Exploring the broader issuesIt is important to consider some of the possible risks or outcomes during or after an episode of intoxication or overdose. Once you have determined that the young person is in no immediate physical danger, you can begin to examine some of the broader issues in the young person's life. The relevance of the youth-focused systems approach discussed in Topic 2 now becomes apparent. For example, you may now need to find out more about the individual in terms of their general health, any mental health issues and other factors to help inform the ongoing assessment of the young person's needs. Use the diagram in Topic 2 as a prompt to remind you of the factors that you might need to consider in assisting the young person.
You may also begin to explore such family factors, as the young person's relationship with their parents, as well as broader environmental issues such as need for accommodation and other support services. This involves a more holistic, community-based approach with the worker identifying support services that may assist the young person's immediate needs. It may or may not be part of your role to undertake further assessment of the young person. You should clarify your organisation's core role and policy in relation to working with young people if you are unsure.
Remember that not all episodes of intoxication are the result of underlying problems such as abuse or trauma. So it is important not to assume that the young person has well established and problematic patterns of AOD use.
Health factorsHowever, factors relating to a young person's intoxication may be due to individual factors such as potential health complications or mental health problems. Depending on how lucid the young person is, and whether you have other sources of information (such as peers who may be able to provide information about who should be contacted), it is important to find out some more information about the young person. If at all possible, it is important to maintain communication with the young person, so that they do not feel excluded in your attempt to assist them.
Key issuesSome of the key issues that you might consider in relation to the young person include:
- What is the young person's general physical condition? You may be able to gauge from their clothing, hygiene and general appearance whether they are likely to be weak and malnourished.
- Are there any existing or likely health problems? Try to find out if the young person has any existing health problems.
- Has there been any history of mental health problems? Have they previously been diagnosed as having any psychiatric condition, seen a health professional for psychological issues, been on medication for a psychiatric condition, shown symptoms of depression, extreme anxiety or psychotic thinking and behaviour? Top of page
- What is the young person thinking, feeling and planning? Remember that the risk of self-harm and suicide is higher amongst young people who are highly intoxicated (NHMRC, 2001). Have there been recent attempts to harm themselves and/or others, or have they expressed intentions to self-harm or harm others? Do they possess (or have access to) weapons?
If a young person seems agitated, depressed or desperate about their situation, they may be at risk of self-harm without declaring their intentions. Intoxication can greatly exacerbate extreme feelings, impair reasoning and judgement, and distort reality. This can lead to impulsive, spur-of-the-moment decisions to harm oneself.
Do not be afraid of raising the issue of self-harm with the young person. Ask if they are thinking of hurting themselves and whether they have made any plans for self-harm. Take every precaution to protect the young person from self-harm by notifying other workers and relevant authorities. Potential self-harm or harm to others justifies breaking confidentiality.
- Are they living in stable accommodation and is it safe for them to return? Ascertain where they are living and whether the arrangement is a stable one
- What (if any) other high-risk activities are they engaging in?
- Has the young person previously had contact with you or another agency? If the young person already has a rapport with a worker from your own or another agency, is it possible to contact them? Could they be of assistance in helping the young person?
- What does the young person want to happen? Addressing the needs of a young person also involves determining what they want to happen. On occasions, what they want may be so potentially harmful (e.g. more drugs to use immediately) that you may have to override their desires in order to protect them and/or others. However, at other times their wants, even if quite unconventional, can be accommodated. This will greatly increase the chances that they will engage in treatment after sobering-up or in the future. Some examples of a young person's immediate concerns could be:
- making contact with friends or family members
- a request to see a specific staff member known to them
- accommodation needs/assistance with homelessness
- addressing general health needs including mental health issues
- protection from abuse and neglect
- assistance with sexual abuse and/or trauma
- attention to pressing financial or legal issues
- close support and supervision
- to watch a video or listen to/play music
- to be left alone (with supervision from a distance).