Stella Project response to: Home Office 2010 Drug Strategy consultation paper

Transcription

1 Stella Project response to: Home Office 2010 Drug Strategy consultation paper Background AVA (Against Violence & Abuse), formerly GLDVP, was formed on 12 April 2010 as a national second tier service working to end all forms of violence against women and girls. AVA s Stella Project is the leading agency addressing drug and alcohol related domestic and sexual violence. The Stella Project started as a partnership between the GLDVP and the Greater London Alcohol and Drug Alliance (GLADA) in During 2002, discussions between GLDVP and GLADA identified gaps in the current service provision for both survivors and perpetrators of domestic violence who are problematic substance users. GLDVP and GLADA therefore decided to create the Stella Project in order to find positive and creative ways to work towards more inclusive service provision. In 2010, as the GLDVP made steps to incorporate wider forms of violence against women and girls into its new remit of AVA, the Stella Project decided to incorporate sexual violence into the scope of its work. This was in recognition of the level of sexual violence experienced by women who access drug and alcohol treatment services, and in recognition of the research highlighting drug and alcohol use as coping mechanisms for experiences of trauma. Response to consultation paper Our response to this consultation focuses on questions A1, B3, C2, C4, C7, D1-3, D8 and E9-12, and specifically addresses the concerns of women experiencing problematic substance use. A1: Are there other key aspects of reducing drug use that you feel should be addressed? The third point of the Government s vision for a new drug strategy is a more holistic approach with drugs issues being assessed and tackled alongside other issues such as alcohol abuse, child protection, mental health, employment and housing. It is a crucial that in pursuing a more holistic approach to problematic substance use, the Government considers the intersections between problematic substance use and 1

2 violence against women and how this affects women s engagement with and retention in treatment. A 2005 UK study found that 51% of respondents accessing domestic violence agencies claimed that either themselves or their partners had used drugs, alcohol and/or prescribed medication in problematic ways in the past five years (Humphreys & Regan, 2005). Almost two thirds of survivors of domestic violence in the same study began their problematic substance use following their experiences of domestic violence. Studies in the UK and the US have shown that 30% - 60% of women accessing drug or alcohol services have experiences of current or past domestic violence (Powis et al, 2000; Swan et al, 2001). Findings from the British Crime Surveys revealed that 44% of domestic violence offenders were under the influence of alcohol and 12% affected by drugs when they committed physical violence (Budd, 2003). The Stella Project strongly supports the view that substance use does not cause domestic violence. Rather, the use of substances can be a disinhibitor which gives a perpetrator the belief that they will not be held accountable or responsible for violent behaviour. Similarly, there is no causal link between women s use of substances and her experiences of domestic and/or sexual violence. Rather, substance use is often a way for women to cope with their experience of violence. Women who experience any type of sexual abuse in childhood are roughly three times more likely than nonabused women to report drug or alcohol dependence (Kendler et al., 2000) and a study of female drug users in Scotland found that a third had experienced sexual abuse (McKeganey et al, 2005). The intersections between problematic substance use and violence against women mean that women accessing drug and alcohol services have specific experiences and needs which require specialist support (Becker and Duffy, 2002). Further, particular groups of women often have specific needs that require targeted support, including young women, Black, minority ethnics and refugee women and women involved in prostitution. Any holistic approach must also recognise the crucial role of specialist support services. We recommend that the Government links its 2010 Drug Strategy to its forthcoming Violence Against Women and Girls Strategy. B3: Which groups (in terms of age, location or vulnerability) should prevention programmes particularly focus on? Women s past experience of violence, especially sexual exploitation, is a significant background variable for problematic substance use (Vogt, 1998). Therefore, specialist domestic and sexual violence services, including specialist services for young women, should be seen as a key aspect of women s substance misuse prevention. 2

