Transcript Davis Turkington, Public Health Agency

Response to Hidden Harm
in Northern Ireland
Davis Turkington
Senior Officer (Health & Social Wellbeing
Improvement)
Public Health Agency
Background
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UK Hidden Harm Reports (2003, 2007)
O’Neill Inquiry (2007)
Hidden Harm
(2003)
When parents use drugs:
Key findings from a study
of children in the care of
drug-using parents
Hogan, D and Higgins, L.
Dublin: Trinity College, 2001
Hidden Harm
Three Years On
(2007)
Hidden Harm:
responding to
the needs of
children of
problem drug
users
ACMD 2003
6 key messages
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We estimate there are between 250,000 and 350,000
children of problem drug misusers in the UK – about
one child for every problem drug misuser;
Parental problem drug misuse can, and does, cause
serious harm to children at every age from conception
to adulthood;
Reducing the harm to children from parental problem
drug misuse should become a main objective of policy
and practice;
6 key messages
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Effective treatment of the parent can have major
benefits for the child;
By working together, services can take many practical
steps to protect and improve the health and well-being
of affected children;
The number of affected children is only likely to
decrease when the number of problem drug users
decreases.
Hidden Harm
Three Years On:
Realities,
Challenges and
Opportunities
ACMD 2007
Purpose
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To describe and comment on progress on
implementation of the recommendations of
the original Hidden Harm report
To provide practice examples and
information about implementation initiatives
To identify key learning for the future
Northern Ireland in 2007 report
“work in Northern Ireland to respond to Hidden
Harm has taken some time to get off the
ground”
“It is early days for work on ‘Hidden Harm’ in
Northern Ireland.”
Northern Ireland in 2007 report
“There is clear evidence of progress in
England, Scotland and Wales in relation to
safeguarding the welfare and protection of
children of problem drug users. However,
progress varies across different areas in the
four different countries.”
Northern Ireland in 2007 report
“The Northern Ireland New Strategic Direction
for Alcohol and Drugs includes a significant
range of targets for training at both regional
and DACT level……….However, there is no
specific reference in the document to
training to equip workers to respond to the
specific needs of children of problem drug
users”
O’Neill Inquiry
Recommendation 17(Mental Health /
Childcare Interface )
• DHSSPS and Boards should ensure that
each Trust puts in place a joint protocol
designed to manage the interface between
mental health and child care services
Scale of the Problem
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Hidden Harm – partly because the data was
not being collected.
ACMD estimates extrapolated from what
data was available.
Did not include people who had problems
with alcohol but not with other drugs.
Scale of the Problem
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200,000 and 300,000 children in England
and Wales where one or both parents have
serious drug problems.
Between 41,000 and 59,000 children in
Scotland with a problem drug using parent.
Scale of the Problem - NI
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Problematic alcohol misuse is a significantly
more widespread problem than illicit drug
misuse
It is estimated that 1 in 11 children in the UK
are living in a family where there is an alcohol
problem. In the 2001 Census, there were
451,514 children in Northern Ireland: it could
therefore be extrapolated that there are
approximately 40,000 children in Northern
Ireland living with parental alcohol misuse.
Scale of the Problem - NI
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In 2007/08, 22% of problem drug misusers
presenting for treatment were living with
children, which equates to 412 adults
although the number of children is not
identified. However, this is clearly an
underestimate, as it only captures
information about the children of parents
who are seeking treatment.
Scale of the Problem - NI
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40% of children on the child protection
register are there as a direct result of
parental substance misuse.
70% of our “Looked After Children” are living
away from home as a direct result of
parental substance misuse.
Interagency Protocols
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Protocol to Promote Inter-Agency Working
with Children & Families Affected by
Substance Misuse (Eastern Health and Social
Services Board, 2006)
Joint Service Protocol to meet the needs of
children and unborn children whose parents
or carers have alcohol or substance misuse
problems ( Western Health and Social Care
Trust – Health and Social Care Board, 2009)
Interagency Protocols
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Effects of parental substance misuse on
children
Confidentiality/information sharing
Roles and responsibilities – Adult substance
misuse services and family & childcare services
Assessment and referral
Both protocols supported by training
programmes
Regional Hidden Harm
Action Plan - DHSSPSNI
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This plan focuses on children born to and/or
living in households where there is alcohol
and drug misuse, including the misuse of
over-the-counter and prescribed medication.
Regional framework for the development of
local Hidden Harm action plans.
Public Health Agency/Health and Social
Care Board
Hidden Harm Action Plan
Approved by DHSSPSNI October 2009
Policy Context
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New Strategic Direction for Alcohol and Drugs
2006-2011
Our children and young people, our shared
responsibilities 2006
Our Children and Young People – Our Pledge
2006
Care Matters in Northern Ireland 2009
Families Matter: Supporting Families in
Northern Ireland 2009
Principles
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The welfare of the child should be the
paramount consideration.
Work with the complexity of the issue.
A non-judgmental approach
A shared commitment and response
Provision to respond to the needs of children
and families affected should be integrated
within mainstream Children's and Adult
services
Principles
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A focus on prevention and early identification
Not all families affected by substance misuse
will experience difficulties
Parental substance misuse may have
significant and damaging consequences for
children
Building on family strengths
Principles
Services need to be based on:
• What children say they need
• What parents/carers say they need
• Evaluation of effectiveness.
Structure
COMPLEX
NEEDS
COMPLEX
SAFEGUARDINGA
FEGUARDING
Continuum of
Service
Provision
FAMILY SUPPORT
ei Provision
FAMILY SUPPORT
EARLY INTERVENTION
EARLY INTERVENTION
P
PREVENTION
REVENTION
Baseline for
Hidden
Harm
Training and
workforce
development
Baseline for
Hidden
Harm
Training and
workforce
development
Public
awareness
J Joint
protocols
Public
awareness
ont protocols
Priority Areas
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Training and Workforce Development
(Regional)
Joint Leadership and Interagency Working
Arrangements (Regional)
Hidden Harm Information Baseline (Regional)
Public Awareness and Good Practice
(Regional)
Continuum of Services (Local)
Implementation
Regional Hidden Harm Quality
Assurance Group
Local Implementation Groups
Northern
LIG
Eastern
LIG
Southern
LIG
Western
LIG
Projects/services
Examples:
• Joint Agreement between Adult and
Children’s Services in responding to the
needs of Parents with Mental Health issues
and/or Substance Misuse, Their Children
and Families
• PHAROS project (Barnardos)
• Steps to Cope
Projects/services
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Midwifery training
Taking the Lid Off
NSPCC awareness raising campaign
Baseline and monitoring data
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Gateway services
Addiction Services
Children's Services Planning
+ services such as:
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School counselling
Youth service
Sure start
Youth justice