Disgracefully, there is no adolescent residential drug rehab in the UK. This is why the Centre for Policy Studies has just hosted an urgent Teen Rehab Action meeting writes CPS Executive Assistant Sarah Bailey.
Last week the Centre for Policy Studies Prisons and Addiction Forum hosted a meeting to discuss the need for residential rehabilitation treatment for adolescent drug abusers and dependents.
This initiative, driven by Sarah Graham of Sarah Graham Solutions, a member of the Advisory Council on the Misuse of Drugs and an adolescent addictions therapist / counsellor, brought concerned parties together at the Centre for Policy Studies. They agreed that there is the reason - evidence of need - and the ability and expertise available to develop far more effective adolescent-specific addiction treatment than is available at present.
In fact the facilities, the experts and the necessary tools already exist to set up a pilot model in the Southwest of the UK within 6 months. What has been lacking is any commitment of support from the government.
Yet national statistics on young drug and alcohol use demonstrate the extent of the problem. In 2011, a staggering 23% of pupil’s aged 15 reported taking drugs in the last year, with 6% of pupils aged 11 and above saying they had taken drugs in the last month. Just over a third of those who took drugs in the last year said that they usually took them once a month or more. The drug of choice is still cannabis. Although adolescent use has dropped over the last 12 years, we are one of few European countries where youth cocaine consumption continues to rise and where the age of initiation into drug use continues to drop.
In view of the mounting and now incontrovertible evidence that early users run a higher risk of later drug dependence; the risk of irreversibly impaired cognitive functioning (a significant drop in IQ) in those who start using cannabis before 18 years old; and the increased risk of psychosis, the need for robust early intervention is imperative.
Several present at the meeting cited their professional and personal experiences of the psychological, social and economic causes – including childhood and family influences- that lead to such risky drug using behaviour amongst troubled teens.
The consensus was that, as a result, young addicts are unlikely to get better in the environment which has fed their problems and that there is therefore a desperate need for dedicated adolescent residential rehabilitation centres. Such centres have been successfully developed in the US and proven to have lasting results. Newport Academy in California is a prime example.
Adolescent addiction therapists present at the meeting argued that current adult-centric thinking surrounding ‘addiction’ does not sufficiently account for or address the rates of dual diagnosis and developmental differences in the cases of child and adolescent substance abuse. Complex emotional and mental health issues which surround young repeated (substance abusing) offenders differ from those surrounding adult addiction, the treatment, as a result, needs to involve more comprehensive and holistic approaches.
It was agreed that the developmental needs of children and adolescents require appropriate programming to reflect this. An integrated and multi-faceted treatment can address the developing individual build the personal tools to get teens back into education, form healthy relationships and build opportunities to believe in themselves.
Residential treatment programmes too far away, too short or too irrelevant to the individual will not work to have any lasting effect. As a consequence, it is clear that any investment in this becomes redundant when teens fall straight back into the same problems as they came from. The only residential rehab for teens in the UK (now closed due to lack of funding for referrals) though running a first rate programme was too remote and had no provision built in for satisfactory aftercare and supervision.
Newport Academy suggests a minimum of 45-90 days to provide effective and long lasting treatment.
The proposed model of treatment, as discussed in the meeting, is to pilot a rehabilitation centre to meet local needs. It would be open to young people with complex needs as well as substance misusers, with the idea that this should then be replicated regionally. The centre would run 12-week programmes seeking to work as a therapeutic community including educational therapy, group activities with outdoor elements and opportunities for work experience development. Families would have access to an intensive programme to work alongside children, in a way that can only be possible with localised regional rehab centres. The centre, in addition, would work with an outreach team to look at the long term outcome following the 12 week programme.
Thanks to the work and investigation of dedicated individuals from special interest groups on abstinence based treatment, potential buildings and units in desirable environments have been identified and are all but ready to be developed into such centres, along with staff willing and trained in this treatment.
The challenge lies in the bureaucracy and funding limitations that might deter government and local authorities from supporting such specialist centres. For example the 2004 Children’s Act saw the government move towards a co-operative approach, pooling relevant agencies including Education, Health, Mental Care and Social Services and their budgets along with this. However this has proved complex to a degree when raising the funds to refer an adolescent to rehab. The complexity between Local Authorities and their varying departments make the level of bureaucracy hard to break. Despite proven research that residential rehabilitation is the most successful route to recovery, The National Treatment Agency (NTA) does not believe that there is any need to direct any of their dedicated adolescent funding for such referrals.
The view was expressed that persuading government and the NTA of this need was more than a challenge; that if the complex needs of children and adolescents are to be met the consensus was that a push for full philanthropy may be the only solution to create an example that the government would be persuaded to follow and support.
In order to get the proposed rehabilitation model off the ground two things need to be done. Firstly, people’s perceptions need to be changed on the nature of young people’s addiction and psychological needs. Secondly, the costs need to be met: the proposed pilot scheme has been costed and it is estimated it would run at estimated £3 million over a two-year timeframe.
This would give the timeframe needed to guarantee the level of quality staff required to allow for effective treatment. We can reasonably look to achieve, through charities and benefactors, the raising of the necessary funds. The groundwork has been done and the train is ready to run, we just need to fuel to make it go.
The next Teen Rehab Action meeting is proposed for mid to late October.