Alcohol Action Ireland has in recent weeks responded to national consultations relating to the lives of children and families.
Although we do not provide services, as the national advocate for reducing alcohol harm, we believe that given the hugely troubling effects of alcohol on family life, there is much to be said about what kind of services are offered to children and families who need support, and how they are monitored and evaluated.
As so well demonstrated by the recently published Alcohol Overview Report from the Health Research Board, alcohol harm affects many aspects of life in Ireland and so has implications for multiple services and supports. More than half of Irish drinkers are classified as hazardous drinkers and at least 200,000 children in Ireland are currently living in homes where there is parental problem alcohol use.
The science of early childhood development tells us that relationships young children experience with adult caregivers influence lifelong learning, behaviour, and physical and mental health—for better or for worse. In order to address the needs of the thousands of children living with alcohol harm in the home, there is a real need to develop properly resourced supports for such children.
Parenting Support Services
Responding to the Department of Children, Equality, Disability, Integration and Youth Public Consultation on the Development of a National Model of Parenting Support Services, AAI called for innovative evidence-based programmes for parents to be made more widely available in all communities.
In order to destigmatise seeking support, it must be recognised that problem alcohol use in the home is a whole of population issue, and not just something that happens in ‘other’ communities. For families in need, seeking support should be normalised and not seen in terms of the family having a child protection issue.
Awareness of parental problem alcohol use and its impact on young and adult children should be raised through information campaigns and training that targets healthcare, social care, early years, child protection, family support, education, and mental health sectors – as well as families and communities.
There is strong evidence for the impact of parenting interventions for substance using parents on their parenting practices and wider family functioning. Parents benefit when the intervention begins with education in fundamental psychological processes such as emotional regulation mechanisms. AAI believes that providing psycho-education to parents where they and/or their children are in receipt of a service is hugely important in terms of helping parents to understand the significance of early years, the impact of toxic stress and issues in the home such as domestic abuse and parental problem substance use.
This chimes with the Center on the Developing Child at Harvard University’s recommended “design principles” to improve outcomes for children and families. They recommend that to be as effective as possible, policies and services should: Support responsive relationships for children and adults; strengthen core skills for planning, adapting, and achieving goals; and reduce sources of stress in the lives of children and families.
National Standards for Children’s Services
The second consultation AAI responded to concerns HIQA’s new national standards for children’s services.
These services are for children who for one reason or another are receiving a welfare intervention and may no longer be in the family home. AAI strongly welcomes the standards, which set out what outcomes a child should expect and what a service needs to do to ensure high-quality, safe and consistent children’s social services.
AAI believes, however, that the concept of trauma-informed services – not mentioned anywhere in HIQA’s lengthy document, must form part of the standards.
An extremely robust and consistent body of evidence strongly links childhood adversity to negative outcomes across the lifespan including, mental health problems, addiction, low educational achievement, relationship problems, self-harm and suicide, physical ill-health and early death. This is why it is imperative that services address the role of traumatic life events in their service delivery design.
Trauma-informed care acknowledges the need to understand a young person’s life experiences and what has brought them into the service in the first place and would enhance the principle of a human rights-based approach that recognises children have the right to be treated with dignity and to be recognised as individuals who are able to participate in and exercise a level of control over their lives.
Along with this important principle of a human rights-based approach, safety and wellbeing and responsiveness, HIQA’s standards also put accountability as one of its four guiding principles.
It is vital that services are accountable to children and families as well as their funders.
Hearing children’s voices in relation to the adversities in their lives is a vital tool in ensuring that their needs are being met. Services should build the Lundy model of child participation into what they do and produce regular reports reflecting this engagement. This would support the implementation of the recently published National Framework for Children and Young People’s Participation in Decision-Making. The framework seeks to build capacity to hear children’s voices through providing training and practical tools to ensure that children and young people are included in decision-making in all settings where decisions made by adults will impact their lives.
Finally, AAI believes Ireland needs a public policy agenda based on scientific concepts that fully acknowledge—and respond to—the impact of toxic stress and trauma on the child’s health and well-being. Research on childhood adversity in Ireland needs to be undertaken to inform government policy and practitioners on the nature, prevalence and impact of adverse childhood experiences to subsequently develop a national ACEs strategy guiding the development of trauma-informed services and systems.
There is also a great need for timely and better data collection on alcohol harm across many state agencies and bodies, so that services that work with children can be better informed about their needs.
With research, data and the sharing of information, we need to connect all of our services – children, family, mental health, health care, education, in order to deliver consistently high-quality services –as HIQA states – regardless of the type or location of the service and to ensure that it is effective in meeting the needs of children, their families or the people caring for them.