Early Intervention and Prevention in Aberdeenshire

NOVEMBER 2018

Aberdeenshire Alcohol and Drug Partnership Authored by: Chloe Henderson

Table of Contents Introduction 1

Aims and Objectives 1

Background and Context 2

Summary of Methods 5

Presentation of Findings 6

Early Intervention and Prevention Task Group Overview 7

Early Intervention and Prevention 8

Key Informants – Themes of Discussions 9

o Low attendance at EIP 9 o Duplication of efforts/overlap with GIRFEC 9 o Current Roles and relation to EIP 10 o EIP in Aberdeenshire 10 o Current issues/problems/barriers 13 o Across lifetime - too broad? 15 o Gaps 17 o Need done differently/improve/help 18 o Focus and Priorities 19 o Hopes for EIP/Future/Moving Forward 20 o Membership and Buy In 21 Highlighted Issues 22

EIP around the Globe and Scotland 29

Future Direction for Early Intervention and Prevention 36

Recommendations and Moving Forward 42

Key Informants who took part in the Mapping 44

Bibliography 49

Prevention is about intervening before something becomes a problem

Early intervention is about responding where there already is a problem

Introduction

This report was requested by the Aberdeenshire Alcohol and Drug Partnership in order to establish what current facilities exist within Aberdeenshire in regards to early intervention and prevention. Also to review the priorities and functions of the EIP group. The exercise was completed by Chloe Henderson of Robert Gordon University and took place between July and November 2018.

Aims and Objectives

Aim: To complete a mapping exercise of current early intervention and prevention services within Aberdeenshire in relation to alcohol and drugs, identify any gaps/overlaps within this area and review the functions of the current EIP group within the ADP.

Objectives:

1. Design and complete a mapping exercise of all the existing EIP services within Aberdeenshire.

2. Establish what the current EIP priorities and actions are.

3. Identify any gaps and/or overlaps in delivering on EIP priorities.

4. Examine the links between the EIP group’s agenda and GIRFEC.

5. Consider whether the EIP group needs to consider looking at all ages within its approach or if this is too broad.

6. Establish what the value of having the EIP group is and how to make the group viable.

7. Analyse and present results of mapping exercise in order to help inform the future direction for early intervention and prevention.

Background and Context

Aberdeenshire is a vast area, comprising of large rural/remote areas with a number of main towns that provide for its 261,800 inhabitants.

The unemployment rate in Aberdeenshire is 2.9% which is

lower than the Scottish average

4.2%.(Nomis, 2017)

Compared to the rest of Scotland, Aberdeenshire has low levels of deprivation. However, the statistics may be impacted by the high number of oil workers who live in Aberdeenshire but commute into Aberdeen. The general health of the population is also higher in regards to life expectancy and lower mortality rates from respiratory and heart disease.

Notwithstanding this, Aberdeenshire faces significant challenges to reduce health inequalities across its diverse communities and improve access to services in rural areas. There are pockets of deprivation associated with difficulty accessing public services. Parts of Fraserburgh have significantly lower life expectancy rates and for younger people in the Banff & Buchan area there are significant concerns with alcohol and drug misuse.(Health and Social Care Partnership, 2016) There is potential to change culture, attitudes and health related behaviours to improve lives and reduce the demand on social and health services.

Drinking Culture from a Cost on the NHS

Young Age £5.6 Million a year 13 Year Olds 33% 15 Year Olds 60% For alcohol related hospital admissions in Who have had alcohol have been Aberdeenshire.(LOIP, 2016) drunk at least once.

Alcohol Dependency Parental Attitudes to Alcohol 12,400 65% Children drinking at home Aberdeenshire citizens are 48% parents/relatives purchased estimated to be alcohol dependent. alcohol for them.

Drug Availability Drug Related Deaths

17% of 13 year olds 83% of DRD’s over 35 years old 36% of 15 year olds 10/12 DRD’s in Aberdeenshire 2016 In Aberdeenshire have been offered were older people. drugs.

Death by Location Mental Health and Drugs

34% total DRD’s 87% Psychiatric Conditions

Most deaths occurred in the North of 6 months prior to drug related death Aberdeenshire, Banff & Buchan. individuals had mental health issues.

Summary of Methods

This mapping exercise consisted of a mixed method approach including a review of documentation, background research and semi-structured interviews with key informants. These approaches were used to gain a broad understanding of early intervention and prevention within Aberdeenshire from a variety of perspectives.

Interviews were carried out one on one with individuals from a variety of organisations across Aberdeenshire, including statutory and the third sector. Individuals had questions tailored to them depending on their area of expertise, such as the police, community justice, poverty/deprivation, secondary schools, third sector charities and community learning. Interviews were also conducted with current EIP group members. The methods used are summarized in the following table alongside some of the questions used in interviews.

Methods Details 1. Initial discussion with Alcohol & Drugs Health Context and Narrative Improvement Officer and Chair to get background and history of early intervention and prevention work and agree aim of the exercise. 2. Review of relevant documentation provided in regards to EIP and current alcohol and drug issues within Aberdeenshire. 3. Independent research into the topic area and identification of possible outcomes. Face to face semi-structured interviews with Statutory Interviews various key informants who are involved in EIP in some regards, but not all had previous involvement with the EIP group. Face to face interviews with 3rd sector 3rd Sector Interviews organisations who are interested in EIP. The majority of which focus on young people but not exclusively.

Presentation of Findings

The areas explored in this report and Current Set- issues that were highlighted in the up/Views interviews are presented in three main sections as illustrated opposite.

The specific issues presented in each Highlighted Recommen- section and how they relate to the Issues dations original objectives are outlined below.

Current Set-up/views of EIP and Mapping of Services

Describe and map the current provisions and set up of early intervention and prevention across Aberdeenshire including any gaps/overlaps in services.

 EIP Task Group Overview  Statutory Services  3rd Sector Services

Issues Highlighted by the Mapping Exercise

Gaps and/or overlaps that were identified by conducting interviews with key informants across Aberdeenshire. Findings and ideas as to why the EIP has been poorly attended in the past.

1. Overlaps and Duplication of Efforts 2. Mental Health Link 3. Inequality/Deprivation 4. Access to Services/Poverty of Transport 5. Stigma & Social Isolation 6. Culture of Alcohol 7. Parental Attitudes to Alcohol 6

Early Intervention and Prevention Task Group Overview

To determine the flaws and future direction of the EIP group, we must first look at its current functions and past projects to establish what has been achieved thus far. The EIP Group held its first meeting in June 2014 and in later meetings started to set out priorities that should be focused on. Past members of the group have included representatives of the 3rd Sector, Education, and Council. NHS, Police, Women’s Aid & CLD.

