Transition Years
The transition period for a young person is a time of continuous change as they grow, develop and mature. Teenagers naturally grow in independence and need to try new things, take on responsibility, and be allowed to learn from their mistakes. Through this process young people often question and test the assumptions, rules and boundaries that shape their lives at home, in education and in their communities.
The following issues are the most significant factors affect life changes of young people:
Wider determinants of health
Education
Young people with low educational attainment are likely to have fewer opportunities in life (e.g. employment).
Employment
Unemployed young people are more likely to suffer from poor health than those who are employed.
Behaviour and lifestyle
Alcohol misuse
Adolescence is a time that young people experiment and may become involved in risk-taking behaviours. Alcohol misuse can lead to poor health.
Illicit drug use
Adolescence is a time that young people experiment and may become involved in risk-taking behaviours. Illicit drug use can lead to poor health.
Smoking
Smoking is the leading cause of preventable death; almost all (90%) smokers start smoking during their teenage years.
Sexual health
The early onset of sexual activity can have a major impact on young people’s lives and can lead to teenage pregnancy and sexually transmitted infections.
Illness and death
Self-harm and suicide
Deliberate self-harm and suicide have disproportionately high rates among young people.
Mental health
One-in-ten young people have a diagnosable mental health problem. Many continue to have poor mental health as adults.
1. What are the key issues?
Wider Determinants of Health
Education and employment
A higher proportion of 16 to 18-year-olds in Stockton-on-Tees (9.1%) are not in education, employment or training (NEET) compared to the England average (5.8%%).
Behaviour and lifestyle
Alcohol misuse
A higher proportion of under 18-year-olds in Stockton-on-Tees (53.7 per 100,000) are admitted to hospital due to alcohol-specific conditions than the England average (42.7 per 100,000).
Illicit drug use
A higher proportion of 15 to 24-year-olds in Stockton-on-Tees (130 per 100,000) are admitted to hospital due to substance misuse than the England average (75.2 per 100,000).
Smoking
In Stockton-on-Tees, 18.2% of adults smoke regularly (approximately 35,000 people).
Sexual health
The teenage (15 to 17-year-olds) conception rate in Stockton-on-Tees (35.4 per 1,000) is higher than the England average (30.7 per 1,000).
A higher proportion of 15 to 24-year-olds in Stockton-on-Tees (43.2 per 1,000) have been diagnosed with a sexually transmitted infection (including chlamydia) than the England average (34.4 per 1,000).
Illness and death
Self-harm and suicide
A higher proportion of under 10 to 24-year-olds in Stockton-on-Tees (643.7 per 100,000) are admitted to hospital as a result of self-harm than the England average (346.3 per 100,000).
Mental health
A higher proportion of under 18-year-olds in Stockton-on-Tees (114 per 100,000) are admitted to hospital for mental health conditions than the England average (87.6 per 100,000).
2. What commissioning priorities are recommended?
Wider Determinants of Health
Education
Increase the number of young people in Stockton-on-Tees progressing to and remaining in education, training or employment from age 16 onwards. Ensure post-16 providers receive the ‘soft’ information about individual pupils which will help them to put in place effective pastoral support mechanisms. Improve pre-16 providers’ understanding of the qualifications and skills needed for post-16 progression.
Employment
Reduce the number of young people who are not in education, employment or training (NEET).
Tackle and improve employability and worklessness in disadvantaged areas
Behaviour and Lifestyle
Alcohol misuse
Reduce alcohol-related harm to young people, families and communities, through the delivery of sustained and consistent messages about alcohol consumption, to influence attitudinal change and create a cultural shift.
Reduce the availability of alcohol with a particular emphasis on sales to young people.
Substance misuse
Reduce substance misuse amongst young people through early identification and intervention
Smoking
Develop a comprehensive tobacco control strategy that includes the impact of smoking on children and young people and aims to prevent uptake.
Sexual Health
Reduce under-18 conceptions by maintaining efforts to reduce teenage pregnancy in the context of child poverty and health inequalities and focusing targeted interventions in specific areas.
Illness and Death
Self-harm and suicide
Develop a comprehensive understanding of self-harm and suicide and further identify levels of unmet need (building on existing local research and evidence).
