Interventions in schools to prevent and reduce alcohol use among children and young people

NICE have published their guidance on school based interventions to prevent and reduce alcohol use among children and young people.

The introduction to the guidance makes it clear that its scope goes beyond schools:

The guidance also covers pupil referral units, secure training units, local authority secure units and further education colleges.

It is for teachers, school governors and practitioners with health and wellbeing as part of their remit, working in education, local authorities, the NHS and the wider public, voluntary and community sectors. It may also be of interest to children and young people, their families and other members of the public.

The guidance makes it clear that there are:

no national guidelines on what constitutes safe and sensible alcohol consumption for children and young people, so the recommendations focus on: encouraging children not to drink, delaying the age at which young people start drinking and reducing the harm it can cause among those who do drink.

Recommendation 1 is the critical one (from our perspective) as it addresses what schools and other education settings should do about education and advice. The actions they recommend are:

• Ensure alcohol education is an integral part of the national science, PSHE and PSHE education curricula, in line with Department for Children, Schools and Families (DCSF) guidance.
• Ensure alcohol education is tailored for different age groups and takes different learning needs into account (based, for example, on individual, social and environmental factors). It should aim to encourage children not to drink, delay the age at which young people start drinking and reduce the harm it can cause among those who do drink. Education programmes should:
  • increase knowledge of the potential damage alcohol use can cause – physically, mentally and socially (including the legal consequences)
  • provide the opportunity to explore attitudes to – and perceptions of – alcohol use
  • help develop decision-making, assertiveness, coping and verbal/non-verbal skills
  • help develop self-esteem
  • increase awareness of how the media, advertisements, role models and the views of parents, peers and society can influence alcohol consumption.
• Introduce a ‘whole school’ approach to alcohol, in line with DCSF guidance. It should involve staff, parents and pupils and cover everything from policy development and the school environment to the professional development of (and support for) staff.
• Where appropriate, offer parents or carers information about where they can get help to develop their parenting skills. (This includes problem- problem-solving and communication skills, and advice on setting boundaries for their children and teaching them how to resist peer pressure.)

Recommendation 2 asks schools to develop interventions for pupils who are thought to be drinking harmful amounts of alcohol. The recommendation suggests brief interventions pointing out the harmful effects of alcohol, how to reduce risk and where to get support. The other active suggestion is to refer the young person to appropriate services. All of this must be done while being cognisant of:

best practice on child protection, consent and confidentiality. Where appropriate, involve parents or carers in the consultation and any referral to external services

Recommendation 3 focuses on the partnerships that may be needed to deliver the interventions. This includes developing partnerships to:

• support alcohol education in schools as part of the national science, PSHE and PSHE education curricula
• ensure school interventions on alcohol use are integrated with community activities introduced as part of the ‘Children and young people’s plan’
• find ways to consult with families (parents or carers, children and young people) about initiatives to reduce alcohol use and to involve them in those initiatives
• monitor and evaluate partnership working and incorporate good practice into planning.

NICE have developed tools which they expect will help local agencies (including schools) to deliver the guidance, these can be found here.

In summary they suggest that there should not be additional costs associated with Recommendation 1, as:

Drug, alcohol and tobacco education is part of PSHE, PSHE Education and Citizenship, and is also included in National Curriculum Science at key stages 1-4.

The new PSHE and PSHE education curricula, which are being introduced from September 2008, move away from an emphasis on content and instead promote concepts such as ‘healthy lifestyles’. They should be tailored to meet individual needs. Alcohol education involves promoting a healthy lifestyle as harmful drinking is linked to a range of health-related problems.

With Recommendation 2 they say that there isn’t a current definition of what constitutes harmful drinking for young people. They expect this to be addressed by the expert working group being brought together by the DCSF at the moment. As a result they say:

Depending upon the definition of harmful drinking in children and young people and the likelihood of those young people and children identified accessing the recommended services, there may be an increase in the number of referrals. Once the number of children affected by this recommendation can be fully identified, an assessment of any additional training needs which may arise is required and additional training provided.

Again with Recommendation 3 NICE suggest there should not be any additional costs:

Schools, local authorities, PCTs and children services already work in partnership on the national Healthy Schools Programme. This covers PSHE and PSHE education, including education on drugs including alcohol. It is therefore assumed that this recommendation will not incur any significant additional costs to involve other organisations where appropriate.

Filed under: NICE, alcohol