3 Young people with a state care background are at an increased risk of developing or having problems with substance use (Ward et al, 2003). Further, young women care leavers are especially vulnerable to commercial sexual exploitation, and women with a history of state care are disproportionately represented amongst women with problematic substance use involved in on-street prostitution (Cusick, 2002). We recommend that women s substance misuse prevention programmes include specialist domestic and sexual violence services, and are linked to domestic and sexual violence prevention programmes. We recommend that substance misuse prevention programmes include increased, holistic support for young women care leavers. C2: Do you think the Criminal Justice System should do anything differently when dealing with drug-misusing offenders? Around 70% of women entering custody require clinical detoxification, compared with 50% of men. In a study conducted at Holloway in 2001, around half of those who didn t require clinical detoxification, nevertheless treated positive to stimulants or cannabis. Women with histories of violence and abuse are over represented in the Criminal Justice System (CJS), with up to 50% of women in prison report having experienced violence at home compared with a quarter of men. One in three women in prison have suffered sexual abuse, compared with just under one in ten men, and up to 80% have diagnosable mental health problems. Furthermore, around 18,000 children are separated from their mothers by imprisonment every year and 34% of women in prison are lone parents (Corston, 2007). Women offenders experiences of violence must be recognised in the delivery of substance misuse treatment within the CJS, including understanding the role of partners in encouraging drug dependence upon release from prison. On their release, many women have no option but to return to an abusive partner who either encourages substance use and/or jeopardises their treatment for substance use. Therefore, safe accommodation for women leaving prison is essential to both ensure women s safety, and to reduce the likelihood of re-offending. The Corston Report, published in 2007, provided a comprehensive study of the needs of women in custody, the majority of whom experience problematic substance use. The Stella Project strongly supports the recommendations made by Baroness Corston, which are yet to be fully implemented. Over the past few years, new criminal justice responses have been developed to divert substance users away from the CJS. Arrest referral schemes, which divert people arrested for drug or alcohol offences into treatment, have been shown to be an effective way of encouraging engagement with treatment services, and thereby reducing levels of problematic substance use and re-offending (Birch et al, 2006). In 2008, the Stella Project worked closed with the Home Office Alcohol Strategy Unit to deliver training to the alcohol arrest referral pilot projects. This focused on appropriate and safe responses to domestic violence perpetrators who accessed the scheme. We are encouraged that the subsequent Home Office guidance on 3

4 developing arrest referral pilots released last year recommended that domestic violence training is mandatory. We would like to see this continued and further developed and would be happy to work with the Home office on this. Court diversion schemes provide similar benefits, and have been a successful tool in supporting women involved in on-street prostitution, many of whom are problematic substance users, into support services that address both problematic substance use and routes out of prostitution. However, opportunities for diversion from the CJS are not available in all areas and the level of support available differs depending on the commitment of police and local authorities to this approach. This applies also to Engagement and Support Orders, created under Section 17 of the Policing & Crime Act 2009, which provides the opportunity of court diversion for people convicted of loitering or soliciting for the purposes of prostitution. It is also important that diversion schemes from the CJS are available nationally, and provide flexibility to increase chances of success for those referred through them. In many cases, the requirements of arrest referral and court diversion schemes (Drug Treatment & Testing Orders, Alcohol Arrest Referral schemes and Drug Intervention Programmes) do need to be adapted to meet the needs of women. Given the high incidence of experiences of gender-based violence experienced by women in the CJS, these schemes must acknowledge that women have additional needs in order to feel safe and supported to continue in treatment, including womenonly spaces, childcare facilities, travel assistance, varying opening times and outreach or floating support services. We recommend the implementation of the recommendations from The Corston Report. We recommend the provision of safe accommodation for women leaving custody who are experiencing problematic substance use and domestic and/or sexual violence. We recommend that measures to divert substance misusing offenders from the Criminal Justice System into treatment are made available nationally, including the provisions of the Policing & Crime Act We recommend that measures to divert substance misusing women offenders from the Criminal Justice System include access to specialist treatment that addresses women s additional needs. C4: What forms of community based accommodation do you think should be considered to rehabilitate drug offenders? A UK study found that between 33% and 85% of women contacting domestic violence refuges and outreach services were experiencing problematic substance use (Humphreys et al, 2005). The same study found that between 26% and 67% of service users in substance misuse agencies were experiencing domestic violence. A 4

