Developing and operationalising a multi-component drug outreach service for young people aged 16-25 in England

Background: 

In England over the last decade young people’s illicit drug use and drug-related harm has increased whilst youth-specific provision, and referrals for specialist substance use support have decreased. Recreational drug use is often normalised with young people not recognising the risks.

Since 2019, a pioneering ‘1625-Outreach’ service has delivered universal, selective, and indicated drug prevention interventions to young people aged 16-25 in both urban and rural settings in Derbyshire, England. The unique multi-component model aims to reduce demand for illicit drugs and associated risky behaviours by increasing knowledge, skills and resilience through education, responsive outreach, festival stalls, night-time economy interventions and targeted social media campaigns. 

Interventions are guided by multi-agency stakeholder input, targeting those most vulnerable to drug use at key transition points where risks are highest. This enables support to diverse, underserved groups, who typically do not engage with services

This paper explores how to operationalise a multi-component co-produced model, its translatability and sustainability and creative ways to demonstrate its impact. 

Methods

A scoping review of the drugs outreach and community engagement literature was conducted. A Patient and Public Involvement group of young people informed the research design, and a Stakeholder Advisory Group oversaw the research activity.    

The fieldwork defined the strands of the model, and explored its place in the wider system, the workforce’s leadership, knowledge, credibility and communication, and measurable outcomes. Fieldwork comprised: logged observations in ten outreach settings; focus groups with three diverse groups of young people (N 19) representing age cohorts 16-17 and 18-25 (co-producing a Theory of Change), and two practitioner groups (N 12). Two participatory workshops (young people/stakeholders) facilitated further exploration of emerging themes (N 54). Qualitative data from each activity was recorded and analysed thematically.  

Results

The multi-strand/multi-agency model was agile, facilitating innovative responses to changing drug use in the local area. Multiple placed-based approaches including digital outreach reached significant numbers of underserved groups including those with neurodiversity, LGBTQ+, and not in education, training or employment. Lived experience of workers gave credibility and trust to relationships, and the team’s position as  lead agency in a multi-stakeholder system facilitated verification of local intelligence and rapid response. 

Conclusions 

The model’s place in the system allowed ‘expert’ leadership that inspires confidence and commitment. Its translatability and sustainability is ready to be examined through its replication and implementation in Sheffield, England. Further study across the two sites will demonstrate the impact on young people’s knowledge, confidence and resilience to prevent drug-related harm.