Mental health
Undertake a needs analysis of the emotional health and wellbeing of children and young people
3. Who is at risk and why?
Wider determinants of health
Education
Young people are at greater risk of low educational attainment if they:
- Live in a deprived area;
- Have a family member who is unemployed;
- Live in a single parent family;
- Are a looked after child;
- Have a family member who has low educational attainment;
- Have a poor attendance record;
- Have a family member who misuses substances;
- Suffer from a mental health condition;
- Have a learning disability;
- Misuse alcohol;
- Use illicit drugs;
- Smoke.
Employment
Young people are at greater risk of not gaining employment if they:
- Live in a deprived area;
- Have a family member who is unemployed;
- Live in a single parent family;
- Are a looked after child;
- Have a family member who has low educational attainment;
- Have a poor attendance record;
- Have a family member who misuses substances;
- Suffer from a mental health condition;
- Have a learning disability;
- Misuse alcohol;
- Use illicit drugs;
- Are homeless;
- Are not in education, employment or training (NEET).
Behaviour and lifestyle
Alcohol misuse
Young people are at greater risk of misusing alcohol if they:
- Live in a deprived area;
- Have a family member who misuses alcohol;
- Have friends that misuse alcohol;
- Have a family member who is unemployed;
- Live in a single parent family;
- Are a looked after child;
- Have low educational attainment;
- Have a poor attendance record;
- Have a family member who has low educational attainment;
- Are homeless;
- Are involved in prostitution;
- Are a teenage mother;
- Use illicit drugs;
- Are not in education, employment or training (NEET).
Illicit drug use
Young people are at greater risk of using illicit drugs if they:
- Live in a deprived area;
- Have a family member who use illicit drugs;
- Have friends that use illicit drugs;
- Have a family member who is unemployed;
- Live in a single parent family;
- Are a looked after child;
- Have low educational attainment;
- Have a poor attendance record;
- Have a family member who has low educational attainment;
- Are homeless;
- Are involved in prostitution;
- Are a teenage mother;
- Misuse alcohol;
- Are not in education, employment or training (NEET).
Smoking
Young people are at greater risk of smoking if they:
- Live in a deprived area;
- Have a family member who smoke;
- Have friends that smoke;
- Have a family member who use illicit drugs;
- Have a family member who is unemployed;
- Live in a single parent family;
- Are a looked after child;
- Have low educational attainment;
- Have a poor attendance record;
- Have a family member who has low educational attainment;
- Are homeless;
- Are involved in prostitution;
- Are a teenage mother;
- Misuse alcohol;
- Are not in education, employment or training (NEET).
Sexual health
Young people are at greater risk of a sexually transmitted infection (STI) if they:
- Live in a deprived area;
- Are of black or minority ethnicity (HIV);
- Are aged between 16 to 24-years-old (STI);
- Are a man who has sex with another man (HIV);
- Have low educational attainment;
- Have a poor attendance record;
- Are not in education, employment or training (NEET);
- Are sexually active at an early age;
- Misuse alcohol;
- Use illicit drugs;
Young people are at greater risk of a teenage conception if they:
- Live in a deprived area;
- Have low educational attainment;
- Have a poor attendance record;
- Are a looked after child;
- Are not in education, employment or training (NEET);
- Are sexually active at an early age;
- Misuse alcohol;
- Use illicit drugs;
Illness and death
Self-harm and suicide
Young people are at greater risk of self-harm and suicide if they:
- Live in a deprived area;
- Have a mental health condition;
- Have a family member with a mental health condition;
- Use illicit drugs;
- Smoke;
- Misuse alcohol;
- Have stressful family situations;
- Are a teenage parent;
- Are a looked after child;
- Are involved in the youth justice system;
- Have a learning disability;
- Have a physical disabilities;
- Have a serious or chronic illness.
