5.5 Substance Misuse and Families with Children

RELEVANT CHAPTERS

This should be read in conjunction with the Joint Service Protocol re: Families and Children Affected by Parental Drug/Alcohol Misuse.

AMENDMENTS

Section 7, Useful Resources was added in August 2011 with a link to the children’s booklet ‘You are not on your own’ booklet published by the Children’s Commissioner for England.

Background
Safeguards and Concerns
Referrals
Assessment and Initial Child Protection Conference
Confidentiality
Services for Pregnant Women
Useful Resources

1. Background

1.1	The effects on children of the misuse of alcohol and drugs by one or both parents or carers are complex and may vary in time, which is why a thorough assessment of needs and risk of harm is important. In some cases the misuse of alcohol and drugs may be one factor which, when linked to domestic abuse or mental illness, may increase the risks to the child.
1.2	The circumstances of children must be carefully assessed not only to consider immediate risks but also the long term effects on the child of their parents’ alcohol/drugs misuse. Parental substance misuse can and does cause serious harm to children at every age from conception to adulthood.
1.3	An appropriate response to these children often requires the close collaboration of a number of agencies - both statutory and confidential voluntary agencies. These would include Local Drug Action Teams, Health and Maternity Services, Adult Social Care and Children’s Social Work Services, Adult Treatment Services, Courts, Prisons and Probation Services.

2. Safeguards and Concerns

2.1	Parental substance misuse in itself is not a reason for considering a child to be suffering or at risk of suffering Significant Harm although it may be a contributing factor.
2.2	A thorough assessment by all relevant agencies is required to determine the extent of need and potential level of risk of Significant Harm in every case.
2.3	Where there is concern that a parent is involved in substance use, the effect on the child needs to be considered, including: The child’s physical safety Possible trauma to the child resulting from changes in the parent’s mood or behaviour The impact of the parent’s substance use on the child’s development including the emotional and psychological well being, education and friendships The extent to which the parent’s substance use disrupts the child’s normal daily routines and prejudices the child’s physical and emotional development Impaired parenting capacity Intermittent and permanent separation or frequent visitors to the home. Inadequate accommodation and frequent changes in residence and in cases of drug misuse, the following should also be considered: The impact on the child of being in a household where illegal activity is taking place particularly if the home is used for drug dealing How safely the parent’s drugs and equipment are stored The impact on the unborn child as a result of maternal substance abuse.
2.4	The circumstances surrounding dependent, heavy or chaotic substance use may inhibit responsible childcare, for example, substance use may lead to poor physical health or to mental health problems, financial problems and a breakdown in family support networks.

3. Referrals

3.1

Professionals, when confronted with a child in a substance-misusing environment must ask themselves “What is it like for a child in this environment?” If they cannot satisfy themselves that the child is not being harmed or in need, they must refer the child to Children’s Social Work Services – see Referrals Procedure.

4. Assessment and Initial Child Protection Conference

4.1	Children’s Social Work Services will consider whether it is appropriate to undertake an Initial Assessment in relation to all referrals. They will always undertake an Initial Assessment and consider a Core Assessment of all pre-birth and pre-school children in a substance-misusing environment, where a child has been judged by another professional as a Child in Need including in need of protection.
4.2	Assessments will be conducted on an inter-agency basis and further guidance on such assessments can be found in the Joint Service Protocol re: Families and Children Affected by Parental Drug/Alcohol Misuse.
4.3	If at any stage it is considered that a child, including an unborn child, may be at risk of Significant Harm, the Referrals Procedure must be followed. All relevant agencies must be involved in any Strategy Discussion.

5. Confidentiality

5.1

Confidentiality is important in developing trust between parents and staff in agencies working with them in relation to their drug use.

5.2

All agencies, both statutory and non-statutory, should have written procedures on confidentiality which provide for the sharing of information where there is concern about the wellbeing of a child who may be suffering or at risk of Significant Harm. When agencies start any work with substance-using parents or with pregnant women who use substances or children living with substance using parents, these procedures must be explained to them.

6. Services for Pregnant Women

6.1	When a woman with a substance misuse problem attends for antenatal care, she should be encouraged to contact the specialist Community Drugs Team for assessment and advice on the treatment options available to her.
6.2	If a woman continues to misuse substances, a referral to Children’s Social Work Services must be made so that consideration can be given to undertaking an Initial Assessment to explore the impact of the substance misuse on the unborn baby and parenting capacity.

7. Useful Resources

7.1

The Children’s Commissioner for England has published a booklet to help children affected by parental or carer alcohol abuse. It helps children discuss what they can do to keep safe and how the the alcohol abuse is affecting their life. The booklet is called ‘You are not on your own’ and is available here.

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