Back row: (from left to right) Davina Cooper, Thomas Humphreys, Andrea Cameron, Tariki Manawaiti, Kaylib Heke, Kane Rudolph Middle row: Robert Diamond, Summer Hamilton, Sheridan Ashby, Bernie Hetaraka, Shirleyanne Brown, Mika Nathan, Rachel Woodworth Front row: Harrison Tanenui-waara.

A successful student-led open forum, focussing on the “Is It Worth It?” campaign which addresses youth access to alcohol, was held in Whangarei earlier this year.

Students from Tikipunga and Whangarei Boys High Schools were involved in the planning, content and timetable of the open forum day.  Students and staff from seven of the nine high schools in the Whangarei area attended the open forum day.

The day of presentations and discussion was MC-ed by two extremely confident and entertaining students.  Students from the participating high schools facilitated presentations and workshops looking at five themes from a youth perspective.

Presentations and discussions covered:

• How are we drinking?
• Influences
• Consequences of drinking
• Impact on friends and whanau
• Benefits of not drinking alcohol – a balanced perspective

 Activities during day encouraged thinking, questioning, participation, brain storming, role play, writing poetry, acting and above all, honesty, from students and teachers alike.

The students shared their experiences of activities they had done in their schools, including awareness days and results of a survey asking where young people got their alcohol.  The survey showed that a majority of young people get their alcohol from their parents.

“There is not enough education (not just for young people, but for parents as well) about how much alcohol is in some drinks,” said one of the students.  “My friend’s mum gave him a box of 12 RTDs for the night.  That is a lot of alcohol!”

“This forum, as part of the Is It Worth It? project, has helped to increase the skills, knowledge and choices of young people by providing information, advice for the growth of youth leaders,” said Shirleyanne Brown from ALAC.  “Young people get to use their ideas and creativity to spread the message around their choices regarding alcohol and its consumption.”

Ms Brown said young people are well aware that success will limit their access to alcohol, and they are okay with that.  “Young people in our community have been rocked and affected by effects of alcohol, including seeing their friends dying as a result of alcohol-related harm.  They want to do something about it.”

“We are seeing a real commitment to addressing alcohol issues in our schools,” said Bernie Hetaraka, from Manaia PHO.  “Students and teachers have taken away a number of ideas from this forum to help them plan a variety of initiatives to implement in their own schools.”

“Senior students are going back to their schools and planning activities like orientation days, report nights, and displays for next year.  In some schools we are seeing the awareness for alcohol issues being integrated into the curriculum.” 

This day was made possible by the Steering Group, consisting of students and teachers from Tikipunga High and Whangarei Boys High school, with the support from Bernie Hetaraka (Manaia PHO), Rachel Woodworth (ACC) and Shirleyanne Brown (ALAC), and funding provided through the Community Alcohol Action Fund (CAAF) from ALAC.

The “Is It Worth It?” Project

 Whangarei high schools, working alongside Bernie Hetaraka (Youth Health Co-ordinator – Manaia PHO Ltd), identified alcohol as one of the issues young people are facing both within the family and friends social settings.

 As a result, Is It Worth It? began.  It has been running in Whangarei High Schools for the past two years.

 The main objective is for Whangarei young people to have heightened awareness and responsibility regarding the supply of alcohol to minors, the choices they have, the decisions they make and to ultimately keep young people safe from the adverse effects of alcohol.  It also reinforces the responsibility of parents and caregivers regarding the supply of alcohol to minors.

The first two schools to roll out the project were Te Kura Kaupapa Maori O Te Rawhiti Roa and Tikipunga High School.  These schools undertook a survey that asked the question “Who supplies your alcohol?” in an effort to highlight a local picture concerning youth access to alcohol.

Since then the remaining seven high schools, through their health teams, have been offered the opportunity to also conduct this survey.

 The findings from the above survey have reflected those of The University of Auckland, Faculty of Medical and Health Sciences document “Te Ara Whakapiki Youth 07 – The Health and Wellbeing of Secondary School Students In New Zealand”.  It states that the most common sources of alcohol for students were their parents (54%) and friends (53%).

