Guidance for Hertfordshire Early Years Settings on Drugs and Alcohol This is a framework to help staff in early years settings to identify families who may have issues with drugs and alcohol, and signpost or refer to the appropriate local services and information points. February 2014
Contents The advice in this guide is adapted from Addaction: First Steps (2012) For Children s Centres working with Parental Substance Misuse: Best Practice Guidance
How to use this guide If you work in an early years setting in Hertfordshire, you are likely to come across families who have issues with drugs and alcohol. Often you may be the first person to notice that a family has a problem. This guide aims to provide you with the practical support you need to be able to provide initial advice to families in this situation, and to make sure that other local services know about the family if they need to. This is important because we want to try to help families early, before their problems with alcohol and drugs become more serious. This guide includes information about: How to identify families who may have problems with drugs and alcohol How to provide initial advice and support to families, including how to raise this difficult topic with parents How to signpost families to the expert professional services available in Hertfordshire, which support and treat families with drug and alcohol problems
Why is it important to support families with drugs or alcohol issues? It can have an immediate effect on parenting When alcohol and drug use become a problem it can result in different types of poor parenting behaviour: Disorganisation: if the priority is obtaining and drinking alcohol or taking drugs, care for others will come second. Inconsistency: emotions and moods may vary unpredictably with intoxication and anxiety. The effects of alcohol and drugs can lead to highs and lows. Going without: if money goes to pay for alcohol or drugs, spending on food, housing and other essentials suffers. Parenting issues: with frequent intoxication, emotional and practical care responses will suffer. For example, volatile moods may result in overly strict or emotionally withdrawn parenting. It can have a long term effect on children and young people Children from families where parental alcohol or drug misuse is a significant factor are more likely than other children to: Start using alcohol and other drugs at a younger age Use alcohol and drugs in risky fashion Have problems with alcohol and substance misuse Have a higher prevalence of psychiatric disorder It can be a symptom of wider problems in a family Serious issues for families such as domestic abuse, relationship breakdown and mental health problems can be linked to drug and alcohol misuse. These can all have very negative effects on children.
How to identify families that may have issues with drugs or alcohol Often families who are experiencing problems with drugs or alcohol may try to conceal their symptoms and downplay their problems, making it difficult to identify them. The following list of possible signs of alcohol and substance misuse may be helpful to help you to identify families at risk they cover symptoms for both mild and serious misuse. Be aware that use of different drugs can have very different effects, and the symptoms described below may be attributable to causes other than substance use. Signs in a child s behaviour Children s behaviour and their ability to cope is often affected by alcohol or drug use in their family. If you sense that something isn t quite right in a child s behaviour, it is useful to consider whether it could be a symptom of drug or alcohol use in their family. A child may demonstrate through play or by talking to professionals (or other children) that their life is impacted by substance misuse. Physical signs in parents Bloodshot eyes, pupils larger or smaller than usual. Changes in appetite or sleep patterns. Sudden weight loss or weight gain. Deterioration of physical appearance, personal grooming habits. Unusual smells on breath, body, or clothing; tremors, slurred speech, or impaired coordination. Behavioural signs in parents Mentioning in passing a recent night out involving taking drugs or drinking large amounts of alcohol. Disorganisation in bringing children to childcare settings. Drop in attendance and performance at work, not keeping appointments. Unexplained need for money or financial problems. May talk about the need for money, not pay childcare or child group fees, or borrow or steal to get money. Engaging in secretive or suspicious behaviours. Lying (often very convincingly), untrustworthy, secretive. Sudden change in friends, favourite hangouts, and more visitors coming to the house. Frequently getting into trouble (fights, accidents, illegal activities). Psychological signs in parents Unexplained change in personality or attitude. Focused on self and seemingly little empathy or concern for others and their needs. Sudden mood swings, irritability, or angry outbursts. Periods of unusual hyperactivity, agitation, or giddiness. Lack of motivation; appears lethargic or spaced out. Appears fearful, anxious, or paranoid, with no reason. Signs in the home Drugs paraphernalia such as rolled up notes, cigarette ends, and foil. A large number of empty bottles.