Priorities  Encourage parents, schools and communities to help establish the social norm that children and young people do not normally use alcohol or other drugs  Ensure that generic life-skill and social norm methods are used within the Curriculum for Excellence to help children and young people make informed lifestyle choices  Ensure that as part of the wider ‘Getting it Right for Every Child’ framework, children assessed to be especially at risk of using alcohol or other drugs can access positive interventions designed to support them and divert them from harm

Role of Members and Accountability

 Members of the EIP group have a responsibility to ensure the agreed actions and purpose of the group is fulfilled  Members are expected to inform the agenda of any emerging issues  EIP group will be held accountable by the ADP through their delivery plan and updates in order to achieve their outcomes within agreed timescales

Early Intervention and Prevention

Early intervention and

prevention has been established

as more effective and less

expensive than later

remediation. This is a generally

accepted idea; however, levels

of spending on preventative

measures have continued to be

low. Initially you must spend

money to save money in the

long term, but prevention

attempts successes are hard to

evidence.

Challenges

There is a lack of funding in all areas and when a budget is tight it is easier to justify cutting preventative measures. There is a lack of clarity as how to fund prevention, where does the money come from, whose priority is it and who should be targeted? There is a lack of strong direction and willingness to challenge the culture and complacency in current methods.

Solutions

A long term approach would be successful in prevention as it would provide the evidence needed for further funding into the area. Short term projects, while necessary, need to take a back seat. Innovation and willingness to try new approaches to learn what works. Evaluating the levels of success of each project to identify and replicate successful interventions. Risks need to be taken, there is not enough evidence yet but in order to establish what works there needs to be an element of risk. Collaboration and partnerships would be beneficial in helping to bring together a currently fragmented approach.

Key Informants – Themes of Discussion

Meetings were held with key informants across Aberdeenshire in regards to EIP provisions currently. Some informant’s job roles actively involve EIP, some have previously sat on the EIP task group but others were not aware of EIP at all or were more concerned with harm reduction and recovery.

An initial list of informants was provided that the ADP was aware of and has worked with previously; this list was then expanded upon by recommendation by the informants themselves.

Themes of discussions are shown under the main theme headings below.

Low attendance at EIP

 Highlighted that the group has direction issues and there is often a last minute agenda and it is not appealing/inspirational enough. The same ground is often repeated but the group needs to know what the plan is moving forwards. The various plans need to be translated into action. There is a lack of determined focus and the group needs active direction.  Needs direction from the top, shift money earlier down the chain – if not then there’s no point. Be more proactive and provide support/advice. Partnerships need to be a 2 way street, needs to be made a strategic priority and has direction. Opposed to continuous meetings about meetings. Need to align with the 3rd sector more as they are currently underutilized. Options to engage in further education, gap in the market for 14-25 year olds. People need a safe space and need to be neutral/non-judgmental to avoid defensive answers.

Duplication of efforts/ overlap with GIRFEC

 Yes there is an overlap with GIRFEC. Need to establish what exactly GIRFEC is doing i.e. early intervention; just working with the chaos? We know the intentions of what they do – but not what happens in reality. Who

else is involved? Show us kids taken through GIRFEC process for XYZ reasons.  Yes there is an overlap. More needs to be done out-width school environment. If you find a drunk child in the park, who deals with it? Not practical to follow GIRFEC process, can’t ask child who their named person is in that circumstance.  There is a lot of overlap and duplication of efforts in some areas. People need to work together and see it as part of their job. Questions need answered; what are the objectives of the group? What are they trying to get out of having the group? Strategic partnerships would be beneficial.  GIRFEC priority is children’s safety so there is bound to be an overlap. There is a distinction between children, who have parental issues with substance abuse – who would be dealt with by GIRFEC and children with their own substance abuse issues who would be dealt with by EIP Group. But there is a mix between these also.

Current Roles and relation to EIP

 Involved in the MEOC service that is in place to signpost what help is available in the local community. Conversation tactics used to bring up certain topics and identify problems in individual’s lives. Links to alcohol/drugs, smoking, employability, physical activity, skills etc. Focus on mental wellbeing. Trying to change the culture so everyone is able to signpost to get people help they need.  Legislative duty to work together to reduce reoffending. Focus on offenders but community justice oversees everything. Identify local priorities; early intervention in particular needs improvement. Need to help individuals who are not yet in the justice system.

EIP in Aberdeenshire

 There was a drop in youth disorder previously but things are changing. Currently a lack of youth activities that are needed, lots of children attending summer games/shows. As a result lots of underage drinking, police resources used to deal with drunken children. Inverurie prom 10

marquee 300-400 drunken children and about 1000 at Echt show. GIRFEC sometimes deals with young people who have only offended once etc. – is this early intervention and is there an overlap? Garioch area becoming a problem with youth drinking – lack of diversionary activities and social media influence. Lack of budget for programs at the moment.  2016 project was successful, want to expand it but waiting to hear back about funding. Social work redirected funding so early intervention is taking a back seat. Backlog of offenders that needs dealt with. Project helped children through helping their parent’s issues, e.g. providing housing help to ensure a more secure environment. Active hub failed in the past, didn’t ask children what they wanted and times have changed.  There is a channel shift to look at EIP rather than just crisis management. EIP is something that is agreed and talked about but no one is willing to do anything. All talk no action. Very cluttered landscape of partnerships – lots of different groups and duplication of efforts. Need better links rather than superficial partnerships.  Aberdeenshire numbers are quite small. There is a lack of work that is well paid and consistent. Particular problems with rural areas, everything is in the city rather than the Shire. Very poor transport links, no affordable housing and not to a good standard. Access to services – assumption that everyone has access to internet which is wrong. Responsibility on carers causing them to look at substances to make them feel better. Areas of deprivation in Aberdeenshire are Peterhead, Fraserburgh, Banff, Buchan, Macduff, Kemnay, Huntly and others. Particular issue with child poverty in Kemnay which is unusual as it is within commuting distance of Aberdeen.  There is currently a disconnect, used to have good access to services but there have been changes with admin and budget. Less services from a school perspective. Frustration with EIP group, cannot just accept a half done job. Current problem in Aberdeenshire with oil downturn – loss of jobs and homes. Cultural problem surrounding alcohol here. Tackling symptoms rather than cause – Sobering Thought campaign. Problems with group are the plans are too broad, trying to do too much so what is done is done badly. Need people who are fully engaged and direction. Looking at substance misuse in schools, teachers find it hard to know who to contact. Too much focus around GIRFEC, they do not help children

