CEO Blog: How to ensure prevention works for all

Some reflections on my first four months as Chief Executive at Mentor, in which I outline two early priorities: to bring alcohol and drug prevention into the mainstream, and to promote and strengthen evidence-based prevention practice, both within our own work and in support of other agencies.

2 March 2015 | CEO Blog

I have now had the privilege of being Chief Executive with Mentor for four months. I believe that these early days are really important. As a new Chief Executive you have a chance to look at an organisation with a fresh perspective and clarity which are sometimes more difficult later in a tenure.

Two early priorities really stand out for me. The first, a longstanding organisational objective, is to bring prevention into the mainstream – to widen prevention activity both through Mentor’s own practice and through advancing the importance of prevention to policymakers and other key stakeholders. And secondly, of critical importance, to promote and strengthen evidence-based prevention practice, both within our own work and in support of other agencies.

It is therefore heartening to see the Advisory Council on the Misuse of Drugs (ACMD) echo these objectives in its latest briefing paper, Prevention of drug and alcohol dependence. ACMD reiterates the importance of prevention among young people within the broader drugs strategy, recognising that the majority of young people do not use drugs; effective prevention therefore has the potential to avert a significant portion of drug use and drug-related harm in the UK before it occurs. ACMD’s briefing synthesises recent discussions in the drug prevention field and offers several key insights to inform policy development.

What doesn’t work

First, there is “strong evidence” on prevention strategies that do not work. School-based drug curricula that provide information about drugs in isolation, fear-based approaches or ‘scare tactics’, and stand-alone mass media campaigns have consistently been shown to be ineffective at improving outcomes – some studies even suggest that emphasising the dangers of drug use may enhance the status of drug-taking. [1] However, despite these approaches losing credibility, they continue to be adopted by some schools in the UK. With schools representing the most efficient way to deliver universal alcohol and drug education, it is vital that teachers are able to follow best practice. It is in this context that Mentor developed the Alcohol and Drug Education and Prevention Information Service (ADEPIS) to provide guidance and support to schools, so that teachers are able to follow best practice based on the latest national and international evidence.

What does work

ACMD recognise that we are only beginning to generate quality evidence on what works in prevention. However, the Council point out a number of promising approaches, including multi-sectoral programmes with multiple components and certain skills-development-based school programmes. Further, the report advises that the available evidence supports a more holistic approach that embeds universal drug prevention into wider strategies that support healthy development and wellbeing in general.

Here, AMCD’s briefing is reflected in Mentor’s practice: we are currently trialling a range of programmes that seek to strengthen the evidence base of what works in prevention in the UK. Boys and Girls Plus adopts a life skills model that has showed promising results in the US, with extensive research from Gilbert Botvin; the programme challenges attitudes towards drugs in the context of healthy lifestyles through building skills and resilience. Mentor is also trialling the Good Behaviour Game, a social influence approach to classroom management that has demonstrated improved behaviour and attainment and, in the long term, a reduction in smoking and substance misuse. We have also introduced to Britain a Swedish initiative, Effekt, which empowers parents and carers to influence adolescent alcohol use. [2]

Bringing prevention into the mainstream

The AMCD briefing paper cites an outstanding need for more evaluation to strengthen our understanding of what works – particularly economic analyses that make the case for prevention by demonstrating long-term value for money. By trialling a range of evidence-based programmes and grounding resources such as ADEPIS in evidence from renowned national and international sources, Mentor hopes to contribute to improving national practice. By focusing on programmes that utilise a mix of the key factors linked to preventive outcomes – normative education, social resistance skills, broader health-based education, interactive methods – we can strengthen our understanding of what works and build our capacity to deliver effective prevention.

There are certainly many challenges, in particular with regard to demonstrating the economic case for prevention, rolling out preventive interventions on a wider scale and ensuring programme fidelity. However, with growing recognition of the importance of prevention through policy advocates like AMCD, we can continue to raise awareness, to build the evidence base of what works, and improve prevention practice, to the end that young people throughout the UK have the opportunities to thrive free from the harms of alcohol and drug misuse.

[1] Cragg, A. (1994) ‘The two sides of fear’. Druglink Institute for the Study of Drug Dependence. September-October: 10-12.

[2]For a comprehensive summary of the evidence around drug prevention programmes in schools, see Mentor’s 2011 Prevention Evidence Brief.