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Nov
02

Blog: Inspiration from Iceland – Drug Prevention is Possible!

Pamela Quiery from the South Eastern Drug and Alcohol Connections Service tells us about the recent visit to Northern Ireland by Jón Sigfússon, the Director of Youth in Iceland at the Icelandic Centre for Social Research and Analysis (ICSRA) to share his knowledge of the inspirational Icelandic Prevention Model.

As part of our action plan for the year we wanted to look at effective, evidence-based prevention in the field of alcohol and other drugs. It was our good fortune that around this time the Icelandic Model of Prevention received widespread media coverage of their successes over the last 20 years in preventing alcohol and drug use in young people. We were extremely impressed by what we read: in 20 years Iceland went from the highest rates of alcohol and drug use amongst young people in Europe to the lowest. In 1997, Iceland had 15-20 drug treatment facilities for young people, today they only have two. We wanted to learn more so we invited Jón Sigfússon, the Director of Youth in Iceland at the Icelandic Centre for Social Research and Analysis (ICSRA) to share his knowledge with us here in Northern Ireland.

We were honoured that Jón agreed to visit us for two days in September 2017. He spoke at two events: the first was an event in the South Eastern Trust area for those working at a grassroots level in local communities; the second event took place in Belfast Castle and was a full day seminar looking at how the Icelandic Model might be implemented in Northern Ireland. Jón was joined by his colleague from Romania, Dr. Adrian Sârbu, who spoke about how he has been successfully adapting the Icelandic Model in Bucharest for the past 10 years.  The seminar brought together key decision- and policy-makers from the Public Health Agency, the Department of Health, Department of Education, Policing, Councils and Community Sector.

So how did Iceland do it?

The Icelandic approach is based around a detailed questionnaire completed every two years by every school child in Iceland aged between 10 and 20 years old. The survey asks questions about the young people’s lives, how they spend their time and how they are doing emotionally. The data is analysed and results are available within two months giving an up-to-date picture of what is going on for young people at a local level. The data identifies the factors that are having a negative impact on young people making them more likely to use alcohol and other drugs (risk factors) and the factors that are having a positive impact making young people less likely to use alcohol and other drugs (protective factors). The researchers found that by strengthening the protective factors and weakening the risk factors young people naturally lost interest in experimenting with alcohol and drugs. Although the situation varies between countries and cultures, the main protective factors for young people are universal: children’s relationship with their parents and involvement in good quality organised activities.

Graph showing the decline in alcohol, smoking and cannabis use in young people aged 15-16 years old in Iceland.

All the agencies involved in young people can access the data and work together to improve outcomes. The outcomes can be measured easily as the questionnaire is repeated every 2 years so progress can be seen and the programme adapted as necessary.

What type of changes did they make in Iceland?

In the city of Reykjavík 7% of the council’s budget is now spent on youth activities. Every child receives a Leisure Card every year to the value of €430 to be spent on their choice of activities. The city sees this money as an investment in the young people and it saves money in the long term. In order to be preventative, activities must be organised and of high quality.

A lot of work has gone in to supporting parents and encouraging them to spend more time with their children. According to Jón “Parents are the biggest preventative factor in children’s lives”. In Iceland, parents sign up to a ‘Parental Contract’ which sets out rules for both parents and children about spending time together, rules about children’s drinking and drug taking and the time children must be home. On a government level, Iceland restricted the availability of alcohol and introduced minimum unit pricing. These are a few examples of the type of interventions adopted by Iceland since the model was introduced in 1997.

Young people in Iceland do not receive any drug education as part of this initiative, it simply is not necessary. There is no evidence that drug education works and in fact it could make young people more likely to experiment with drugs. When asked about this Jón said “We should not make children responsible for their own health, it is our responsibility”.

But what about Northern Ireland, would it work here?

Over the last twenty years the Icelandic team have worked with cities in eighteen countries across Europe to implement the model through the ‘Youth in Europe’ initiative and more recently they are working with countries in South America and Africa through the ‘Planet Youth’ project (see www.planetyouth.community for more info). Each of these countries or municipalities has a unique set of circumstances and challenges. As the interventions in each country are carefully tailored based on the survey results, the approach is highly adaptable and effective. In the words of Dr. Sârbu “Finding the real needs of local communities is the basis of intervention”. However, prevention does not yield overnight results. It takes at least five years before changes start to be seen when implementing this model.

What next?

Jón’s visit was extremely well received and feedback from the seminar revealed a broad consensus of support for the approach. The Chief Medical Officer, Dr. Michael McBride, who opened the seminar and is also the Chairperson of the NSD steering group, committed to discussing the Model at the next NSD meeting with a view to assessing the viability of implementing this approach in Northern Ireland. The Connections Service would welcome a pilot of this approach in Northern Ireland. We have great infrastructure and a passionate, well-educated workforce so I have every hope that this model could work successfully in Northern Ireland and I believe we have the potential to create positive change for our next generation of young people.

The South Eastern Drug and Alcohol Connections service is funded by the Public Health Agency under Northern Ireland’s New Strategic Direction (NSD) for Alcohol and Drugs. The Connections Service works closely with the local Drug and Alcohol Coordination Team (DACT) which brings together all the key organisations with a role to play in addressing alcohol and drug issues.

From left to right: Dr. Adrian Sârbu (University of Bucharest), Pamela Quiery (South Eastern Drug and Alcohol Connections Service), Jón Sigfússon (ICSRA) at Belfast Castle Seminar on the Icelandic Model of Prevention.

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