earlier on which is early intervention. Too GIRFEC concentrated; need to get there before problems arise. Issues with parental substance misuse affecting children.  Lots of children currently on the periphery of offending that need addressed. Geographical issues in Aberdeenshire – may need different approaches for different areas. GIRFEC used but if it is a one off issue then they never find out what is wrong. Police get names to make referrals but would be more beneficial to get referrals from teachers in schools. Lack of diversionary activities currently. Acceptance of alcohol levels in different areas, children are drinking earlier in life. Not aware of any problems if there are no crimes/offending. Link between lack of diversionary activities and youth drinking in Garioch – current focus.  Currently police have to deal with people with mental health issues because they are the first point of contact – not sure of what to do with them, need someone else to help. STIGMA among older people, never want to admit they have a substance abuse problem and won’t seek help. People are often scared of the police and think they will get in more trouble if they admit problems. Mental health issues are underreported and many are self-medicating with alcohol and drugs. Link between childhood ACES and trauma, many have PTSD like symptoms. There is value in early intervention; it is counter-productive to just respond to incidents.  At the moment GIRFEC provides shared language around wellbeing across all services. They don’t wait until things get worse – look at indicators before. Gives staff ability to make assessments of children and young people by looking at attendance at school etc. SHANARRI used to identify child, share with named person, process if child is at risk, and notify social worker/police. Child may not meet social work criteria but a plan is still put in place for them. Family and child centred, parents need to be present and children never dealt with in isolation. GIRFEC helps staff know that this is part of their job – legally required to act. If a child needs a targeted intervention that isn’t universally available then a child’s plan is put in place to see what need to be achieved, such as diversionary activities, additional support etc. 

 Sometimes involved in GIRFEC group. There is a guidance team at the Academy that is aware of what’s going on currently and where there needs work. Work closely with police and parents in regards to drugs and alcohol. Issues with parents not attending meetings and looking at how to get them involved. Guidance team interview every child and have a good knowledge. Alcohol is a lot more accepted in rural areas than drugs.  AFC doesn’t do reactive – everything involves early intervention and prevention. Partner with schools, Football for life uses interest in football to get hard to reach client groups- all ages and genders etc. Improving health & wellbeing such as improving attendance at school/engagement.  ADA provides brief interventions for alcohol and drug perspective. Focus on education etc. People who aren’t yet using. Previous focus was on insight project in schools. Trying to work with people recreationally using drugs. Large focus on harm reduction.  Funding problem currently in Aberdeenshire – would like to expand but need help. No funding from council etc., everything raised by themselves. Isolated children geographically. Deal with children aged 4-16 years, close case when they are 16 but can continue to see befriender volunteer. Get referrals from education, social work, health services. Not aware of any other services involved in EIP or that there is an EIP Group.

Current issues/ problems/barriers

 Lack of attendance, no clear agenda and no engagement. Questions if the EIP group should deliver on GIRFEC actions. Need agreements with partners on what to do – need to make remit so we know what group is delivering on. Less duplication of efforts and need to get everyone round the table.  Youth anti-social behaviour at present. Bigger than just the ADP, not one organization can tick all the boxes – need to work together. As is often the case, too much talking not enough action.  There shouldn’t be a Drugs and Alcohol EIP group, should be an Aberdeenshire EIP group that deals with everything as it’s such a broad issue. Cannot look at it in isolation. Police, community safety etc. could pull it together – needs to deal with substance abuse, crime, mental health

etc. Could be partnership rotation with different partner in charge every 4 months.  Availability of substances, parental attitudes need addressed. Advice could be given, up skilling of people so they know the signs. Break barriers on information sharing – especially in schools. Analysis of need – collection of data.  There is a STIGMA problem in regards to substance abuse amongst older people especially; people tend to bury their heads in the sand. There is often an element of bullying/harassment at work and social isolation. There are safety issues with people on medication at work. Need to combat myths in regards to alcohol and drugs in the workplace.  Mental health currently has strict threshold criteria, suicidal children but mental health team don’t seem to be interested or have capacity, this is a gap that needs to be addressed. Referrals need to come from schools first rather than police. Looking into developing street sports and funding it as a diversionary activity. Collaboration with AFC Community Trust. Try to support older people in avoiding chaotic lifestyles, problems in tenancy with alcohol, drugs, noise etc. Need to address trauma in childhood leading to mental health problems and social issues. Recognition for those not in the justice system but starting to cause concern.  Issues with funding, EIP results are not immediate and may have to wait 10 years to see real change. Could possibly evaluate success by police attention after they leave school.  There needs to be a look into long term outcomes, favouring early intervention. Prevention is much harder to evaluate than early intervention. Early intervention needs a cultural change to work. Lots of training/education to young people in schools, parents, agencies etc. Hard to see what impact choices and information have. Needs to be a cultural change similar to smoking and drink driving campaigns. Cultural norms with drinking alcohol.  Lots of perceptions made about poverty, Aberdeenshire it seems like it’s not a reality but there are a high number of working poor. Parents seem to be the ones abusing alcohol rather than the children. Alcohol is more available and acceptable to youth. Parents more likely to buy alcohol for children, training needed for youth workers and parents regarding this. Politicians will throw money at issues identified in newspapers but need to 14

look at the long term for things to change. Join up budgets/resources to tackle poverty and substance abuse. Key worker approach needed, establish a trusted relationship. Fisherman and oil workers have a high number of substance abuse as they have a high level of disposable income. Need to look at impact of this as many have been losing their jobs in the downturn – are they coping? Massive lifestyle changes that impact their children.  Lack of attendance could be due to being education focused – a bit “schooly”. Community learning is more sensible and would be beneficial to have links into the 3rd sector. Would get more engagement if there was more focus on younger people – adult issues could be dealt with by treatment group. Need to keep 3rd sector informed.  Getting politicians to invest is difficult, only in office 3 years so want to see results in that time but EIP is long term.  Rural communities have lack of transport; even if diversionary activities were put on then they would have no way to get to it. Nearest swimming pool is Stonehaven. Mental health facilities are poor, closest place is Cornhill in Aberdeen. 65% Mearns Academy pupils travel by bus. There is nothing for them after they get home from school, poverty of transport. Need organisations to go out to where the pupils are or arrange transport. Disparity of services due to geography. Big difference between Laurencekirk and Fraserburgh, need targeted approach. Need someone to let them know what is available currently. GIRFEC may not be enough, need more workers in schools.  Only deal with families with substance abuse problems – none of the children has had issues yet. Impacts on child’s confidence, self-esteem etc. Stigma of having parents addicted to alcohol/drugs, financial poverty – going to school with dirty clothes. Low mood, mental health issues caused by childhood emotional neglect and physical impact that sometimes not fed properly etc

Across lifetime too broad?

