Alcohol named as key child welfare issue of concern ‘worth highlighting’ in Report of Independent Child Death Review Group

Charity calls on Government to introduce “Hidden Harm” Action Plan for children in families with parental alcohol and drug problems: ’denial no longer an option’

Alcohol Action Ireland, the national charity for alcohol-related issues, today urged the Government to adopt a “Hidden Harm” Action Plan, similar to that of Northern Ireland, following the Report of the Independent Child Death Review Group (ICDRG) which names alcohol as a key child welfare issue, second only to neglect as a feature in cases of unnatural death examined, and outlines systemic failure to follow up on risks posed to children by alcohol and drug misuse in the home.

Referring to the fact that alcohol in the home was the second most prevalent issue after neglect in the cases of unnatural deaths, Charity Director Fiona Ryan said:

“While we take the time to stop and remember these children and their families – we should also focus on the changes that are badly needed. After all one in seven children currently in care in this country is there due to parental alcohol and drug problems.

A key lesson from this report has to be: reducing the harm to children from parental alcohol and drug misuse has to become a major objective of child welfare policy and practice and not a marginal issue. The Government needs to introduce a strategy similar to the “Hidden Harm” Action Plan operating in Northern Ireland in order to develop a properly planned, integrated, systemic, effective and accountable response where the welfare and wellbeing of the child is paramount.”

The Independent Child Death Review Group (ICDRG) report states alcohol in the home and the role it played in the lives and deaths of these children is an issue ’worth particularly highlighting’:

 · Alcohol in the home was an issue in one third (37) of the 112 cases of unnatural deaths reviewed

 · That alcohol in the home as an issue was twice as prevalent as other drugs (19) in these cases

 · It was the second most prevalent issue overall, only behind neglect, which was an issue in 44 of the 112 cases.

The report states:

“In reviewing many of the case histories which are the subject of this report the ICDRG cannot help but be struck by the adverse consequences for the welfare of many of these children posed by alcohol. In some but by no means all of the cases alcohol contributed to children being exposed from their earliest years to poor parenting, neglect,

abuse and psychological trauma. Some of these children and young people never recovered and went on themselves to engage in problematic alcohol and substance misuse.” (P22 Executive Summary)

Ms Ryan said: “This report has done a great service to advancing children’s welfare and protection in Ireland and, in particular, shining a light on systemic failures to respond to alcohol and drugs problems in the home citing again alcohol and drugs as a specific area in its summary of concerns:

“Of particular concern in a number of files is the fact that the HSE was aware of drug and alcohol abuse within a number of families, in particular by parents, which must as a natural consequence have given rise to concerns as to the welfare of the children, yet the HSE closed their files in a number of these cases despite the drug and alcohol abuse continuing.

“Children are vulnerable by their very nature and not to continue to attend to these issues and the implications for their welfare is to expose them to too great a risk of harm. Risk indicators such as this were not followed up adequately, or at all, by the HSE in a number of the files. In some cases no social worker was assigned to these families.”

Ms Ryan commended Minister Fitzgerald on bringing this report to light and the Minister’s commitment to working with Minister Roisin Shortall as well as the relevant agencies to develop a fresh new approach saying it was a “sign of real hope”.   She said: “In that spirit, we call on this Government to introduce a “Hidden Harm” strategy for Ireland similar to that operating in Northern Ireland. Denial around the role of alcohol in child welfare and protection is no longer an option.”

Ms Ryan highlighted the lack of basic information around the number of children actually affected:

“The impact of parental alcohol problems on children has been denied or ignored on a societal and state level, yet these children are often leading lives of quiet desperation, unseen and unheard by authorities, unsure who they can turn to. They get our attention only when the most extreme cases come to light and we prefer to think of these as isolated incidents.

“Shockingly, albeit unsurprisingly in light of the ICDRG report’s findings, we do not have even the most basic information on prevalence of the problem and this is in a country where, for example, we have one of the highest binge drinking rates in Europe and one of the highest proportion of children per population in Europe.”

Ms Ryan said that as a result, Alcohol Action Ireland and other charities had over the years have had to commission research in order to gauge the extent of the problem.   A national children’s charity had surveyed 10,000 children and found that one in 11 children is currently being affected by parental alcohol problems. Children report experiencing emotional abuse, anxiety and inappropriate levels of care responsibility ie looking after younger brothers and sisters. The experiences tallied with Alcohol Action Ireland’s commissioned research of adult recollections’ of parental drinking during childhood which found that the equivalent of 71,000 people said they frequently felt afraid or anxious during childhood due to parental drinking, while one in 12 reported witnessing parental conflict linked to alcohol and a significant number had responsibility for siblings.

Alcohol Action Ireland was a member of the steering group of the National Substance Misuse Strategy whose report recommends a “Hidden Harm” type Action Plan for the Republic of Ireland as well as children being able to access services in their own right.


Notes to the Editor:

Background to Hidden Harm

In Northern Ireland, approximately 40% of children on the child protection register are there as a direct result of parental substance misuse and they estimated there are 40,000 children in Northern Ireland living with parental alcohol problems. Ms Ryan highlighted one of the key challenges in developing a planned, integrated, systemic, effective and accountable response was the lack of basic data on children negatively affected by parental alcohol and drug problems.

Hidden Harm is a term used to describe the lives of children and young people affected by parental drug and alcohol problems.

“These children can suffer in silence; their circumstances are often not known to services; they often do not know where to turn for help; and the impact of their parents’ substance misuse has a deep and long-lasting impact on their lives, which may not fully emerge until young adulthood and beyond.”[1]

Following a three year inquiry, the Advisory Council on the Misuse of Drugs in the UK published a report in 2003 entitled Hidden Harm: responding the needs of children of problem drug users, alcohol was included under drugs. The key messages of the report were as follows:

 · it is estimated that there is about one child for every problem drug misuser in the UK

 · 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 drug misuse should become a major objective of policy and practice

 · 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

Hidden Harm Action Plans developed for Northern Ireland and Scotland

Some of the guiding principles of the Northern Ireland “Hidden Harm” Action Plan in working with children born to and/ or living with parental alcohol and drug misuse are:

 · The welfare of the child should be the paramount consideration

 · A shared commitment and response to the issue including inter-agency working

 · A focus on prevention and early identification minimises the risk of crisis or tragedy occurring in the lives of children affected

 · Not all families affected by substance misuse will experience difficulties –routine screening and assessment will help determine those who are

 · Parental Substance Misuse may have significant and damaging consequences for children and it is important that proper planning and service provision is in place

General on children affected by alcohol problems in Europe

 · Approximately 9 million children in the European Union are affected by their parents’ drinking problems[i] . These children suffer from neglect, feelings of shame and self-blaming for their parents’ addiction and from continuous conflicts at home. Many children and young people have to witness and suffer violence[ii] .

 · It is estimated that in Europe, alcohol is a causal factor in 16% of child abuse and neglect cases[iii] .

[i] Anderson, P. and   Baumberg, B., 2006. Alcohol in Europe. London: Institute of Alcohol Studies.

[ii] as in i

[iii] as in i

For further information or comment contact: Conor Cullen 087 2195723/ 01 878 0610

[1] PHA/HSBC Hidden Harm Action Plan: Responding to the Needs of Children Born to and Living with Parental Alcohol and Drug Misuse in Approved by DHSSPS October 2009