1. FAMILIES: MULTIPLE NEEDS AND NO SIMPLE ANSWERS February 2 nd 2015 Galway Vivienne Evans

2. Who we are Adfam’s mission is that everyone affected by someone else’s drug or alcohol use should be able to access the help and support that they need. Established by a mother with a heroin using son National umbrella organisation for anyone working with families affected by substance misuse 2,000+ supporters from broad spectrum of services

6. Scale There are 250,000 children of problematic drug users… …and 1 million children affected by parental alcohol misuse

7. The numbers Nearly 1.5 million adults will be significantly affected by a relative’s drug use The cost of harms they experience as a result amounts to about 1.8 billion per year The support they provide would cost the NHS and local authorities about 750 million to provide if it were not available

8. Scale 150,000 people are affected by drug use in prison

9. Why? Families affected by addiction problems are important for four significant and related reasons: Involvement of family members in the treatment of their relatives with addiction problems can enhance positive outcomes Family members in these circumstances show symptoms of stress that merit help in their own right Effective treatment of the parent can have positive benefits for the child/family Better outcomes for children are achieved if they remain with their families

10. Why families? Families and recovery Rebuilding family relationships is a key constituent of recovery Families provide vital recovery capital Families are well placed to help map individualised routes away from drug dependency

11. Key issues Families need to recover too; their journey is as individualised as recovery for the individual Families do not always recognise the term ‘recovery’ and the language surrounding recovery Family members do not recognise recovery for themselves; a corollary of the user Family members don’t always want to be recovery capital Are families part of the problem? Stigma and shame Feeling they are not deserving of support How do we support children through their parents’ recovery?

12. Multiple needs When sorrows come, they come not single spies But in battalions. Homelessness, reoffending, problematic substance misuse and mental ill health. Troubled families or troublesome families?

13. Multiple needs Dual diagnosis is common: it may affect between 30 and 70 per cent of those presenting to health and social care settings Family services are working with families supporting a ‘loved one’ with complex needs drug/alcohol and mental health services are not equipped nor mandated (i.e. commissioned and resourced) to provide tailored support for families with mental health problems, or relationship problems family members often find themselves acting as advocates for the family member with complex needs – fighting their case with several agencies, including mental health and drug/alcohol treatment services drug/alcohol treatment services and mental health services often view the family member as an intrusion rather than a positive agent for supporting the ‘loved one’s’ recovery.

14. Family Interventions: Three Broad Categories interventions that work with family members to promote the entry and engagement of drug and/or alcohol users into treatment the joint involvement of family members and the relatives using drugs and/or alcohol in the treatment of the user interventions aimed to respond to the needs of family members affected by drug and alcohol problems in their own right [Copello, Velleman and Templeton, 2005]

15. What’s needed National co-ordination and leadership Drugs and children’s and family strategies Workforce development Outcome measurements and targets Cost/benefit Local advocates

16. Some things don’t change?