5 US study found that 47% of women in substance misuse treatment reported current domestic violence and that 59% of these women did not complete treatment for substance use, compared with 71% who did not report a violent relationship (Swan et al, 2001). Despite this high proportion of women with problematic substance use who have current or past experiences of domestic and/or sexual violence, there is only limited refuge provision for women substance users. Women often increase their substance use in order to cope with their experiences of violence and failure to support women around their experiences of domestic violence may impact on their success in substance use treatment (Galvani and Humphreys, 2007). Women-only spaces, in both residential rehabilitation services and non-residential drug treatment services, are vital to ensuring women s safety and providing them with the best opportunities for long-term recovery. In mixed services, women report feeling intimidated and vulnerable (Becker and Duffy, 2002). Further, black, minority ethnic and refugee women are less likely to access mainstream services (Becker and Duffy, 2002) and specialist accommodation for these women is an important tool to ensure their equal access to substance misuse treatment. Women also are unlikely to access residential substance use treatment if this means leaving children with an abusive partner, thus residential facilities must include accommodation for children (Galvani and Humphreys, 2007). We recommend that community based accommodation for women substance users is women-only and includes accommodation for children and access to support around experiences of domestic and sexual violence and sexual exploitation. We recommend that specialist community based accommodation is provided for black, minority ethnic and refugee women. C7: Which partners in the public, voluntary and community sectors - would you like to see work together to reduce drug related reoffending in your local area? The Making Every Adult Matter (MEAM) campaign 1, a coalition between Clinks, DrugScope, Homeless Link and Mind, provides a model for people with multiple needs and exclusions to be supported by a range of statutory and voluntary services, recognising that coordinated responses deliver more positive outcomes. Specifically, an multi-agency treatment approach for substance misusing women should include Drug Alcohol Action Teams (DAATs), GPs, mental health professionals, social services, probation officers, CARAT workers, Benefits Agency, Citizens Advice Bureau and Housing teams (Becker and Duffy, 2002). Further, the high proportion of women in substance misuse treatment who have past or current experiences of domestic and/or sexual violence suggests that treatment agencies must also engage with local Multi-Agency Risk Assessment Conferences 1 See: 5

6 (MARACs) and agencies that attend these conferences, including voluntary sector violence against women services and Victim Support. 2 Since childcare concerns are a key factor in women s access and engagement with substance misuse treatment, agencies which support the children of substance misusing parents must be engaged as key partners in reducing women s problematic substance use. These agencies include midwives, health visitors, Sure Start, nurseries, pre-schools, playgroups, schools and Connexions (Becker and Duffy, 2002). Effective partnership working amongst these agencies requires workforce development. For example, the 4,200 new health visitors to be based in Sure Start centres must be trained in identifying and providing support and onward referral for problematic substance use and domestic and/or sexual violence. Integrated, multi-agency responses are more than just referral pathways between services, they should provide seamless services, with a consistent approach across agencies, open and transparent communications and decisions, and an understanding of commonalities and differences in agencies perspectives (Becker and Duffy, 2002). In order to offer a consistent approach, it is important that different sectors have shared targets, rather than working towards different goals. In this respect, the Government must be cautious of implementing localism at the expense of providing the consistent approach that best meets women s needs. The Stella Project has been working to improve multi-agency responses in London since 2002, and has seen significant increases in partnership working during this time. In a review in 2008, 31 (91%) London boroughs showed some evidence of joint working between the domestic violence and substance misuse sectors, 26 (79%) had stated objectives or priorities relating to joining up work around domestic violence and substance misuse in their strategies or action plans, and 18 (55%) have specified action to address domestic violence and substance misuse, with evidence of these taken place and/or monitoring arrangements in place (Stella Project, 2008). For example, in Brent the Domestic Violence Coordinator secured funding to deliver a series of training sessions for both the substance misuse and domestic violence sectors. The lead manager for substance misuse was engaged in the work of the local domestic violence advocacy project and identified the possibility of increasing referrals to local substance misuse agencies through inter-agency working. This led to three years DAAT funding for a substance misuse worker at the domestic violence advocacy project. In follow-up mapping conducted in 2010, the Stella Project found that Brent s Independent Domestic Violence Advisor is partly funded by the Drug & Alcohol Action Team, that substance misuse agencies attend the Multi-Agency Risk Assessment Conference, and that there is an established referral pathway between agencies across the two sectors. We recommend that the Government consider the Making Every Adult Matter model for a coordinated approach to substance misuse treatment. 2 In 2011, the Stella Project will be developing a programme of training and support, in partnership with CAADA, to ensure local drug and alcohol agencies are able to participate effectively in MARACs. 6

