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Contents

1. Introduction
2. The Screening Process
3. Recording
4. Substance Misuse Awareness Raising Tool (SMART)

1. Introduction

Screening young people around their drug use is part of a substance misuse early intervention strategy. It aims to identify substance related issues for young people, provide information and support where necessary and prevent young substance users from becoming problematic adult substance misuses.

In Bexley the following looked after children who must be screened are:

• All looked after children of secondary school age
• All looked after children where issues of concern have been identified: this could be by the foster carer or another.

All Children looked after for the past 12 months should be screened twice a year.

The Children's Independent Reviewing Officer’s will monitor compliance through the looked after review process and recommendation action where required.

2. The Screening Process

The screening process takes the form of a conversation that can be woven into the Assessment Framework process. The aim of screening young people is not simply to establish if the young person has a problem but also to assess the young person’s knowledge of drugs and to start a dialogue around all aspects of substance use e.g. the law, long term health implications etc. The questions in the screen are not prescriptive; they are intended to be used as an aide memoire to guide the conversation. The screening process is not intended to be a tick box exercise and it is not intended that the screen be given to the young person to complete. It is intended that the screen take the form of a conversation/interaction between worker and young person.

Carrying out Screening

The drugs and alcohol screening process should always take place at the initial point of contact with the young person, where their needs are already being assessed. It should not be carried out as a stand alone activity but as part of the assessment and care planning process.

As with all screening and assessment procedures, the substance misuse screening process needs to be reviewed regularly BY WHOM? and the young person’s individual needs regarding substances updated and recorded.

For young people who are in receipt of a service e.g. service users of the  screening will need to be carried out and again reviewed at regular intervals.

The Substance Misuse Awareness Raising Tool (SMART) has been designed to support the substance misuse screening process. It is an aide memoire, with questions that can be used partially or in full. It is presented on page 3 together with the outcomes process.

Triggers

For young people entering the care system. Substance misuse screening must be carried out at the initial assessment. In line with the core assessment requirements, substance misuse screening should be carried out within 7 weeks of first contact.

For looked after young people. Substance misuse screening must be carried out at 6 monthly intervals. It could be incorporated into the following reviews:

The young person’s Case Review. The Independent Reviewing Officer will monitor whether screening has been completed for individual cases.

The screening process may be complete or partial depending on the young person. At the very least it is expected that all Children’s social care staff will be able to ask the looked after young people if they require any information about substances (including alcohol and cigarettes).

3. Recording

It is important to record the fact that you have had a ‘screening conversation’ with young people on CF21.

Follow theses instructions:

• Go into Classifications
• Category - other LAC Codes
• Classifications - SMART - Substance Misuse Discussion record it here.

4. Substance Misuse Awareness Raising Tool (SMART)

SMART is an aide memoir. There are no forms to complete. The SMART questions can be woven into existing assessments. The purpose of using SMART as a substance misuse early intervention tool is to determine the following:

• The young person’s knowledge of substances
• Whether the young person is using substances
• If the young person is at risk due to their substance misuse.

SMART provide prompts for key areas that could be explored with the young person over one or more meetings.

Before asking any questions around substance use, it is necessary to remind the young person of Bexley’s confidentiality policy and to tell them that you want to talk to them about substance use as it is an important issue for young people in this borough.

Assessing risk will be different for each looked after young person according to their age, ability and a range of other factors in their lives. The following will be useful in helping to identify risk:

• Is the young person using substances on his/her own?
• Which substances is the young person using?
• What is the method of administration - how is the substance being used?
• Is the young person using substances every day?
• What risks are the young person putting themselves at due to their substance use?

It is always important to consider alcohol use as well as drug use.

Areas	Prompts
Knowledge of drugs and alcohol	What do you think about drugs and alcohol? Where do you get your information from? How would you rate your knowledge of drugs and alcohol? What do you know about their affect on your body/mind? What do you know the law in relation to drugs and alcohol?
Drug use - Past and Present	Have you used any substances in the past? (Including alcohol and cigarettes)? How old do you think you were when you first started using these substances? How did you use them? When was the last time you used?  What did you use? Are you currently using anything? What are you using? How are you using it? How much are you using and when are you using it?
Contact with other users	Can you tell me who you use with? Do you use alone? Do others know about your drug use e.g. parents? carers, trusted adults?
Behaviour	What do you feel like when you are using? What do you feel like when you are not using? Would you like to describe what happens when you are under the influence? (Aggression/depression/elation/unconsciousness)
Views of young person	Do you think that your drug/alcohol use is causing any problems in your life? (Money/relationships etc.)
Motivation	Would you say that your drug use is of concern to you? Have you tried to make changes to your drug/alcohol use in the past? (What helped/didn’t help?) Do you think you might want help at this point? Do you know what kind/what’s available?

SMART: Outcomes Summary

Outcome		Action
1.	No immediate action.	Review at a later date.
2.	Provide substance use advice.	This will include general information and harm minimisation advice where appropriate.
3.	Provide substance use information.	This will include providing leaflets and printed information.
4.	Seek professional advice from substance use specialist.	Cases can be discussed on the phone with the Youth Engagement Service: 01322 356354
5.	Make referral to The Youth Engagement Service: 01322 356354	Refer to the Youth Engagement Service if the following criteria are met: Regular use Binging Risk taking behaviour Significant impact on the young person’s emotional well being The YP wants to address their substance misuse and make changes in his/her life One of 1 - 4 plus number 5 is necessary for the referral to be accepted. If the YP needs more specialist support, the onward referral will be made by YES.

End