Universal prevention targets the entire population, regardless of individual levels of risk, with programmes, initiatives and messages aimed at preventing or delaying the onset of illicit drug use.
3.4.1 England
Universal drug education is included in the national curriculum in England, where it is a statutory part of the science curriculum for schools. Pupils are required to be taught “the effects of
‘recreational’ drugs (including substance misuse) on behaviour, health and life processes.” Drug education can be expanded through the non-statutory Personal Social and Health Education (PSHE) programme; however, there is no standardised approach for doing so. Guidelines do state that teaching should draw on good practice (Department for Education, 2014). Evidence suggests that well-delivered PSHE can have a positive effect on young people, and that interventions that help build confidence and resilience can prevent drug use (Home Office, 2016b). In 2015, four House of Commons committees requested that PSHE be made mandatory in schools; however this proposal was rejected and is still under review.
Alcohol and drug prevention briefing papers
As part of a series of briefing papers for teachers and practitioners, Mentor-ADEPIS (Alcohol and Drug Education and Prevention Service) published a document in 2016 that looks at how building resilience and preventing children and young people’s mental ill health can prevent substance abuse. It aims to provide teachers, educators and the wider school workforce with practical guidelines on how to prevent children and young people from developing mental health problems as a result of alcohol and drug misuse (Mentor-ADEPIS, 2016).
In 2016 the Association for Young People’s Health in conjunction with Public Health England (PHE) published a resource, A public health approach to promoting young people’s resilience, on building resilience in young people (Association for Young People’s Health, 2016). This document is aimed at policy makers, commissioners and service planners and providers, and builds on previous work such as the PHE framework for young people’s health, and resources such as Rise Above which is focused on resilience and helping young people to make positive health decisions.
Sources of support and information about drugs
There are several universal prevention communication programmes in England. For example,
‘Talk to FRANK’,16 a campaign from PHE, provides information about drugs to young people (under 16) and their families. Advice can be accessed through a number of channels including a 24-hour helpline operated by trained advisors, the FRANK website, SMS, email and a live online chat service. There have been increases in the number of website visits and emails to FRANK in recent years (2.2 million in 2009/10 to 4.2 million in 2014/15).
Rise Above is another prevention communication programme, which was launched by PHE in November 2014. It is an interactive resource where young people can find material aimed at encouraging them to build resilience, encourage empowerment and talk about important issues in their life, including drugs, alcohol, smoking, body confidence, relationships and exam stress.
Rather than providing information only, a range of situational tools and skills-based resources are available on the website. Since Rise Above was launched, there have been almost 350,000 unique visits to the website, 1.09 million views of Buzzfeed posts, 4.9 million video views of Rise Above content across vloggers and the Rise Above channel on YouTube and 52,429 unique visits to the MTV Rise Above Wall.
PHE has also developed its role in supporting local areas: sharing evidence to support commissioning and the delivery of effective public health prevention activities; and launching toolkits to support local areas’ responses on specific issues around new psychoactive substances (NPS) and other drug groups.
3.4.2 Scotland
In Scotland, education has developed to encapsulate broader life learning for children and young people through the Curriculum for Excellence,17 where traditional education is integrated with wider life learning for three to 18-year-olds. In the Curriculum for Excellence, learning in health and wellbeing is designed to promote confidence, independent thinking and positive attitudes. This learning helps enable children and young people to become resilient to risk taking behaviours and understand the wider impacts of staying safe and making positive choices.
In December 2016, the Scottish government produced a literature review examining drug education and prevention (Scottish Government, 2016f). The report argued that drug prevention is better provided through holistic strategies that promote healthy development and wellbeing, with targeted drug-specific interventions provided for those at most risk of harm or already misusing drugs.
16 See: http://www.talktofrank.com/
17 See: https://education.gov.scot/scottish-education-system/policy-for-scottish-education/policy-drivers/cfe-(building-from-the-statement-appendix-incl-btc1-5)/What%20is%20Curriculum%20for%20Excellence
Know the Score
‘Know the Score’18 provides factual information and advice to young people, their families and professionals. It is supported by the Scottish government and provides an online 24-hour information service and a telephone helpline on drugs information and advice from 8am to 11pm, seven days a week.
Choices for Life
The Scottish government funds the ‘Choices for Life’ schools-based substance misuse education programme, delivered in partnership with Young Scot and Police Scotland. This programme provides education on drugs, alcohol and tobacco through an information website for young people and their parents, teachers and carers. It also provides a series of community events to engage young people directly and provide credible information to help them make the right health choices. The Choices for Life website hosts a series of interactive short films to educate teenagers on a wide range of topics including the dangers of NPS, peer pressure, alcohol, smoking, cannabis, substance misuse and drug driving.
In 2015/16, Choices for Life aligned itself with an existing successful event, Rock Challenge.
This performing arts initiative delivers positive healthy lifestyle messages to young people. It raises awareness of social issues affecting young people including smoking, drugs, alcohol and anti-social behaviour, and encourages them to make informed lifestyle choices. Police Scotland allocated a support officer to the participating schools and made funding available to help with their projects.
In light of the findings of the literature review ‘What works’ in drugs education and prevention (Scottish Government, 2016f), the Scottish government is currently reviewing the education and prevention activities that it supports directly, to ensure that these are in line with the evidence base on what works. It is proposed that in the 2017/18 financial year, a review of the Choices for Life programme will be undertaken.
