The information presented below was obtained from external agencies via Safer Bristol. These agencies are mainly concerned with substance abuse by the children themselves, but they also refer to ‘Hidden Harm’ – the damage caused to children by their parents’ substance abuse.
- 1 – Transition to Adults’ Services
- 1.1 – Issues that need to be considered
- 1.2 – View from the young people’s services
- 1.3 – View from young people
- 2 – Statistics on parental substance abuse
Bristol Early Intervention Service
The Bristol Early Intervention Service is now operational in every mainstream secondary school and several specialist schools in Bristol, offering informal advice and drop in services to young people, as well as offering a screening process for young people concerned about their own or some one else’s substance use.
The 2009-10 Annual Report states that 74 out of 750 children identify hidden harm issues, 60 new young people were seen in the hidden harm service and that the service is working at full capacity.
Drugs & Young People Project
The Drugs and Young People Project (DYPP) is part of CYPS, funded jointly by Bristol City Council and Safer Bristol. The project has two main parts, known as ‘At Risk’ and ‘Hidden Harm’. They work with children and young people affected by substance misuse; their own and that of their parents and carers.
The ‘At Risk’ part of the project provides a treatment service for young people, up to the age of 18, whose substance use has become problematic, and for the adults working with or looking after them. They focus on young people identified as particularly vulnerable to substance misuse (that is children in care or exposed to substance use within their family and homeless young people). Substances include legal and illegal drugs, alcohol and solvents.
The ‘Hidden Harm’ part of the project works with children and young people, aged between 5 and 15, who are affected by the drug or alcohol misuse of their parents or carers. They prioritise young people who are subject of a Child Protection Plan, whose carers are currently misusing substances and those who are receiving little other support.
The Drugs and Young People Project can only accept referrals for young people whose needs are so significant that they have been assessed as requiring an allocated social worker. DYPP workers work in partnership with social workers and will contribute to assessment and Child Protection, Children in Care and Child In Need processes.
22 out of 29 At Risk children also report parental substance misuse, and a similar number report domestic violence. Parental use is predominantly heroin or alcohol. The majority are chronic users with little engagement in treatment programmes.
The current capacity in the Hidden Harm service is inadequate. Many children do not receive a service, or have to wait. At the end of 2009‑10, 53 children were receiving a service, of whom 33 were new referrals. 14 children were awaiting a service.
Numbers of children referred to the Hidden Harm service during 2009-10:
- LAC – 1
- CPP – 14
- CIN – 15
- Other – 3
Opening Doors is the umbrella name for specialist substance misuse services for young people in Bristol. It is part of the wider youth offer in the city forming part of the ‘Someone To Talk To’ services.
The service involves the joining together of services commissioned by Safer Bristol from:
- Youth Offending Team
- Child & Adolescent Mental Health Services
- NHS Bristol
- Voluntary Sector
The aim of Opening Doors is to deliver a more joined up service to the most vulnerable young people across the city. Reaching out to young people in the settings and communities where they live.
Transition to Adults’ Services
The Young People’s Substance Misuse Needs Assessment 2008/09, published by Opening Doors, is mainly concerned with substance misuse by children, but also mentions hidden harm. The most worrying aspect of the report is the evidence that young people are not receiving adequate care during the transition from children’s to adults’ services. Figure 1, Figure 2 & Figure 3 and the bullet points below are closely based on the Opening Doors Needs Assessment.
Figure 1 – No of 10 – 25 year olds in Children’s and Adults’ Drug Treatment Services
Figure 2 – No of 15 – 25 year olds receiving treatment for Cannabis use
Figure 3 – No of 15 – 25 year olds receiving treatment for Alcohol use
Issues that need to be considered
► Young people that are leaving specialist substance misuse services are not being identified as priorities by adult treatment services. Here referrals are not accepted, the young people are not attending assessments or they are dropping out of adult treatment very quickly.
► Adult services are offering a different model of engagement. Young people’s services are more flexible/outreach orientated. Particularly pronounced for primary alcohol users.
► Different/changing patterns of drug use across this age range.
► Lack of 18-25 specialism in the adult services.
► Different needs of 18-25s to both older and younger groups.
► Vulnerable/damaged group at 18 – this may not be the best time in terms of development to have a transition.
View from the young people’s services
These views were expressed by the service managers of the young people’s treatment services in Bristol-
► Young people often do not fit criteria for adult services – often the criteria [are] too high
► The adult services are not able to offer outreach intensive service that young people’s services offer, thereby losing young people (i.e. falling between gaps)
► The adult services need to be flexible to allow for the transition period – they should start off with intensive support and reduce this over time
► Knowledge of what is available for young people and thresholds-especially around alcohol services
► There are differences in the approach of young people’s and adult services
► Difficulty accessing specialist services i.e. mental health
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View from young people
These comments were taken from young people at an Opening Doors Feedback Group-
► “Just because I’m 18 it doesn’t mean that I’m an adult”
► “I’m feeling a loss as to what to do next”(when I turn 18)
► “The adult services don’t use the right type of language with you. They say words that are confusing to you”
► “It’s easier to be open and honest with the young people’s services”
Statistics on Parental Substance Abuse
- Estimates from the Advisory Council on the Misuse of Drugs (ACMD) in 2003 indicate 2 ‑ 3% of all children are affected by parental drug use. This equates to about 1600 ‑ 2400 children in Bristol. They also estimate that there is one child under 16 for each problem drug user. This equates to about 8700 children in Bristol.
- Estimates from Alcohol Harm Reduction Strategy England in 2004 indicate between 780k and 1.3m children are affected by parental alcohol misuse. This equates to about 6500 ‑ 10,600 children in Bristol.
- National Children’s Bureau data from 2006 report 18.5% of LAC and 20% of CPP have problematic drug-using parents. A third of long-term LAC involve alcohol misuse. 20 ‑ 30% of parents who physically abuse their children are heavy drinkers. In Bristol 33% of CPP have a risk indicator, at the point of initial conference, of parental drug or alcohol misuse.
- Alcohol Concern estimate that 40% of all social work cases involve children whose parents misuse alcohol. In Bristol this would equate to nearly 1400 children at any one time, or over 2000 during the year.
- Foetal Alcohol Syndrome Aware report that 1% of all live births show evidence of being on the FAS spectrum. This equates to about 60 new babies per year in Bristol.