Accessing drug and alcohol assessment and treatment services for young people involved with youth justice.

 

When to use this procedure

When case managing young people who require assistance accessing support for drug and alcohol abuse.

 

What else you need to know

 

Practice context and legislation

  • A significant proportion of young people involved with youth justice use drugs and alcohol in a way that interferes with their social functioning and has significant health and legal consequences for them.
  • The purpose of this procedure is to outline the processes by which young people involved with youth justice are able to access appropriate drug and alcohol assessment and treatment services.
  • The Youth Justice Drug Policy and Strategy (2007) draws on best practice evidence to provide a clear and enabling direction for staff who work with young people who may misuse alcohol or other drugs.
  • The overarching aim of the Youth Justice Drug Policy and Strategy is to assist young people to stop using drugs. This aim is based on the belief that the use of drugs by young people is often illegal, detrimental to their health and wellbeing, and has negative consequences for their successful transition to independence and adulthood.
  • The Australian Community Support Organisation (ACSO) manages the Community Offenders Advice and Treatment Service (COATS). The COATS program purchases drug treatment for young people involved with youth justice from state government funded drug treatment providers across Victoria.
  • Under this model, the majority of assessments are undertaken by local drug and alcohol treatment agencies, with a small number conducted by the youth justice health service. To encourage continuity of care, where young people have an existing relationship with a drug and alcohol treatment agency, this should be maintained during the time the young person is in contact with the youth justice service.
  • Under the 'Pathways to treatment' model, COATS manages all payment/brokerage for young people involved with youth justice drug and alcohol treatment, either via prepaid drug treatment capacity for young people involved with justice within the agency service agreement, or brokerage payments for treatment services. Referral to COATS triggers the payment processes for a young person’s treatment.
  • Youth Justice is committed to ensuring that responses to a young person’s drug and alcohol use are developmentally age-appropriate and in line with community expectations.
  • The list of principles below have been drawn from the Youth Justice Drug Policy and Strategy and underpin best practice in the delivery of drug and alcohol treatment for young people involved with youth justice:
    • The pathway from drug use to abstinence is not easy to navigate. A range of strategies to keep the young person safe and well on their journey towards abstinence need to apply beyond their court or parole order.
    • Timely linkages with the drug treatment service sector supports engagement with the young person.
    • Drug and alcohol services and interventions are most effectively delivered to young people in a holistic and individualised manner.
    • Drug and alcohol services should be targeted to those young people who have been assessed as having a high need.
    • Drug and alcohol intervention with young people should focus on their behaviour and causal factors as well as treatment aimed at reducing or stopping the use of drugs.
    • Drug and alcohol use is often cyclical. Intervention may need to be applied repeatedly before change is achieved.
    • Transition planning is crucial. Continuity of service provision should be via a through-care model to minimise the negative impact of key transition points, including leaving youth justice centre and beyond the intervention of Youth Justice.
    • Young Aboriginal people have particular needs that require a specific response.
    • Youth justice must be aware of, and responsive to, issues relating to a young person’s ethnicity.
 

Roles and key tasks

Case manager

Undertake intake, assessment and client service planning. Implement intervention regarding homelessness. Consult with other professionals in the case management of dual order young people. Complete referrals to drug and alcohol agencies.

Team leader / team manager

Provide guidance and consultation on, and endorsement of, case management issues as required.

Assistant Director / Manager Individual and Family Support

Provide oversight, direction and monitoring of the Area youth justice service. Provide case consultation regarding court recommendations, breaches and young people exhibiting high risk behaviours.

Youth Justice Senior Practice Advisor

Provide consultation on case management issues, particularly in relation to high risk young people. This should occur subject to any local area agreements between Assistant Director / Manager Individual and Family Support and the Senior Practice Adviser.

 

The procedure in detail

Drug and alcohol assessment process

Following receipt of a court order, deferral of sentence, supervised bail or as part of parole planning, the young person will be involved in a comprehensive assessment process. At this time, it may be determined that the young person has issues relating to drug and/or alcohol use and that specialist assessment and treatment may be required. A young person may also have a special condition attached to their order directing drug and alcohol counselling.

After obtaining consent from the young person, the youth justice case manager will arrange for a drug and alcohol assessment to take place. The assessment may be completed either by:

  • an accredited drug and alcohol assessor from a recognised drug treatment service, or, where this is not possible,
  • an accredited drug and alcohol assessor from the youth justice health team           .

COATS clinical staff may be called upon where an urgent assessment is unable to be completed by either of the above accredited assessors.

Referrals to accredited drug and alcohol assessors, should be made in accordance with the individual agency’s standard referral process.

To minimise duplication, and with the young person’s consent, the youth justice worker provides the accredited drug and alcohol assessor with any relevant information about the young person’s history.

Notifying COATS of drug and alcohol assessment

Once the assessment is arranged, the youth justice worker will notify COATS of the assessment date and time using the COATS referral notification form.

Completion of the referral notification allows COATS to record and broker treatment. COATS referral notification forms are available in each area youth justice team and are to be faxed to COATS on (03) 9413 7186, or scanned and emailed to intake@acso.org.au (External link).

COATS will generate all relevant paperwork and forward it to the assessing agency.

Any queries about the referral process can be made to the COATS Client Services Unit on (03) 9413 7000.

Young people requiring drug and alcohol treatment in youth justice precincts

Youth justice centre health services are responsible for ensuring that all young people are assessed and, as required, provided with treatment services to address drug and alcohol issues whilst they are undertaking their sentence. 

Youth justice centre health services are also responsible for ensuring timely and appropriate referrals are made to community based drug and alcohol treatment providers to enable young people to receive continuity in drug treatment when they leave the youth justice centre.

