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A FAMILY AFFAIR? SUPPORTING
CHILDREN LIVING WITH PARENTAL
SUBSTANCE MISUSE
Cliona 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 CHILDREN
TREATMENT 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
A Family Affair? Supporting Children Living With Parental Substance Misuse

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A Family Affair? Supporting Children Living With Parental Substance Misuse

  • 1. A FAMILY AFFAIR? SUPPORTING CHILDREN LIVING WITH PARENTAL SUBSTANCE MISUSE Cliona Murphy Alcohol Action Ireland www.alcoholireland.ie Presentation to ICGP conference
  • 2. OVERVIEW  Alcohol – harms and costs  Alcohol and parenting  Impact on children - seeing the family from the child’s perspective  Making a difference  Practice  Policy
  • 3. 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
  • 4. 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
  • 5. 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
  • 6. 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)
  • 7. 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)
  • 8. IMPACT ON CHILDREN  Isolation  Fear and Anxiety  Conflict in the Home  Children take on Parental Responsibilities  Abuse and Neglect  Poverty
  • 9. 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”
  • 10. 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
  • 11. 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
  • 12. 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?
  • 13. 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
  • 14.  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
  • 15. NSMS – SUPPORTING CHILDREN TREATMENT 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
  • 16. 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...”
  • 17. 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
  • 18. 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

Editor's Notes

  1. Resources section – see section on children affected by harmful parental drinking – report on parental substance misuse and its impact on children by the NACD