Young people accessing support or treatment for alcohol and drugs: standards - November 2025

Annex B

Engagement with young people

Scottish Government appointed an independent researcher to lead the co-design work with young people.

We are grateful to the young people who shared their experiences and expectations of services and to the organisations that supported and facilitated this co-design work.

The following themes were proposed by young people to be included in Standards:

1. services need to start before there is a problem

2. different young people need different services

3. accessibility means different things for different young people

4. good support usually takes time

5. consistent, respectful relationships are key

6. safety is a priority

7. the service and workers need to recognise and value the young person’s whole life

8. respecting the young person’s knowledge and ability to make choices is vital

These themes were developed by the working group into the Standards for implementation by local areas:

1. information on Services needs to be widely available so that a young person and their family can get support before substance use becomes problematic

2. young people need a range of services

3. accessibility, means different things for different people

4. good support takes time

5. consistent and respectful support to build positive relationships

6. young person’s safety

7. services should take a holistic view of the young person and value their whole life

8. feedback from young people should be used to improve services

Co-design with young people

The Scottish Government’s Early Interventions for Children and Young People Working Group set out to co-produce with young people, service Standards for young people’s alcohol and drug services. This report outlines the process for engaging young people and the recommendations from young people.

Sixty-four young people engaged in the co-design process. This included care experienced young people, young people who use alcohol and drug services, and young people affected by parental substance use. Sixty-two of the young people came to the co-design process through services.

Design of activity

The researcher leading the project, Dr McMellon, a Senior Research Fellow at Edinburgh University, initially worked with nineteen young people to design a consultation activity that would allow young people to share their thoughts about what makes good alcohol and drugs services for young people and what support they should expect.

The young people involved developed the idea of creating characters who are in need of support for their drug or alcohol use. Over three subsequent meetings with different young people, these four characters were expressed in young-person-friendly language and more information about their lives was added. These young people also developed a set of multiple-choice questions which required them to identify factors they thought were important in young people’s alcohol and drugs services.

Completion of designed activity

The final activity took the young people through the four characters, Kyla, Chenise, Rory and Fasail, discussing what support they need, what would help them to engage with support and what would make them less likely to engage with support.

Two variations on the activity were developed: one for 12–16-year-olds and one for 16–25-year-olds. The primary difference was that the activity for the younger age group only included the two fictional characters that were under 16.

Some of the young people were then supported to go through the activity by a support worker. Fourteen young people aged 12-16 and twenty-seven young people aged 16-25 completed the consultation activities. Some of these young people recorded their responses online, some workers sent young people’s responses, and some young people responded in a group setting with the researcher.

Four young people then supported the consultant to write up the recommendations.

Themes proposed by young people

The following recommendations represent the key themes emerging from the full consultation. The young people who supported the consultant to interpret the themes wanted to emphasise that these recommendations are interconnected and cannot be considered in isolation from each other. The recommendations are not in any particular order and the order does not represent importance.

1. Services need to start before there is a problem:

• Normalise talking about drug and alcohol use in families and communities.
• Make sure there is information about services in the places that young people and families go everyday.
• Support, educate and empower community and religious leaders to support and advocate for young people who may not have support from their families.
• Young people need support about how to support their peers who ask for support or who they are worried about.
• Education about drug and alcohol use needs to be non-judgemental and should cover harm reduction, managing physical and social risks, and possible connections between substance use and other things going on in young people’s lives.
• Young people should be involved in service design to make services more relevant to young people’s lives.

2. Different young people need different services:

• Young people should be able to get support from: youth groups, support in schools, social work, specialist drug and alcohol support workers, GPs, other healthcare providers including pharmacies, counsellors/therapists and residential rehab - not everyone will need all of these, but they should be available to all young people if they need them.
• Long waiting lists are not an excuse for young people not getting help.

3. Accessibility means different things for different young people:

• Online services, phonelines and in person support should be available and the young person should be able to choose which they can access.
• While choice is good it can be overwhelming - young people need clear information and support to help them make decisions about which services to access.
• Young people and their carers should be able to self-refer to services.
• Young people should be able to choose where they meet and when they meet.
• Young people need to know that there will not be police involvement if they access a service.
• Wherever possible, young people should be able to bring an existing support worker or trusted person to support meetings until they feel comfortable to attend alone.
• Online resources should be available in different languages and interpretation should be available for in person support in different spoken languages and BSL/SSE.
• Information needs to be available in visual formats that are aesthetically appealing and adhere to accessibility standards.
• Young people shouldn’t automatically lose a service or go back the beginning of a waiting list if they miss an appointment or if they move address.
• Services should discuss how they will communicate with a young person, ensure that the young person is comfortable with what is agreed and follow through on the agreement.

4. Good support usually takes time:

• Services should not be time limited - where there are genuine reasons why the support must be time-limited, young people should be able to self-refer to the service in the future.
• Professionals should allow young people to take their time to talk about their drug/alcohol use and should not pressure them or ask too many questions.
• While young people understand why initial assessments are sometimes necessary, these can be intrusive and put young people off opening up.
• Services need to give professionals time to get to know young people and work at the young person’s speed.
• The young person and the professional should work together to develop realistic goals for their time together.

5. Consistent, respectful, relationships are key:

• Workers need to take time to build a trusting relationship, and services need to recognise that this is an important part of the work.
• When workers build a strong relationship with a young person it enables them to genuinely tailor their approach to be most likely to be successful for that individual rather than rely on assumptions.
• If workers are perceived to minimise a young person’s experiences or compare them to other people, then this will damage the developing relationship.
• Support will work best where it recognises and builds on existing positive relationships in the young person’s life.
• Young people may need support to build positive relationships with their peers.
• Services need to prioritise consistency and have careful processes for the transitions when a worker leaves their post or a young person has to change support worker for any reason.

6. Safety is a priority:

• Alongside building a positive relationship, harm reduction and safety should be the professional’s focus in earlier meetings.
• Other people in the young person’s life should have access to resources and information about safety and harm reduction.
• Young people recognise that confidentiality is vital and complicated.
• Be honest about the limits of confidentiality before you begin working together.
• The young person’s safety should be at the centre of all conversations about confidentiality.
• Even if you have to tell their parents – or another trusted adult – you can involve the young person in what you say and how you say it so that they feel like you are working together not against each other.

7. The service and workers need to recognise and value the young person’s whole life:

• Issues with substance use and other things going on in a young person’s life are interconnected, so the support also needs to be interconnected.
• A worker should take the young person’s lead on how much they want to address other issues.
• One worker cannot do everything, but building a strong relationship will make it more likely that the young person will be open to ideas about other places they can get support.
• The link between substance use and mental health is very important and needs to be taken seriously.

8. Respecting the young person’s knowledge and ability to make choices is vital:

• Support will be most successful when the worker and young person work together and understand each other but it is not always an easy path to get to this point.
• Workers need to be careful not to treat young people like they know nothing or minimise their experiences or opinions.
• Services should respect and encourage young people’s ability to express preferences and make choices about the support they receive.
• Workers should stay interested in hearing about the young person’s life and recognise that they can learn from hearing about different experiences, opinions and ideas.
• Professionals should respect individual young people’s boundaries - for example, ‘just because you like hugging doesn’t mean I do’.