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?