Drug & Alcohol Family Support Needs Analysis Report

Drug & Alcohol Family Support Needs Analysis Report

Drug & Alcohol Family Support Needs Analysis Report Debbie McDonagh Family Support Development Worker Problem drug use has considerable negative impacts for families and their functioning. The effects of drug misuse on the family overall include deteriorating relationships and making the family dysfunctional, psychological and social problems, increased stress, depression and behavioural disorders, financial difficulties, all of which can contribute to family breakdown and negative impacts on adult and child members of the family. (NACD, 2004. The Role of Family Support Service in Drug Prevention) National Policy Context The National Drugs Strategy (2001-2008) Identified the need to strengthen support for families under the following headings: Prioritise the provision of family supports by Drugs Task Forces

Development of family support networks Implementation of the NACD report on families Report of the Working Group on Drugs Rehabilitation (2007) Service providers should actively encourage family participation Service providers should be trained to deal with families who are trying to cope with the drug-related problems of a family member. Families should be seen as service users in their own right The potential of the involvement of the family in supporting the recovering drug users should be utilised A pilot short-stay respite programme for families of problem drug users should be developed. National Drugs Strategy (interim) 2009-2016 Develop a series of prevention measures that focus on the family

Support for families experiencing difficulties due to drug/alcohol use Parenting skills Targeted measures focusing on the children of problem drug and/or alcohol users aims at breaking the cycle and safeguarding the next generation Support families trying to cope with substance-related problems, in line with the recommendations of the Report of the Working Group on Drugs WRDTF Regional Strategy: The Way Forward Develop a series of prevention measures that focus on the family under the following programme headings (NDS) Support for families experiencing difficulties due to drug/alcohol use Parenting skills Target measures focusing on the children of problem drug and/or alcohol users aimed at breaking the cycle and safeguarding the next generation Develop family support groups throughout the region for families affected by substance misuse Complete an independent analysis of the Strengthening Families Programme

Investigate the needs of families affected by substance misuse involve families in the development of this research piece Expand the existing drug & alcohol parenting programmes to the wider community Engage with front line domestic abuse services around the area of substance misuse Family Support Initiatives (WRDTF funded) Family Support Groups Teen wellness programme Wellness/respite days Headspace programme (Roscommon) Child to parent violence intervention programme Living with addiction courses Personal Development courses (Castlerea Prison FVC)

Wasted (a play run by ARTSI about families affected by addiction) Funding for SFP, CRAFT & 5-STEP Targeted workshops/seminars Regional network Website Home-truths conference and awareness week WRDTF Family Support Development Worker Training Facilitation Awareness Work with Families Network

Programme development Family Support Resource Research: Needs Analysis Needs Analysis - Background This research: Aims to contribute to a greater understanding of the ways families affected by substance use seek support in the western region. Explores the availability and effectiveness of supports to families from a service perspective Contributes to the development of a family support strategy to identify and help improve service provision to families affected by substance use It is envisaged that the report will: Identify gaps in existing service provision for drug and alcohol family support;

Contribute to the continuing development of drug and alcohol family support services in the region; Highlight appropriate training as identified by relevant services; Ensure that interventions and services remain an integral part of WRDTF work with children and families affected by substance use; Provide recommendations for the forthcoming strategy Needs Analysis - Methodology Region: Galway, Mayo and Roscommon Questionnaire piloted by 2 organisations Anonymous online survey distributed to 174 potential participants Limitation: voice of family members is absent from the research 158 out of 174 invitees completed survey and (99 organisations) Needs Analysis - Methodology Of those who participated:

91 were community/voluntary, 61 were statutory, 6 private sector Respondents to the survey work in counties Galway (31%), Mayo (13%) and Roscommon (15%) with ten percent of respondents covering all three counties. Over a quarter (49) did, however, indicate their professional responsibilities either were limited to smaller areas within these counties or extended to several midland counties (15) and nationally (5) What the literature says Impacts of Substance Use Substance misuse has resulted in stark and enduring problems for many families and communities (Orford et al., 2007). Family disruption

