Health Committee - The Government's Alcohol StrategyWritten evidence from the National Society for the Prevention of Cruelty to Children (NSPCC) (GAS 18)

Summary

There are a significant proportion of children living with alcohol misusing parents who, as a result, are at an increased risk of abuse or neglect.

The Government’s alcohol strategy does recognise the need to identify and support problem drinkers who are also parents. However, the NSPCC believes there should be a greater focus on the impact of alcohol misuse on children. Implementation of the strategy provides a key opportunity to ensure the risks to children of parental alcohol misuse are addressed and families are better supported.

Given the framework of the Health Select Committee’s inquiry into the Government’s alcohol strategy, this submission highlights the need for public services and interventions to recognise the needs of entire families, and to ensure a joined up approach to adult and children’s services. This will better protect children from harm and support parents’ understanding of the harmful effects of alcohol misuse on their children, ultimately helping them to control their drinking.

The impact of Alcohol Misuse on Children

1. It is estimated that between 780,000 and 1.3 million children in England aged under 16 have parents whose drinking is classified as harmful or dependent.1 Around 79,000 babies under one year old in England have a parent who is a harmful drinker, which is equivalent to 93,500 babies in the UK. And around 26,000 babies under one year old in England have a parent who is a dependent drinker, which is equivalent to 31,000 across the UK.2 Furthermore, parental alcohol misuse is present in a number of cases of child abuse and neglect. Evidence shows that it was present in 22% of Serious Case Reviews in England from 2007–09.3

2. When parents misuse alcohol, it can impact upon children physically, mentally and emotionally, the effects of which can be both severe and long lasting. It can also have a profound effect on parenting as parents who misuse alcohol are less likely to be able to look after their children or develop healthy relationships with them and other family members. These vulnerable children can be left struggling to cope with complex problems that become difficult to solve.

3. Babies, given their total dependence, are particularly vulnerable to abuse and neglect if their parents are drinking excessively. Furthermore, damage can start before the baby is born as research indicates that alcohol is one of the most powerful and dangerous neurotoxins that can affect brain development during pregnancy.4 , 5

What the implementation of the Government’s alcohol strategy needs to address

4. The Government’s alcohol strategy quite rightly aims to tackle problem drinking and focuses largely on the public face of alcohol misuse including crime, violence and antisocial behaviour. The NSPCC welcomes the Government’s recognition in the Strategy that a significant proportion of adults in alcohol treatment are parents with childcare responsibilities. However, we believe that parental alcohol misuse and the impact it has on children in the family should be considered more fully in order to ensure it addressed effectively and all family members receive the necessary support.

5. Both children and their parents living in these difficult situations need help and support to tackle their problems. Too often, adult alcohol services focus on the needs of the problem drinker rather than treat parents as parents and recognise the needs of their children. Families have been seen as an adjunct to their treatment and services for family members or family units in their own right are not widely available.

6. Therefore, there is a clear need to develop treatment services which meet the needs of the whole family, as this approach is more likely to succeed in supporting children and other non-drinkers in the household. Interventions need to focus on parenting. For example, whenever adults are in touch with primary, acute or specialist services because of alcohol misuse, they should be asked if they are a parent so that any risks to their children are identified and dealt with and they can be supported in this role. This would include parents automatically being offered parenting support, and children being offered practical and emotional support to deal with the impact of alcohol misuse on their lives. This may be particularly powerful where parents have young babies and may be more open to change.

7. It is important to appreciate that treatment that includes consideration of the whole family can also be more successful for the drinker. For example, a parent returning to a family after detoxification is more likely to maintain abstinence or controlled drinking if it has been possible to address their whole environment and change some of the factors that may have contributed to alcohol misuse in the first place, such as family relationships and stress in parenting.

8. In order to protect children we need to find ways of detecting and helping them at an earlier stage, and fully understand the nature and extent of the problem. When local authorities and health services undertake Joint Strategic Needs Assessments these should include data on the number of children affected in their area by parental alcohol misuse to enable them to commission services to support these families, in order for there to be sufficient support available to parents drinking excessively.

