The Hidden Harm agenda in Camden

1. The Hidden Harm agenda in Camden • Safeguarding London’s Children • December 2008

2. Objectives of sessions • Overview of the issues in the UK • UK policy response to date • Camden’s approach • Ways forward • Learning form other boroughs and responsibilities for us to take away today

3. Overview of the issue • Drugs • Hidden Harm estimates that between 2-3% of children aged under 16 years (200,00-300,000) have one or both parents with serious drug problems. • Alcohol • The Alcohol Harm Reduction Strategy for England 2004 estimates that between 780,000-1.3 million children under the age of 16 years in the UK are estimated to be affected by parental alcohol misuse. • This represents 10% of children under the age of 16 in England and Wales • Adults in treatment • 158,594 PDU’s nationally of which 16% (25,043) were in London • Q1 and Q2 showed that there were 10,783 parents in treatment of which 18% (1977) were in London

4. Overview of the issue • Rates of children in care affected by parental substance misuse: • No national data • 40-70% of children subject to care proceedings is because of parental substance misuse • 40% of cases known to SSC had evidence of parental substance misuse through analysis of core assessments • Foetal alcohol syndrome • In 2002-2003 128 children were identified with FAS, an increase from the previous year of 90 (2001-02) and 95 in (2000-01). • Diagnosis of FAS is rarely recorded in the Hospital Episode Statistics. The reason for this is that it is difficult to diagnose the condition at birth and often evidence for the diagnosis becomes more apparent at school age

5. UK policy response • Hidden Harm (2003)- Responding to the needs of children of problem drug users (2003) The report outlined 48 recommendations for the UK government (the fours separate administrations) to take on board relating to policy, legislation, commissioning and service delivery. • Hidden Harm- Three years on: Realities, challenges and opportunities (2006) ACMD published a progress report which described the findings that the HH Implementation Group had found around what steps the 4 UK administrations had taken over the three years • Drugs Strategy: Protecting families and strengthening communities (2008-2018). The new 10 year drug strategy. One of the four strands “Preventing harm to children, young people and families” more explicitly outlines the impact of parental substance misuse on children. This strand also outlines a number of priorities to reduce the harm of children through earlier intervention and prevention work with families as well as an action plan outlining activities to be taken forward by central government.

6. Our starting point 2005 • Governance– • Hidden Harm sub group- Staying Safe Sub Board and DAAT. Scrutinised by CSCB • Standard agenda item on DAAT • Operational working groups- specific work streams • Annual action plan developed • Hidden Harm seminar and consultation with professionals- • Consultation with stakeholders as to what we need in place • Over 200 attendees

7. Camden’s starting approach Family Drug and Alcohol Court SSC services- Hospital social work teams MALT CAF – trigger question to substance misuse Working relationships between SSC and treatment providers- Roll out of Drug Use Screening Tool (DUST) screening Pockets of good practice but no consistent approach Other Services- Family Alcohol Service (FAS) Young People’s treatment service Range of adult treatment services CASA- providing support to families affected by substance misuse

8. Camden’s approach • Policy development- • New working protocols between SSC and adult treatment providers • CP lead within Quality Assurance team • Development of new specialist posts- • Senior practitioner substance misuse • Family support worker (substance misuse) • Specialist substance misuse health visiting post

9. Camden’s approach • Research and data management- • Audit of cases known to SSC • Joined up case reviews • Research commissioned to look at prevalence within SSC • New National Drug Treatment Monitoring System requirements • Building new data set into young people’s treatment services • Training the workforce- • Safeguarding and substance misuse training • Motivational training with alcohol clients for SSC • New requirements in contracts with adult treatment providers

10. What difference have we made? • Raising profile locally of issues- Hidden harm subgroup • Innovative developmental work- Family Drug and Alcohol Court- cross borough working • Increase in social work and treatment provider staff’s confidence • Improvements in referral pathways and screening of young people affected by parental substance misuse • Earlier prevention and identification – legal planning and pre birth CP conferences

11. Next steps • Development of a Camden Hidden Harm Strategy • Updating guidance of working with substance misusing parents • Fit for Purpose toolkit • Develop work with grandparents • Rolling out parenting support • Review and re commissioning of maternity services • Exploring feasibility of drug testing • Questions

12. Group work activity • What services/provision is there in your LA that promotes the identification of substance misusing parents and provides a service that supports a child to remain safely in the family setting? • 2. What do you see are some of the key strengths and barriers of improving outcomes for children affected by parental substance misuse in your LA? • 3. What do you see are key actions and changes which you can take away from today’s seminar to improve the support for children affected by parental substance misuse?

13. Questions Sally Heath- Commissioning Manager, CSF Sally.heath@camden.gov.uk Tel: 020 7974 1322 Patricia Denney- Principal Officer, Social Care and Safeguarding Division Patricia.denney@camden.gov.uk Tel: 020 7974 6628