 It is not too broad; the approach needs to be together. Children have adults around them that impact their lives; you can target the adult in order 15

to help the child. Need to focus on parental attitudes to alcohol and children getting alcohol from their parents.

 Yes, too broad. Present day with current resources it needs to be more targeted to address inequalities.

 Yes, too broad. Plenty of things need done across a range of organisations, cannot be looked at in isolation.

 Older people focus on criminal justice that needs to be separate from youth justice. Across an entire lifetime might be too broad, not a practical way to look at it. How do you get everyone in the same room that way? Possibility to divide up by location so it is easier to address problems.  Need to look at transitions in people’s lives rather than early intervention. Older people might not have support structures; look at life changes where people may be vulnerable. Some may seem like they are coping but they aren’t, look at isolation and loneliness. Information on local area, look at spikes in medical centres when they attend GP’s. Talk about life and come up with a plan for them; it may be job support, housing etc. STIGMA around alcohol and drugs, shame and guilt about not being able to cope as an adult.  Yes this is too broad, that’s why it has been unsuccessful. Children’s group was looking at protection side but EIP is too broad. What exactly do you need to do to intervene in childhood to stop ACES/trauma that then prevents problems in adulthood? Early intervention should be about young people.  Evidence of parents struggling – this impacts the children. Issues with lack of parental engagement in school. Need workers in schools in cluster areas that establish relationships with pupils and their families – long term.  Too broad of an approach, 80:20 approach needs to be levelled out. Needs balance and a small bit of money could prevent a lot of problems. Adults have a lack of support compared to children, no teachers etc. looking out for their wellbeing.  AFC has no limits to age or target group. Family approach, 3 generation family could be involved in 3 different projects. Young people focus is on

physical activity, wellbeing etc. Adults are a behavioural change, or lifestyle. Advice, peer support, dementia friendly communities. Community led.  Huge amount of social isolation and stigma. Older people participate in activity then there is an informal chatting time. Some hardly ever leave their house etc. Need to challenge the stigma of what they can and can’t do. Need to give them a voice/choice. Don’t make assumptions about older people, just because it’s cold doesn’t mean they can’t go outside. Non-judgmental environment. Some come along smelling of booze etc. Build relationship of trust over time.  ADA is an all age service 14 to 78. Demographics are different; alcohol users are older and drug users usually teens/20 and over 35 years long term use. Both parents and children abusing substances. Referrals come from schools, social work etc.  Different approaches needed. Most people start recreationally experimenting but need to look at reasons they start problematic use. Targeted approach. Children in care system statistically more likely, 70% have mental health issue and self-medicate.

Gaps

 There is no overlap or contrast issues within the ADP. However, if you disbanded the group it seems it wouldn’t make a difference but if the group didn’t exist – who would lead?

 The many partnerships/groups are lacking, lack of clarity on who to go to. What is the pathway if someone is picked up on the streets needing help? If they don’t get support at that time they move past the early intervention stage.

 Not familiar enough with services available. Socially deprived areas need more addressed, each area is different and needs different things. Blanket approach to fixing issues would be foolish.  Lack of diversionary activities and facilities – most money goes into recovery. There is a “fun” element to taking alcohol and drugs which isn’t

addressed. Oil downturn causing people to lose jobs, homes etc. Offshore workers abusing alcohol and periods of drinking extending.

Need done differently/improve/help

 Need to prioritize an action plan, deploy people/resources and financial aid. Make use of limited time with community members which are a finite resource in order to engage with information. Decide what priorities/focus should be and supply active leadership.

 Need to establish whose priority it is, and needs to be a person or mechanism in place to keep an overview so progress isn’t lost/forgotten. Needs to be a focus on older people. Needs a clear priority, there is a lack of communication and no one is working together or round the table at the same time.

 Evaluation needs to be built in and there needs to be clarity about goals and what needs to be achieved. How to achieve it and how to measure its benefit. Use evidence to do things robustly, it needs to be evaluated properly so money isn’t thrown about. There is a big gap between EIP for adults and children, does it need to be divided?

 Doesn’t think there is a need for EIP group. Only can move forward with tangible objectives with people who can deliver on them. People who can action things and have the resources to deliver.

 Employers trained and given knowledge so they can give referrals to relevant organisations when problems arise. Helplines need put in place and links to mental health are important. Help and support needed rather than discipline and zero tolerance policies. Identify individual’s issues that are causing substance abuse, such as family bereavement etc.

 Need to intervene before people enter into the justice system. When drunk and disorderly people are taken in, there needs to be interaction with them at that point. Police and substance abuse teams need to work together, do

follow up visits and assess needs of individual. Identify issues involving mental health, housing, employment etc. Not using custody as only option, community sentencing prevention work to stop them getting custodial sentence. Lots of duplication of efforts currently.  Key stages in lives where transitions could be improved, research saying without support will go onto negative outcomes. People are busy and there is a lack of resources. Need something out of a partnership in order to work together, wider range of clients needed and long term benefits.  Need to address transport issues, perhaps a community bus. Need a whole families approach to work with parents to help the children. Priority family’s works well in city – a lot of parents don’t know how to be parents. Best course of action would be a 5 year pilot, need long term projects and get results later. Lack of resources for mental health and limited time. Police could take adults into Cornhill after emergency referral – Penumbra. Looking to expand on project that was successful previously. Active hub was unsuccessful but trying new pilot with AFC Community trust and Street Sports in Garioch area.  Need to identify red flags in individual’s lives and intervene before their lives become chaotic. Need collaboration with mental health specialists – police not fit to deal with it at present, don’t have resources. Anti-social behaviour amongst young people can identify younger siblings that may also need help. Culture change needed in regards to acceptance of alcohol and wanting to change for the better. Need to treat cause rather than symptoms, will save time and money in the long run. Need a change in mindset overall that prevention is worthwhile pursuit. Current trend among vulnerable older people in Aberdeenshire is “cuckooing”.  ADP could get referrals as befriend a child only deals with children but are aware of their parents who have drug and alcohol problems that are not being addressed. These issues are impacting on the children massively which falls under early intervention and prevention – families approach.