9. Pregnancy is also a key opportunity to give support to help mothers reduce problem drinking. While the Government’s strategy does highlight the risk of foetal alcohol spectrum disorders, targeted public education must also highlight that alcohol use in pregnancy is also associated with miscarriage, early labour and still births,6 and find further ways to reach out and influence these mothers. Midwives, health visitors and others still struggle to identify and treat pregnant women who are drinking too much, therefore improved screening is needed to identify mothers who are drinking too much for the safety of their baby. The NSPCC has also identified the development of a rigorous framework and tools for pre-birth risk assessments as a key intervention in order to identify the level of anticipated risk and determine how it can be successfully managed, and we are currently planning to develop a new service in this area.

NSPCC Services Supporting Families Affected by Alcohol Misuse

10. The NSPCC has developed the following innovative services to provide the support we believe these families need:

Family Alcohol Service: Our multi-disciplinary team works with parents to help them understand how their drinking affects their children, and helps children overcome the harm caused where one or both of their parents are drinking. Families with children 12 years old or under are allocated an NSPCC children’s worker and an adult alcohol worker. The aim of the service is to prevent family breakdown through early intervention and by bridging the gap between adult treatment and childcare services. Parents are offered advice, guidance, treatment and information on how to stop drinking and become safer parents, and children are provided with services such as individual therapy and support groups.

Family Environment: Drug Using Parents (FEDUP): This new service works with children between five and 11 years old. NSPCC practitioners lead groups of up to five children, some of whom are subject to local agency child protection plans, over ten weekly sessions. The practitioners enable and support children to talk about their feelings, particularly in relation to family life and living with adults who are substance users. The groups give children a safe space and mutual support to build self-esteem. Throughout the duration of the work, if the NSPCC believes children are not safe then appropriate action will be taken to ensure the child’s safety and well-being. Through an eight week individual plan of work, practitioners also help the parents understand how their addictions affect their children and discuss with them ways in which they might change their behaviour.

Parents Under Pressure: Originally developed in Brisbane, Australia, this is an intensive home visiting programme which supports alcohol and drug misusing parents to build parenting skills and develop safe and caring relationships with their babies. NSPCC workers visit the homes of alcoholic or drug-using parents who have babies under two years old on a weekly basis. The parents can phone the workers for emergency support outside the home visits. The programme teams work alongside other agencies involved with the family, including local children’s services, drug and alcohol teams, mental health agencies, GPs and other local health services.

The above services are being delivered as part of the NSPCC’s strategy to prioritise certain types of abuse and the most vulnerable children. We are pioneering 27 new programmes of work within our priority areas, building on knowledge we have gathered from around the world, and we want to share our learning and expertise in order to show what works and promote the most effective interventions. We would be more than willing to organise a visit to our services for members of the Health Select Committee.

About the NSPCC

The National Society for the Prevention of Cruelty to Children (NSPCC) aims to end cruelty to children in the UK by fighting for their rights, listening to them, helping them and making them safe.

We share our experience with governments and organisations working with children so together we improve the protection of children and we challenge those who will not learn and change. We campaign for better laws and we educate and inform the public to improve understanding bout child abuse.

Our services include the NSPCC Helpline, for adults worried about a child, and ChildLine, the UK’s free, confidential helpline for children and young people.

May 2012

1 Prime Minister’s Strategy Unit (2003) Alcohol Harm Reduction Project – Interim Analytical Report.

2 Manning, V. (2011) Estimate of the numbers of infants (under the age of one year) living with substance misusing parents, NSPCC.

3 Marian Brandon, Sue Bailey and Pippa Belderson (2010) Building on the learning from serious case reviews: A two-year analysis of child protection database notifications 2007-2009, Department for Education.

4 National Scientific Council on the Developing Child (2006), Early exposure to toxic substances damages brain architecture.

5 Welch-Caerre, E. (2005) “The neurodevelopmental consequences of prenatal alcohol exposure,” Advances in neonatal care, 5(4).

6 Sher J. (2010), Ten Facts about Foetal Alcohol Harm, Children in Scotland.

Prepared 21st July 2012