Dave Liddell describes how policy and practice need to combine to respond effectively to the 150,000 children affected by their parents' drug and alcohol use.
Scotland has an estimated 60,000 problem drug users and high rates of alcohol problems, putting it among the top countries in Europe for alcohol and drug problems per head of population. Drug problems expanded massively in Scotland in the early eighties and have become more entrenched since that time. We are now seeing problems in second and third generations of families with services finding it difficult to intervene.
The issue of parental drug and alcohol problems is undoubtedly one of the most challenging facing Scotland. The Scottish Government's drug strategy, The Road to Recovery, published in 2008, has an entire chapter devoted to the subject of 'getting it right for children in substance misusing families'. It highlights the need to do more at a local level to improve services for children, on prevention, early intervention and protection.
The Scottish Government, in its 2011 manifesto, stated its ambition for a parenting strategy:
'....the development of a national parenting strategy that encourages agencies to work together to support new parents and allows them to develop their parenting skills. Parents will have access to a guaranteed level of support across the country.'
Bringing these two policy areas to together is vitally important if we are to effectively address this huge problem.
There are an estimated 50,000 children of problem drug users and perhaps 100,000 children whose parents have alcohol problems, so there are potentially 150,000 children affected. Some parents with drug or alcohol problems may be isolated and lack support but still manage to ensure that their children are well nurtured.
Some people with drug problems can function well as parents but there are those who are failing badly, with their children being harmed significantly. This does not just depend on the abilities of individual parents but also on the support around them. Parenting abilities among drug users vary over time due to a range of factors. Personal difficulties, such as family problems, health and drug/alcohol use along with wider issues, such as welfare benefits and housing have a massive impact on vulnerable parents, and therefore, on their parenting capacity.
Children may be affected in many ways. The Aberlour report of 2006 Have we got our priorities right? describes:
The challenge for policymakers and practitioners, therefore, is immense.
The public discourse about this has been polarised, with the extreme view expressed by some politicians and academics that all parents with alcohol and, in particular, drug problems should have their children removed into care. This is clearly a completely impractical suggestion, given the scale of problems, the limited availability of foster carers, places within children's homes and prospective adoptive parents.
There has been little work on finding out what type of support parents with drug or alcohol problems would like. Since parental activity is at the heart of the issue, it seems remiss, even unwise, to miss the opportunity of getting their perspective on the key issues underpinning their attitudes and behaviours. So what are they looking for?
From our own work, particularly speaking with our volunteers who are parents and have a history of problem drug use, the following themes and issues emerge:
Parents with extensive experience of social work often say that there is no clarity about what being a good or good enough parent is and that custody decisions are not sufficiently objective. Their perceptions are that, too often, the management of their case is based on whether 'a social worker likes me', with a feeling that 'parents who are worse than us still have their children' and that the 'goalposts are always changing'.
While these views are from a relatively small sample, they highlight the issues that practitioners face in responding to parental drug and alcohol drug problems. The themes also highlight the potential value of systematically collecting the views of parents to inform how best to provide services.
What also comes through from our work with parents, reflected in a recurring theme from services, is that child welfare services and adult addiction services do not work closely enough with each other. Often, there is also a lack of awareness and understanding between the adult addiction workers and the children and families workers about the impact of parental drug problems from each other's perspectives. This can get in the way of finding effective solutions.
Adult services can sometimes address the needs of the adult client only, with the perspective of the children either not recognised or ignored. This is likely to happen particularly when a service does not identify the additional needs of a parent with children - for example, when an adult service sets up an arrangement for dispensing methadone which requires a mother with small children to walk a considerable distance or a service that has a busy and chaotic waiting room and makes no specific provision for parents attending with children.
Although we have known for years about this shortfall in recognising of the dual 'personas' of parents with drug problems, most areas, despite some pockets of good practice, have not yet bridged this.
However, on a more positive note, we know that:
The Scottish Government stated recently in the context of the proposed Children's Services Bill: 'Simply framing legislation that places a duty on planning partners to work together, where appropriate, to get it right for every child is unlikely to have much impact and may actually add more bureaucracy and barriers.' This is exactly right. The challenge is to encourage and work with frontline services to deliver improvements to joint working and effective practice.
Failing to do this and to intervene effectively will cost our society and individual families dear in both the short and long-term.
David Liddell is director of Scottish Drugs Forum, the national non-government, membership-based drug policy and information organisation in Scotland. He is a member of the UK Government's Advisory Council on the Misuse of Drugs and is also an active member of the European Civil Society Forum on Drugs.
The Scottish Government (2008). The road to recovery. Edinburgh: The Scottish Government
Aberlour Childcare Trust (2006). Have we got our priorities right? Stirling: Aberlour Childcare Trust and Association of Drug Action Teams in Scotland
Scottish Drugs Forum (2009). Internal report of survey of services. Glasgow: Scottish Drugs Forum