Focus and Priorities

 There needs to be more in place for older people to combat STIGMA so they aren’t shunned. More focus on mental health/trauma in life. 19

 Needs to have specific priorities, 1 or 2 things done at a time to manage workload. E.g. put in place a 3 year action plan and stick to it. Services provided to young people are limited, not enough intervening earlier. Project in schools was beneficial, need to go into schools and work with young people before they end up high tariff. Mental health issues such as anxiety increasing in young people. Broad spectrum of mental health related to substance misuse. 3-18 years old and preschools – there is a potential to intervene extremely early. Get mental and emotional wellbeing right and everything else gets better. Engage with young people and see what they want/need. Needs to be done well – potentially one dedicated officer for the role. Spend money to save money in the long term.  Need to address lack of transport in rural areas. Sometimes children don’t want to engage in services due to STIGMA involved. Introduce more diversionary activities such as Bike Smart. Evidence has shown upstream methods are successful, children who experience ACES more likely to go to prison etc. later in life. Current trends show number of children referrals are reducing and HMC Grampian no longer need young offenders wing now.

Hopes for EIP/ Future/Moving Forward

 There is currently frustration with the EIP group; it has had a lack of progress and unsure priorities. It needs to be more engaging to attract followership and regular members. There is currently a direction vacuum that needs to be addressed. The group needs to be more appealing and have some relevance within the ADP. The current agenda may need to be scaled down.  Don’t think there should be an alcohol and drugs EIP group. But there should be a multi-agency group that covers a range of issues.  Key worker approaches – especially in rural communities. Family learning centres, changing things to develop a positive relationship with client group. Tackle STIGMA especially in regards to older people. They will not access services if they feel judged. Put advice workers into GP surgeries, GP will refer someone to the workers if it is a social issue rather than medical. These workers will pick up on depression, isolation, bereavement etc. and provide support. 20

Membership & Buy In

 Successful partnerships will only work if people who are giving up time to come can see tangible methods of making a difference.  Group of people should lead the group in a strategic way. Clear aims and objectives, these people will ensure there is representation. Clarity of targets, objectives, monitoring and accountability.  Members need to have a role and want to attend the meetings. Currently EIP is too broad and sits within different strands. If everyone is doing EIP does there need to be a group?

Highlighted Issues

As interviews were conducted there were a number of issues that kept recurring and being mentioned by individuals in isolation of each other. As early intervention and prevention is such a broad topic, there are a wide variety of areas that impact a person’s life – all which contribute towards physical and mental wellbeing.

Duplication of Efforts/Overlaps in Services An issue that repeatedly came up in meetings was the lack of clarity of what EIP services were available in the Shire and who was providing them. This caused speculation on potential duplication of efforts, especially among services available to young people such as diversionary activities.

rd This was especially prevalent in the 3 sector, who stated they were underutilised and were not even aware there was an EIP group in existence. They all highlighted that partnerships and sharing of information would be key in tackling this problem, alongside using funds in a more productive way. Statutory services have previously funded diversionary activities such as the Active Hub which was not very successful and remained stagnant. Possible rd future projects that use the knowledge and resources of the 3 sector may be able to better achieve this. Minimising duplication of efforts would help save funds being wasted and allow a broader range of problems to be tackled. Also gaining clarity on the role of GIRFEC and how broad their remit is in regards to early intervention and prevention would be beneficial in future planning. 22

Mental Health Link

A topic that was frequently brought up was the link between mental health issues and substance abuse, and although there is a general awareness of this – there is a distinct lack of services that tackle both issues together. Stressful life experiences have been linked with likelihood of experiencing mental health problems. If these issues are addressed via early intervention, this may prevent further decline Adults living in the most deprived in mental wellbeing. Stressful life areas are approximately twice as experiences include; likely to have common mental  Poverty health problems as those in the  Poor housing least deprived areas. (21% versus  Unemployment 11%).  Childhood adversity

Dual-diagnosis or co-morbidity can present itself in several ways. Psychiatric issues may occur as a result of substance misuse, or prior psychiatric disorder may result in abuse of substances. As stated previously in the report, 87% of all individuals who had a drug related death had a mental health condition 6 months prior to their death. If co-morbidity issues are tackled early enough it may save lives. (Scottish Government, 2017)

Young people’s mental health also needs to be addressed. There is a strong link between childhood trauma and addiction later in life. Exposure to adverse childhood experiences results in the individual being seven times more likely to have issues with alcohol misuse, five times more likely to take drugs and twelve times more at risk of suicide.

Inequality and Deprivation

Prevention is key to preventing substance abuse, as it takes into account the wider factors affecting substance misuse such as deprivation, health inequality, homelessness and mental health. Problematic drug use disproportionately affects people who experience socio-economic disadvantage. Deprivation may lead to psychological harm through stressful life experiences such as financial issues, unemployment and housing. Individuals then use these substances to reduce the stress and anxiety caused by this.(Health Research Board, 2016) In Scotland’s most deprived areas, the rates of alcohol related death were six times higher than in the least deprived areas, and alcohol related hospital stays were nine times higher. As Aberdeenshire is one of five Council areas in Scotland with the most data zones without deprivation overall, it skews the results and hides areas within Aberdeenshire that have a high level of deprivation.

In Aberdeenshire deprivation tends to be concentrated in Banff & Buchan, primarily in Fraserburgh and Peterhead. These areas are in Scotland’s 10% most deprived. Residents are 7 times more likely to be unemployed compared to the rest of Aberdeenshire. Deprived communities have 40% more alcohol outlets. 5 out of the 6 most deprived data zones in Aberdeenshire have the most severe household overcrowding problem. Residents are 6 times more likely to require an overnight hospital stay for a drug misuse compared to the shire average.

Geographical Isolation & Access to Services

Nearly half (44%) of Aberdeenshire’s data zones are in Scotland’s 20% most deprived for service access.

Another issue that is linked to inequality is the lack of access to services and poverty of transport that is experienced in more rural areas of Aberdeenshire. Although it is linked, it deserves its own section as it was one of the most raised points in the meetings as being a major problem. (SALAG, 2014).

