2.4.6 Drug Using Screening Tool (DUST) |
RELEVANT CHAPTERS
Contents
1. Introduction
Every child and young person should be screened using the DUST (Drug Use Screening Tool) at least once per 12 month period (between 1st October and 30th September). (Please refer to protocol for details regarding when a DUST should take place more often than once per year).
The DUST is a tool to enable non-specialist workers to speak with young people regarding drugs and alcohol; to distinguish whether there is a substance mis/use issue and identify potential risk levels; and to consult or make referrals where appropriate.
Wherever possible the DUST should be completed as a result of directly engaging the young person in conversation regarding the three sections on the DUST form (substance use, social situation/behaviour, and general and psychological health).
The DUST should be recorded as a discrete episode on Frameworki a minimum of once per 12 month period (between 1st October and 30th September), whenever an issue is identified. (Please see protocol for further detail regarding Frameworki recording).
Whenever a substance mis/use issue is identified workers should consult with the LCAS Substance Misuse Social Worker, in the first instance, around ways of working with/engaging the young person, and to discuss potential referral scenarios.
2. DUST Protocol
This protocol is informed by the Care Matters: Transforming the Lives of Children and Young People in Care paper and Every Child Matters: Change for Children - Young People and Drugs document, which identifies children and young people who are in, or have been through, the care system, as vulnerable and potentially 'at risk' of substance misuse. 'Choosing not to take illegal drugs' is an aim within the Every Child Matters outcome, 'Be Healthy'.
This protocol has been developed in order to ensure that young people who are at risk of developing substance misuse issues are identified as early as possible to prevent harm and to enable them to be able to reach their full potential. The Updated National Drug Strategy (2002) emphasises the importance of reducing drug use by young people, and proactively screening for this will aid in prevention and early intervention as well as supporting those in crisis. Screening is an ongoing process; the time frame given in this document serves as a guideline only and does not negate the need to consistently monitor a young person's well being, including potential and actual substance misuse issues, throughout the working relationship.
The DUST (Drug Use Screening Tool) has been purchased by Haringey DAAT to assist the borough to ensure a consistent approach to screening and assessing young people's substance misuse needs across all services; to put in place clear referral systems; and to build a reliable database of young person's substance misuse needs in the borough. It is to be used as a guide for engaging young people in conversation around substance misuse and other risk factors in order to proactively identify issues and provide support for young people where appropriate.
The following lays out guidance for the use of the DUST by the LCAS.
Every young person should be screened for substance misuse using the DUST. For the Leaving Care Team this will take place at the point of their referral being received. For the Unaccompanied Minors Team this will take place for clients aged 12 years onwards (unless there are substance misuse indicators evident at a younger age), and the DUST will take place following the initial assessment and incorporated into the core assessment as part of that process.
The DUST should be completed as a result of directly engaging the young person in conversation regarding the three sections laid out on the form (substance use, social situation/behaviour, and general and psychological health). As such, the DUST is not a tool to be used in isolation from the young person without their input, and, as best practice, workers should not assume whether any issues do or do not exist, on their clients' behalf. (Exceptions may include cases where the young person is missing, or where the young person regularly presents as intoxicated but refuses to discuss this despite their workers' best efforts). Conversations about substance misuse should be carried out in an age-appropriate manner.
If a young person refuses to engage regarding the DUST, then their wishes should be accepted, and noted on Framework - I, specifically recording that the worker attempted to complete the DUST, the date this occurred, and the reasons why the DUST was not able to be completed. (Please note, as best practice the worker should explain to the young person the purpose of the DUST, the reasons for asking about substance misuse, and how the information will be recorded. This will allow the young person to make an informed decision, as well as understand that this is meant to be a respectful and supportive exercise in order to ensure their well being. This will also encourage engagement as part of a supportive and transparent process).
If substance misuse is identified as being an issue for the young person, consultation should take place with the Substance Misuse Social Worker as procedure in the first instance. This reflects best practice, as well as being a valuable method of recording and monitoring support and referral pathways. If a referral is indicated the worker should, with the young person's permission, be referred to In-volve Haringey or the LCAS Substance Misuse Social Worker. The LCAS Substance Misuse Social Worker can provide support to help determine if a referral to In-volve Haringey is necessary. Alternatively, the LCAS Substance Misuse Social Worker is available for consultation regarding substance misuse and ways of working with the young person. This will be particularly relevant in instances where the young person does not give permission for a referral, does not wish to engage at this stage, or does not see their substance use as an issue for concern.
If the young person is referred to In-volve Haringey, then the DUST form will be used as the referral form. If the DUST does not reveal substance misuse issues and the worker has their suspicions that these do exist, then the DUST should be redone three months later. (At this point, the working relationship may have further developed between the worker and the young person and the young person may be willing to disclose more at this point).
If, after completing the first DUST, the worker feels that the young person has been honest and reported openly regarding substance misuse, then a follow up DUST needn't be completed until 6-12 months later. However if the young person's circumstances change (i.e.) they become homeless, they are NEET, they suffer loss or bereavement, they start offending or their rate of offending increases, etc., then the DUST should be reapplied.
When risk factors other than substance misuse are identified the DUST should be applied again within the next 3-6 months. The young person should also receive interventions around information and education and, with their permission, be sign posted into services that offer support in preventing substance misuse (i.e.) Positive Futures, KICK at Tottenham Sports Centre.
If there are no substance misuse issues at the start of the young persons' involvement with the Leaving Care and Asylum Service, then the DUST does not need to be reapplied until 12 months later. (However practitioners should be aware of significant life changes and obvious signs and symptoms of substance misuse).
In any case a DUST form should be completed with a young person once per 12 month period (between 1st October and 30th September).
3. Recording the Dust/Framework - I
The DUST should be recorded as a discrete episode on Frameworki a minimum of once per 12 month period between 1st October and 30th September. This recording mechanism is set up as a discrete episode on Frameworki. The episode consists of two parts;
- "DUST Survey Form"
and, - "Substance Misuse". Both parts should be completed each and every time a new episode is recorded (only exception being if the young person is missing or refuses to discuss, in which case only the "Substance Misuse section will be completed).
"DUST Survey Form" refers to the recording of the DUST form specifics, and enables the information to be collected systematically and consistently so that issues, needs, gaps and patters can be monitored, both for the service and for the borough.
The "Substance Misuse" section of the episode records substance misuse related OC2 information which is a statutory requirement for all local authorities. This information is collated annually.
4. Support for Staff
The LCAS Substance Misuse Social Worker is available to support staff regarding use of, and recording of, the DUST.
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