6. Effective practice where children are affected by parental substance misuse (PSM)

• Children affected by PSM are more likely to develop emotional and behavioural difficulties, fall behind at school and become socially isolated. Maternal alcohol and drug misuse during pregnancy is likely to have a marked impact on a child’s later health and development and may be linked to later behavioural problems.
• Parental drug misuse and alcohol misuse often co-exist and are more likely where families are affected by other issues, including parental mental ill health, domestic violence, neglect and social deprivation. Given this, a multi-agency response is required. For parents, services should include interventions to address drug and alcohol use from prevention through treatment and relapse prevention, mental health support, parenting programmes, and education and employment skills training. Work should include fathers, as well as mothers, and supportive extended family wherever possible. For children, services should include recreational, educational and therapeutic services. Facilitating access to universal and targeted services in health, housing, child care and education is also crucial.
• Despite the negative impact that PSM is likely to have on family life, many children will prefer to stay in parental care. Where there are other support mechanisms for children, not all children affected by parental substance misuse will experience poor outcomes. This dilemma requires practitioners to listen to children’s views about what they want to happen, but balance this with clear assessment of whether children’s needs can be met within the home environment.

Cleaver et al, 2007; Mitchell and Burgess, 2009