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Parental alcohol misuse and children

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The All-Party Parliamentary Group for Children of Alcoholics and the Office of the Children’s Commissioner has been calling for greater awareness about the effects of parental alcohol misuse among practitioners and those working with children. Recommendations include producing a national strategy, increasing the availability of support for families affected, and improving data collection on these families.

In early March, Health Secretary Jeremy Hunt agreed to make Britain’s 2.5million children of hard-drinking parents part of the government’s mental-health strategy and to publish data on the scale of the problem within weeks, as well as appointing a minister with “responsibility for policy relating to children of alcoholics”. The move followed a “constructive” meeting with Labour MPs Liam Byrne, Caroline Flint and Jonathan Ashworth, the shadow health secretary, who are all children of alcoholics. Together with the National Association for Children of Alcoholics charity (disclosure: I am a trustee) and the Sunday Express, they have been campaigning for government to adopt a Manifesto for Children of Alcoholics.

The manifesto sets out the 10 key points which government needs to address if children of alcoholics are to be properly supported – giving a minister responsibility for the issue is now an achieved recommendation. “The Heath Secretary said he had followed coverage of the campaign and was genuinely interested in children’s mental health and recognised that alcoholism is one of the most serious problems children can face,” Byrne commented of their meeting.

Moving towards this month’s agreement, Hunt last December pledged £500,000 for helplines including Nacoa’s, to support children being raised by alcoholic parents in the UK

Ashworth had earlier explained there was a need for urgent action because the cost of alcohol-related harm was not only the £3.5billion NHS price-tag, but up to £7billion in lost productivity for the UK economy. His advocacy was triggered when he came across the work being carried out by his Labour colleague, Liam Byrne, whose childhood was affected in a similar way to his and who chairs the All-party Parliamentary Group for Children of Alcoholics. Together, they commissioned a report on parental alcohol misuse from the Parliamentary Office of Science & Technology. Published in February during Children of Alcoholics Week, it found that:

  • Alcohol misuse was implicated in 37% of cases of a child’s death or serious injury after abuse or neglect between 2011 and 2014
  • A Freedom of Information request by the APPG for Children of Alcoholics to local authorities in England found that, in 2016, more than half of councils did not have a strategy to support children affected by ‘PAM’
  • 61% of care applications in England involved misuse of alcohol and/or drugs
  • 92% of 53 councils that responded to the survey confirmed that they were cutting budgets for alcohol and drug treatment services, from -58.1% in Lancashire to -1.1% in Wolverhampton.

Current policy on children affected by PAM

Responsibility for children affected by PAM spans government departments, including those with responsibility for health, education and communities & local government, as well as local authorities, as it can include adult treatment, children’s social care services and public health. The Government’s 2012 Alcohol Strategy made no mention of children affected by PAM. Later guidance by Public Health England in 2013 and the Department for Education in 2015 did recognise the need. The 2015-2020 Troubled Families programme, administered by the Ministry of Housing, Communities and Local Government, works with families affected by substance misuse (drugs and/or alcohol), among other problems. Evaluation findings for this are due in autumn.

In 2016, the chief medical officer published new guidelines on health risks from drinking, which included advice on drinking during pregnancy. The 2017 Drug Strategy recognises that many approaches to address drug misuse also apply to tackling alcohol misuse.

The Scottish government’s alcohol strategy includes the aim to support families affected by PAM, including improving the identification of those affected, sharing information among agencies, and building availability of support services.

The Welsh government’s strategy also includes the aim to support and protect families, and specialist Integrated Family Support Services work with families affected by PAM. In Northern Ireland, addressing the effects of PAM is a key priority in the New Strategic Direction for Alcohol and Drugs, including commissioning therapeutic services for children affected.

Key points of the parliamentary research

Most evidence on the effects of parental drinking on children focuses on drinking at or above harmful or dependent levels. It is unclear at what level parenting is impaired.

There are no systematic national data on children affected by parental drinking. It is estimated that 189,000-208,000 children in England live with an alcohol-dependent adult, while 15,500 children live with an adult receiving treatment for alcohol dependence. Estimates are likely to underestimate the scale of the issue due to under-reporting.

The effects of parental alcohol misuse can start before birth and continue into adult life. Heavy drinking during pregnancy can lead to Foetal Alcohol Spectrum Disorder, an under-diagnosed condition linked to behavioural and learning difficulties, and increased risk of mental illness and involvement in crime.

Parental alcohol misuse disrupts routines and leads to inconsistent and unpredictable parenting. Children can feel isolated, stigmatised and guilty, and might have to take on caring responsibilities. PAM is linked to a greater risk of mental and physical health problems, including eating disorders and depression. It is also linked with neglect and domestic abuse, and child protection cases involving PAM have poorer welfare outcomes for children.

Protective factors, including self-esteem and having a trusted adult role model, help children to be resilient and to have positive outcomes. Family-focused services improve outcomes for alcohol misusers as well as children and are cost effective.

Helpline: 0800 358 3456 or http://www.nacoa.org.uk.