There are between 250,000 and 350,000 children of problem drug users inEngland, Scotland and Wales. The Advisory Council on the Misuse of Drugssays up to 1.3 million children in the UK are affected by parentalalcohol misuse. But many feel that the gap between adult and children'sservices means these children do not get the support they need.
Last year, the Commission for Social Care Inspection warned: "In ourinspection of adult services we find assessments often focus on theneeds of adults and do not adequately address the support needs ofparents."
In May, the children's commissioner for England Al Aynsley-Green echoedthe concerns. "Few authorities have protocols to help children's andadult teams work together," he said.
Close the gap
Three councils in London, though, are bucking the trend by setting upthe UK's first family drug and alcohol court. Islington, Camden andWestminster councils are working with the Children and Family CourtAdvisory and Support Service (Cafcass), the Inner London Family Courtand Brunel University to close the gap between adult and children'sservices.
Based on a US scheme, a judge, treatment specialists and social workerswill see cases where children are at risk of going into care because oftheir parents' substance misuse. The court will be able to make same-dayreferrals for advice and support. The aim is to improve cross-departmental working and reduce the number of children going intocare.
The scheme has been planned for three years and should be ready inJanuary, says Anthony Nagle, drug and alcohol manager at IslingtonCouncil's children's services. A key feature will be early - andsustained - intervention. "Families will go in front of the same judgeevery two weeks. There will be parent mentors, robust treatment packagesand expert help. Hopefully, decisions will be made much quicker," saysNagle. He believes that early intervention, ensuring parents gettreatment, and working with them to find out why they use drugs willenable services to manage the situation far better than in the past."You have to demonstrate that you're listening to parents. You also haveto recognise family strengths - as well as weaknesses - and positivelyreinforce them."
For Islington, the new court is one of a number of measures designed toaddress the widespread, but largely hidden, issue of parental drug andalcohol abuse. Nagle says: "Sixty to 70 per cent of care proceedings inIslington, Camden and Westminster are drug or alcohol abuse-related, butit's not a core issue in social work training."
He believes this lack of training must be addressed, which is whyIslington now provides additional drug training for all its children'sworkers.
In July, Islington also started a drug-testing programme. "It givesfamilies the opportunity to demonstrate they're drug-free and makingprogress," says Nagle. "Parents from 13 families are being tested on aweekly basis. When tests are positive we talk to them, find out whattriggered the relapse, what the context was and how it can be addressed.This regular interaction with the parent often gives you a betterinsight into their situation than the testing does." The tests arevoluntary, but because many are involved in care proceedings, parentstend to feel obliged to participate. "Parents like it because people areupfront and honest with them," says Nagle. "It is all based on evidence,not on hearsay."
Therapy and support
Many of the council's cases are referred to Casa Family Service, acharity that provides therapy and support to families affected byparental substance misuse. "After initial sessions with parents orcarers on their own, we invite parents and children to attend togetherfor weekly sessions," says senior manager Hazel Jordan. "Familiesidentify goals for strengthening aspects of family life, and worktowards them. As well as these sessions, we work therapeutically withchildren and young people on an individual basis to supportresilience."
Islington has also placed a specialist children's social worker in itsadult services department, a move Nagle believes has been integral inaddressing the gap between adult and children's services.
A spokeswoman for Ofsted insists good local authorities do haveprotocols in place for linking adult and children's services to ensurefamilies receive support. "We should also recognise that the challengesof co-ordinating adult and children's services are not new. It isimportant to balance any current concerns with the benefits forchildren, young people and families of bringing together children'sservices as part of the Every Child Matters agenda," she adds.
Di Hart, principal officer at the National Children's Bureau's childrenin public care unit, is co-author of the toolkit Adult Drug Problems,Children's Needs: Assessing the Impact of Parental Drug Use, which isdesigned to help councils overcome issues such as this. She says NCBworked with two local authorities, which she would not name, to discussthe challenges they faced. "Social workers have only had half a day oftraining about drugs, yet the majority of their cases relate to them, sothe toolkit has drug information," she says. "It provides a suggestedassessment model, which offers a way of interpreting cases. It's beendistributed to every local authority and feedback has beenpositive."
