independent advocate reducing alcohol harm

Keeping It In The Family Round Table: Full Report

Summary

Children living with parental alcohol problems are effectively invisible The services available to these children and their families are limited and often do not appear to “join-up”

What needs to happen… Children affected by parental alcohol problems need to become visible to politicians; policy-makers; professionals and public

Services available to children need to join-up; the mechanisms need to be put in place connecting service experience/ observations to top-level planning and funding

The Scottish experience suggests real change for children affected by parental alcohol problems will happen when the issue is viewed as a child welfare/ protection issue

The Report

On the morning of 4 December a cross-section of Irish charities/NGOs and public health officials met to discuss the estimated 61,000 to 104,000 children in Ireland affected by parental alcohol problems. It was the first opportunity many of us had to focus on the issue and share experiences.

Children affected by parental alcohol problems can experience a spectrum of harm from depression and anxiety, social withdrawal, behavioural problems, stress and missed school through caring roles to domestic violence, child abuse, a shortage of food and clean clothing and other forms of neglect.

Two themes quickly emerged from presentations and discussions:

  • Children experiencing alcohol related harm in the family from parental alcohol misuse are effectively “invisible” in terms of policy-making and this filters down to services
      
  • There does not appear to be an integrated “joined-up” service response to meet the needs of these children and their families

Children affected by alcohol problems are also subject to wider policy issues which impact on their wellbeing: there is no real national alcohol policy; there is no minimum pricing on alcohol which means alcohol can be sold as a loss leader; there is an increase in home drinking and an increase in women drinking. The themes informed a series of conversations built around a number of questions which flowed from one central thought: What would need to happen so that the issue of families affected by parental alcohol problems become visible and change happens?

The questions covered were as follows:

  • Who needs to be involved in this issue?
      
  • Who has an interest in this being on the policy agenda – and who has an interest in this not being on the policy agenda?
      
  • What change needs to take place and how can it happen?  

Our discussions were informed by Dr. Shane Butler, senior lecturer in social policy at Trinity College Dublin, who provided an overview of Irish social policy and its interaction with services as well as Tam Baillie and Louise Hill of Barnardo’s Scotland whose insights into the Scottish experience allowed us to draw parallels with our own experiences in Ireland.

Who needs to be involved to move this issue?

The following were suggested:

  • Political decision makers/ statutory decision-makers
      
  • Senior managers in service provision and other relevant professionals  
      
  • NGOs to facilitate development of multiple credible voices to speak out on issue  
      
  • Media influencers  
      
  • Children/ families affected by parental alcohol problems  
      
  • General public/ segment for maximum reach  

Who has an interest in this not being on the policy agenda?

The general consensus was that conflicted attitudes around alcohol are contributing to keeping the reality of these children’s lives invisible. There were a number of contributing factors – economic operators seeking to increase profits; Government reliant on alcohol derived revenue; general public conflicted about levels of own drinking. The worsening economic situation will mean that any move to increase taxation on alcohol as a means of reducing consumption will be met with opposition framed around jobs and the economy.

Which stakeholders are already committed to taking action and who else needs to be on board?

  • Disparate HSE services/projects but there appears to be no “join-up”  
      
  • Some NGOs that work with families have noticed the issue on radar but have not specifically focussed on it  
      
  • In terms of other stakeholders that need to be involved, relevant NGOs and charities, professionals working in treatment/ general services; experience of working with families in the drugs treatment field may provide learnings around working with families affected by parental alcohol problems
      
  • The media could potentially open-up the issue and help make the reality of these children’s lives and that of their family visible  

How will change happen for these children?

  • Political motivation
      
  • Crisis Public service commitment/ champion
      
  • Unofficial network development  
      
  • Pilot projects to inform evidence base/ relevant for service oriented actions  

What actions could be undertaken?

There were multiple views whether to prioritise actions around a services focus or an advocacy/ policy focus. The following are a mixture of views from research, elements of services provision to advocacy activities:

  • Specific focus is needed on services currently responding to children living with alcohol-related harm in Ireland ie adult-oriented addiction services and welfare services focussed on child welfare/protection
    * Potentially an action research project – three community care areas focusing on children and addiction  
    * Roll-out of brief advice/ intervention training to all health professionals in contact with families  
      
  • Mechanisms/structures need to be put in place to feed information on changing patterns of need among children and families, changing client profile from service level up to level at which planning and funding decisions are made.  
      
  • Need to challenge widespread cultural norms of acceptance of availability/ accessibility and acceptance of problem alcohol use  

What could a potential advocacy strategy look like?

  • Identify who needs to be engaged with:
    * Political decision-makers Senior departmental officials – DOHC and DOJ
    * Senior service provider managers
    * Health Professionals: GPS, social workers, public health nurses etc
    * Media
    * People who would have been affected by parental problem drinking during their childhood
    * Children currently living in this situation Highlight the fact that children affected by parental alcohol problems is a potential child welfare/ protection issue Develop evidence base: potentially qualitative and quantitative; perhaps initially qualitative because of expense of quantitative.  

How to ensure the voices of children living with parental alcohol problems are heard?

There was recognition that there are real problems in engaging with children due to the hidden nature of alcohol problems in family, research ethical questions etc. There is a current data shortage on children and families affected by parental alcohol problems. Could a study on prevalence of children and families affected by parental alcohol problems be carried out? For example, similar to Sexual Abuse and Violence in Ireland report Develop solutions focussed recommendations: including a potential research project around service provision and a model of best practice as to how alcohol treatment and child welfare services can work together. Alcohol Action Ireland would like to thank Dr. Shane Butler of TCD, Tam Baillie and Louise Hill of Barnardo’s Scotland as well as the organisations and individuals who participated in this event as a first step to raising awareness of children affected by parental alcohol problems. For more information on our keeping it in the family campaign click here