For young people released on parole, referrals to community based treatment agencies must be done in consultation with the area youth justice parole worker during the parole planning phase.

Where a young person has an existing relationship with a drug and alcohol treatment agency

If a young person has an existing relationship with a treatment agency, and it is appropriate to do so in the event of a re-referral, the relationship with that agency or worker should be continued as the primary treatment provider.

Individual treatment plan

Following assessment, if applicable, an individual treatment plan will be negotiated and ongoing treatment recommendations made. The assessor will inform COATS of any treatment to be arranged and COATS will make contact with the most appropriate drug treatment agency (if this has not already been established).

An initial appointment for engagement in treatment will be obtained and details forwarded to the youth justice worker who will, in turn, inform the young person.

A forensic ‘episode of care’ is based on the young person’s needs and, therefore, is not time limited.

Case coordination and case management

Young people on dual statutory orders with youth justice and child protection may also be involved with disability services, housing, or out of home care who will have case management responsibilities for the young person.

Young people involved in more than one program frequently require a collaborative response and coordinated care team approach.

For the care team to work effectively, it is necessary to establish and agree on which service will have lead case management responsibility.

Primary case management responsibility will usually be held by the service that has the most involvement with the young person and is negotiated on a case-by-case basis.

In determining this, the nominated lead worker will establish information sharing and communication arrangements for the care team and that facilitate purposeful planned outcomes.

Refer to the procedure for ‘Youth justice care teams’ for more information.

Ongoing support of the young person

The role of the youth justice worker in the young person’s drug and alcohol treatment is to:

  • support the young person to attend and engage in drug treatment
  • co-ordinate other supports as required
  • facilitate regular care team meetings that include, as appropriate, the treatment provider
  • provide ongoing case management including referrals as needed for additional support such as accommodation, mental health services or vocational opportunities.

The drug treatment agency will maintain regular contact with the youth justice worker in relation to the young person’s attendance and progress in treatment.

Communication regarding a young person’s progress during treatment must be conducted in accordance with the Health Records Act 2001.

Closure of episode of care

When the treatment episode is complete, the treatment clinician will liaise with the youth justice worker and notify COATS via a ‘Treatment completion advice’ form. COATS then processes the ‘Treatment completion advice’ form and proceeds with or adjusts payment.

The ‘Treatment completion advice’ report will be forwarded to the youth justice worker who attaches an electronic copy to the young person’s CRIS file, and stores a hard copy in the paper file.

The above process occurs regardless of the duration of treatment.

Reassessing young people exited from treatment

It is not uncommon for young people to complete their drug and alcohol treatment prior to the expiry of their youth justice order. In these cases, it is the responsibility of the youth justice worker to, where possible, monitor the young person and their need to return to treatment.

If there is concern the young person has recommenced substance use or has increased risk taking behaviour involving drugs and/or alcohol, the youth justice worker must take the necessary steps to either re-engage the young person in treatment or to have them reassessed by the previous treatment agency.

The process for re-referral is the same as for an initial referral.

Children’s Court Clinic – drug and alcohol assessments

The Children’s Court Clinic is an independent body which conducts psychological and psychiatric assessments of children and families for the Children’s Court of Victoria. In some instances, limited drug and alcohol treatment may be provided.

The clinic has two dedicated clinicians who conduct drug and alcohol assessments of young people who appear before the courts and may make recommendations for treatment in their reports. Young people can only be assessed by the clinic at the court’s request, however this can be requested of the court through a young person’s legal representative, or as a recommendation in a presentence or breach report.

The reports provided by the clinic are used to assist the court in making decisions in both the family and criminal divisions of the children’s court.

Refer to procedure for 'Children’s Court Clinic' for more information.

Pharmacotherapy Support Program – community

The Pharmacotherapy Support Program provides support to young people involved with youth justice through the payment of pharmacotherapy dispensing fees. Under the program, the government reimburses pharmacies for the dispensing costs of methadone and buprenorphine for young people who are less than 19 years of age on a court order supervised by youth justice.

This assistance is an encouragement for young people to begin and continue with pharmacotherapy as a replacement for opiate use.

Young people who turn 19 years while on a youth justice order will still have access to the program until the completion of their order.

If the general practitioner or community pharmacy has not informed the young person that they are eligible for payment, then the youth justice worker may need to fax a statement notifying the Drugs Poisons Regulations Group of the young person’s potential eligibility for the program.

Ensure that the Pharmacotherapy notification form and Pharmacotherapy informed consent form are completed.

Refer to the procedure for Pharmacotherapy for more information.

Pharmacotherapy treatment within youth justice precincts

Pharmacotherapy treatment is also available within youth justice precincts for young people who are opioid dependent.

Pharmacotherapy was introduced in recognition of the effectiveness of this treatment to reduce opioid use and harms associated with illicit drug use and in recognition of the need to ensure that young people in a youth justice precinct have access to the same treatment that they would otherwise have in the community.

Young people entering a youth justice precinct who may require pharmacotherapy medication are identified through the initial health assessment conducted within 24 hours of entry to a youth justice precinct (or 12 hours for young people who identify as Aboriginal or from the Torres Strait Islands).

Other points of referral include self referral, via a youth justice worker, or by health or other program staff. Where a young person has been found to be substance affected, or in possession of opiate or drug equipment whilst in the youth justice centre, staff should refer the young person to the health team for assessment.

Any queries about pharmacotherapy for young people in a youth justice centre should be directed to the Youth Health and Rehabilitation Service (YHARS) in the youth justice centre.

Refer to the procedure for Pharmacotherapy for more information.

 

Additional information