Post on 12-Jan-2016
FAMILIES: MULTIPLE NEEDS AND NO SIMPLE ANSWERS February 2nd 2015
Galway
Vivienne Evans
Who we are
• Adfam’s mission is that everyone affected by someone else’s drug or alcohol use should be able to access the help and support that they need.
• Established by a mother with a heroin using son
• National umbrella organisation for anyone working with families affected by substance misuse
• 2,000+ supporters from broad spectrum of services
Scale
• There are 250,000 children of problematic drug users…
• …and 1 million children affected by parental alcohol misuse
The numbers •Nearly 1.5 million adults will be significantly affected by a relative’s drug use•The cost of harms they experience as a result amounts to about 1.8 billion per year•The support they provide would cost the NHS and local authorities about 750 million to provide if it were not available
Scale
• 150,000 people are affected by drug use in prison
Why? Families affected by addiction problems are important
for four significant and related reasons:
• Involvement of family members in the treatment of their relatives with addiction problems can enhance positive outcomes
• Family members in these circumstances show symptoms of stress that merit help in their own right
• Effective treatment of the parent can have positive benefits for the child/family
• Better outcomes for children are achieved if they remain with their families
Why families? Families and recovery
• Rebuilding family relationships is a key constituent of recovery
• Families provide vital recovery capital• Families are well placed to help map individualised routes away from drug dependency
Key issues
• Families need to recover too; their journey is as individualised as recovery for the individual
• Families do not always recognise the term ‘recovery’ and the language surrounding recovery
• Family members do not recognise recovery for themselves; a corollary of the user
• Family members don’t always want to be recovery capital • Are families part of the problem?• Stigma and shame • Feeling they are not deserving of support • How do we support children through their parents’
recovery?
Multiple needs
When sorrows come, they come not single spies
But in battalions.
• Homelessness, reoffending, problematic substance misuse and mental ill health.
• Troubled families or troublesome families?
Multiple needsDual diagnosis is common: it may affect between 30 and 70 per cent of those presenting to health and social care settings
• Family services are working with families supporting a ‘loved one’ with complex needs
• drug/alcohol and mental health services are not equipped nor mandated (i.e. commissioned and resourced) to provide tailored support for families with mental health problems, or relationship problems
• family members often find themselves acting as advocates for the family member with complex needs – fighting their case with several agencies, including mental health and drug/alcohol treatment services
• drug/alcohol treatment services and mental health services often view the family member as an intrusion rather than a positive agent for supporting the ‘loved one’s’ recovery.
Family Interventions: Three Broad Categories
• interventions that work with family members to promote the entry and engagement of drug and/or alcohol users into treatment
• the joint involvement of family members and the relatives using drugs and/or alcohol in the treatment of the user
• interventions aimed to respond to the needs of family members affected by drug and alcohol problems in their own right
[Copello, Velleman and Templeton, 2005]
What’s needed
• National co-ordination and leadership• Drugs and children’s and family strategies • Workforce development • Outcome measurements and targets
• Cost/benefit• Local advocates
Some things don’t change?