Emerging practice: Interventions and Pathways
Information on interventions provided by YJLD pathfinder sites and case examples of successful liaison and diversion intervention.
YJLD worker coordinating multi agency support
The YJLD worker picked up a young person with a worrying offence after checking the local police/YOT information sharing system. Looking at the local data systems, he picked up that there were child protection concerns about other children in the family but none had been logged concerning this young man who was now 14 years old. He made a home visit to find that the family was very on edge. They would not let him into the house but consented to him talking to the young man 'for 10 minutes' outside the house. The young man revealed that the family had been told that his mother would be sectioned that day and they had all barricaded themselves in the house. He agreed to see the worker again when things had 'calmed down'. The worker was concerned about this situation and returned to the office and made emergency calls to all other agencies involved to share information on developments, to review immediate action to promote the safeguarding of the children and to suggest an emergency multi agency panel to plan a coordinated pathway forward.
YJLD worker advocating on behalf of the young person and their family
A young woman was arrested for possession of cannabis and was diverted to attend, along with her mother, an appointment with the YJLD worker for screening.
The worker picked up some parenting issues but also some reluctance on the part of her mother to engage with any parenting support work. It also transpired that the young woman had been excluded from school in the day preceding her arrest. The worker felt that there were grounds to liaise with the school to explore the exclusion. She encouraged the mother to arrange an appointment and offered to attend with the family. This meeting went well and the exclusion decision was reversed after all agreed to a package of support.
This practical help also helped to engage the young woman and the mother paving the way for a package of individual and parenting support.
Delivery of brief intervention while waiting for full assessment
A 15 year old young man who had been picked up with a knife had been referred by a police officer who had been troubled by some comments made by the boy’s mother. The YJLD worker visited the home and picked up a number of issues.
The boy had started to carry the knife mainly as protection because of previous experiences of domestic violence directed both at him and at his mother by a former partner. The young man also disclosed some experiences which were really disturbing him and which suggested to the worker that he may be experiencing the early stages of psychosis. Although very disturbed by some of his experiences (he had experienced the TV in his bedroom talking to him), he was also anxious about linking with mental health services. The worker explained the real benefits of catching things like this early and the young man was convinced and agreed to a referral. A referral was made to a specialist team locally dealing in Early Intervention in Psychosis. There was a short wait for assessment.
The health worker continued to provide support to the family, as well as picking up additional information to help the specialist assessment. The health worker also completed a brief cognitive intervention in relation to the young man’s management of his anxiety (which linked to knife carrying). The young person continued to go through the court system where he received a referral order to address the specific issue of knife carrying but the package of care also included a robust package of voluntary health treatment and support from the Early Intervention in Psychosis team.
Emergency practical help delivered by YJLD worker
James was in the police cells after being removed from his home due to an angry dispute with his mother. He attempted to self harm when he was arrested and was making continuing threats to hurt himself. The YJLD worker was called in to talk to James by the police sergeant and the duty child and adolescent mental health services (CAMHS) team were also contacted to attend the police station a while later.
An overnight ‘risk management’ plan was jointly developed between the CAMHS team and the YJLD worker (who liaised with James’ mother). The plan involved James being supported back home that night by the YJLD worker, being followed up first thing the next day and taken to a ‘fast track’ specialist CAMHS appointment the for fuller assessment of his and his family’s ongoing support needs.
The YJLD worker provided wraparound support to the young man and his mother while he waited for a support package to be organised.
Ongoing support provided by YJLD worker
Carl, a 17 year old young man was arrested for theft of a small amount of money. Carl was given a Final Warning and later referred to the point of arrest Youth Justice Liaison and Diversion project after disclosing to the police that he had previously overdosed several times.
The YJLD worker completed an initial assessment. Carl had never known his father, and his mother had left, leaving only a note, the previous Christmas. Carl was living alone and had to budget his money independently. He struggled to maintain relationships and others took advantage of his giving nature. Carl did not meet the threshold for specialist CAMHS services.
The YJLD worker completed a brief ‘wraparound’ intervention with Carl providing practical help and support with benefits, organisational skills, budgeting and developing interpersonal boundaries. Carl took another overdose during the time he was in contact with this worker. However, he came to see the YJLD worker of his own accord to talk things through after getting out of hospital. The YJLD worker liaised with local health and social services to strengthen their responses to promote his safety but the worker continued to monitor progress. Carl also worked with the YJLD worker on the triggers for his overdose attempts and on his coping skills. Carl has since gone from strength to strength and, supported by the encouragement of his worker, independently set up job interviews and looked into apprenticeship schemes, planning for his future.
After continued engagement with his YJLD worker, Carl also disclosed obsessive-compulsive disorder type symptoms revealing patterns of repetitive behaviours often absorbing up to 2 hours of his day. The worker was able subsequently to link Carl with specialist evidence based support and he showed continued improvement.
Carl eventually came off benefits and secured a full time job, is working well and is becoming more independent. He is managing his rent and bills on his own. He subsequently experienced a domestically abusive relationship which resulted in him suffering significant injuries. However, even at this later point, Carl re-connected with the YJLD worker who was able to support him through this. Carl has not taken an overdose for many months now and has described being able to stop himself when urges to self harm become strong. Carl has started to develop positive relationships with a few work colleagues. Carl is looking forward to his future.