Geographical access takes into account average driving/public transport times to services such as GPs, Retail centres, Schools & Post Office. Unlike the other domains where Aberdeenshire scores well compared to the national average, in regards to geographical access it is poor. New Pitsligo has a particular problem ranking 52 out of the 6,976 in Scotland. Poor transport impacts feelings of social isolation and a ‘lack of things to do’ for all age groups. Having the services available means nothing when people are unable to access them.

Stigma & Social Isolation

Among older people with drug problems there is a real issue with isolation, stigma and discrimination. A very high proportion (79%) live alone, with many affected by family breakdown, job loss, mortality amongst friends and family which all contribute towards further isolation. They are more likely to be unemployed, low education, homeless and effected by stigma.(National Institutes of Health, 2015) There is a high level of stigma across society and the fear of discrimination prevents people from accessing services. If individuals receive help via early intervention during these transitions in their lives where they are most vulnerable it may prevent further dependency on substances.

Of the 12,400 dependent drinkers in Aberdeenshire, only 14% are engaged in services. Many individuals drink beyond the recommended limit but still function within society, they tend to believe they do not have a problem due to the stereotype of an “alcoholic’ not matching them and they will not seek help due to fear of stigma. The demographic of those engaging in harmful drinking has changed; with the highest rates of alcohol related hospital admissions being men aged 55-64 and women 45-54.

Culture of Alcohol

Drinking alcohol is deeply ingrained in Scottish culture and binge drinking is a particular issue. People in Scotland drink nearly 25% more than England and Wales. There is a strong link between poverty and alcohol abuse, with men in deprived areas being 7 times more likely to die from alcohol related causes. 1 in 4 people in Scotland (26%) are drinking to hazardous or harmful levels. Consistent binge drinking is a behaviour that can lead to alcoholism where the individual is physically and mentally dependent and this can cause chaos in their lives. Alcohol also has an impact on crime levels as 63% of perpetrators of violent crime were under the influence of alcohol at the time. (AFS, 2015).

In Scotland excess drinking is

more likely to occur in more

affluent areas but those in

deprived areas are significantly

more likely to die or be admitted

to hospital due to alcohol use.

However, in Aberdeenshire this

is the opposite with those in

more affluent areas being more

likely to be admitted. This may

be due to more disposable

income available to those in the

oil and gas sector. Developing

a low alcohol consumption

culture and reduced

acceptability will reduce the

level of harm in Aberdeenshire.

Early intervention has been shown to be beneficial in treating alcohol abuse as it addresses the underlying triggers and issues that cause alcohol dependency. Treating the cause rather than the symptoms before it becomes a bigger issue. It helps individuals modify their behaviour and foster coping skills and the self confidence that is needed to minimize substance abuse.

Parental Attitudes to Alcohol

Drink and drug use amongst young people has fallen significantly in the last 10 years but there is still a serious problem with many at risk of developing more serious and enduring substance misuse problems that develop into adulthood.(Young People's Health Partnership, 2015) Early intervention approaches tackle substance misuse among young people and reduce the risks of it becoming problematic misuse. (National Institutes of Health, 2016)

Studies have found that increased levels of alcohol consumption by the parents are linked with hazardous adolescent drinking behaviour. Future action plans aimed at tackling youth drinking should also be aimed at challenging parent’s attitudes towards and consumption of alcohol.

Parental attitudes towards alcohol in Aberdeenshire were an issue that was brought up by almost everyone in the mapping exercise. 65% of children in Aberdeenshire are drinking alcohol at home compared to the Scottish average of 46%. This highlights that parents in Aberdeenshire are providing their children with alcohol, perhaps believing they are doing the right thing by not letting them get it from an outside source but in reality they are promoting the use of a drug. Children in Aberdeenshire are sourcing their alcohol primarily from parents/relatives 41% compared to the Scottish average 29%. They are less likely (0%) to try and get a stranger to buy them it compared to 13%. This is in contrast to drugs where children are more likely to obtain them at a party or on the street, this further highlights that alcohol is an ‘acceptable’ drug to parents.

EIP around the Globe and in Scotland

In this section research into successful attempts at early intervention and prevention will be analysed from global sources as well as nationally within Scotland. Some of these concepts have been put into practice with evaluated results and others are merely conceptual. This section is intended to provide context as to how the EIP group could move forward and help to establish what the best method would be.

Early Intervention and Prevention within Scotland

The joint Scottish government and COSLA statement identified the following principles in regards to how to achieve early intervention; (Scottish Government, 2017)

 Universal ambitions – reduce inequalities in a variety of areas so everyone has the same outcomes and opportunities  Identify those at risk of not having these opportunities and take action to prevent that risk materialising  Make sustained and effective interventions where these risks have materialised  Shift focus to building capacity of individuals/families/communities to secure outcomes and address the external barriers they may face to maximise their life chances, making use of high quality and accessible public services

Looking at these principles shows that the Scottish government has identified inequalities and poor access to services as large problems which need addressed, which echoes the findings in the mapping exercise.

“Children and young people will be a natural focus of early intervention. Many risks start to become apparent during childhood and there is good evidence to suggest that the earlier the action to prevent or mitigate risk and harm, the better.”

North Ayrshire Early Years Strategy

North Ayrshire’s Community Planning Partnership created an Early Years strategy in regards to early intervention and prevention. They have stated they are shifting their resources into early intervention and prevention for young people. This plan aims to improve outcomes for vulnerable children aged 0 to 8. They are trying to encourage responsive parenting, healthy attachment and resilience. It identifies the various factors which can lead to harm and chaotic families, such as alcohol and drug misuse, domestic abuse and poverty. In order to improve these situations the goal is to improve outcomes and reduce inequalities for all young children and families across Scotland.

Methods that will be implemented are support through parenting programmes, enhancing individual parenting capacity, providing integrated early years centres, delivering direct support to vulnerable families in their own homes, intensive support by family nurses to vulnerable young mothers and improving resilience in children. (North Ayrshire Council, 2017)

Glasgow Integrated Children and Young People’s Service Plan

This plan was put together as a collaboration between Police Scotland, Glasgow life, Community Safety Glasgow, Glasgow Citywide Forum, Glasgow HSCP, NHS Glasgow and Glasgow City Council.(Glasgow City Council, n.d.)