Marital instability and breakdown Harassment, fear of or actual violence Unemployment and poverty Physical and mental ill-health. Domestic violence and/or psychological abuse Intimidation (threats, property damage, housing problems) Financial strain and debt WHAT THE RESEARCH SAYS. Individual, family, and community factors and their interrelationship are associated with engagement or not in alcohol and/or drug use The prevalence of substance use has dramatically increased over recent decades. Ireland, in particular, has one of highest levels of alcohol consumption in Europe Drug and alcohol interventions should aim to address the interaction of all risk and protective factors impacting the lives and development of affected children and families A key challenge is treating substance misuse as part of a set of

complex problems being experienced by users and their family and not solely as a problem for individual misusers WHAT THE RESEARCH SAYS. Including families and social networks of substance misusers in treatment programmes, can positively influence the direction substance use problems take, improve outcomes and reduce negative effects for families Multi-component interventions providing support for substance users and their children, for example, can achieve increased outcomes in terms of improved family relationships and cohesion, parental involvement in childrens lives, and family communication Substance misusers are more likely to engage in programmes that support a process of recovery which takes account of their family life Support should be part of a whole systems approach where agencies respond flexibly and employ effective partnership processes in addressing the needs of both users and families

Needs Analysis: Key Findings Survey Respondents Services provided by the organisations Answer Choices Yes No Total responses Information 145

1 146 Support 139 4 143 Advice 131 6

137 Referral 125 6 131 Advocacy 110 9 119

Counselling 72 27 99 Group Support 69 30 99 Home Support

60 32 92 Treatment 26 38 64 Support to Families Experiencing Difficulties due to Substance Misuse

Assessment tools that include questions relating to substance use Records retention Over half (86) of respondents indicated their service did not retain records of family members seeking support for substance use. Nearly half (26) of 53 respondents who commented felt substance use is not integral to the support/treatment their organisations offer. Substance use (whether by an individuals or its effect on family members) would only be recorded if it was deemed relevant to the support and/or recovery of service users. If substance misuse is an issue and the client was seeking support, it would be noted in the case notes of the file if the addiction caused a child protection incident or if our staff observed a parent or child under the influence it would be reported in notes or formal report depending on the incident

Provision of Information to Family Members A large majority of survey respondents provide information to families affected by substance use. For example: If deemed suitable we would furnish clients with leaflets, contact details of relevant services and support when needed family members to access these. Would use the putting the pieces together pack with adolescents Often we will work with a parent to identify and challenge their addiction and make appropriate referrals, such as GPs, addiction counselling, AA, drugs service, screening, residential treatment, a plan for a family in case of relapse Information offered to families affected by substance use Answer Choices

Percentage Responses Telephone contacts of support groups 86% 136 List of support agencies 83% 131 Pamphlets 65%

102 Web resources 46% 73 Other 22% 34 None 4%

6 Support provided to families (General) Yes No Total responses Education 73% 27% 139

Parenting support 62% 38% 138 Youth work 54% 46% 132 One-to-one counselling

Group support 52% 50% 48% 50% 134 136 Training 46% 54% 136

Complementary therapies Respite 12% 8% 88% 92% 121 122 None 19% 81%

80 Support provided to families affected by substance use Yes No Total responses Education 58% 42% 131

Parenting support 40% 60% 126 Youth work 38% 62% 122 One-to-one counselling

32% 68% 125 Group support 26% 74% 125 Training 20%

80% 123 Complementary therapies 7% 93% 113 Respite 4% 96%

111 None 14% 86% 81 Supports Offered Apart from referring clients on to more suitable services, a number of respondents again commented on how their work is limited to the issue and/or client base their organisation is mandated to serve. Therefore, many respondents have little or no engagement with families affected by substance use

70 of 81 participants responding to this question indicated they work in organisations providing none of the supports h Programmes provided by participating organisations Personal development and educational supports as important aspects of their work to support families and communities Other programmes and initiatives. Examples include SPHE, stress management, suicide prevention awareness, parenting courses, personal development and lifeskills. Fewer than half (42%) of life skills programmes and a little over a quarter (28%) of parenting courses included substance use component Respite for Family Members Less than 10 percent of service providers provide respite support

