The bleedin' obvious: long-term support reconnects at-risk young people.

Twenty young people with a history of incarceration, substance abuse and disconnection provided Whitelion with insight into 'what worked' in changing their at-risk behaviours. The answer was obvious--state support beyond 18 years of age, perhaps until the mid-twenties. These young people require specialised intervention, and help accessing community structures, particularly jobs, which would ordinarily be out of reach. One program recommended as a viable model for Australian community organisations wanting to reconnect young people is the rigorously evaluated Job Corps program (USA), which integrates accommodation, long-term support and employability training programs.

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Can't we get you on Mastermind, Sybil? Next contestant--Sybil Fawlty from Torquay, special subject the bleedin' obvious.

Basil Fawlty (Fawlty Towers: The complete collection 1975)

Initial expectations were that the teenage remodelling might stop at eighteen, nineteen maybe twenty and now we're just looking at the brain imaging and looking at cognitive development--probably twenty-five. So you know if we say adolescence starts at twelve, if you're still developing into your twenties, eighteen is almost in the middle of that. Wood (2005)

The material in this paper is drawn from Building Bridges (Lemmon 2006), the third in a series of studies of at-risk young people involved with the Melbourne-based Whitelion program. Whitelion provides employment, mentoring and role modelling opportunities for young people who have been involved with the juvenile justice system. In an attempt to identify "what works", 20 young people (between the ages of 19 and 24), who were demonstrating significant positive life changes, participated in a series of in-depth interviews. Rather than provide a comprehensive overview of all young people in the Whitelion program, the study endeavoured to find common themes among young people who have successfully put their lives back on track. They discussed their alcohol and illicit substance use; connectedness to family, friends and community; their experience of the juvenile justice system; and their participation in employment and educational programs. They were asked to comment on their perceptions of changes in behaviour and attitude, and whether they believed that any programs, including Whitelion, had contributed in some way to these.

It will be argued that the participants were only capable of finding their way into early adulthood and reconnection to the community because a significant layer of supports and interventions was extended into their early to mid-twenties rather than being pulled from under them when they ceased to be under the care and control of the state at age 18 or younger. Despite frequent occurrences of outrageous and self-destructive behaviour, they were not abandoned. Instead, they were given access to a range of opportunities from which their lack of education and qualifications would ordinarily preclude them. Unlike many with similar backgrounds, they were supported and lifted back into society.

   Yeah it's growing up, I'm sure there are a lot
   of people out there who don't want to do this
   anymore but they have no way out.

   Female, 24 years

Support that is available for as long as it is needed, allied to creative interventions providing jobs, appears to be an effective approach in enabling young people with a history of incarceration, substance abuse and disconnection to develop into responsible, connected adults. Wald and Martinez (2003) contend that the dearth of support systems for disconnected young people may be one of the most significant factors inhibiting their attempts to claw their way into the mainstream of society. Remove support at a critical juncture and their lives may go into permanent freefall.

From previous studies of Whitelion clients (Lemmon 2001, 2004) through to the current investigation, it was blindingly obvious that, almost to a person, the participants wished to radically change their lifestyle. However, once caught up, it was extremely difficult to find a path out. The young people offered clear insight into how the system could be reconfigured to aid in this process.

The evidence from Building Bridges suggests that the time may have arrived to extend our support and intervention systems well beyond the standard coming-of-age moment. In the mainstream, one's 18th birthday is a time of loosening barriers and a gentle step into adulthood (you can drink, gamble, smoke and vote) but, in essence, life goes on as before. For young people in the care of the state, their 18th birthday gift was, until recently, and is, unless they actively "opt-in", the door slamming in their face.

The seeds of real behavioural change in this group may well have been planted earlier but they appear to have grown only during the period from the late teenage years through to the early twenties. All of the young people in this study highlighted the crucial importance of having responsible, supportive adults in their lives to whom they could turn to again and again for help with community connections, health issues and employment opportunities. This support is not dissimilar to that which families provide to the majority of our young people. The most significant finding is that "what works" is in fact the "bleedin' obvious": long-term support and intervention beyond 18 years of age.