7 We recommend that multi-agency responses to women s substance misuse include agencies providing support to survivors of domestic and/or sexual violence. We recommend that the Government provide ring-fenced funding for workforce development, to accompany any new partnership approaches to substance misuse. D1: Thinking about the current treatment system, what works well and should be retained? Women substance users are often managing a range of issues alongside their problematic substance use, such as experiences of current or past domestic and/or sexual violence, childcare responsibilities and engagement with social services, and mental health needs. The more effective ways of working in the current treatment system are those which address problems beyond women s problematic substance use (Becker and Duffy, 2002). The Women s National Commission s Still We Rise report, based on focus groups with 300 women across England and Wales, including women experiencing problematic substance use, offers an excellent insight into both the strengths and weaknesses of the current treatment system. Importantly, women noted that the most effective supports were also those with long waiting lists: There s a woman s group at the drugs project and at probation, which have waiting lists. If I could go somewhere and do some art or pottery or learn to use a computer, get some skills, but there s nothing to do (cited in Women s National Commission, 2009). In London, the nia project, Solace Women s Aid and Eaves offer examples of good practice in supporting women experiencing the overlapping issues of problematic substance use and gender-based violence. The nia project in Hackney provides temporary safe accommodation, support and advocacy to women and children feeling domestic violence, and has a substance misuse worker who works specifically with women with drug and alcohol issues and develops partnership working with external agencies. Solace Women s Aid provides a substance misuse service, including assessment and individual care plans, for women experiencing domestic violence either in the community, or at any refuge across any of the London boroughs. Eaves Scarlet Centre provides advocacy and support for women experiencing violence across all London boroughs, and has specialist substance misuse and mental health workers. However, these holistic, women-centred services are under threat of closure due to funding cuts. Foundation 66 s specialist Women s Alcohol Service in London (formerly ARP) provided a women-only safe space where services such as domestic violence counseling were offered, but has now been closed. Eaves Chamlong House, a specialist refuge in Southwark for women with problematic substance use, mental health and learning difficulties, including women involved in prostitution, was closed earlier this year. Both Solace Women s Aid and Eaves Scarlet Centre services are facing closure in early 2011, pending the outcome of a review of London Councils funding. 7

8 The current treatment system s harm reduction model allows women substance users to set their own definition of recovery, which may not necessarily be abstinence, but may be achieving a better quality of life or increasing their personal safety. It is important that any change to this approach takes account of the views of service users themselves. We recommend that the Government ring-fence funding to protect existing services that address both women s experiences of problematic substance use and domestic and/or sexual violence. We recommend that the Government conduct a wider consultation that seeks the views of service users on what works well in the current treatment system. D2: Thinking about the current treatment system, what is in need of improvement and how might it need to change to promote recovery? Galvani and Humphreys (2007) identified five main areas in the current treatment system that needed improvement in order to increase women s access to, and engagement with, substance misuse treatment: inadequate childcare provision and fears around child protection issues; perpetrator control; a lack of flexibility or due consideration for women s safety in service structures; lack of access to refuges or safe accommodation; and gaps between stages of service delivery. Targeted, holistic, client-centred treatment services that provide supplementary services seem to impact positively on women s completion of treatment (Galvani and Humphreys, 2007), and yet they remain few and far between. Effective substance misuse treatment for women requires women-friendly service structures: womenonly spaces, flexible appointment times, appropriate opening hours, fast-tracking for women suffering domestic violence, childcare facilities, access to refuges or other safe accommodation, travel assistance, outreach/home visits, and specialist services for BMER women (Galvani and Humphreys, 2007; Becker and Duffy, 2002). Women themselves, in focus groups conducted by the Women s National Commission, identified similar gaps in the current treatment system: Women need more women-only drugs services. When you ve made your mind up to get clean, women s rehab services should be available at that point, not in 6 months time. What we want is somewhere like a safe home just for women, so you don t have to go to loads of places, where there are counsellors that come to you, you have a key-worker that supports you, they understand what you ve been through and help you get off drugs and off working on the streets (cited in Women s National Commission, 2007). There should be residential drug treatment places specifically for women. There aren t enough women-specific services, drugs services and help around violence and abuse to get out of this lifestyle. We need one service that does all this, that caters to our needs so we don t have to go around 10 different agencies to get help. Is that so difficult? (cited in Women s National Commission, 2007). We need a here and now service, something that s more immediate and accessible, would break down the barriers. The problem is that a woman in crisis is made to wait a month, by the time they can get the service they ve already coped for a whole month 8

