Hidden Harm: the impact of addiction on children & families
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1 Hidden Harm: the impact of addiction on children & families Dr. Ann Hope, Department of Public Health & Primary Care, Trinity College Dublin, Ireland
2 Presentation Outline Conceptual framework for studying alcohol s harm to others Risk pyramid for children and families Impact of parental drinking on children Frontline staff experiences Policy Implications Mutli-layered responses
3 Alcohol s harm to others Neglect or abuse to a child, to a partner Injuries assault, homicide, traffic crashes, workplace accidents Default on social role - as a family member, friend or worker Property damage to clothing, car or house Toxic effect on other (FAS) Loss of amenity or peace of mind kept awake, being frightened Source: Room R (2011). The harm of alcohol to others. WHO Collaborative project
4 Context - International WHO 2010 Alcohol s harm to others (AH20) from drinking requires special attention Priority area for WHO international research International Group for Studies of Alcohol s Harm to Others (IGSAHO)
5 Aim of study (2011) To profile children s exposure to risks from parental/ adults drinking in Ireland Gather new information Examine existing data with a new eye Discuss with frontline staff who work with children and families Hope A. (2011). Hidden Realities: Children s exposure to risks from parental drinking in Ireland. NWAF
6 Hidden Realities Report November 2011
7 Impact of parental drinking on children - surveys Hidden Realities Report (Hope 2011) 56% of adults, who had children living with them reported regular hazardous drinking Local communities aware of exposure to risk for children, in particular children being verbally abused and children left in unsafe situations ISPCC Report (2010) One in eleven young people (12-18 yrs.) said that parental alcohol use had a negative affect on them Emotional impacts, abuse and violence, family relations, changes in parental behaviour and neglect
8 Alcohol's harm to children due to others drinking Risk to children 1+ harms 10.1 % child verbally abused 9.2 child left in unsafe situation 5.4 child witness to serious violence in home child physically hurt One in ten carers reported children experienced 1+ harms from others drinking Hope A (2014). Alcohol s harm to others in Ireland. Dublin: Health Service Executive.
9 Impact of adult drinking on children child protection data Hidden Realities Report (Hope 2011) One in seven child welfare concerns involved family members who were abusing alcohol/drugs Alcohol abuse mentioned in one of every three child abuse cases in NW Parental alcohol abuse interacted with several other issues o o o o Child out of control due to behavioral problems Domestic violence, Mental health problems, Parent unable to cope
10 no of referrals Child Welfare and Protection Referrals to HSE, Child Welfare Child Protection Source: Child and Family Agency.(2012) Review of Adequacy for HSE Children and Family services 2012
11 Primary Reason for Welfare concern following initial assessment (2010) Family problems 69.8% Child problems 30.2% Family Problems: Family member abusing drugs/alcohol 15.9% Parent separation/other disharmony in home 13.6% Parent unable to cope 8.4% Mental health problems in other family members 5.8% Family difficulty re housing/finance 4.7% Domestic violence 4.6% Other 15.2%
12 Sept 2013-mid July Cases 864 Children
13 Reasons for seeking Court Orders Reasons Number % Parental disability Parental drug abuse Neglect Multiple Parental alcohol abuse Physical/emotional abuse Other Parent absent/deceased Sexual abuse Childs risk taking Not recorded Domestic violence Trafficked/abandoned % were Irish 39% were divorced/separated 35% were single Coulter C. (2014). Second Interim Report. Child Care Law Reporting Project
14 Frontline Staff Experiences
15 Scotland (2013) Commissioned by Alcohol Focus Scotland Research Team Ann Hope Jennifer Curran Gillian Bell Alison Platts
16 One part of study Case Study, Edinburgh Findings from 16 agency interviews from the perspective of those who experience harm from others drinking, as described by frontline staff
17 Experiences as a result of others drinking Family disharmony -relationship problems, tension, arguments, unpredictability and chaotic lifestyles Impact on children worry, fear and uncertainty can lead to neglect and poor school attendance Communities- experience noise, verbal abuse and disturbances Public service providers
18 Living with a problem drinker affects the whole family, like ripples in a pond People don t realise that their binge drinking can have a negative effect on others. The perspective is that harm is caused by dependent drinkers The problem is that alcohol doesn t come as an issue on its own.. Drugs and mental health issues can often also be present
19 Frontline Staff experiences Role of alcohol in family support services NW A sense of swimming against the tide Damaging drinking culture acceptance of getting drunk Burden children bear due to parental alcohol abuse Hidden secrets Care role reversal Impact on social life making friends, schooling, bullying, isolation Survival instinct Staff intervention on alcohol occurs at the extreme end of alcohol abuse/ crisis point Many family support services in NW, but few are evaluated on outcomes Hope A. (2011). Hidden Realities: Children s exposure to risks from parental drinking in Ireland. Letterkenny: North West Alcohol Forum.
20 Policy implications? Alcohol related harm is a much bigger problem when AH20 is added Burden is high, in terms of economic costs, service provision and quality of life AH20 reach impacts on children, families, friends, work colleagues and the wider community Corrosive effect on well-being & quality of life AH20 a significant public policy issue
21 Multi-layered Policy Responses 1. Tertiary prevention responses Provide intensive support to families in crisis Pay attention to multiple risk factors ( mental health, domestic violence, housing, work) Provide community supports & family based interventions Provide support to grandparents and other carers Build capacity of CPS workers to evaluate AOD issues
22 2. Secondary prevention responses Regularly gather information about family situations of AOD clients Needs of family and drinker - not always the same Are AOD services in a position to respond to children of their clients with AOD problems? Children First guidance important in helping to focus on risks to children Linkages between agencies central to supportive environment for children
23 3. Primary prevention responses Focus on community and societal level factors Changing drinking culture Risky drinking or drinking to intoxication around children Family & School based activities alcohol free Implement effective alcohol policies Best 3 buys for population based approach(who)
24 WHO Top 10 Best buys package for population-based approaches Smoke-free environments Warning about the dangers of tobacco use Bans on tobacco advertising Raising taxes on tobacco Raising taxes on alcohol Restricting access to retail alcohol Bans on alcohol advertising Reducing salt intake and salt content of food Replacing trans-fat in food with polyunsaturated fat Promoting public awareness about diet and physical activity
25 Hidden Realities Report November 2011
26 THANK YOU
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