London School of Hygiene & Tropical Medicine

Current government programmes aimed at reducing drug and alcohol use among young people may be ineffective and may even be doing more harm than good, according to a paper published today in Public Policy Research, the quarterly journal published today by the Institute for Public Policy Research.

Street-based programmes, by contrast, which aim to engage with young people on their own 'territory', have the potential to be more effective in reaching the most at-risk young people and are also likely to be cheaper to operate.

The Connexions service, which launched in 2001, aims to provide advice, guidance, support and personal development opportunities for 13-19 year olds, focusing on the one-in ten young people 'not in education, employment or training' who are known to be most at risk of misusing drugs and alcohol. Connexions advisers work with young people individually, in isolation from their friends and social networks. They are assessed on the numbers of young people with whom they have contact, and whether they progress to education, employment or training.

But Adam Fletcher and Chris Bonell, of the London School of Hygiene & Tropical Medicine's Centre for Research on Drugs and Health Behaviour, argue that Connexions is too target-driven and individually-focused, and that it may not be working. Current targets neglect outcomes such as young people's self-esteem, happiness and wellbeing, all of which are likely to be critical if lasting and meaningful change is to be achieved. And, crucially, the service fails to address the importance of peer pressure in influencing a young person's decision to misuse drugs and alcohol.

Perhaps most worrying, the authors cite research which indicates that centre-based youth work approaches may actually do more harm than good, by inadvertently introducing young people to peers engaged in frequent and heavy drug and alcohol use.

They call for more attention to be given to 'detached', street-based youth work, whereby youth workers meet and support young people away from youth centres or other buildings linked to the youth service, such as sports centres, and instead work with them on their own territory, on the streets, in parks, bus shelters and other places where they choose to meet and socialise.

The authors comment: 'Centre-based youth work programmes targeting individual young people are likely to have only limited success because they still largely ignore their social relationships and, in particular, the norms of their peer group. Once a young person is in contact with drug-using peers, such youth work responses are insufficient.

'Detached youth work, by contrast, has been shown to be more effective in reaching those young people most at risk. By working with young people in their existing friendship groups rather than by engineering new ones, detached youth workers can avoid the potentially harmful social network effects associated with centre-based youth work and avoid introducing young people to whole new networks of drug-using peers'.

Detached youth work could also be cheaper to deliver. Providing detached youth work for the 5% most deprived young people in the UK would cost around £24 million a year, with coverage for the bottom 50% only £142 million a year. This is far less than has been spent on the Connexions service (£450 million between 2001 and 2004 alone).

The authors conclude by cautioning that existing detached youth work projects are rigorously evaluated to assess their impact on young people's drug and alcohol misuse before any roll-out.