9 and won t use it. And appointments are pointless, because you re busy or you forget, and then you have to wait another whole month, but in another month you could be dead (cited in Women s National Commission, 2007). We all need help, we don t have much self-worth or we wouldn t put up with violence in the first place, we have no self-worth working on the streets, we just need something to realise how we can be, what we can do. There should be women s services with art classes and other things to do, as the days are long and empty and that s when problems [with drugs] start or get worse. We need a programme that would build self-worth, help girls to realise how special they are self defence, art, hair, makeup that kind of thing (cited in Women s National Commission, 2007). We recommend increased investment in holistic services that address both women s experiences of problematic substance use and domestic and/or sexual violence. D3: Are there situations in which drug and alcohol services might be more usefully brought together or are there situations where it is more useful for them to be operated separately? Many substance users use both drugs and alcohol problematically, and it is generally beneficial for service users to be able to access support in one place, rather than going to separate services. Investment in specialist, separate services would be better placed with women-only services and targeted support for Black, minority ethnic and refugee women. We recommend that drug and alcohol services are combined. D8: Treatment is only one aspect contributing to abstinence and recovery. What actions can be taken to better link treatment services in to wider support such as housing, employment and supporting offenders? An emphasis on recovery must also be accompanied by investment in aftercare, such as through outreach workers who can provide holistic, one-to-one support that increases the chances of engagement through taking the service to the service user. Outreach workers are a particularly effective resource for aftercare work with women, particularly because of childcare responsibilities, and can support women in their contact with social services, parenting skills, accessing welfare and housing benefits, accessing mental health services, and linking them into community networks and education and employment opportunities. Approaches to treatment and recovery must also recognise, however, that recovery is not always a linear process, and that even with support, many people will relapse. It is important that substance misuse services prioritise maintaining contact with service users and consider alternatives to excluding clients who fail to meet the standards of treatment programmes (Becker and Duffy, 2002). The Government must consider the potential implications of a funding regime for substance misuse services which incentivises abstinence results, including the possibility that agencies will cherry pick those service users believed to have the greatest chance of abstinent recovery. 9

10 We recommend that the Government invests in holistic aftercare, including outreach support. We recommend that the Government does not provide substance misuse services with financial incentives to achieve abstinent recovery with service users. E9: Based on your experience, how effective are whole family interventions as a way of tackling the harms of substance misuse? E10: Is enough done to harness the recovery capital of families, partners and friends of people addicted to drugs or alcohol? Whilst whole family interventions may be effective in some instances, agencies must exercise caution to ensure that this approach is not used with families where domestic violence is being perpetrated. A 2008 evaluation of families who disengaged with the Family Alcohol Service (FAS) in London, domestic violence was clearly identified in five of the seven families (Taylor et al, 2008). This study noted that substance use was often a coping mechanism related to domestic violence, and the experience of domestic violence impacted directly on engagement with treatment and their ability to address the drink problem and minimise the impact on the child (Taylor et al, 2008). This suggests that whole family interventions which include the abuser are neither appropriate, nor effective, for families where domestic violence is being perpetrated. It is important that agencies using this approach have a comprehensive risk management strategy in place and that staff members thoroughly trained in identifying and providing support around domestic violence. The higher rates of prevalence of domestic abuse within the substance treatment population suggests that substance misuse workers must have a thorough understanding of the dynamics of power and control within domestic violence relationships, before they can begin to effectively harness the recovery capital of families, partners and friends. Without a strong understanding of domestic violence, workers risk stigmatising and silencing sufferers of domestic violence, for example through holding them responsible for a perpetrator s recovery, encouraging them to depend on a perpetrator in their own recovery, and/or minimising opportunities for disclosure of domestic violence by referring to the perpetrator as a source of support. We recommend that measures are put in place to ensure the safety of survivors of domestic violence in whole family interventions, including risk assessment procedures in all treatment agencies. We recommend that whole family interventions in families where domestic violence is being perpetrated do not include unsafe practices such as family therapy or mediation involving the perpetrator. 10

