Parental mental illness & substance use: are we really starting to ‘Think Child,

1. Parental mental illness & substance use: are we really starting to ‘Think Child, Think Parent, Think Family’? Claire McCartan & Gavin Davidson SCHOOL OF SOCIAL SCIENCES, EDUCATION & SOCIAL WORK

2. VV Parental mental health & substance use in NI • NORTHERN IRELAND O’Neill Inquiry 2008 Poor communication at many levels: Hospital to hospital Multidisciplinary teams 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

3. 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

4. VV Think Family NI • Development of educational resources • TF Social Work Pilot – Support Worker & Champions • Interface groups in each Trust • Research Evaluation 2018 – 19% aware of TF, 10% using it • E-learning resource – international collaboration between QUB, HSCB, Norway & Australia • Training the trainer – CiNI role out in the voluntary & statutory sector • Case file audit • NORTHERN IRELAND

5. 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 • Specific referencing to Think Family • Signposting info • interagency collaboration • Significanttime delays • Trust governance, GDPR, access

6. 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 • 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 QUB Heritage

7. 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 • 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 QUB Heritage