Parental mental illness substance use are we really
Parental mental illness & substance use: are we really starting to ‘Think Child, Think Parent, Think Family’? Claire Mc. Cartan & Gavin Davidson SCHOOL OF SOCIAL SCIENCES, EDUCATION & SOCIAL WORK
Parental mental health & substance use in NI • Inquiry NORTHERN O’Neill 2008 Poor communication at many levels: IRELAND Hospital to hospital Multidisciplinary teams VV 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 • Development of educational resources • TF Social Work Pilot – Support Worker & Champions • • NORTHERN Interface groups in each Trust IRELAND • Research Evaluation 2018 VV– 19% aware of TF, 10% using it • E-learning resource – international collaboration between QUB, HSCB, Norway & Australia • Training the trainer – Ci. NI role out in the voluntary & statutory sector • Case file audit
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 • S • ig. Specific nifican referencing to Think Family t time d • T • rus. Signposting elays info t gover nance, • interagency collaboration GDPR , acces s
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 QUB Heritage 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
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 QUB Heritage 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
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