Nevertheless, Hart believes not enough is being done to support childrenwhose parents misuse drugs. "In Scotland, they've been much moreproactive at the government level - particularly about getting involvedvery early in cases," she says. "In England, there's been a less robustresponse from government. A strategic lead from above would be helpful.More multi-agency working is needed, as well as getting people workingmuch closer together on the ground."
One challenge is that parents often try to hide or downplay their drugproblem because they fear their children will end up in care if theymention drugs. "You need to build trust but it is a big problem tryingto engage parents. It is hard for local authorities to be proactive,they lack resources and may not have the time to really look intoproblems," explains Hart.
One organisation doing sterling work, according to Hart, is Brighton'sOasis Project, which provides support to female substance abusers andtheir children, as well as children affected by a sibling's drug abuse."For children up to five, we run a creche, with a high staff-to-childratio and a focus on the child's development," says director MickyRichards. "We work with children for a sustained period, often up to ayear. With the older children we do group work and one-to-one therapysessions. We use art as a medium for helping the kids expressthemselves. It's usually a 12-week programme, but there are lots ofthings out of their control in these children's lives so we may extendthis. The children like it because it is a place where they won't bejudged."
Another important part of the organisation's work is its pack forteachers, whom Hart says are often the missing link in this issue. Thepack offers training, and gives a list of warning signs. Despite allthis, Oasis had to reduce services in April because of fundingconstraints; it gets money from the local primary care trust, grants,charitable funds and other sources.
Build self-esteem
These challenges are familiar to Sian Kavanagh, departmental manager atArch Initiatives, a charity for people affected by drugs in Merseyside,Halton, Warrington and Cheshire. "Services are client led. We go totheir homes. If you're a mother with young children you're not reallygoing to get on a bus and come to us," she says. "We also providetreatment for children in community centres. We try to build self-esteemand resilience, and improve communication within the family. Thesefamilies are very isolated. They don't want people from lots ofdifferent services coming to them."
Arch Initiatives has been active for more than 20 years but money is achallenge. "Funding is a huge issue as it only ever lasts for threeyears," says Kavanagh. "From next March our services will besignificantly reduced unless we find replacement funding."
For Martin Barnes, chief executive of Drugscope, the national outlookremains mixed. "There has been an improvement in the level and range ofservices," he says. "But there needs to be further awareness raising andtraining. Funding for drug treatment has reached record levels, but it'snot gone to services that work with families and young people.
"A lot of services working with young people and families are unsureabout their long-term funding."
TIPS: WHEN PARENTS ABUSE DRUGS
1. A crossover post, for example a children's social worker based in theadult services department, helps to prevent work with families sufferingas a result of the gap between adult and children's services
2. Do not leave it all up to the frontline workers. Practitioners can'tdo the job on their own, they need a strategic framework to work within'sufficient resources and practical support
3. Do not see everything through the lens of substance use. Not all drugand alcohol users are bad parents, nor does abstinence mean parentingwill necessarily improve. Drug and alcohol misusers are prone torelapses, so parents need ongoing support to help maintain positivechanges
4. Develop training that is tailored to local needs and ensure socialworkers have an understanding of drugs, alcohol and local treatmentservices. Treatment workers also need to understand the impact ofparental substance misuse on children
5. It is important not to lose sight of the child. Find out about theirexperiences and what they want to see happen with their families. Youshould also have an empathic approach to both children and parents. Thelatter should be motivated rather than receiving threats
Source: National Children's Bureau and London Borough of Islington
- Further information NCB's toolkit - Adult Drug Problems, Children'sNeeds: Assessing the Impact of Parental Drug Use - is at www.ncb.org.uk.The Government's cross-department web site, with information andresources for professionals whose work involves drugs, iswww.drugs.gov.uk. The Oasis Project's web site is at www.brightonoasisproject.co.uk. Arch Initiatives' is at www.archinitiatives.org.uk.
