Aims and objectives:
Substance misuse appears to be a growing problem and poses a major challenge for health professionals. It is estimated that there are 200,000 – 300,000 children in England and Wales who have one or both parents with a serious drug problem (Home Office Hidden Harm 2003). Problematic drug alcohol use is strongly associated with socio-economic deprivation and can affect parenting capacity. The adverse effects for children are multiple and cumulative and cover a wide range of physical, psychological and social aspects of a child’s life. The regional Drug Strategy Team – East Midlands is looking to form closer links with Drug Action Teams (DATS) and Area Child Protection Committees (ACPC) in order to support the development and implementation of effective high quality services for drug using parents and their children. To this end the positive 'ICARE' Parenting Course for Drugs and Alcohol using parents was developed and commenced in January 2004 and has so far proved to be successful in supporting this group of parents. Parents have reported that they are now not using drugs and children are being prevented from going into care.
Support for the change:
This new group has received funding from the Community Safety Partnership in Derby City as it demonstrated in the pilot phase improved outcomes to the parents and children. Initially there was some reservation about the group being held in its current location because of the negative stereotype of drug users. Attitudes have changed in the weeks the course has been running and the group are now accepted. The group are pleased to be invited to such a pleasant environment and to be given the opportunity to develop as parents.
Patient and public influence:
The parents' views and expectations have helped to shape the parenting course. An initial pilot course highlighted several issues such as accessibility and child support and the need for funding such a course. As a result transport was provided to enable parents to attend sessions more easily and a crèche was provided for the children. These initial group members helped to design the course with the two workers. The proposed agenda is explained and any suggestions and individual needs are then included in the programme. Throughout the course group discussions and peer support are encouraged to facilitate sharing of experiences. An evaluation is ongoing to ensure the course meets the needs of the group members.
Impact on the workforce:
This group has proved the need for training of health professionals in using an empowerment approach in their work ensuring the involvement of parents in the delivery of the programme. A multi-agency approach has been adopted using health visitor, midwives, basic skills workers and child-care workers.
Measuring the results:
Derby Community Partnership is supporting this group with funding. It is a unique group so impossible to compare performance, however through continuous evaluation it has been proved that parents have gained enormous confidence and increase in self -esteem. Three group members are now on two working parties helping to set up guidelines for care of the baby on the ward after birth and multi-agency care of drug using women. The group is seen positively by Social Services and is receiving direct referrals. One of the families' children are now removed from the Child Protection Registrar because of the support from the group. Recently a full two-page article was presented in the local media about the success story. It is important that group members have ownership and they have recently designed the new name and logo ICARE (short for Infant Care) and are advertising the group more widely.
Improved performance:
The specialist midwife who facilitates this group has recently received a Reducing Health Inequalities award. Initial evaluation by the group members has shown an improvement in their lifestyle. Other evidence has shown empowerment of group members demonstrated within the group, as they are more willing to put forward their opinions and discuss issues, increasing social skills amongst group members also evident when attending other appointments. The self-reflection by group members examining how they were parented and their own skills to date increased motivation in tackling lifestyle issues. The children are benefiting from being able to access the area and all its facilities and are learning separation from parents in a positive environment. Also group members have learnt to have trust and confidence in each other.
Reflecting diversity:
This is the first parenting course in Derby City that has been specifically developed for parents with drug and alcohol problems, recognising the specific needs of this client group.
Sharing the learning:
This parenting course has now been advertised across Derby City by flyers and posters in social services departments, GP surgeries and other relevant venues. A recent article in the Derby Evening Telegraph has shared the success story of one of the parents in her fight against drugs.
Outstanding features:
The specialist midwife and health visitor have designed this course together with parents and now the parents are training as mentors to enable them to give support to other parents in similar situations. Some of the parents are accessing other learning that will enable them to return to work. It is hoped that this course will spread to other areas of City.
