Links between parental substance misuse and child maltreatment

1
Links between parental substance misuse and child
maltreatment

• What do we know and what lessons can be learnt?
• Dr Sarah Gorin, Child Protection Research Group

2
In the morning my mum used to do breakfasts and
everything when she was sober. But when it got
towards the (end of) the dayshe used to drink
more and more.if I didnt cook for myself I
would have just starved.. I was surprised that
the social workers didnt do anything.even talk
about putting me into foster care. When we were
living with my mum and I were looking after her
and she was drinking a lot and threatening to
take her own life, they came up to visit
sometimes to see how she were, but they never
ever mentioned even thinking about putting me
into foster care. They didnt say, oh youre in
danger or anythingExtract taken from Bibby, A.
and Becker, S. (2000) Young carers in their own
words. Calouste Gulbenkian Foundation London.
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What will be covered

• What do we know about the scale of parental
  substance misuse and types of child maltreatment?
• What do we know about how parental substance
  misuse impacts upon children?
• What are the key problems facing professionals?
• What lessons can be learnt from the research?
• What are the recent key policy developments?
• List of useful references for further reading

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Estimating the scale of parental substance misuse

• We dont know how many parents who are providing
  care for children misuse substances
• 27 per 1,000 households headed by couples (with
  or without children) include someone with
  alcohol dependence. This rises to 38 per 1,000
  for lone parent households. (OPCS, 1996)
• Drugs misuse is less common with 9 per 1,000
  families having an adult with a drug problem
  rising to 24 per 1,000 for lone parents. This
  information is likely to be an underestimate.
  (OPCS, 1996)
• Estimates for the numbers of children who are
  currently living with an alcohol misusing parent
  vary from 300,000 to 2.5 million (Cleaver, 1999)

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Parental substance misuse and child maltreatment

• Research in the USA and in the UK shows that
  parental substance misuse may reduce parenting
  capacity and is a major factor in cases of child
  maltreatment
• Research on SSD records provides some indication
  of the extent of identified parental substance
  misuse and risk of harm. These figures
  disproportionately represent families that
  experience poverty, social disadvantage and
  exclusion and are less likely to identify
  children living in more affluent families who may
  experience parental substance misuse
  (particularly alcohol misuse) and those that move
  frequently, are homeless or remain invisible to
  the system.
• Figures show that substance misuse is most common
  in the more serious cases known to SSDs such as
  children on the Child Protection Register and/or
  in court proceedings.

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Parents with substance misuse problems who have
contact with SSDs
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Type of parental substance misuse problems and
nature of maltreatment

• No large-scale, systematic research has been
  undertaken into the association between use of
  different types of substances and child
  maltreatment (Cleaver et al, 1999).
• Neglect is the most commonly experienced form of
  maltreatment that children may experience and
  cuts across the use of different types of
  substances (Kroll and Taylor, 2003).
• Some research suggests that risk of physical
  abuse is more strongly associated with parental
  alcohol misuse. (Famularo et al, 1992 Harwin
  and Forrester, 2003 and Gorin, unpublished).
• There are mixed findings about sexual abuse. One
  study suggested links with cocaine use (Famularo,
  1992) whilst others have found that substance
  misusing parents were rarely a feature of sexual
  abuse cases (Gorin, forthcoming Forrester, 2000)

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Vulnerability of children to parental substance
misuse

• Not all children will be at risk of significant
  harm because of parental substance misuse and
  patterns of risk will change. It will depend on a
  variety of factors such as type and nature of
  substance misuse, quality of parenting (and other
  support available to the child) and resilience of
  the child.
• However children who live in families where a
  parent has a substance misuse problem are at a
  higher risk of a range of adverse outcomes in
  their childhood and through to adulthood.
• Children are thought to be more vulnerable when
  alcohol and drug use coexist with domestic
  violence and where both parents use substances
  (Cleaver et al., 1999)

