1. Twelve Month Follow-Up of Mothers from the ‘Child Protection and Mothers in Substance Abuse Treatment Study’ Stephanie Taplin PhD, Rachel Grove & Richard P. Mattick PhD Association of Child Welfare Agencies Conference 2012

2. Background to the study ‘Child protection and mothers in substance abuse treatment’ study Funded by NSW Community Services, National Drug & Alcohol Research Centre & University of NSW (2007-2010) and NSW Health (2011-12) Major aim: To compare mothers in opioid treatment involved with child protection with those not. And: To describe their characteristics, parenting, children, and interventions.

3. Why recruit women on the OTP? Large numbers on OTP [6,442 women 2010] Around half all AOD treatment entries have children; most women entering treatment are mothers of dependent children To recruit mothers not known to child protection Child protection concerns re heroin use & parenting OTP allows parents to continue caring for their children

4. Methods Women on OTP with a child < 16 yrs Recruited through nine public and private OTP clinics across Sydney 171 women interviewed May 2009 to May 2010 Estimated 59% response rate Consent obtained to access treatment and Community Services records (up to 12 months after interview)

5. Sample demographics CharacteristicsSample (n = 171) Age at interview37 years (median) School years completedYear 10 (median) Indigenous status22% Aboriginal Relationship status32% married/de facto Source of income87% on government benefits Housing58% living in public housing Age first birth21 years (median) 39% teenage mothers

6. Major risk factors CharacteristicsSample (n = 171) Age first heroin use19 years (median); range: 10-40 yrs AOD treatments23 yrs (median) age first treatment Mental health 39% on psychiatric medication 54% reported recent psychiatric illness Domestic violence18% had a current AVO Crime42% prison history; 16% recent trouble with police Own abuse history 65% reported abuse as a child (41% physical abuse, 55% unwanted sexual experience, 44% forced sexual intercourse)

7. Women’s child protection involvement Child protection system involvement Number (n = 171) Percentage Current *66 (56 with child/ren in care) 39% (33%) Past4325% Nil6236% * At least one child in care and/or investigation/service within previous 6 months [Grella, Hser & Huang (2006)]

8. Major research question Are mothers in drug treatment services who are involved with child protection services different in terms of parenting and other characteristics to those mothers who are not involved?

9. Areas tested: Comparing mothers currently involved with CP versus those not Age; age first birth; number children Schooling; income; financial problems Aboriginality Mental health; domestic violence Own abuse & criminal history Social supports Drug treatment & heroin use history Recent substance use

10. Significant in bivariate analyses: factors associated with child protection involvement (p < 0.01) L ower level of schooling (< Year 12) No driver’s licence Greater number of children Criminality: recent trouble with police and having a prison history Lack of social supports: irregular contact with parents and not being able to get help when needed Extensive substance use history: more AOD treatments, younger age first AOD treatment, and younger age first heroin use.

11. Significant variables in logistic regression model VariableOdds ratio95% CI Number of children1.431 *1.004, 2.039 Being on ‘psychiatric’ medication 2.962 *1.226, 7.157 Seeing own parents No contact/rarely Monthly/weekly Daily ** 1.234 0.220 ** 0.465, 3.275 0.071, 0.676 * p < 0.05; ** p < 0.01

12. Follow-up study Twelve month follow-up via child protection records of consenting women Analysis of predictors of child protection involvement after 12 months Descriptive analyses: new births, CP interventions, removals, reunification s CP records of 78 women were accessed.

13. Logistic regression analyses at 12 mths Instability in the model so results not presented here. Reasons: (1) non-random sample (over- representation of CP and previously significant variables) (2) small sample size Does not mean there is no association.

14. Other findings over 12 mths 62 children were still in OOHC at 12 mths (41 in kinship care) 30 children reported to child protection 15 families reported for ‘drug abuse by carer’ Two women had older children removed Children of 4 women in OOHC at interview were being restored

15. New births over 12 mths Six of the 78 women had new babies. All six were reported to child protection for ‘drug abuse by carer’. Five were reported prenatally Four babies had been removed from their mother’s care at birth or within a few months of their birth.

16. Conclusions from the study Multiple problems and disadvantages experienced by most women in sample High level of child protection involvement – long term care and new births Rather than severity of substance use, other factors are of greater importance in child protection involvement Opportunity in treatment to better address women’s needs and prevent future problems for them and their children

17. Link to main study report Taplin, S. and Mattick, R. (2011) Child Protection and Mothers in Substance Abuse Treatment, Sydney: National Drug and Alcohol Research Centre. http://ndarc.med.unsw.edu.au/resource/child- protection-and-mothers-substance-abuse- treatment Contact: Dr Stephanie Taplin, Associate Director (from 14Institute of Child Protection Studies August)Australian Catholic University stephanie.taplin@acu.edu.au