11 E11: Do drug and alcohol services adequately take into account the needs of those clients who have children? Clients who are responsible for children are predominantly women, and studies consistently show that a lack of appropriate childcare is a key barrier to women s access to, and retention in, substance misuse treatment. Women who are experiencing domestic violence are often prevented by a perpetrator from accessing substance misuse services, and her children can be a powerful way in which a perpetrator has control over her, such as through making threats like reporting her as an unfit mother (Galvani and Humphreys, 2007). These women may also choose not to access a service that does not have childcare facilities, since it would mean leaving her children with the perpetrator (Galvani and Humphreys, 2007). However, whilst substance misuse services generally recognise the importance of childcare facilities, they usually lack the financial resources to provide these facilities (Becker and Duffy, 2002). Fears around child protection issues are also a key reason women don t seek support, and for women substance users who are experiencing domestic violence this fear is often compounded by an understanding that their children will be deemed at risk on both fronts. We recommend that the Government ensure women s substance misuse treatment services are adequately funded to include access to childcare (in community-based treatment), accommodation for children (in residential treatment), appropriate opening hours and support around contact with social services. E12: What problems do agencies working with drug or alcohol dependent parents face in trying to protect their children from harm, and what might be done to address any such issues? Since child protection concerns are a key barrier to women s access of substance misuse services, it is imperative that substance misuse agencies are open and transparent about their responsibilities in respect of child protection, and inform and discuss disclosures to social services with the service user (Becker and Duffy, 2002). Agencies are more likely to be able to protect children from harm if they have the trust of their service users, and service users are confident that they will receive support through their contact with social services. Substance misuse agencies can employ various strategies to protect children from harm, including providing specialist children s workers, providing parenting support, and liaising with social services through providing assessments and attending child protection conferences (Becker and Duffy, 2002). Workers in substance misuse agencies must be aware of the prevalence of experiences of domestic and/or sexual violence amongst people accessing their services, and be trained to identify perpetrators and sufferers of domestic violence. 11

12 Violence towards a mother is a significant risk indicator for child abuse, with estimates of between one-third and two-thirds of children in homes where the mother is being abused also being at risk of being abused (Home Office, 2000). In one study of women and children who had left a domestic violence abuser, 27% of the partners had also assaulted the children (Abrahams, 1994). Where cases of domestic violence remain unidentified, the risk to children is not properly assessed and women s continued substance use, despite treatment, may lead to greater social services involvement. Specialist domestic violence agencies play a crucial role in providing assessment and support around children s exposure to domestic violence, providing opportunities for increased partnership working between the domestic violence and substance misuse sectors. Good practice examples include Solace Women s Aid s Family Service, which provides a specialist substance misuse and domestic violence children s worker for children and young people. AVA s Children & Young People s Project founded and coordinates the Community Group Programmes in London and across the UK. The programmes are for children, young people and their mothers who have experienced domestic violence and provides a community based setting for them to share and talk about their experiences. It is originally a Canadian model and has been piloted and successfully evaluated in the London Borough of Sutton. Each programme runs over a twelve-week period for children aged 4-21 (children are divided into age-specific groups). The Department for Children, Schools and Families, the Department of Health and the National Treatment Agency for Substance Misuse s Joint Guidance on Development of Local Protocols between Drug and Alcohol Treatment Services and Local Safeguarding and Family Services promotes a Think Family approach to safeguarding the children of drug and/or alcohol dependent parents, yet makes no mention of domestic violence. The Stella Project is concerned that in its current form, this guidance is inadequate to protect children in families where domestic violence is being perpetrated, despite the fact that these families are over-represented amongst service users of agencies. The Stella Project has significant expertise in this area, and would welcome the opportunity to work together with the Government to further develop this Joint Guidance to support children and families affected by domestic violence. We recommend that all substance misuse agencies provide support for service users around parenting, contact with social services and referrals to specialist domestic violence agencies. We recommend that all substance misuse workers are trained around domestic violence and child protection. We recommend increased investment in services for children and families in the domestic violence sector, addressing the overlapping issue of problematic substance use. 12