Factors for positive change?

Research into at-risk young people returns to the same themes: their lives are marked by problems, such as substance misuse, criminality, unemployment etc., which are intimately related to an individual's alienation from the community, a lack of connection to safe and trustworthy adult figures and a belief that they do not belong (Smith 2004; Department of Premier and Cabinet 2005; Loxley, Stockwell & Toumborou 2004; Philip, Shucksmith & King 2004). The focus of this paper is on factors that have contributed to positive change in a group of 20 young people who have not only survived a long period of at-risk behaviours but who are, by their own measure, developing bright futures.

State support

In an ideal world, a control group, those who had been given the opportunity to participate in Whitelion programs but had declined, would have been established and their trajectory over a similar period measured. However, as documented by the Victorian Department of Premier and Cabinet (2005), when young people leave the juvenile justice system and / or care and control of the state, there is no significant monitoring of their movements which makes them extremely difficult to locate and contact.

Participant: "I needed a lot of support with drug and alcohol stuff--I had been using heroin since I was 11."

Interviewer: "So how come you started using heroin at 11, that's pretty young?"

Participant: "Family stuff."

Female, 24 years

The evidence from this group is that the journey from the development of the initial problem through the period of dependency to the stage of substantial control over their substance use, and the direction their life is taking, typically constitutes a 10-year struggle. This time span has significant implications for agencies concerned with identifying best practice in working with young people to overcome disconnection and substance abuse problems. The Whitelion approach highlights the importance of a long-term commitment and the capacity to develop individually tailored responses to each person's unique set of circumstances.

There has been recognition in a number of jurisdictions in Australia, including NSW and Victoria, that the state has been too eager in the past to relinquish responsibility for young people in their care. In 2005, the Victorian Department of Premier and Cabinet developed guidelines for a significant increase in involvement with this target group. The guidelines recommend that:

* young people be contacted rather than left to seek out support;

* the state acknowledges a spectrum of reasons for disengagement and that responses need to be individual;

* the state introduces a universal follow-up of all disengaged young people over several years.

* each young person leaving care is provided with an individually tailored suite of support, ongoing general counselling and a stable adult presence over several years.

Participant: "Once I had my freedom, I pretty much got up to mischief straight away."

Interviewer: "That's nicely put. You obviously knew where to find mischief."

Participant: "Yeah, it found me and I found it."

Female, 24 years

Incarceration as a positive experience

   If I hadn't gone to Parkville and being in
   Whitelion, I would have been dead.

   Female, 23 years

All 20 of the young people in Building Bridges had been incarcerated as a result of their involvement in the juvenile justice system. The prospect of long-term disconnection is exacerbated by the negative effects of incarceration on future school completion and employment prospects and by recidivism rates of over 50% (Wald & Martinez 2003, p.9).

It would appear that staying out of jail was a major incentive for participants to change the direction in which their lives were going. For many their incarceration was intimately connected to their heroin use. Time spent in Parkville, a Melbourne juvenile justice centre, reduced their access to heroin and other substances and gave them time to think. It gave them an opportunity to experience life without being substance-affected. For example, one 24-year-old female stated that she used her time in Parkville to reflect, "I had six months to think about it, before I got out on parole, and I just thought it is either now or never".

It was also at this point that participants were receptive to contact with a range of responsible adults--staff from juvenile justice and Whitelion--who were able to offer guidance, support and opportunity. Many young people felt that these adults had a "belief" in the young person's capacity to overcome the challenges he or she was facing in life, and that this was a significant factor in their making tentative steps towards a new life. For example, a 24-year-old female felt that this level of support played a key role in her changing her life:

   A lot of people say it is up to the person, but that's not totally
   true. It is up to the person, but they have to have the support
   there to be able to pull through. And I was lucky to have that
   there [Whitelion and Parkville]. Ultimately it was me that changed
   my life, but I had support there, people telling me you can do it,
   you will do it and we are going to help you do it.