Mental health
Young people are at greater risk of having a mental health condition if they:
- Live in a deprived area;
- Have stressful family situations;
- Have a family member with a mental health condition;
- Are in a single parent family;
- Are a looked after child;
- Have low educational attainment;
- Have a family member who has low educational attainment;
- Have a learning disability;
- Have a physical disabilities;
- Have a serious or chronic illness;
- Use illicit drugs;
- Smoke;
- Misuse alcohol;
- Are a teenage mother;
- Are involved in the youth justice system.
4. What is the level of need in the population?
Wider determinants of health
Education
Stockton-on-Tees has a higher rate of young people not in education, employment or training (NEET) than the England average (chart below).
Source: ChiMat - Child Health Profiles
Behaviour and lifestyle
Alcohol misuse
In Stockton-on-Tees, the proportion of under 18-year-olds admitted to hospital for an alcohol-specific has decreased over the last seven years but it still remains above the England average (chart below).
Source: LAPE (http://www.lape.org.uk/atlas/index.html)
Illicit drug use
Stockton-on-Tees has a higher rate of substance use among young people than the England average (chart below).
Source: ChiMat - Child Health Profiles
Sexual health
In Stockton-on-Tees, the conception rate of under 18-year-olds increase since 1998-00 but there has however been a year on year decrease since 2006-08 and remains above the England average.
Source: www.swpho.nhs.uk
Illness and death
Self-harm and suicide
Stockton-on-Tees has a higher rate of hospital admissions as a result of self-harm than the England average (chart below).
Source: ChiMat - Child Health Profiles
Mental health
Stockton-on-Tees has a lower rate of hospital admissions for a mental health condition than the England average (chart below).
Source: ChiMat - Child Health Profiles
5. What services are currently provided?
Stockton Families Service Directory contains comprehensive information about local and national services and activities such as support groups, sports, money and benefits, drama and dance:
http://search3.openobjects.com/kb5/stockton/directory/family.page
6. What is the projected level of need?
Wider determinants of health
Education
Behaviour and lifestyle
Alcohol misuse
Sexual health
Illness and death
Self-harm and suicide
7. What needs might be unmet?
Wider determinants
Education
In Stockton-on-Tees, 45% of student left school in 2012 without 5 good GCSEs including English and maths.
Employment
There needs to be earlier identification of the sector-specific business needs for education and training to address any projected skills shortages.
There are insufficient training and work-based learning opportunities, i.e. apprenticeships.
Behaviour & Lifestyle
Smoking
As young people continue to take up smoking there is a continuing need to educate them about the harms of cigarettes and the benefits of not smoking.
Sexual Health
Dedicated sexual health services for young people are required to meet their needs.
Illness and death
Self-harm and suicide
There is a need for a ‘service pathway’ for those in transition between child and adult services.
Mental health
Due to the lack of a robust mental health needs assessment for children and young people it is difficult to assess what needs are unmet.
8. What evidence is there for effective intervention?
Wider determinants of health
Education
Fair Society Healthy Lives a review of health inequalities (2010); Sir Michael Marmot http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review
The foundation years: preventing poor children becoming poor adults (2010); Frank Field http://www.nfm.org.uk/news/77-family-policy/486-frank-field-final-indpendent-report-on-poverty-and-life-chances
Employment
Neilson & O’Donnell (2012) approaches to supporting young people not in education, employment or training a review http://www.nfer.ac.uk/nfer/publications/RSRN01/RSRN01.pdf
Behaviour and lifestyle
Alcohol misuse
Preventing harmful drinking (PH 24) (2010) www.nice.org
Alcohol-use disorders (CG 100) (2010) www.nice.org
School-based interventions on alcohol (PH7) (2007) www.nice.org
Illicit drug use
Drug Misuse: psychosocial interventions (CG 51) (2007) www.nice.org
Interventions to reduce substance misuse among vulnerable young people (PH4) (2007) www.nice.org
Smoking
School-based interventions to prevent smoking (PH23) (2010) www.nice.org
Preventing the uptake of smoking by children and young people (PH14) (2008) www.nice.org
Brief interventions and referral for smoking cessation (PH1) (2006) www.nice.org
Sexual health
Prevention of sexually transmitted infections and under 18 conceptions (PH7) (2007) www.nice.org
Long-acting reversible contraception (CG 30) (2005) www.nice.org
Illness and death
Self-harm and suicide
Self harm long term management (CG133) (2011) www.nice.org
Self harm (CG16) (2004) www.nice.org
Mental health
Depression in children and young people (CG28) (2005) www.nice.org
Social and emotional wellbeing in primary education (PH 20) (2009) www.nice.org
9. What do people say?
Wider determinants of health
Education
Most children and young people intend to embark on further study after Year 11 and to attend higher education. A notable minority are thinking about pursuing a work-based route (including apprenticeships).