The main focus is not on early intervention and prevention but it is included heavily within the plan. It varies throughout the report but key points are;  Constructive partnership with the third sector  Early intervention approach to family support to improve wellbeing of child  Transforming children and families services in the city to focus on early intervention and support families in becoming resilient and self-dependent  Deliver early intervention priorities through joint coordinated response  Reduce replication and redirect resources to early intervention  Focus on families ‘just coping’ who are invisible to statutory services  Nurseries to become Family Learning Centres  Implement Learning Community Joint Support teams in schools

Iceland – Early Intervention and Prevention

Iceland has been successful in

reducing its youth drinking, from

42% in 1998 to 5% in 2016. It has

been deemed a radical way of

turning around the problem but it is

also evidence based. They wanted

to create a programme not to treat

children with problems but to stop

those taking drugs or drinking in the

first place. Their previous education

based approach had not worked

and they wanted to do something

more proactive.

It was made illegal to buy alcohol

under the age of 20, links between

parents and schools were

strengthened. Parents were

encouraged to spend more quality

time with their children and keeping

their children home in the evenings.

A law was also passed prohibiting children between the ages of 13 and 16 from being outside after 10pm in winter and midnight in summer. State funding for diversionary activities was increased for sports, dance, art etc to give kids alternative ways to feel part of a group and feel good rather than use alcohol and drugs. Low income families were also given financial help to take part in more recreational activities, which included a £250 per year leisure card.

Short term-ism impedes effective prevention strategies in the UK, there is no national coordinated alcohol and drug prevention programme so it is left to local authorities and schools which often results in children just being given information about the dangers of drugs and alcohol – a strategy which evidence shows does not work. (The Independent, 2017)

Nordic Children Early intervention for children and families

This project was created by the Nordic Council of Ministers which

includes representatives from Sweden, Norway, Finland, Denmark

and Iceland. It focuses on early preventative intervention for families

at risk of social marginalisation.

It compiles good examples of early intervention from each of the respective countries. One of which is Parental Support in the Nordic Region – the idea that instead of more there needs to be fewer programmes but they need to be evaluated and more effective.

The project has four focus areas; current research on risk and protection factors, promising examples of early intervention in the Nordic region, simplified access to services and let the children’s voices be heard.

The project highlights the importance of early intervention being early on in life, and how it needs to be a continuous process. There needs to be both universal intervention and targeted intervention adapted to the target group. Also there is a focus on helping parents, especially in the first few years of the child’s life.

Alongside very young children the project also looks at school preparation programmes as early intervention and pre-school being a place to identify vulnerable children and put measures in place to intervene. (Nordic Welfare, 2012) 33

Reykjavik’s Prevention Policy 2014-2019 For children, adolescents and their parents This policies main aims are a violence free society, a drug free childhood, self- respect and respect for others and active participation for those young people not currently in school or working. It emphasises a health promoting society where all children have equal opportunities and ensure they live in a secure and constructive environment. (City of Reykjavik, 2014)

The strategies are divided into age ranges of the children to provide targeted intervention that is most effective. 0-5 years – Building a solid foundation for life, assisting the parents in prevention and tackling signs of negative self-identity. 6-9 years – Children supported both at school and at home. Begin participating in after school programmes and leisure activities. 10-12 years – Child given more responsibility and independence. Targeted intervention early at any signs of risk related behaviour. 13-15 years – Effects of peer group felt strongly, the more time parents spend with children the less likely to engage in drugs or other substances. 16+ years – After they leave school part of their safety net disappears and during these years many risk factors can appear. Individual support needed.

Canada: First Years First

This is an early childhood development strategy developed to engage health professionals, policy makers, communities, parents and educators in a broad- based effort to support young children and families. It is an approach built upon scientific evidence that shows early experiences have a lasting impact on health, development and later life. Negatives childhood experiences such as poverty, neglect and abuse can leave children vulnerable to poor development and health. (Society, 2018)

It creates opportunities where children can grow up in supportive families, communities and systems. Building better early child development systems have long-term benefits such as chronic disease prevention, reduced spending in health and social services and crime prevention. First years first focuses on principles such as focusing on assets and strengths of the child and their family, implementing a system- wide approach, early intervention and prevention, proportionate universality, community driven solutions and on- going monitoring and regularly re-evaluating the system.

Future Direction for Early Intervention and Prevention

Research has shown that certain behaviour and circumstances in young people’s lives are strongly linked with substance use. Iceland used a method of establishing risk and protective factors to begin tackling the issue.

Risk and Protective Factors

Family Factors

Peer Extracurricular Group Activities Effect

General Wellbeing

o Family Factors – Time spent with parents, support, monitoring, and control.

o Peer Group Effect – positive and negative, staying outside late, hanging out on streets.

o General Well Being – Both inside and outside the home, bullying at school, issues at home etc.

o Extracurricular Activities – Sports, Organised Activities vs. Unorganised.

Iceland’s Comprehensive Approach – Universal Interventions The State

 Act on how long children can stay outside – outdoor time limits.  Age limit, access to places selling alcohol.  High age limit for buying alcohol and alcohol monopoly. Municipality

 Data driven intervention.  Information to parents and other stakeholders – magnets with the outdoor hours published and distributed.  Encourage parents/caregivers to comply with the law.  Organise search in collaboration with Police.  Access to organised sports and other constructive leisure time activities “The Leisure Card”. Schools – Youth Centres

 Alcohol-free gatherings, in line with the outdoors hour’s law.  Education to parents and students.  Support parent-groups (education, provide facilities for their work). Parents

 Parents-walks around neighbourhoods to follow up on the outdoor hours (social capacity, share information).  Parent contracts on outdoor hours etc.  Joint family time – encouraged to spend more time with their children.  Support participation in healthy recreational activities like organised sports. Youth

 Spend more time with parents/family. 37

 Increased participation in organised sports and leisure activities.

Healthy Promoting Community – Lifecycle Approach

Alcohol and substance abuse prevention Mental health promotion Physical Activity Nutrition Smoking prevention Dental Health

Violence and injury prevention The Success of Iceland

So far Iceland alongside other Nordic countries have been pioneers in implementing early intervention and prevention. As it was introduced there in the 1990’s there has been sufficient time to show the results and it is very clear their approach is working. (Reykjavik, 2018).

Partnerships

An issue that was highlighted in several of the interviews was the lack of partnerships, especially with the third sector. There are many third sector organisations that engage in early intervention and prevention that the EIP Task Group is unaware of, such as Befriend a Child and Aberlour Childcare Trust.

If successful partnerships were made there would be opportunities to reach not just young people affected by substance abuse, but their parents also. The EIP group could potentially help by working jointly on projects or simply by providing additional funding for early intervention and prevention related work that highlights individuals suffering from substance abuse that are not actively engaging with statutory services at the moment.

