Does the alcohol or drug dependency of a parent necessarily place a child at risk – to the extent that they should be removed from their care?
In the first programme of Someone To Watch Over Me we witness the aftermath of a baby death where questions are asked about the mother’s drug use. We also follow the birth of a baby to an alcohol and drug using mother. Working with drug and alcohol dependant mothers is a significant part of the child protection role.
The simple answer would seem to be not to allow any baby to go home with a mother in this situation, but would such a decision be in the long-term best interests of the child and would it breach the rights of the parent? Should parents be banned from drinking alcohol?
As we see in the first two programmes, such dependency does not necessarily lessen the love a mother has for her baby and in some situations children can thrive despite living with a drug or alcohol dependant parent.
This decision is always a close call for social workers.
The debate has now closed, but Lucy Rai, part of the Open University's team of accademic consultants for Someone To Watch Over Me has chosen a selection of messages from the many we received.
Many thanks to all those who have contributed to this debate which has produced some very thoughtful and interesting ideas. In this response we have tried to select a range of opinions, so if your individual contribution is not included you will still hopefully find a view that reflects your own.
At one end of the spectrum contributors felt that the risk of leaving a child with drug/alcohol dependant parents is always too great:
I believe that a child is at risk if left with a parent with a drug/alcohol addiction drugs i.e. illegal substances, how could a parent either on illegal drugs or alcohol possibly look after a demanding newborn child. The parent needs help and support to get clean then progress to build a relationship/bond with the child.
Others shared these concerns but recognised some of the complexities of making individual assessments of risk including balancing the rights of the child against the rights of the parent:
It is obviously very complex decision to ever make and case specific. I do see that taking a baby away from a drug or alcohol addicted parent would not necessarily be the best option, though I cannot imagine a parent could ever provide a stable environment for a child if addicted to drugs or alcohol. It seems to me, as far as possible, mother and child ought to be allowed to grow in life together, though a child does have rights to a reasonably good start in life, which is why it is so important to monitor certain situations and at times provide support and intervention for dysfunctional families. I wish today's social workers the wisdom they need to cope with these difficult issues, and the sensitivity and intuition they need to understand the individual nature of each case they encounter.
One contributor shared her own very personal experience of being the child of an alcohol dependant mother, reminding us of the importance of listening to the needs of the child:
Hi my name is Lavinia. I am 22 years old now. When I was young (under 5) I along with my two older sisters were taken into care. This was because my mother was an alcoholic and a prostitute. When social services got involved they had placed us in a foster home that to them was keeping us "safe" from our mothers drinking problem. Whilst I was in care I suffered abuse both sexual and physical. I always had a lot of hatred for social workers because I blamed them for the abuse I suffered, when it was my mother’s fault for drinking. So YES alcohol places kids of all ages at risk. To this day my mother still drinks heavily and I hate her so much for what I had to go through when I was younger. I also agree social services have a part to do with it, they are been given a lot of the blame. They should have checked to see where they were sending me.
The next contributor reminds us that there are many alternative options that can go alongside either removing or leaving a child with the parent:
I think that alcohol or drug dependency in a parent should always ring alarm bells, and is enough to warrant an assessment of that person's parenting skills and ability to meet the child's needs. But there are so many pieces to the picture and only with all of the others can you have a sense of whether or not the child is at risk. I don't think it's right to suggest in the question that the fact that a child is at risk should lead to the child being removed from the family home, as there are so many other options that could be considered first.
The following contributor also emphasises the need for individualised responses. Not only are there differences in lifestyle and impact of drug / alcohol misuse on parenting, but individual drugs result in different behaviours which may pose varying levels of risk. Variations could include the cost of the addiction, whether they are habit forming or create physical dependence or whether they subdue or arouse an individual’s behaviour. Even the method of taking the same drug can heighten or reduce the level of risk. The nature of parents support systems can also be a vital factor in establishing the level of risk:
Alcohol or drug dependency cannot 'necessarily' place a child at risk. Obviously in different situations, dependency could lead to behaviours or omissions which do place children at risk. Each situation should be assessed individually. It is the impact the alcohol or drug dependency is having on an individual that is assessed rather than the existence of an alcohol or drug dependency. This should apply to any factor which may impact on parenting skills such as mental ill health, age or learning disability. There should never be a presumption that anyone could not be a good parent based on a single factor such as an alcohol or drug dependency but on a holistic assessment taking into consideration all the relevant facts. I feel in these assessments there should be a truly independent body involved to help with decision making.
I believe that all families should be assessed in this individualised way to ensure a right to family life.
Some contributors shared their own experiences of working with drug or alcohol using parents:
I have worked doing assessments on drug using parents and I do not believe that they all place their children in a risk situation. Some parents are protecting their children in an effective way. There is however even at a low level some impact on the child from substance use. I believe that there should be more funding available to support the work of social services to employ specialist workers to work with the parents and provide support and education to social workers and to raise the parents awareness of the impact of substance use on their children.
Finally we come full circle to the opposite end of the spectrum; drug use in its varied form is a common, in fact institutionalised part of life in many other cultures. Those responsible for making assessments need to be cautious that relatively socially acceptable drug use, such as weekend drinking, prescription drugs and smoking, are assessed alongside other forms of drug use:
In today’s society a fair number of people apparently have some sort of alcohol or drug dependency whether it would be young people binge drinking over the weekend or people with depression that are dependant on there medication etc. so if you are going to remove children from their homes because of some sort of dependency that pretty much leaves every parent in the country not capable of looking after their own children.
If you would like to find out more about the issues involved in substance dependency and pregnancy there is information available on the following two websites:
National Treatment Agency for Substance Misuse (NTA): www.nta.nhs.uk
Of note is their publication section, which includes "Models of Care". This online resource sets out a national framework for the commissioning of treatment for adult drug misusers.
The BBC and the Open University are not responsible for the contents of external websites.
The following book, which looks at the needs of children of substance misusing parents, may also be of interest:
'Parental Substance Misuse and Child Welfare'
Author: Kroll, Bryna; Taylor, Andy.
Publisher: Jessica Kingsley
Publication Date: 01 Sep 2002