3.4.3 Wales
In Wales, in line with the goal laid out by Working Together to Reduce Harm: The Substance Misuse Strategy for Wales 2008-18 (Welsh Assembly Government, 2008a), the All Wales School Liaison Core Programme has been developed to deliver drugs education in primary and secondary schools.19 The Steroids and Image Enhancing Drugs Educational Toolkit for Young People (11-16 years) has been developed and issued for all schools and youth groups across Wales (Public Health Wales, 2014b).20
Welsh Network of Healthy School Schemes
The Welsh Network of Healthy School Schemes (WNHSS)21 is an initiative to ensure schools adopt a holistic approach to health with a focus on substance use (both licit and illicit). Each local authority employs healthy schools practitioners to support schools in the areas. Once schools have been involved in the scheme for nine years, they can apply for a National Quality Award (NQA). This award assesses the school on its approach to the seven key topic areas of food and fitness, mental and emotional health and wellbeing, personal development and
18 See: http://knowthescore.info/
19 The All Wales School Liaison Core Programme is jointly funded by the Welsh Government and the four Welsh police forces and targets pupils aged between five and 16. See: https://www.schoolbeat.org/en/parents/know-the-programme/national-events/what-is-the-all-wales-school-liaison-core-programme/
20 See: http://www.wales.nhs.uk/sitesplus/documents/888/SIEDS%20Toolkit%20English.pdf 21 See: http://www.wales.nhs.uk/sitesplus/888/page/82249
relationships, substance use and misuse, environment, safety and hygiene. In August 2015, 87 schools across Wales had achieved the NQA, an increase from 65 in August 2014. A further 266 are working towards being assessed.
Healthy and sustainable further education and higher education settings
The Healthy Colleges and Healthy Universities framework22 was launched in Wales in 2015 as an extension of the WNHSS into Higher Education and Further Education settings. One of the six health topics detailed in the framework is substance use and misuse. The framework sets out criteria for various aspects of college and university life, covering: governance, leadership and management; facilities, environment and service provision; community and communication;
and academic, personal, social and professional development. It aims to create a healthy and sustainable further education environment for both staff and students and provides guidance on how this may be achieved.
DAN 24/7
Dan 24/723 is a bilingual (Welsh and English) 24-hour information and telephone helpline service, which frequently runs targeted campaigns. Traffic to the website increased by 29% from 2013/14 to 2014/15. It has been updated to reflect current issues such as NPS and a recent campaign to raise awareness of hepatitis C in Wales. The service has also increased its presence on social media platforms in the past year. It is hosted by the Betsi Cadwaladr University Health Board with funding provided by the Welsh government. The helpline is aimed at assisting individuals, their families, carers, and support workers within the drug and alcohol field to access appropriate local and regional services.
3.4.4 Northern Ireland
The school curriculum places a specific focus on the development of relevant ‘life skills’ among pupils. In particular, through Personal Development and Mutual Understanding24 in primary schools, pupils are provided with opportunities to develop strategies and skills for keeping themselves healthy and safe. Post-primary school pupils, through Learning for Life and Work,25 are provided with opportunities to investigate the effects on the body of licit and illicit substances and the risks and consequences of their misuse.
During the 2014/15 financial year the Council for Curriculum, Examinations and Assessment (CCEA) updated the CCEA/Department of Education guidance on drugs and alcohol. The new guidance was published on the CCEA website in August 2015.26 In Northern Ireland, the Public Health Agency27 develops public information campaigns for various target groups and settings.
In addition, Northern Ireland buys into the telephone helpline element of the FRANK campaign.
A new community support and local awareness raising service, called ‘Connections’, was put in place in July 2015 to raise awareness of the harm alcohol and drug misuse can cause, work with local communities to address their priorities, and raise awareness of local services.
22 See: http://www.wales.nhs.uk/sitesplus/888/document/270938 23 See: http://www.dan247.org.uk
24 See: http://ccea.org.uk/curriculum/key_stage_1_2/areas_learning/personal_development_mutual_understanding 25 See: http://www.nicurriculum.org.uk/docs/learning_for_life_and_work/training/LLW-Guidance.pdf
26 See: http://ccea.org.uk/curriculum/drugs_guidance 27 See: http://www.publichealth.hscni.net/
Thingyapp
In Northern Ireland, the Police Service of Northern Ireland, Big Lottery Fund, Youth Justice Agency and Family Support Northern Ireland have funded an app, designed by young people, called Thingyapp. Thingyapp offers young people health advice, including advice on drugs and alcohol, and signposts individuals to agencies where they can receive further help and information.
3.4.5 UK-wide
Good Behaviour Game
The Good Behaviour Game is a classroom-based approach that has been trialled in a number of countries around the world. A trial is ongoing in UK primary schools funded by the Education Endowment Fund and led by Mentor. The programme is an approach to classroom management and aims to develop life skills in young people to build resilience and confidence in dealing with challenges. Evaluations in other countries have shown long term benefits including a reduction of risk-taking behaviour, including substance abuse, later in life. An evaluation report will be published in August 2017.
Unplugged
Unplugged is an intervention aimed at 12-14 year-olds and is delivered through a series of 12 one-hour modules in schools. The programme has been trialled in a number of European countries and has been shown to be effective in preventing and reducing alcohol misuse and smoking. It aims to give young people the skills they need to resist influences from peers and information regarding the negative health consequences of drug use.