Very few of the young people spoke negatively about their experiences in the juvenile justice system. Parkville was referred to, only half-jokingly, as a "holiday camp", "easy" and "a holiday" by several participants. This was because they believed that both the Parkville and Whitelion staff were committed to helping them rather than punishing them: as one 24-year-old female stated, "I didn't have a hard time in there, but I learnt a lot about myself. I had a lot of counselling, I had a lot of time to think".

However, it must be emphasised that the threat of getting caught up in the adult justice system appears to have been a powerful tool in motivating change. A 19-year-old male stressed that, "after I went to the cells, I swore to myself that I didn't want to go back. I wanted to work hard to stay out".

There is much to be said for removing at-risk young people from an environment that encourages them to perpetuate their antisocial and dangerous behaviours. Most people adjust to the norms set by the groups that they are embedded within, thus if everyone around you is using heroin then you are likely to use too. Equally, if you are a member of a social grouping that values and rewards positive behaviours then you will be more likely to respond to these. A 24-year-old female stressed the importance of completely changing her group of friends and acquaintances: "I see a lot of familiar faces in the city from Parkville and they are still where they were years ago. That's why I don't really want to say hello".

It should be stressed that this is not an argument for the introduction of greater levels of incarceration for young people, indeed for many it is a terrifying experience that can result in further trauma including physical, sexual and emotional assault as well as interaction with more "criminally hardened" peers. However, for most in this particular cohort, their substance abuse was the key problem, and while incarcerated they chose to tap into the support offered rather than the negative opportunities.

Changing substance use behaviours

Eighteen of the 20 participants stated that they had significant problems in the past with their substance use (heroin was the major issue for 14 participants). Substance abuse developed hand-in-hand with other life crises; they were little more than children when they began using (the average age was 14 years), and emotionally vulnerable children at that.

Participant: "I was an alcoholic when I was 15 so I never really went back to being an alcoholic."

Interviewer: "So how did you manage to stop drinking? What did you do to stop?"

Participant: "I moved to Melbourne and discovered heroin."

Female, 20 years

Darke, Ross and Teesson (2007, p.49) contend that the younger a person is when they start using heroin, the greater the likelihood of ongoing dependence and severe drug-related problems. Even taking Spooner & Heatherington's (2004) evidence of an exponential rise over the last decade or so in the number who have used illegal drugs (in 2001, only 20% of 20- to 24-year-olds reported that they had never used ecstasy), the level of substance use in this group of young people massively exceeds our recalibrated norms. It was only as they made the transition into adulthood that most were psychologically and emotionally able to make the decision to break their dependency.

All 20 of the young people who participated in the study believed that they now had significant control over their use of substances. This finding must be treated with a degree of caution as it is not unusual for people to under-report their use of illicit substances and, further, the author did not clearly define what was meant by "significant control". For example a 24-year-old female stated, "it's been three years since I've been clean, but I started on the buprenorphine and I've been on it for three years". There is no doubt that many of the participants still used substances, some at worrying levels, but all were comparing themselves to a situation in the past when their lives were defined by their substance use, so, by this measure, they see themselves as having "significant control".

Recovery has been a long, slow process punctuated by relapses, near-death incidents and criminal activity to fund their habits. While participants were frank about lives replete with debasing experiences, there were some things that most were unwilling to readily disclose. For example, in interviewing a range of young people across three studies of the Whitelion program (Lemmon 2001, 2004, 2006), only one person spoke of resorting to prostitution to support their drug use while, anecdotally, the author is aware of several males and females who have been down this path.

What works?

