A FAMILY AFFAIR? SUPPORTING CHILDREN LIVING WITH PARENTAL SUBSTANCE MISUSECliona Murphy

Alcohol Action Ireland

www.alcoholireland.ie

Presentation to ICGP conference

OVERVIEW

Alcohol – harms and costs Alcohol and parenting Impact on children - seeing the family from

the child’s perspective Making a difference

Practice Policy

ALCOHOL – WHERE’S THE HARM?

1,500,000 adults drink in a harmful pattern Average consumption in 2010 was 11.9 litres

alcohol for every person aged 15+ (equivalent of 125 bottles wine or 45 bottles of vodka or 482 pints)

Alcohol responsible for 88 deaths every month in 2008 2,000 beds occupied per night in acute hospitals 28% attendances at A&E

ALCOHOL – ECONOMIC BURDEN

Health care costs = €1.2 billion Criminal justice system = €1.2 billion Road collisions = €526 million Lost output due to work absences = €330

million To the taxpayer = €3,318 To the shopper - cheap alcohol can be

subsidised by increasing price of other goods

ALCOHOL AND PARENTING

Problems for parents are problems for children

Parental alcohol problems can and do cause serious harm to children

Children often suffer the impacts of parental alcohol and drug problems long before their parent’s health suffers

Each dependent user of alcohol will negatively effect the lives of two other close family members

Ask about alcohol use

HOW MANY CHILDREN?

One in eleven Irish children say parental drinking has a negative effect on their lives – that’s 109,684 children (ISPCC, 2010)

A nationally representative survey of 18-40 year olds found that when parents drank weekly or more often: 14% said they often felt afraid or unsafe as a result of their

parents’ drinking 14% said they often witnessed conflict between their

parents either when they were drinking or as a result of their drinking

11% said they often had to take responsibility for a parent or a sibling

Impact did not differ according to socio-economic class(Alcohol Action Ireland Keeping It In the Family

Survey, 2009)

HOW MANY CHILDREN?

One in ten Irish adults reported that children, for who they had parental responsibility, experienced at least one of the following harms as a result of an adult’s drinking Left in an unsafe or unsupervised situation Yelled at, criticised or otherwise verbally abused Physically hurt Witness to serious violence in the home

(Hope, 2011, National Drinking Survey 2010)

IMPACT ON CHILDREN

Isolation Fear and Anxiety Conflict in the Home Children take on Parental Responsibilities Abuse and Neglect Poverty

IMPACT ON CHILDREN

Trauma and distress result when“caregivers not only fail to

provide comfort at times of extreme stress, but are themselves the principal source of that stress”

LISTENING TO CHILDREN

They care more about drink than their children

When they are drunk they are in fighting mood

He hits me in my sleep when he drinks It puts you off your work in school as you’re

thinking about it I don’t get to go anywhere or have fun the

next day because I’m minding my brothers It upsets me sometimes – I’m scared at times

as well

SEEING THE CHILD

Who is your client? Seeing the patient as parent

Is their drug/alcohol use impacting on their parenting capacity?

What is the impact on the child on a day to day basis?

Do other agencies need to be involved? How can you support the patient as parent?

The welfare of the child as the first and paramount consideration

SEEING THE CHILD

Parents engaging with effective treatment has positive outcomes for children

Bridging the gap between adult treatment and child welfare services

Does your agency have policies and procedures for responding to concerns about child welfare and safety?

Am I clear about my responsibilities in relation to Children First?

MAKING A DIFFERENCE - POLICY

Recommendations of the Report of the Steering Group of the National Substance Misuse Strategy

Overall aim is to reduce per adult consumption to 9.2 litres

Main Recommendations (supply) Increase price/reduce affordability through excise

duty and minimum pricing Introduce a social responsibility levy on the drinks

industry Phase out sports sponsorship and introduce

legislation to restrict advertising Structural separation of alcohol from other

products

Revised low-risk weekly consumption guidelines

Labelling of packaged alcohol – grams, calories and health warnings

National screening and brief intervention protocol

Develop services for children and families and improve interagency working

Research and monitoring activities

NSMS – SUPPORTING CHILDRENTREATMENT RECOMMENDATIONS 12-14

12. Develop comprehensive outcomes and evidence based approach to addressing needs of children and families experiencing alcohol dependency problems. This would involve a whole family approach, including the provision of supports and services directly to children where necessary

This approach should be guided by and co-ordinated with all existing strategies relating to parenting, children and families and in accordance with edicts from the Office for the Minister for Children and the Child & Family Agency

13. Explore extent of parental problem substance use through the development of a strategy similar to Hidden Harm in Northern Ireland and respond to the needs of children by bringing together all concerned organisations and services

14. Develop family support services

WHAT IS HIDDEN HARM?

Hidden Harm – Report of an Inquiry of the Advisory Council on the Misuse of Drugs (2003)

Hidden Harm Action Plans developed for Scotland, England, Wales and Northern Ireland

“These children can suffer in silence; their circumstances are often not known to services; they often do not know where to turn for help; and the impact of their parents’ substance misuse has a deep and long-lasting impact on their lives...”

HIDDEN HARM – KEY MESSAGES

Estimated one child for every problem drug user in the UK

Parental problem drug misuse can, and does, cause serious harm to children at every age from conception to adulthood

Reducing the harm to children from parental drug misuse should become a main objective of policy and practice

Effective treatment of the parent can have major benefits for the child

By working together, services can take many practical steps and improve the health and well-being of affected children

SUMMARY

Parental alcohol problems can and do cause serious harm to children’s health, development and welfare

The welfare of the child is the first and paramount consideration

Shifting focus Seeing the family from the child’s perspective Seeing the patient as parent Asking about the child Asking about alcohol Reporting concerns

A Hidden Harm Action Plan for Ireland