Parents in substance use services need better care integration, research finds

New research finds that substance use treatment services are not adequately identifying and responding to the needs of parents in the legal system.

The research project, led by academics at Glasgow Caledonian University, used electronic health records to identify how to better integrate policy and practice for parents involved in public family law proceedings cases (care proceedings) and receiving treatment for substance use in England.

Dr Martha Canfield, from the university’s School of Health and Life Sciences Department of Psychology, said an important part of the research was building a better profile of the types of parents in substance use services.

“Parents in substance use services are likely to have a very particular set of experiences that can, in turn, make it very difficult to provide sufficient care for their children.

“Unfortunately, substance use treatment services are not adequately capable of identifying and responding to needs of the mothers as well as the fathers. It is vital that proper methods of screening are created including when and how to assess childcare issues among service users so that proper support can be provided.”

Approximately 162,000 UK children under the age of 18 currently live with an opiate dependant parent, while 200,000 live with a parent who is alcohol dependant. Parental substance use is considered a significant risk to a child’s health, education, social and biological development, and is often linked to childhood maltreatment and neglect. Despite this, there is a lack of evidence-based practice to help address the needs of parents with substance use problems.

Dr Canfield and her team undertook five linked studies, analysing the electronic health records of women and men attending substance use services at South London and Maudsley NHS Foundation Trust (the Trust) to better understand the characteristics of both the individual and their treatment. Records of the women were then linked to data sourced from family courts to further investigate the relationship between treatment and childcare status.

An analysis of the data established a distinctive profile of service using mothers, including being younger, more socially deprived, more likely to be experiencing housing problems, and have a history of experiencing domestic violence, as well as coming from racially minoritised backgrounds compared to other service users who were not mothers.

“Our society typically views mothers as the primary caregiver, and this is reflected by the lack of data in clinical notes as to the childcare responsibilities of fathers in these services,” Gail Gilchrist, Professor in Addictions Healthcare Research at King’s College London and a senior author of the report, said. “While every case is different, our study did find that the participation of the child’s father can be a protective factor for maintaining childcare while mothers undergo treatment, but more research is vitally needed in this area.”

The report proposed eight recommendations to promote better care in substance use services, including: better staff training to account for the high proportion of missing data about parental characteristics, and remove the barriers that stop mothers in crisis from accessing substance use service.

The researchers also suggest that future studies into this area should combine different data sources with collaborative approaches that can effectively explore the relationship between parental substance use and child welfare.

Ash Patel, Programme Head for Justice at the Nuffield Foundation which funded the research said the project “adds to the growing evidence base about the families that come into contact with child social care services and the family justice system providing further insights into the often-complex needs of a parent going through treatment for substance misuse.”

“The research lends support to the arguing for a more integrated or coordinated delivery of services to support better outcomes for both mothers and their children.”