Transcript Dr Brynna Kroll - Living with an elephant

LIVING WITH AN ELEPHANT: DRUG MISUSE,
PARENTING & CHILD WELFARE
BRYNNA KROLL
Senior 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 interagency 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 areas40 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’
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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 interagency 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)