As people listen to others and begin to tell their story in CADS family and friends support groups, the most common statement is

 ”I thought I was the only one”

Sadly, only a proportion of families experiencing addiction issues gain access to specialist treatment services. Often when this happens the focus is usually on the individual presenting with the alcohol and drug issue rather than the wellbeing of the whole family and whanau.

“A part of the enormous social cost of alcohol and other drug (AOD) abuse, alcohol and other drug issues impact significantly on New Zealand families, friendships and communities,” says Trish Gledhill, Director, Kina Families and Addictions Trust.  “The need to address these issues requires little argument.”

With the support of ALAC, the Mental Health Commission and the JR McKenzie Trust, Kina has recently produced Living Well – a resource to promote the health and wellbeing of families and friends of people affected by a loved one’s alcohol and other drug use.

Living Well is a framework utilising the Stress Coping Model, a primary health model developed by Alex Copello and colleagues in the United Kingdom. The approach has demonstrated how the effects of stress and the increased rates of psychological and physical symptoms experienced by people with family alcohol and drug issues can be mitigated towards healthier outcomes (Copello, A., Orford, J., Velleman, R., Templeton, L., & Krishnan, M; 2000).

Living Well has been designed to be applicable to a New Zealand context in reflecting the diversity of our families.  It incorporates family resilience concepts, aimed to instil realistic hope for people while they explore their various coping strategies in response to these issues.

While the resource has been designed to ‘stand alone’ for individuals to use, it is ideally introduced in a setting that is conducive to family inclusive practice in addressing alcohol and drug issues, and by a worker who understands the model and can support its delivery with a consistent approach.  Therefore, to ensure the most effective utilisation of the resource and the most benefit to families, training and support in the application of the model will be provided to key staff such as practice nurses.

Living Well can be used on its own, as the basis for working one to one with family, and also in group situations.  Living Well employs the Stress Copying Model by simply modeling the process and guiding AOD clinicians and family members to identify current coping strategies and to utilise those that are most likely to support their own health and wellbeing.

“This resource has been enthusiastically received in the sector with several requests for copies to assist with service delivery,” says Trish.

Community Alcohol and Drug Services (CADS) provides services in Auckland for those concerned about their own or someone else’s use of Alcohol and Other Drugs (AOD) and has been using Living Well.

“Through providing a simple and effective framework, the Stress Coping Model, demonstrated in Living Well has been found to be a lovely way of working with affected others in these settings,” says Suzy Morrison, Family Services Coordinator, CADS Auckland.  “It can also reduce any fears voiced by AOD clinicians that they need to be a family therapist to work with families.”

“The resource is gaining popularity with both clinicians and family members and is in high demand as part of CADS service delivery,” say Suzy.

Kina Trust’s objective is to see Living Well accessed by people through different ways across the AOD sector and the wider community.

“The next Kina project is aimed at the promoting effective utilisation of Living Well in a number of accessible community and primary health settings,” says Trish from Kina Trust.

Copies of Living Well may be obtained from Kina Trust. To contact Kina Trust visit their website on www.kinatrust.org.nz or email info@kinatrust.org.nz

The Whanganui-a-Tara Courts and Health (WATCH) project began in October 2006, started service delivery in early 2007 and has now been running for over a year in Wellington. The project was developed and guided by an inter-sectoral working group and was funded by Capital & Coast District Health Board (C&CDHB), Ministry of Health and the Ministry of Social Development.  Wesley Community Action was contracted as the host organisation for the service.

The service was designed with input from Judge John Walker and feedback from other judges, people with expertise in the criminal justice and health sectors and with input into the design from young people already in the criminal justice system and struggling with drug and alcohol issues. There was strong involvement and support from local Police, Courts, Probation and health providers with experience in this area.

This working group recognised that many young people in this situation wanted to get off the train but faced multiple barriers that often led to a sense of fatalism that their life was on a one way track to prison. Given this chance to have input, most expressed aspirations for a drug and alcohol free future, a good job, happy family life – but had almost given up thinking that these things could happen for them, says Justine Mecchia, Contracts & Relationship Manager Primary Care for Capital & Coast DHB.