It is impossible to break down the drivers of change into constituent parts and, therefore, to rigorously evaluate the precise value of specific interventions made by Whitelion or any other organisation. However, it may be useful to refer to key findings from research that has evaluated the efficacy of a wide range of programs for high-risk youth in the USA. According to Public/Private Ventures (2002), the only programs that could be proven to produce positive outcomes were those that were well structured, well implemented and provided participants with intensive exposure to a variety of program activities. Few if any community programs could prove that they produced a significant and sustained impact in the target group. The exception was the Job Corps, where the components seen to be responsible for success were "extensive education and vocational services, including job placement, and other support services directly related to their employability and personal development" (Public/Private Ventures 2002, p.6). These factors were underpinned by a residential component, "which removes participants from often-negative neighborhood environments, intensifies the program experience, and has been shown to be effective for all subgroups of youth" (Public / Private Ventures 2002, p.6).

Without drawing too long a bow, it can be argued that the Whitelion mentoring and employment programs, in tandem with incarceration in the juvenile justice system (the residential component), mirror the important ingredients for change in the Job Corps program.

It needs to be noted, however, that Job Corps, Whitelion and other similar community organisations are not the only pieces in the jigsaw puzzle that determine whether or not a young person moves away from an "at-risk" lifestyle. The evidence gathered in Building Bridges suggests that the process of moving from severe at-risk behaviour (significant substance use, criminality, homelessness, dislocation and disconnection from the community) to a position of relative "normality" is a long road involving a multiplicity of interconnected factors.

The experiences of the young people in this study suggest that a 10-year period of risky behaviour may be the norm before such disconnected young people make positive changes in their lives, and that a strong framework of support and intervention has to be in place for them to make these changes. The young people who were interviewed are close to completing this transition; most are now aged between 21 and 24, but were between 11 and 14 when they first started using substances and displaying risky behaviours. They have relied on the state and community organisations to intervene significantly in their lives in a way that transcends the experiences of most citizens. The key formal interventions that participants believe really worked are listed below:

* state support--clear policy in relation to substance use, and appropriate support to users. In addition, the policing of drug availability, the funding of rehabilitation programs, as well as universal access to service provision (health, child protection, education, justice);

* programs that provide day-to-day support and help keep young people alive. They include child protection, accommodation and substance abuse interventions such as the provision of clean needles; and

* support programs that extend past 18 years of age and provide highly individualised, tailored programs, particularly those that reconnect young people to community through jobs, mentoring and ongoing support. As an example, a 24-year-old female said:

   [Whitelion] assisted me with driving when I got released, they put
   me on the Methadone Program and put me in activities when I got
   released to keep me busy post-release so I wouldn't relapse. I did
   the Mentor Program and we used to go out a lot. Now five years on
   she is still my best friend.

Many of the participants felt a great sense of achievement, and none hankered for a life marked by substance abuse, criminality and chaos. All realised that the path to their present position was not an easy one and that the possibility of slippage was ever-present. Several stated that they had actively chosen to lead a very conventional lifestyle (job, long-term partner, children) even though it would have been easy to go back to the excitement of previous at-risk behaviours, particularly substance abuse. They offered no single factor, but rather a combination of some or all of the following interventions to explain "what works" in implementing positive changes in their lives:

* Being able to turn to responsible adults again and again, no matter how often they "stuffed up". A 19-year-old male said that Whitelion's mentoring program, which has provided a significant adult in his life for two years, contributed to his turnaround:

   I dare say I would have been the career criminal by now; I didn't
   go that way because of having my mentor. I think having the advice
   from him, his support and encouragement has helped me make the
   right choices.

* Maintenance therapies and a commitment to replacing heroin with buprenorphine and methadone. The importance of these factors cannot be overstated. Several participants were "fed-up" and embarrassed with the daily trek to the pharmacist and this was a major factor in wanting to become totally substance-free. For example, a 24-year-old woman said:

   I'm just ready; I am so sick and tired of having to go to the
   chemist every day. I hate being in there, it is embarrassing. I did
   this [using heroin] almost nine years ago. It is just about time,
   to grow up. I did the crime and the time. I'm scared of going
   through the pain, but I'm going to have to, I'm sick of being on
   this. I can't go anywhere. My partner went to Cairns to see his
   father and I couldn't go because I had to go to the chemist every
   day.

