In this section

• What is screening?
• Why screen young people for
  substance misuse?
• Screening Vulnerable Groups
• When should you use the screening tool?
• How should screening happen?
• What is screening trying to establish?
• Outcomes of screening

What is screening?

Screening is a common process used in Health Care Services. Screening should be a relatively short and simple process that can be administered by non-specialist staff. The aim of any screening programme is to identify which people from a given population have, or are likely to develop, a specific condition. Screening programmes are set up because many health conditions can be prevented if they are picked up early enough and treated.

Screening:

• Usually uses a standard 'tool' like a blood test or a questionnaire, so that responses from different people can be consistently compared.
• Indicates whether further investigation, tests or assessments are necessary.
• Ensures efficient use of resources, so that only people who are genuinely at risk are referred to specialist services.

However, screening:

• Is not a comprehensive assessment or diagnosis.
• Does not say for certain whether a condition exists or not.
• Is not infallible - most screening programmes have an element of error. So some people who have the condition are missed; some people who don't have the condition are screened 'positive', but are found not to actually have it when properly assessed.

Screening young people for substance use problems² is less clear cut than other health screening procedures, for example screening for diabetes. Judgements about substance misuse are based mostly on self report by young people or observations about behaviour, rather than a blood test. The practitioner doing the screening needs to be able to establish a good rapport with the young person, and needs a little knowledge and skill to make a judgement based on what the young person says.

Specific issues about screening for substance misuse with young people:

• Substance Misusing behaviour changes over time so screening is not a 'one off' activity
• The term 'substance misuse' is open to interpretation by different people.
• It's illegal activity, so the young person may not want to discuss it with you, or they might not tell the truth, especially if they are worried about
  confidentiality.
• How you ask the questions and how you relate to the person you are asking are as important as the questions you ask.

²In this toolkit 'screening for substance misuse' does not mean urine, oral swab, hair or blood testing. These kind of medical tests check for the presence of alcohol or drugs in the body, but do not indicate whether there are any associated social or health problems. This can only
be determined from looking at the personal and social circumstances surrounding the use.