Drug and alcohol services - improving holistic family support

Annex A

Ask the Family!^[43] – Family Perspectives on Whole Family Support and Family Inclusive Practice

As part of the delivery of RRR in Scotland a working group was established to examine and consider how best to develop WFA/FIP in Scotland for families affected by substance use, delivered locally through existing partnership arrangements. This group met across 2019 to early 2021, including extensive inputs from existing providers of family-based support. The group had established a number of headline priorities that it consider key to driving change and expanding access to services. The group felt it imperative that a dialogue was established with family members, including children, young people and adults who had been affected by substance use in order to first test our own thinking and secondly to be able to adapt the approach taken in order to reflect the powerful voices of those with direct experience.

In December 2020 a group of agencies, working together and led by Scottish Families Affected by Alcohol and Drugs (SFAD) were asked to embark on a series of engagement activities to understand the views and experiences of a wide range of family members, including children, young people and adults, with a particular focus on what a "Whole Family Approach" meant, looked like and felt like from their perspective. The engagement activity also sought to 'road test' the draft principles that had been developed across 2020 by the national group seeking to define Whole Family Approach and family inclusive practice for much wider delivery across Scotland.

The engagement work had the following main components:

• Ask the Family Survey – involving 135 family members (adults, children and young people) who were affected, in some way by substance use
• A conversation café involving 8 family members, who have been affected by substance use
• A set of 13 further individual and group engagement activities where children, young people and adult family members shared their views and experiences about family support and whole family approaches. This was presented as a virtual exhibition including poetry, letter-writing, visual art, film and animation, written materials and audio clips.

The programme of work focussed on the following areas:

• What makes good (and bad) family support?
• What do families value about support/what is important to them?
• What words would families use to describe good family support (and their workers)?
• What difference has support made to families and their lives?
• How would families describe a good family support worker?
• What impact (if any) have their peers had as part of family support (i.e. other group members/ service users)?

The outcomes of the survey, conversation café, individual and group engagement activities have been used to develop an extended list of principles which should guide this next phase of development of whole family approaches to support services as well as the family inclusive practice which must underpin these services. The paragraphs below summarise this extensive and powerful piece of work, which can be found in its entirety here:https://www.sfad.org.uk/ask-the-family. There were a range of examples of family support across the country with a generally inconsistent approach across Scotland to supporting families and a "postcode lottery" of services, depending on where you live:

• A lack of awareness of rights to support for families and carers.
• Variations in access and availability of support services for children, young people and adult family members across Scotland.
• The length of time family members have to wait to access help or support – with family members being affected by substance harm for an average of 16 years, but not reaching family support for the first time for an average of 8 years. Only 1 in 8 reached family support in the first year they were affected.
• The extent to which individuals within and across families are affected by another family member's substance use – with survey respondents reporting on average 11 other people being affected by an individual's substance use, including other family members but also significant numbers of friends, work colleagues and neighbours.
• A great desire for improvements in relationship-based services, based on trust, dignity and respect of families who are being affected by substance use.
• For services to have longevity and no time limits – and not just be limited to episodic and crisis-driven periods of support.
• The experience of the vast majority of family members of being excluded from the treatment, care and recovery services of their loved ones.
• The need to embed the agreed principles of whole family approach into all services – not just those that were substance use specific.