What to do if you think a family may have issues with drugs or alcohol Stage One: Identification Parents are often concerned about the negative impact of their drug or alcohol use on their parenting and their children, but are afraid to talk about it. You will need to be skilled and sensitive in your approach to facilitate disclosure. Try to meet with a parent initially with the aim of finding out about their health and lifestyle as well as if substance misuse is a cause for concern. Actions As part of a conversation with a parent, include routine, unthreatening questions about drugs and alcohol. Provide parents with information about drugs and alcohol by using topic based discussions on healthy lifestyles, smoking cessation, general parenting and other issues. Provide posters, leaflet and handouts about drugs and alcohol for parents to take away as part of general packs of information. Appoint a person in the team/centre for parents to talk to if they are ever concerned about their own or another person s substance misuse. Example questions We all know parenting can be stressful, what kinds of things do you do to relax? Family life can be tough and we all have to cope, can you tell me what helps you cope? Alcohol and drugs are quite a normal part of life for many people, but they can become a problem at times. What do you think? When people come here we need to know how best to support them, and part of that is to ask questions about health, lifestyle etc. Can you tell me any concerns you have about your health or lifestyle, for example any medication you are on, how much alcohol you drink etc.? Resources You can order local leaflets, alcohol unit calculators and information on substance misuse from Hertfordshire Health Promotion you will need to register first: http://www.healthpromotioninherts.nhs.uk/
Stage Two: Give Brief Advice If you think a parent needs more help, you may want to offer them some brief and simple advice. Try to raise awareness of their situation, and assess their willingness to engage in further discussion about their health and lifestyle. It s important to encourage a parent to make a change now, before their problem becomes more serious. Actions Hold a private conversation with a parent who you think may be misusing substances. Focus on the stress, anxiety or worry they may be experiencing, and which their use of substances appears to manage. Make a judgement about whether you think the child or children are safe, and whether a referral is needed (see page 8 for more details) If their substance use is recreational, support the parent to understand the need for safety planning to ensure that their children are looked after. Raise the parents awareness that recreational use can develop into problematic use. Deliver brief advice to support the parent to make changes and stay safe. Example questions You ve said that you drink/use drugs at times. Can you tell me if you or anyone else has any concerns about this, of if you need more information to help keep things safe? You ve said that you drink/take drugs, and that it helps you cope. It s also true that alcohol/drugs place you at increased risk of a range of problems. We can help make sure you avoid these. Are you happy for me to do this? I m sure you ll be aware that there can be health and other risks associated with alcohol/drugs. I can give you advice about avoiding these risks. Is this something you would be interested in? You ve said you are happy with your drinking and don t need to make any changes. I would like to give you some information to take away just in case you decide you need to make some changes in the future Resources The following websites may help you to prepare for helping a parent. Or you can signpost parents so they can access information themselves: https://www.drinkaware.co.uk/ http://www.nhs.uk/livewell/drugs
Stage Three: Brief Intervention If a parent needs, or is open to, more formal support, speak with them again to try to give them the tools they need to change their attitudes towards substance misuse, and to deal with any underlying problems. Actions Promote the message that it is not unusual for parents to use drugs/alcohol at times of stress and difficulty, and that you and others are there to help them deal with any problems they may have. Ensure an assessment of their children s safety and wellbeing is undertaken. Consult with a local substance misuse support organisation for advice, and make a referral for a parent to see a substance misuse worker if appropriate: You may want to ask the parent if they would like you to arrange a meeting with a substance misuse worker at your setting. You may want to offer to accompany a parent to attend substance misuse treatment for the first time. Example questions We ve identified that there are some concerns about your drinking/drug use, and some changes you would like to make. I can help you with some of this, and I can also involve others who know even more about this sort of thing, and together we can help you make these changes. Is that OK? You ve said that there are some changes you probably want to make. There are a number of things you can do next, and once I ve explained what they are you can decide on the next step. Resources Spectrum is Hertfordshire s main drug and alcohol treatment service and can be contacted on 0800 652 3169. Spectrum will see parents for an initial meeting at children s centres if the parent is in agreement and a referral form has been completed. There are other smaller treatment, support and advice organisations in Hertfordshire, which may be suitable for families with different needs: see the local resources section at the end of this document.
When to refer to social services If you have a suspicion or a concern about a child, talk to your line manager or designated safeguarding lead, and follow your own organisation s safeguarding procedures. If at any time you think that a child has suffered significant harm or is likely to do so, you should make a referral to social services through the Customer Contact Centre on 0300 123 4043. You should let the parent know that you are making a referral, unless you think that doing so will put the child at more risk. If you are unsure, you can: Read the Hertfordshire Safeguarding Children Board manual Contact the Targeted Advice Service at Hertfordshire Council for advice, on 01438 737511
Local resources and services Spectrum (Hertfordshire s Drug and Alcohol Treatment service) 9 treatment hubs across Hertfordshire run by CRI, most with Saturday opening hours. Requires a referral form to be completed. Can also give advice over the phone. 0800 652 3169 Hertspeak and One Herts One Family Two county wide projects run by Westminster Drug Project which offer services for families affected by parental drug and alcohol use. 01462 442442 The Living Room A charity offering a free therapy and support service for people experiencing difficulties related to alcohol or drugs. Has bases in Stevenage and St. Albans. 01438 355649 (Stevenage) / 01727 854479 (St Albans) Resolve A free to access, adult, drug and alcohol structured day service in Welwyn Garden City. 01707 690739 Talk Alcohol Counselling Service Offers counselling to people with alcohol difficulties in Hertfordshire who meet certain criteria. 01462 701956 Hertfordshire Health Promotion Provides local leaflets, alcohol unit calculators and information on substance misuse. Hertsdirect.org Provides online information about all types of support services in Hertfordshire. National resources and services DrugScope supports professionals working in drug and alcohol treatment, drug education and prevention and criminal justice. Alcohol Concern is a leading national charity working on alcohol issues Alcohol Learning Centre provides online resources and learning for commissioners, planners and practitioners working to reduce alcohol-related harm. Release provides a free confidential and non-judgemental national information and advice service in relation to drugs and drug laws. Children s Society s Stars National Initiative is a hub of information, guidance and resources on parental drug and alcohol misuse Addaction Guide for Children s Centres in working with parental substance misuse.