* Becoming involved in a long-term relationship and/or having children. The more connections that are made with family, non-using friends, mentors, workmates and the wider community, the stronger the resolve to stay on the straight-and-narrow.

* Being given employment opportunities (most required several) from which these young people would ordinarily be precluded because of their lack of education and formal qualifications.

* Luck, which enabled them to avoid permanent physical or mental damage (and allowed them to stay alive). Often this is enhanced by the intervention of the state, the judiciary and service providers in the welfare field. A 21-year-old male stated "I reckon it might just be luck. I haven't even OD'd (overdosed on heroin) when I was using. I've seen my parents OD a couple of times. How can it happen to my parents and not me?"

* The maturation process: the older participants became, the more likely it was that they could see the inevitable path that their lifestyle would lead them down - premature death, the junkie lifestyle and no ownership of "things" (e.g. house and car).

Finally, the long-term support and opportunities created by Whitelion were seen by many to have been a significant contributor to their achievements. The personal relationships that participants formed with Whitelion staff members were perceived as being life changing. Several staff members were consistently cited for their capacity to offer hope, friendship and guidance. Time and again participants spoke of how they had "stuffed up" in their lives and in the workplace, and how Whitelion staff had encouraged them to try again and created the opportunities for them to do so.

Conclusion

   That's through [Whitelion staff member], he got me a job a few
   times and I stuffed it up. I didn't really care, and he said to me
   when you clean yourself up call me and I'll be there. He has done
   that a few times. The last time I got on ice and lost my job, he
   said clean up your act and call me and I did and he got me this job
   as an office admin trainee first, and somehow the position came up
   for a commercial coordinator and they offered it to me. And I've
   been doing it for about seven months now.

Female, 24 years

Change is the result of the interweaving of a number of factors, some of which involve a long period of time (a safe place to live, responsible adult carers, interventions that remove young people from dangerous and criminal activity) and some of which involve coalescence at just the right time--the young person makes the decision to change just as an opportunity to take up new lifestyle (work education) arises. It helps if there are special people (partner, mentor, family) to notice that changes are taking place and to support the young person in their enterprises. Like much in social science research, this is not groundbreaking news, and, if we step back it could be seen to be the "bleedin' obvious". Put simply, at-risk young people need the time to grow up, mature emotionally and feel that they are making decisions for themselves. They need to be given special treatment or a lift into community structures that they have been excluded from for much of their lives, and they benefit greatly from having some special people who respect and care for them.

For young people who are in the care and protection of the state, support must be sustained for a period often considerably longer than the 18 years cut-off that is the norm, perhaps until their mid-twenties. There is encouraging evidence that state governments are realising that if they are acting in loco parentis, then they have obligations that extend beyond arbitrary age limits (Department of Premier and Cabinet 2005). If recent research questions our conventional notions of how and when we are capable of achieving adulthood (Wood 2005), then this strengthens the case for ongoing and active intervention.

In Victoria there are now many opportunities for young people to access effective programs, for example for substance abuse and mental health problems, but for the majority of at-risk young people these are opt-in rather than opt-out programs. A more effective system may be one where the state government works holistically with non-government agencies to ensure that all at-risk young people are actively encouraged to participate in relevant programs well beyond the age of 18. An obvious strategy that could prove to be an enticement is to link participation to the provision of safe, secure accommodation with ready access to responsible professional staff. This would require a significant commitment of money and interagency cooperation. A strong argument could be mounted that this approach would pay dividends as a crime prevention strategy and the funds could be recouped from savings made by a concomitant reduction in the incarceration rate.