Behaviour and lifestyle
Alcohol misuse
More than half (51%) of children and young people said that they have never had an alcoholic drink. About two-fifths (42%) said that they had consumed an alcoholic drink and 7% did not wish to say. The majority of all children and young people surveyed had not been drunk in the previous four weeks (68%).
Smoking
Most children and young people said that they had never smoked (77%). The minority of children (10%) said that they had only tried smoking once and fewer children (4%) indicated that they had stopped smoking.
Sexual health
The Added Power and Understanding in Sex education (APAUSE) questionnaire for children in year 11 (2010/11) showed that:
- Boys answered 78% of questions correctly;
- Girls answered 83% of questions correctly;
- 65% of girls viewed their sex and relationship education as ‘ok’; and
- 75% of boys viewed their sex and relationship education as ‘ok’..
Illness and death
Self-harm and suicide
A study by Youthhealthtalks found that some young people felt that professionals (including hospital staff) were unsure how to handle self-harming or how to best help young people.
10. What additional needs assessment is required?
Behaviour and lifestyle
Alcohol misuse
More robust data is required to understand young people’s use of alcohol.
Illicit drugs
More robust data is required to understand young people’s access to illicit drugs.
Sexual health
Act on the results of the recently undertaken sexual health needs assessment.
Illness and death
Self-harm and suicide
There are hidden vulnerable groups where additional information is required. These may include young carers and looked after children.
Mental health
Undertake a needs analysis of the emotional health and wellbeing of children and young people.
Key Contact
Topic lead
Name: Diane McConnell
Job Title: Chief adviser
e-mail: diane.mcconnell@stockton.gov.uk
Telephone number: 01642 526404
Topic author
Name: Paul Welford
Job Title:
e-mail: paul.welford@stockton.gov.uk
References
- Transitions Strategy for Young People with Complex Needs and Additional Needs (Action Plan under review)
Housing
Key contact: Jane Edmends
Job title:
e-mail: jane.edmends@stockton.gov.uk
Telephone number: (01642) 526682
References
Local strategies and plans, with dates
- Private Sector Housing Renewal Strategy (currently under review)
- Sub Regional Housing Strategy 2007
- Local Housing Strategy 2008 – 2011 (currently under review)
- BME Housing Strategy 2008 – 2011 (currently under review)
- Regeneration Strategy 2007 – 2012
- Homelessness Prevention Strategy 2008 – 2011 (currently under review)
- Housing Service Improvement Plan and Service Team Business Unit Plans 2011 – 2014
- Older Peoples Strategy 2008
- Affordable Home Ownership Policy 2008
- Supporting People Strategy 2006 – 2010
- Tees Valley Strategic Housing Market Assessment 2009
- Tees Valley Gypsy and Traveller Accommodation Needs Assessment 2009
- Young Persons Homelessness Strategy 2008 – 2011
- Housing and Support Needs of Teenage Parents
- Core Strategy 2010
National strategies and plans with dates
- Lifetime Homes, Lifetime Neighbourhoods: A national strategy for housing in an ageing society 2008
Other references with dates
Health
Key Contact: Heather Duckers
Job title: Senior Clinical Matron
e-mail: heather.duckers@nth.nhs.uk
Telephone Number:
Speech and Language Therapy
Key Contact: Marian Bateson
Job Title: Head of Children’s Speech and Language Therapy
e-mail: marian.bateson@nhs.net
Telephone Number: (01429) 522712 or 522717
Stockton Riverside College
Key Contact: Lorna McLean
Job Title: Head of Equality and Learning
e-mail: Lorna.Mclean@stockton.ac.uk
Telephone Number:01642 865400