59% of respondents felt family respite services were needed. Day programmes were identified by 93 (59%) service providers as the most beneficial way of supporting families; while 63 (40%) felt overnight stays also would benefit Several commented that it was important for family members to have the capacity to take a break from the situation. Respite support could be beneficial for children growing up in families where addiction is an issue. Effectiveness of drug & alcohol family support services 48% of survey respondents felt drug and alcohol family support services in their region were either very or somewhat effective; 11 percent indicated services were neither effective nor ineffective, 16% perceived supports as ineffective of very ineffective

Main gaps in service provision for families affected by substance use Lack of available resources to provide adequate support Lack of service provision (families, young people and those with mental health needs are identified as groups particularly affected by perceived shortcomings) Lack of awareness and information concerning substance use and the supports available by service providers Need for regular updates and information for general public a lot of families affected by substance misuse dont know there is help out there for them Access to Services (Barriers) Evening and weekends Proximity of services

Minimal treatment options Childcare Transport Outreach Separate HSE services for drug and alcohol Largely rural region with dispersed population Many respondents referred to the substance user rather than family member access Barriers (Respondents comments) A lack of focus among some services toward the needs of affected families Poor co-ordination among support agencies results in inadequate responses to problems and issues which are likely to be rooted in substance misuse I do think that those affected by substance use in their family or group of friends are largely forgotten about. The emphasis

is generally on the substance abuser, rather than those affected by this as well Perceived barriers preventing family members accessing support Percentage Responses Shame / stigma Denial 75% 63% 118 100 Fear

Financial cost Lack of information Accessibility 56% 54% 53% 50% 89 86 84 79 Other family issues Confidentiality Don't know / no opinion

47% 46% 4% 74 73 7 Local support services are clouded under the umbrella of HSE / Child and family agency and some of the families I work with are afraid to access support from these due to a fear of losing their children. Some also have ongoing contact with statutory service for welfare and / or child protection reasons and because of this are reluctant to ask for help / support Support for family members affected by the substance users behaviour and a way of getting them to engage e.g. there may be domestic violence, home management issues, financial management which are all related to the substance misuse but each appears to be dealt with separately in a lot of cases where to refer a dad out of prison who wants to stay alcohol free but has no medical

card for antabuse prescription and no counsellor to go to. where to refer mum who has alcohol issues but is managing at present but has 3 young children and cannot go across town to access service. where to refer young person with parent with alcohol issues that has necessitated them coming into alternative care. If counsellor service was available in local health centre it would be accessible and normal to attend. Needs Analysis: Recommendations Recommendations Improve co-ordination with all relevant services and utilise inter-agency partnership structures; Publicise family support drug and alcohol services better and increase public awareness and knowledge of substance misuse; Establish best practice in drug and alcohol family support and provide regular and worthwhile training courses; Include service users and family members in development of drug and alcohol family support services: and

Ensure an inclusive approach which includes ethnic and cultural minorities within this development process. Next Steps Family Support Strategy Family member consultation Further consultation within the region Targeted measure to breaking the cycle Targeted measures for all family members (Grandparents, children etc.) Continued development of the DAFSN: 90% stated yes/maybe interested in attending a regional drug/alcohol family support network Family Support Strategy for the West Identified areas: Awareness Raising (families, services, community, lobbying) Information (Leaflet development, website, apps, local media etc.)

Workforce Development (training & education for staff and service providers) Training & Education for the public (information seminars, courses) Support for Family members (including Children of Substance using parents, Wellness/Respite?) Networking and Partnership development (DAFSN and other relevant networks) Programme promotion/development (5 Step, Parenting etc.) Thank you Report will be available on www.wrdtf.ie Contact Details: Debbie McDonagh WRDTF Tel:091 480059 Mob: 087 6955557 E-mail: [email protected]

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