Parental mental illness & substance use: are we really starting to ‘Think Child, Think Parent, Think Family’? Claire McCartan & Gavin Davidson SCHOOL OF SOCIAL SCIENCES, EDUCATION & SOCIAL WORK

Parental mental health & substance use in NI VV Parental mental health & substance use in NI NORTHERN IRELAND O’Neill Inquiry 2008 Poor communication at many levels: Hospital to hospital Multidisciplinary teams Consultant to consultant Professionals & the family Lack of understanding about severe mental illness Focus of mental health staff entirely on Mum No attempt to assess the risk to child Ex-partner/Dad not involved in discussions about child’s welfare

Think Child, Think Parent, Think Family Regional action plan - 2009 Pilot across Adult MH & Children’s Services Regional joint protocol developed, better screening & assessment tools The Family Model (Falkov) 6 Domains of Family-Focused Conversations Looking at the present Looking back Developmental origins of the family, difficulties & strengths Looking forward What gets you through, what’s been learned

Think Family NI NORTHERN IRELAND Development of educational resources VV Think Family NI Development of educational resources TF Social Work Pilot – Support Worker & Champions Interface groups in each Trust Research Evaluation 2018 – 19% aware of TF, 10% using it E-learning resource – international collaboration between QUB, HSCB, Norway & Australia Training the trainer – CiNI role out in the voluntary & statutory sector Case file audit NORTHERN IRELAND

QUB Heritage Methods Audit of 30 cases randomly selected from each of the participating Health & Social Care Trusts (N=120 files): 40 from Children’s Services 40 from Community Mental Health Services 40 from Community Addiction Services QUB Heritage Brief audit tool: demographic info about parent & child Contact with agencies & services Specific referencing to Think Family Signposting info interagency collaboration Significant time delays Trust governance, GDPR, access

QUB Heritage Initial Findings Record keeping Record keeping varies greatly between the 3 services & across Trusts Sometimes difficult to identify responsible personnel within file records Very heavy paperwork load – potential for this to be rationalised/manualised more effectively Maintaining record keeping across services e.g. UNOCINI Service provision Cases are extremely complex, long-term protracted support, many with characteristics of intergenerational child protection issues Many service users are involved with a large number of services (mean 12.25, range 6-23) Extensive use & reliance on voluntary sector support services e.g. Barnardo’s, Citizens Advice, Salvation Army etc. which is typical of Northern Ireland provision (legacy of the Troubles) Potential for better care Need for improved co-ordination, continuity & clarity of services/support Ensuring key workers are involved in LAC reviews or CPCCs QUB Heritage

QUB Heritage Initial Findings Think Family Little reference to Think Family files, however, there is clear evidence for multidisciplinary family focused practice Evidence for strengths-based approaches Parental illness being explained in an age appropriate way However, children regularly identified as protective factor in parent’s recovery Further exploration with additional data How do fathers fare when they aren’t living with their children? Financial pressures on services - cost of delays to permanency? Lack of evidence that some younger children haven’t been included in conversations Scrutiny of child protection system – tension between Services Poverty-aware practice identifying needs, stressors & responding to crises QUB Heritage