The four parameters of disclosure
There may be occasions where a young person is putting themselves at risk of serious harm as a direct result of their substance use.
See also risk and protective factors
The four parameters can be used to determine whether confidential information given by a young person should be disclosed to social services or the police because of concerns that a child may be ‘suffering, or at risk of suffering, significant harm’ as a direct result of their substance using behaviour.
Although the four parameters may be of some use without child protection training, to use them properly, you really need child protection training. The parameters are provided for reference only.
1 The age and maturity of the young person
2 The seriousness of the substance use
3 Whether the harm is increasing, decreasing or staying the same
4 The context in which the substance use is set
1 The age and maturity of the young person
As a general rule of thumb, the younger the child, the more difficult it is to guarantee or maintain confidentiality. There is no age limit in law below which a child cannot enter a confidential relationship, but given the problem of establishing competence, and therefore capacity, to consent, it is difficult to envisage children being offered confidential treatment for drug misuse without parental consent or parental involvement, under the age of 13. Indeed, it is possible that a failure to inform parents that a child is misusing drugs could lead to a possible negligence action if the drug service or agency failed to take sufficient action to protect the child from harm as result of that drug misuse.
Protective factors
The child:
- has a good level of maturity without being overburdened with early responsibilities (especially care-giving).
- is able to 'seek help'.
- has a good understanding of risk taking behaviour.
- is open about their behaviour.
- is able to listen to the concerns of others.
- feels in control of their life.
- understands the impact that the substance use is having on other areas of their life.
- has a good knowledge of substance use / or is keen to learn.
Risk factors
The child:
- is under the age of 12.
- is below the maturity associated with their age group.
- has a learning disability.
- has mental health issues.
- unconcerned about their substance use and its consequences.
- has a low level of knowledge about substance use.
2 The seriousness of the substance use
The more serious the drug (or substance) misuse, the more likely it is that disclosure of confidential information to other agencies will have to be considered. In deciding whether or not to disclose, the service must take into account, the level of substance use and the risks involved. The supply source of the young person’s drugs may also be important particularly if the young person in question is open to exploitation.
Risk factors
The child:
- Regular use leading to the development of tolerance or psychological dependence.
- High levels of use, perhaps bingeing - possibly leading to an overdose.
- Drug / alcohol use which regularly suppress appetite resulting in weight loss, or may increase appetite for sugary, processed food.
- The injecting of any substance(this can increase the risk of overdose).
- The use of solvents (especially aerosols), using heroin or crack / cocaine
- If any injecting equipment is shared, it puts the young person at risk of blood borne infections (HIV / Hepatitis C)
3 Whether the harm is increasing, decreasing or staying the same
Harm from substance use needs to be considered in relation to past, present and potential future behaviour. If there is a clear risk to the child or young person arising from present behaviour or evidence of escalated risk to an unacceptable level, it is important that a service takes steps to ensure the future safety of the child or young person.
Risk factors
The child:
- Identifies with substance taking friends.
- Is involved with substance taking peer group and is isolated from positive influences.
- Sees regular drug / alcohol use as a normalised activity.
- Does not have a trusted adult with whom they have a positive relationship.
- Is not able or unwilling to engage with support agencies.
- Finds it difficult to develop or re-engage with a positive social support network (involvement in positive recreational activities).
Family
- Drug and alcohol use is entrenched within the family (this include parental or sibling substance use.
- The family is socially excluded (e.g. involvement in criminal activity, substance misuse) and is not willing to engage with professionals / agencies).
4 The context in which the substance use is set
Where a child or young person has multiple problems, it is likely that other agencies or professionals will need to be involved to resolve these problems or reduce the vulnerability and risk to the child or young person.
Risk factors
The child:
- Is pregnant.
- Is engaging in behaviour which puts them at serious risk (including unsafe sex, risk of physical injury).
- Is receiving threats of or actual violence due to involvement in drug/alcohol use (violence due to debts to suppliers etc).
- Is excluded or not attending school.
- Is vulnerable to abuse, including prostitution.
- Has emotional development impaired (linked to substance use) through depression, anxiety, impulsive or inconsistent behaviour.
- Is engaged in criminal or antisocial activities.
- Has low self esteem.
- Ises drug / alcohol as a way of coping with emotional difficulties in the absence of alternative skills or strategies.
- Has negative self image.
- Not attaining maturation "milestones".
- Has aggressive behaviour or passive behaviour.
- Has difficulties in building positive relationships with others.
- has a disregard for rules / boundaries.
- Has neglect of physical care linked to drug and alcohol use.
- Has antisocial behaviour.
- Has mental health issues possibly linked to substance use.
- Has low levels of motivation.
- uses drugs / alcohol to boost confidence.
- has criminal activity (whether to fund drug and alcohol use or not.)
Parents
- Reaction from parents to their child's drug /alcohol use which puts the child at serious risk.
- Poor parenting.
Based on Crown Copyright material. First steps in identifying young people's substance related needs.
Standing Conference on Drug Abuse (SCODA) 1999 (now Drugscope) and The Children's Legal Centre.