13 Reference list Abrahams, C., Hidden Victims: Children and Domestic Violence. London: NCH. Becker, J, and Duffy, C., Women Drug Users and Drugs Service Provision: service-level responses to engagement and retention. London: Home Office. Birch, A., Dobbie, F., Chalmers, T., Barnsdale, L., McIvor, G., and Yates, R., Evaluation of the Arrest Referral Pilot Schemes. Edinburgh: Scottish Executive Social Research. Budd, T., Alcohol Related Assault: Findings from the British Crime Survey, Home Office Online Report 35/03. Corston, Baroness J., The Corston Report. London: Home Office. Cusick (2002) Youth Prostitution: A Literature Review, Child Abuse Review, 11 (4), Galvani, S. and Humphreys, C., The impact of violence and abuse on engagement and retention rates for women in substance use treatment. London: National Treatment Agency. Home Office, Tackling Domestic Violence: providing support for children who have witnessed domestic violence. Home Office Development and Practice Report. London: Home Office. Humphreys, C. and Regan, L., Domestic Violence and Substance Use: overlapping Issues in Separate Services, Final Report. London: Stella Project. Available: Kendler, K., Bulik, C., Silberg, J., Hettema, J., Myers, J., and Prescott, C. (2000) Childhood sexual abuse and adult psychiatric and substance use disorders in women: An epidemiological and co-twin control analysis, Archives of General Psychiatry, 57 (10), McKeganey, N., Neale, J. and Robertson, M. (2005) Physical and sexual abuse among drug users contacting drug treatment services in Scotland, Drugs: education, prevention and policy, 12 (3), Powis, B., Gossop, M., Payne, K. and Griffiths, P., Drug Using Mothers: social, psychological and substance use problems of women opiate users with children. Drug and Alcohol Review, 19, Roberts, M Young people s drug and alcohol treatment at the crossroads: what it s for, where it s at and how to make it even better. London: DrugScope. Stella Project, Innovative Responses: new pathways to address domestic violence and substance misuse across London. London: Stella Project. 13

14 Swan, S., Farber, S. and Campbell, D., Violence in the Lives of Women in Substance Abuse Treatment: Service and Policy Implications, Report to the New York State Office for the Prevention of Domestic Violence, Rensselear, New York. Taylor, A., Toner, P., Templeton, L. and Velleman, R., Parental Alcohol Misuse in Complex Families: The Implications for Engagement. British Journal of Social Work, 38, Templeton, L., Zohhadi, S., Galvani, S., Velleman, R., Looking Beyond Risk. Parental Substance misuse: a scoping study. Edinburgh: Scottish Executive. Vogt, I Gender and drug treatment systems. In Klingemann, H. & Hunt, G. (eds) Drug Treatment Systems in an International Perspective: Drugs, Demons and Delinquents. London: Sage. Ward, J., Henderson, Z., Pearson, G., One problem among many: drug use among care leavers in transition to independent living. London: Home Office. White, C., Warrener, M., Reeves, A., and La Valle, I., Family Intervention Projects: An evaluation of their design, set-up and early outcomes. London: National Centre for Social Research. Women s National Commission, Still We Rise: Report from WNC Focus Groups to inform the Cross-Government Consultation Together We Can End Violence Against Women and Girls. London: Women s National Commission. 14