinking as a coping mechanism A quarter of all youth crime committed by 17 year olds Transition to adult services and prospect of adult prison

Alcohol use: Prevention Aim to delay first drink Aim to delay first incidence of drunkenness Work with parents Health messages ineffective as sole strategy Peer group resistance messages also ineffective

Intervention: principles Knowledge of the local context Opportunistic and flexible Structured and frequent Timing: within three weeks of an offence  A link in the mind of the young person

Intervention 1: Diversionary activities Sports and leisure activities  Increases self-esteem  Perceptions of control and social skills But must be run by specialist practitioner Be aware of alcohol use in sport / leisure contexts

Intervention 2: Working with young people Young people have barriers to drinking patterns  School  Money  Family Young people use their own strategies to remain safe  Nominating non-drinking friend  Eating a meal prior to drinking

Intervention 3: Long term and short term Different targets for different stages  Stopping or reducing drinking in the long term  Addressing peer group issues in the short term

Intervention 4: Family-based interventions Parenting skills combined with education for young people Identifying risk and resilience factors Parenting contracts

Intervention 5: Harm minimisation Research points to harm minimisation when alcohol use is well-established  Forthcoming guidelines on safe use  But at present professionals advised to check young person’s competence before advising reduction rather than abstinence

Intervention 6: Motivational interviewing Centralising young person to process Stresses own responsibility  Acknowledging problems  Locating them within wider context  Supporting own conclusions BUT limited effectiveness?

The Tools 1. The Developmental Wheel  Used to give a baseline idea of a young person’s developmental stage 2. Using a Narrative Approach  Working with a young person’s story to understand the role of drinking within their lives 3. Risk and Resilience Factors  Helping to target interventions more effectively 4. Practical Strategies  Stressing a young person’s own responsibility to control alcohol 5. Investigating Drinking  Series of questions to investigate motives