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