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Impact on children

• Physical, sexual, emotional abuse or neglect (or
  threats of maltreatment)
• Feelings of fear, anger, guilt, embarrassment,
  shame, secrecy, rejection, loss of love, loss of
  self-esteem/confidence, loss of normal family
  life, fear of losing parents, loss of childhood
• Problems developing/maintaining peer
  relationships
• Social exclusion and isolation, stigma, bullying
• Emotional and behavioural problems
• Difficulties/ poor attendance at school
• Exposure to illegal substances and criminal
  activity, strangers coming into house
• Role reversal undertaking domestic/caring tasks
• Frequent moves and changes in carer/s and schools
• Inconsistency of parenting and boundaries,
  unpredictable moods
• Disrupted routines and family occasions

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• Ever since I can remember Ive been scared. Its
  affected our lives. (Child quoted in Laybourn et
  al., 1996, p.56)
• Dad gets depressed cos he hasnt got a job. He
  drinks and shouts and hits us. Mum left. (Boy
  aged 9, quoted in ChildLine, 1997, p.36)
• I just had to decide myself that even though I
  loved my mum and cared a lot about her I wanted
  to live on my own. Still go to visit her and at
  least if I went to see her and if it got out of
  hand and she got too drunk and violent I could
  walk away. (Girl, aged 18 quoted in Dearden and
  Becker, 2000)

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Assessing Childrens Safety - Factors for
Consideration

• Childrens physical safety while drug use is
  taking place.
• Possible trauma to child resulting from changes
  in parents mood or behaviour
• Impact of parents substance misuse on childs
  development (including emotional and
  psychological well being, education and
  friendships)
• The extent to which parental drug use disrupts
  normal daily routines and prejudices the childs
  healthy physical and emotional development
• Relevant information from other agencies
• Impact on a child of being in a household where
  illegal activity is taking place (e.g. dealing)
• How safely parents drugs and equipment are stored
• Drug Using Parents - Policy Guidelines For
  Inter Agency Working (1997)
• SCODA / LGDF

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Problems facing professionals

• Engaging with adult clients and sustaining trust
  Vs acting on child protection concerns
• Getting adequate and consistent information from
  clients
• Differences between adults and childrens needs
  and services different focuses and clients,
  gaps in worker knowledge and confidence,
  confidentiality issues vs risk to child, sharing
  of information between agencies, differences in
  timescales (need to move quickly with children),
  balancing parents capacity to change with
  long-term risk to child
• Engaging with children, inconsistent evidence of
  how children were coping, difficult to try to
  understand childrens experiences and impact on
  them
• Confusion/ lack of knowledge about guidelines for
  working with substance misusing parents (either
  SCODA or their own agency)
• Difficulties in gaining a holistic assessment of
  families snapshot of peoples lives
• Violence and threats of violence towards staff
• (Kroll and Taylor, 2003)

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What does research tell us about lessons that can
be learnt?

• Closer integration of childrens and substance
  misuse services needed. Responsibility for
  protection of children must be multi-agency and
  communication between adults and childrens
  services is essential to help safeguard children
• Need for multi-disciplinary teams, training and
  preparation (eg. some authorities have a link
  worker that works part-time in social services
  and part time in drug and alcohol services)
• Need to listen to children and parents about
  needs and services
• Provide services that meet needs of whole family
  - counselling and support needed for children but
  often not available
• Be aware of needs of black and ethnic minority
  families that might make children more invisible
  

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Recent policy developments

• NSPCC has made submissions to the
• Home Office Advisory Council on the Misuse of
  Drugs - Inquiry into the Children of Problem Drug
  Users. Due to report shortly
• Alcohol Reduction Strategy consultation -
  strategy to be in place by 2004

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Further reading

• Kroll, B. and Taylor, A. (2003) Parental
  Substance Misuse and Child Welfare. London
  Jessica Kingsley
• Cleaver, H. Unell, I. And Aldgate, J. (1999)
  Childrens Needs Parenting Capacity The Impact
  of Parental Mental Illness, Problem Alcohol and
  Drug Use and Domestic Violence on Childrens
  Development. London The Stationery Office.
• Tunnard, J. (2002) Parental drug misuse a
  review of impact and intervention studies.
  Research in practice. www.rip.org.uk
• Tunnard, J. (2002) Parental problem drinking and
  its impact on children. Research in practice.
  www.rip.org.uk
• Harbin, F. and Murphy, M. (2000) Substance misuse
  and child care. How to understand, assist and
  intervene when drugs affect parenting. Russell
  House publishing, Dorset.