A pilot was run for a year, contracting Wesley Community Action to provide the WATCH service. Wesley who specialise in strengths-based practice developed an innovative, strongly supportive but challenging approach with the participants and have received glowing reviews from all concerned.
An independent review of the WATCH service commissioned by ALAC and ACC confirmed the significant merits of this approach.

The DHB and the MSD have now adopted WATCH as an ongoing way to help address these important health and social needs.

It starts by identifying suitable candidates, young people who are due to appear in court and who have alcohol or drug issues.  If they agree to take part and the judge agrees, a delay in their next court appearance is arranged so they can create a care plan with the WATCH team to try to get themselves back on track.
That means intensive and focussed interventions seeking to address the social and health issues especially drugs and alcohol which are contributing to the young person’s illegal or anti-social behaviour. The WATCH team reports back to the Court on a regular basis and presents a summary of progress when the time comes for the court to pass sentence for the original offence.

That’s not the end of the story. The WATCH team stay engaged with the young offender beyond sentencing, helping to bed in the gains they’ve made in terms of managing substance abuse.

It’s a real win-win situation for the young person and for society because it helps move people away from cycles of criminality, recidivism and drug/alcohol dependency. “We’re going to continue funding providers to deliver this WATCH service locally, and we’re hoping we can help spread the idea to other parts of the country,” Justine Mecchia said.

The evaluation findings were based on a range of data including review of relevant documentation, client file review and interviews with WATCH participants and their family/whānau, interviews with key stakeholders, and analysis of court data relating to number and types of charges faced.

Overall, evaluation results demonstrated that the WATCH project was meeting its objectives. The Project provided real assistance and support for a group of young adult offenders, typically regarded as hard to treat, to make tangible gains in their lives.  The overriding testimony from the clients who participated in the evaluation was that, because of their involvement with the WATCH project link worker, their lives were better and they had developed beliefs, attitudes, understanding and skills which had been positively life-changing. Critically, these changes included positive shifts with respect to alcohol and other drug use and offending behaviour.

• The total number of charges in the 12-month period following entry to WATCH versus the 12-month period prior to entry to WATCH was reduced by 55 percent and there was a notable shift towards less serious offending
• Clients and whänau participating in the evaluation were overwhelmingly positive about the project and the gains made as a result of their involvement.

The evaluation pointed out that low numbers meant many of the gains that clients made could only be reported from a qualitative perspective. For many clients, one of the most valuable aspects of their involvement was having someone they could talk to and rely on. Some Māori clients gained support to connect more closely with their culture and valued working with someone Māori.  Quotes from clients demonstrated the high engagement with the link worker employed for the project.  Without the help from Rob, a link worker for the WATCH Project, and [the course] life would be completely different; [I] would have gone to prison. (WATCH project client, 2008)

• He did not care that I was in a gang.
• He was willing to work with me where I was at.
• When you are on charges it can be really intensive, there are a whole lot of things going on and you need help. Having someone like Rob is really helpful.
• He walks you through the things that might help.

At a function in Wellington to launch the evaluation District Court Judge John Walker praised the project as an idea whose time has come. He said he hoped the cross agency approach organisations involved included Police, Courts, Corrections,MSD, Capital & Coast DHB, health and social service providers – demonstrated by the project would become the norm in providing interventions services.

Julia Carr former Senior Portfolio Manager, Primary Care at C&CDHB who initiated the project, said WATCH was a small project but highly successful. It has the potential to inspire other people to try something different.

There are great opportunities to work at the interface between the health and justice sectors to engage young people whose needs require more than a series of assessments, referrals and courses, she says.
Many, trapped in low income families with stretched resources, struggling with drug and alcohol issues and recurrent court appearances, end up feeling disconnected from the health and social services that could help them. Fines, debt, relationship issues, employment difficulties, parenting responsibilities and expectations from the criminal justice system can all become overwhelming.

This project was inspired by C&C DHB commitment to youth health and to reducing disparities in health and social outcomes through innovation, intersectoral action and just a little courage.  It builds on the strengths of communities, whānau/families and the young people themselves to address their alcohol and drug issues, and also rekindles a sense of hope to build their confidence to explore new options. It’s about health in the broadest sense of the word.

Article from alcohol.org.nz December 2008 Issue.  Click HERE to see the whole December 2008 Issue.