Introduction to Aberlour – Basis of submission
Since it was first established over 130 years ago Aberlour Child Care Trust has developed a reputation for providing quality community and residential care and support services for vulnerable and disadvantaged children, young people and families.
Our 47 services across Scotland currently offer:
• Residential and outreach support to families affected by drugs and alcohol
• A range of community and family centre based services to promote and enhance positive parenting, play, early learning and social skills with vulnerable families and young children
• Intensive supports to severely disabled children and young people, many of whom have profound communication and behavioural difficulties
• Residential care and community programmes for children and young people with social, educational, emotional and behavioural difficulties.
• Drop-in advice, information and support services for young people on issues affecting them, including employment, training and sexual health.
• An outreach service and refuge for children and young people who have or are in danger of running away from home.
As well as providing services, Aberlour is committed to influencing Scottish policy and practice to create positive changes that benefit children, young people and families. Last year Aberlour led two significant Think Tank working groups which resulted in influential published reports; one called “Have We Got Our Priorities Right?” which focuses on children living with parental substance use and the second report “A Matter of Substance?” which looks at the differences between alcohol and drugs and the impact each have on children.
General
Aberlour acknowledges that the consultation focuses on adult mental health and welcomes the recognition within the document of the impact on children and young people. We do believe however that representation on the group was light in terms of children’s services (the Aberlour representative being the sole member form a child care organisation). This was reflected in the report which could have been much more explicit in making links between adult services and children’s services and the importance of these to work together for the benefit of the whole family.
Apart from the lack of specific recommendations arising out of section 16 (Children and Young People) we are in general agreement with the proposals and recommendations contained within the consultation document, We particularly welcome the recommendation that the impact of parental co-morbidity in children, and an exploration into better ways of supporting families be a research priority.
Section 4 - Health Improvement Re substance use is main diagnosis in 14% etc..
It would be useful to know how many of individuals presenting with co-morbidity issues are parents or carers of children.
Section 5 - Promotion, Prevention and Communication
It is acknowledged that the promotion of safe use, including abstinence, will have a beneficial effect on mental health. It is however difficult in practice for substance users (legal and illegal or both) to access psychiatric services for assessment etc until drug free and when there is more intervention focussed on substitute prescribing and not abstinence access to assessment and treatment will continue to be difficult.
Section 12 - Training
The report refers to the ‘considerable development of training and change in attitudes‘ since the publication of Hidden Harm and Getting our Priorities Right. This is in reality been mostly limited to workers in substance treatment services rather than those in mental health services. Mental health workers working with adults who may be parents should have training on the impact of parental substance use and mental health on children. This should have a practical focus on assessment skills, information-sharing, and partnership working and training should be delivered across agency/worker disciplines. There is a need to resolve continuing tensions around substance use versus mental health (i.e. the chicken/egg phenomenon which can mitigate against partnership working) so children’s needs are not overlooked.
Throughout the document it is apparent that both statutory and voluntary services do need different levels of training but funding for the courses/modules and training is an issue that needs to be addressed.
While reference is made to training being incorporated into qualifying training – such as the Child at the Centre initiative between STRADA and Dundee University – this does not address the issue of training for non-social work staff, many who work in the voluntary sector and in agencies providing vital support to families affected by substance use and mental health.
Section 16 - Children and Young People
This section muddles the separate issues of children affected by parental substance use and young people’s own substance use by referring to them in the same paragraph. We would wish to see the two being separate and the different issues addressed separately.
We do however welcome the documents recognition that addressing the impact of parental substance use/mental health on children is not just about child protection but also about promoting positive parenting. Assessment of the impact on children should focus both on risk (safety) and needs (thriving).
As highlighted in Aberlour’s 2nd Think Tank report ‘A Matter of Substance’, agencies tend to set higher thresholds in terms of intervening on children’s behalf regarding the use of alcohol by parents than they do for drug use. There is no reason to expect that this will be any different in the case of parents with mental health and substance use problems. We would suggest that further work is required on addressing this, particularly in relation to training.
There needs to be recognition of the considerable burden for extended family members create in providing substitute caring for children affected. We need to ensure young carers’ groups and other supports have the capacity to address the combined issues of mental health and substance use.
There are no specific recommendations made in the document in respect of children of parents with mental health /substance problems. This needs to be strengthened by making clear recommendations a suggested above.