Applying Tested Methods

As early intervention and prevention is a new and unevaluated approach in Scotland, in order to understand how to implement it effectively it would be beneficial to learn from those Nations doing it successfully. As shown previously in this report, many of the Nordic countries as well as Canada have been using this method for years and have evaluated what works and what does not in this area.

Nordic Children – Early Intervention for children and families  Evaluation of the ‘Early Intervention for Families’ project.  Nordic Centre for Welfare and Social Issues 2012.

Prevention in Iceland – Success and Development  Evaluation of Universal Interventions approach.  Iceland Directorate of Health 2018.

North Ayrshire Early Intervention and Prevention Strategy  Strategy for implementing EIP 2013/17.  North Ayrshire Community Planning Partnership.

Early Childhood Development – First Years First  Early Child Development Strategy.  Canadian Paediatric Society 2017.

Reykjavik’s Prevention Policy – for children, adolescents & parents  New policy development from previous preventive approaches.  City of Reykjavik 2014-2019.

Glasgow Integrated Children & Young People’s Service Plan  Strategic plan for services relating to young people.  Children’s Services Executive Group 2017-2020. 

Recommendations and Moving Forward

Possible methods to tackle highlighted issues in the previous section, research into who is currently leading the progress into early intervention/prevention and where the EIP group should go from here.

1. Partnerships/Collaborations 2. Mental Health Links 3. Culture Change 4. Tackling Parental Attitudes 5. Family Approach 6. Improve Access 7. Targeted Approach 8. Nordic Model

There is a recognition that there is already Early Intervention & Prevention activities, including alcohol and drugs, happening across a range of partner agencies, however it is clear from reading the findings of this report that there is a variety of different interpretations of what Early Intervention and Prevention is and what EIP work would entail. Clarity is required on the widest sense of Early Intervention and Prevention to allow a holistic and collaborative approach within statutory and 3rd sector organisations across Aberdeenshire to embed within existing plans and structures.

GIRFEC is founded on the principles of early intervention and prevention and provides a framework for putting interventions in place for children and young people.

Prevention is key to preventing problematic substance use, as it takes into account the wider factors such as deprivation, health inequality, homelessness and mental health. Problematic substance use disproportionately affects people who experience socio-economic disadvantage.

Early Intervention and Prevention within Scotland

The joint Scottish government and COSLA statement identified the following principles in regards to how to achieve early intervention; (Scottish Government, 2017)

 Universal ambitions – reduce inequalities in a variety of areas so everyone has the same outcomes and opportunities  Deliver early intervention priorities through joint coordinated response  Reduce replication and redirect resources to early intervention

As can be seen above and in the narrative of the findings of this report evidence would suggest, alongside identified principles from the Scottish Government and COSLA that a collective approach across Aberdeenshire would be better placed to deliver on the full range of early intervention & prevention priorities rather than a standalone Early Intervention & Prevention sub group. Successful partnerships will only work if people, who are giving up time to attend, can see tangible methods of making a difference.

Key Informants who took part in the Mapping

An initial list of informants was provided that the ADP is aware of and has worked with previously; this list was then expanded upon by recommendation by the informants themselves.

Aberdeenshire Alcohol & Drug Partnership Team

The EIP task group was created by the ADP and had its first meeting in 2014. All members are aware of its function or are actively working within it. Each team member has different opinions and recommendations on how the group should move forward.

Lead Officer, Strategic Development Officer, Health Improvement Officer Commissioning, Performance and Finance Officer,

NHS Healthy Working Lives - Public Health Practitioner

Healthy working lives is relevant to alcohol and drugs as it provides training for employers in regards to early intervention when their employee is suspected to be substance abusing. Not aware of EIP in a wider context.

Aberdeenshire Health & Social Care Partnership

Some members have previously sat on the EIP Task Group whilst others were not aware of EIP at all or the definition. Some actively involved and others involved to a certain extent and not aware it’s EIP.

Physiotherapist/ MEOC, Project Manager Community Justice,

Community Safety Partnership Aberdeenshire

Focus on anti-social behaviour but also interested in early intervention and prevention. Big involvement in 2016 Barnardos project which was a successful attempt at EIP in Garioch.

Community Safety Officer (Antisocial behaviour)

Aberdeenshire Community Planning Partnership

The Partnership established the Tackling Poverty & Inequalities Group in order to help disadvantaged people and areas in Aberdeenshire. Targets pockets of deprivation such as Banff & Buchan, some of their work falls under EIP definition.

Aberdeenshire Council – Education & Children’s Services – Health Improvement Officer (Education)

Previously sat on EIP task group but has withdrawn. Early intervention and prevention high on priorities but not a lot being done at present.

Aberdeenshire Police

Police Scotland believes early intervention is an important part of their work in identifying children before they enter the justice system.

They work in partnership with other relevant organisations to provide support and help to children and young people.

Sgt Community Safety Partnership, Aberdeenshire Partnership Development Officer

GIRFEC

GIRFEC is founded on the principles of

early intervention and prevention and

provides a framework for putting

interventions in place for children and

young people.

Children and Young People’s Act Project Manager

Mearns Academy, Aberdeenshire, Depute Head Teacher Depute head teacher from Mearns Academy, aware of GIRFEC and is implemented in the school.

Unaware of early intervention and prevention in a wider context and focused mainly on children at Academy age range.

Third Sector Organisations

Some third sector organisations had already worked in collaboration with the Aberdeenshire Alcohol and Drug Partnership so some recommendations were provided on who to meet with but independent research was also done into organisations the ADP was not aware were participating in early intervention and prevention.

Some organisations were aware what they were doing was early intervention and prevention but many were unaware of the existence of the EIP group and anyone else in Aberdeenshire providing similar services.

Aberdeen Football Club Community Trust, Development Officer

Works in partnership with others to improve health & wellbeing, education, equality and social cohesion. Has a variety of projects that are relevant to early intervention and prevention.

Alcohol & Drugs Action, Service Manager ADA

Provides advice and targeted interventions for those affected by substance abuse in Aberdeen city and the Shire.

A lot of focus on harm reduction but ADA outcomes also include prevention of alcohol and drug abuse.

Befriend a Child, Senior Volunteer Coordinator

rd 3 sector organisation that operates in Aberdeen city and some targeted areas in the shire.

Work involves EIP in regards to diversionary activities and building confidence/resilience in children.

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