The 20 young people in the Building Bridges study provide compelling evidence for the capacity of damaged individuals to change their expected trajectory. However, without the ongoing support, intervention and opportunity that came from their involvement with state and community agencies such as Parkville and Whitelion, they may well have suffered the fate of so many others in similar shoes--continued addiction, unemployment, incarceration or death. As community builders we must learn from the evidence of "what works" and, not surprisingly, this turns out to be the "bleedin' obvious"--responsible adults that they can turn to for support, forgiveness for outrageous behaviour and the opportunity to engage in education and employment. What at-risk young people really need is to be given the same opportunities and supports as everyone else, and then some more.

Link between state care and homelessness

Preliminary findings from an RMIT University study suggest a direct link between homelessness and being in state care in childhood or adolescence. The study also indicates a link between higher numbers of care placements and an increased risk of homeless. Over 4,000 homeless people living in Melbourne took part in the study, conducted by Dr Guy Johnson and Chris Chamberlain from RMIT's Australian Housing and Urban Research Institute. More than 1,600 reported being homeless before they were aged 18 years; of these, 40% had experienced state care. Dr Johnson said that these findings show the need for early intervention by child protection services in the lives of children at risk (Age, 15/12/07, p.12).

References

Darke, S., Ross, J. & Teesson, M. 2007, 'The Australian Treatment Outcome Study (ATOS): What have we learnt about treatment for heroin dependence?', Drug and Alcohol Review, v.26, n.1, pp.49-54.

Department of Premier and Cabinet 2005, Policy and strategy projects: Better outcomes for disengaged young people initial scoping, analysis and policy review, Department of Premier and Cabinet: Melbourne, Victoria.

Fawlty Towers: The complete collection 1975, television program, BBC, Roadshow Entertainment, UK.

Lemmon, A. 2001, New directions in working with young people in juvenile justice residential centres: A study of the

Whitelion program, Charles Sturt University, Wagga Wagga, NSW.

--2004, Laying the foundations: Working with "at risk" young people with alcohol, inhalant and other drug problems: A longitudinal study into the effectiveness of the Whitelion mentoring and employment programs, Charles Sturt University, NSW.

--2006, "Building Bridges': Working with "at risk" young people with alcohol, inhalant and other drug problems: A longitudinal study into the effectiveness of the Whitelion mentoring and employment programs, Charles Sturt University, NSW.

Loxley, W., Stockwell, T. & Toumborou, J. 2004, The prevention of substance use, risk and harm in Australia: A review of the evidence, Australian Government Department of Health and Ageing, Canberra.

Philip, K., Shucksmith, J. & King, C. 2004, Sharing a laugh? A qualitative study of mentoring interventions with young people, The Joseph Rowntree Foundation, York.

Public / Private Ventures 2002, Serving high-risk youth: Lessons from research and programming, Public / Private Ventures, viewed 4 February 2008, <http://www. ppv.org / ppv / publications / assets / 149_publication. pdf>.

Spooner, C. & Heatherington, K. 2004, Social determinants of drug-use, National Drug and Alcohol Research Centre, University of NSW, Sydney.

Smith, T.J. 2004, Guides for the journey: Supporting high-risk youth with paid mentors and counsellors, Public/ Private Ventures, viewed 4 February 2008, <http: / / www.ppv.org / ppv / publications / assets / 173_publication.pdf>.

Wald, M. & Martinez, T. 2003, Connected by 25: Improving the life chances of the country's most vulnerable 14-24-year-olds, William and Flora Hewlett Foundation Working Paper, Stanford University.

Wood, S. 2005, 'Teen brain', ABC Catalyst, television program, 28 July, viewed 5 February 2008, <http:// www.abc.net.au / catalyst / stories / s1424747.htm>.

AUTHORS

Alistair Lemmon is a lecturer in the School of Humanities and Social Sciences at Charles Sturt University. He has worked for many years as a practitioner and manager in the welfare and community sector and has had significant experience in the youth sector including homelessness, residential care, juvenile justice and counselling. His current research interest is in the impact of adult mentoring and employment on changing "at-risk" behaviour in young people.