Children’s Services Case Study
Case Study Title:
Young People attending Accident and Emergency department
under the influence of drugs and/or alcohol
Completed By:
Natasha Mason, Petra Farmer, Elaine Hurry
Completed Date:
October 2010
Inspection Framework: Reference to which of the key elements / judgements /
criteria does this case study cover?
Partnership Working
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Partnership working and communication, at all levels, including across the voluntary
and community sectors is well established and promotes safeguarding
The contribution of health agencies to keeping children and young people safe

Arrangements are in place in emergency departments to identify children who are at
risk and to communicate concerns with social care partners.
What was done and why?
Referral Pathway between Accident and Emergency and T3 (young persons substance
mis-use service)
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Young person presents at A&E under the influence of drugs or alcohol
Paediatric liaison nurse identifies potential safeguarding risk
Paediatric liaison nurse refers directly to T3’s hospital and police worker
All referrals are diverse and made in non judgmental manner, referrals are also made
in response to need.
Where complex / immediate needs are present, crisis interventions are delivered.
On 24 February 2010, a referral was received due to an A&E attendance with overdose
and disclosure of cannabis use. Young person was 16 years old, is a ‘not in education
employment or training (NEET). The parent was contacted and and an appointment to
offer assistance around substance misuse was arranged for the young person.
Young person was estranged from his biological father and is of dual heritage, Young
Person had no Afro Caribbean role models in his life which has had an impact on his
identity. No confidence, little eye contact and low self esteem.
A home visit was completed on the same day and young person agreed to T3
intervention. Care plan and assessments completed.
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Young person disclosed that he had been smoking cannabis for two years, and had
increased the amount in the last three months; he disclosed that he had not attended
school for a year and had various interventions from other agencies in Walsall. Young
person was reluctant to engage in CAMHS (child and adolescent mental health services)
and admitted to being on the periphery of drug dealing and gang activity.
T3 worker built a working relationship with young person and gained his trust prior to
commencing interventions, due to him having little trust in service provisions.
T3 worker assisted:
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young person in attending CAMHS appointments, with support of his mother
referred parents to Poppies for family support
liaised with Spurgeons and Walsall Street Teams to encourage interagency working.
Personal goals were set with the young person, including harm minimisation techniques,
psychosocial interventions, identity work and support in accessing training and housing.
The young person attended T3 for regular acupuncture appointments for withdrawal from
cannabis use. Personal relationships advice and condom demonstration were also given,
and condoms distributed as sexually active.
A referral was made to Nacro (seen and heard’ mentoring project), for him to train as a
young person mentor. A Walsall College application was also completed to train in health
and social care.
T3 encouraged the young person to assist in the recruitment process, as an additional
member, on the interview panel at T3 to recruit a new member of staff; his involvement in
this process was of paramount importance.
Young person has now moved into supported accommodation.
The young person along with his parent and siblings were offered a holiday with support
of Poppies. Mother is now regularly accessing alternative therapies for stress
management and improving parenting skills.
What difference has it made for children, young people and their families, how do
we know?
Young person has
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become part of young person’s service user’s involvement forum, attending a
national strategy meeting.
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enrolled at Walsall College.
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moved into own accommodation and is thriving.
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a stronger relationship with parents, extended family and siblings.
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secured a part-time job in a national retail store
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now gained a much healthier peer group and is no longer associating with previous
friends.
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has reduced the amount of cannabis consumed massively (he now has control of
the substance, rather than the other way round. Completed all of his treatment with
CAMHS (over 6 month period)
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a totally different demeanour, now holds himself with pride and confidence.
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developed skills in service user involvement / interview situations.
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