LIVING WITH AN ELEPHANT: DRUG MISUSE, PARENTING & CHILD WELFARE

BRYNNA KROLLSenior Consultant, ARTEC Enterprises Ltd

TWO YEAR RESEARCH PROJECT ( MARCH 2006-8) FUNDED BY THE DEPARTMENT OF HEALTH DRUG MISUSE RESEARCH

INITIATIVE ROUTES

DISCLAIMER: THE VIEWS EXPRESSED HERE ARE THOSE OF THE RESEARCHERS & NOT NECESSARILY OF THE DEPT. OF HEALTH

WHAT WE DID :STRUCTURE OF STUDY

Case record analysis of files of 28 children & young people on CPR where PDM is an issue

Interviews with children, young people, parents & grandparents

Interviews with a range of social welfare professionals from voluntary & statutory drug services, statutory child care & primary health care

Focus groups involving parents and professionals

WHY WE DID IT : RESEARCH OBJECTIVES

To promote the welfare & visibility of children with DMPs by improving inter-agency assessment & intervention

To identify the needs of children, young people & parents & obtain their views about services

To explore professionals’ views of dilemmas & challenges where PDM is an issue

To develop shared principles to inform protocols for good practice

THE ELEPHANT IN THE LIVING ROOM

The substance as a family member Living with an elephant Denial and the challenge to children’s

perceptions User/substance relationship as

family’s central organising principle Implications for attachment and

parent’s psychological availability

ABOUT THE CHILDREN & YOUNG PEOPLE

42 children & young people interviewed aged between 4-20 yrs ( 9 under 10;14 between 10-14; 18 between 15-17 &; 1 aged 20 ; 38 clinical; 4 community)

26 girls & 16 boys living in both rural & urban areas- 40 white; 2 dual heritage

15 living with a parent, 5 in a secure unit, 14 in foster care, 8 with extended family

Majority of children were from single parent households & had to cope with a range of parental problems in addition to PDM (alcohol misuse, mental health problems, DV)

Significant majority of children had anger management problems, had been excluded from school and been involved in bullying, fighting

Just over 50% aged 15-17 & 25% aged 10-14 had used drugs &alcohol themselves, most at worrying levels

Parents /grandparents of 12 of these children also interviewed ;some sibling groups also included

WHAT THEY TOLD US: ‘HOWEVER BADLY YOU WANT YOURSELF TO BE NUMBER ONE, IT’LL

NEVER HAPPEN.......’ Drugs always come first with implications for

attachment & trust PDM generates a range of powerful emotions PDM & caring for children don’t mix – ‘Don’t do it if you

have kids’ Managing parental responsibilities was common Poverty and squalor caused shame & embarrassment Education often compromised, although school a safe

haven for some Life is full of fears – of losing parent /being taken

away/parent being imprisoned/ parent dying Life is often dangerous & frightening; witnessing

violence was common

‘I DON’T WANT TO TURN OUT THAT WAY’

Parents were idealised & excused, despite impact on children

Children worn down by broken promises, multiple disappointments, failed treatment or precarious recovery

Stigma attached to children of drug users in small, rural communities - ‘there goes the junkie’s kid- I bet she’ll turn out the same’.

Children afraid that drug misuse is ‘catching’ Children scared to tell anyone but desperate for

someone to notice Own alcohol/drug use as pain management/ way of

coping but also a way of connecting with drug using parents

‘YOU’VE JUST GOT TO CARRY ON WITH IT, HAVEN’T YOU?’

Importance of grandparents & close friends(&

their parents) as sources of support Importance of supportive professionals (social

workers, teachers etc) ‘What doesn’t kill you makes you strong’ –

keen survival instinct & desire to make something of their lives

‘I just thought “they can’t do anything”’ –if children have failed to ‘fix’ parent, can others succeed ?

Young people offered insightful, sensitive advice for other children, as well as important messages to professionals & parents

ABOUT THE PARENTS & GRANDPARENTS

40 parents & 7 grandparents interviewed + one small focus group

Sample ( largely clinical ) comprised 13 fathers, 2 grandfathers, 27 mothers & 5 grandmothers, living in both rural & urban areas–all white

Majority of parents were single parents with a range of problems in addition to PDM (alcohol misuse, mental health problems, DV) both in the present and the past

Two pairs of grandparents & one single grandmother were caring for their grandchildren full time after CYPS intervention

A significant majority of parents had experienced their own parents’ substance misuse & had had traumatic childhoods

Heroin was the main drug used with some amphetamine, cannabis and alcohol misuse

WHAT THEY TOLD US ABOUT DRUG USE & PARENTING :

‘I USED (DRUGS) TO GET BY, NOT TO GET HIGH’ Most parents acknowledged that drug misuse & parenting

don’t mix High levels of guilt & denial about impact on children Drug use as a management strategy for other problems –

domestic violence, mental health problems, loss Parents rarely asked WHY they use – focus is on managing use

rather than on any help /counselling for the reasons behind it Important to understand the ‘why’ of misuse – not just the

‘what’ and ‘how much’ Roots of use often in trauma, abuse or lack of emotional

support from parents in childhood or adolescence Link between parental use and their own parents’

substance/ mental health issues Drug misuse causes devastation in family networks, with

grandparents often left baffled, guilt ridden and helpless

WHAT THEY TOLD US ABOUT SERVICES: ‘(I WAS) NOT GOOD ENOUGH, NOT BAD

ENOUGH...’

Parents often fall through gaps in services due to thresholds for drug intervention & child welfare

Inaccessible services for drug misuse +poor rural transport militates against punctuality

Too many appointments & meetings undermines engagement & motivation

Importance of personality of worker, being given time to talk, workers being honest and straight and not blaming parents

Importance of key professional who orchestrates inter-agency communication

Grandparents/kin rarely get support when they take over – even when children clearly need help

‘THEY’RE TRYING TO CATCH YOU OUT !’

‘….they wanted me to fail….they wanted to take him off me……everything I said was twisted….’

‘You’ve got to be perfect – more than good enough’ ; ‘ you can never have any problems or admit to relapses or cravings’

Haunted by history - ‘they were judgemental & thought straight away that we were crap parents’.

Lack of consistency re. SW response – why do some people get to keep their children and others not?

Inter-agency working – not consistent More understanding of drug use required –

‘Solve the problems in the life & the drugs will drop off!’

Cases closed too fast- support needed beyond immediate recovery/drug use management

‘I HOPE EVERYONE LISTENS!’ ‘WE ALL NEED HELP’

‘I want someone to stop my mum & dad smoking heroin’ ( ‘Rhondin’,7)

‘The children just need to be taken away from it, really’(‘Mac’,16)

‘Social workers should definitely be more emotionally supportive – most children have only got their social worker’(‘Lizzie’,20)

‘Try to help the parents more’ (‘April’,17) ‘Look for the person inside the junkie’ (‘Annabel',

parent) ‘It’s so much more than the drug use that needs to

be addressed’ (‘Mary’, parent) ‘It’s important to see us as a family’ (‘Matt’, parent)

A MESSAGE TO PROFESSIONALS

They should be helping the parents….and help the children get through what’s going on in the house….they should sit down and listen to children who have been through it, instead of thinking ‘It's our rules, we have to do it by our rules’ & not listen to the children…they should listen to what the children think and what the children feel…..just because people are children doesn’t mean they don’t know what’s right and what’s wrong…..we know ‘cos we’ve seen it – they don’t know what it’s like living with someone who has been using…….. ( ‘Harley’,15)