Drug and alcohol services - improving holistic family support

6. Current situation in Scotland – availability of Whole Family Approaches

"When whole families are treated, outcomes for each individual member improve while simultaneously the communication, coordination, and ability of adult members to support one another and the children increase."

(Substance Abuse and Mental Health Services Administration 2007)

This section highlights:

• Findings from the 2019 CELCIS (Centre for Excellence for Childrens Care and protection) review of the implementation Part 12: Children at risk of becoming looked after, as set out in the Children and Young People (Scotland) Act 2014.
• Challenges from the Frontline Revisited, paper from Barnardo's Scotland and the NSPCC.
• Financial sustainability the need for investment in early and effective intervention – following and delivering on the principles of Christie and 'The Money'.
• The funding being made available from Scottish Government to support this work.

6.1 CELCIS in their review of the implementation of Part 12 of Scotland's most recent major children and young people's legislation^[29] found that, despite enabling legislation and specific duties being in place there continued to be gaps and weaknesses in our support for children, young people and families, including those "at the edges of care". These gaps included:

• Lack of consistency in working with families using a strengths-based approach, despite evidence that suggests such an approach can lead to children and young people being loved, cared for and happy with the right support in place.
• That in isolation, legislation does not lead to culture change in our services.
• Poverty, parental drug and alcohol use, parental mental health, domestic abuse and parental learning disability are key factors that may contribute to children being taken into care in Scotland and therefore the underlying needs of parents and wider family members must be addressed more comprehensively.
• Innovative family-based interventions (such as Family group decision making (FGDM)) services, whilst flourishing in a small number of areas in Scotland, were not embedded into local systems in the majority of areas.
• There was a lack of clarity in support for parenting as a relevant service within families, with many initiatives episodic and short term in nature and not providing the sustained level of help to families required.
• Children's Service Plans needed to be further utilised strategically to develop services to support families where children may be at risk of becoming looked after.
• Access to information about support services for families is limited despite the legislative duty to publish information about relevant services.

6.2 The report made a number of recommendations including:

• Culture change There was a strong value base shared from professionals about having "hope" and "belief in families that change was possible."
• Relationships and skillsets There was a very high value placed on spending time with families and letting them "tell their stories"…. feeling listened to, being part of the solution, understanding what needs to change, and having the right help. Local knowledge of communities and often different families was considered to be important.
• Resources The challenges to supporting families most frequently cited by respondents were "inadequate funding", "working with high levels of risk", high case-loads, lack of early-intervention services, and professionals not trusting families or feeling that "they know best".

"Support is needed at the very point you are clean because that's when all the stuff you've been trying to block out comes through."

(Father, Action for Children)

6.3 In Challenges from the Frontline Revisited ^[30],Barnardo's Scotland and the NSPCC reviewed 14 intensive family support services over a 6-year period. The services had a core commonality in their "whole family approach" and the fact they offered a range of types of support to both parents, carers and children and young people experiencing multiple adversities, found that"intensive family support services can play an important role in mitigating child poverty by reaching out and accessing wider social and economic resources for families."

6.4 The research also found that:

"…intensive family support services help children and parents with complex adversities in their lives but who are below the threshold for statutory intervention"

6.5 and in doing so:

"…these interventions can break the well-established association between childhood experience of multiple adversity and the increased likelihood of negative outcomes continuing throughout their life course."

"Without Circle, things would be a lot worse, my mental health would be a lot worse and I think I would be smoking more cannabis and drinking more, I would be more stressed out and less focused on my own self-care which is helping me a lot. They listened to me, made me feel important. I don't have children living with me at the moment but things are moving forward and I am having more contact with them. I am also thinking about my future more."

(Father, Circle East Lothian)

6.6 Over and above the ability of these services to intervene with families the services also provide the critical

"…extras'…for their families through spotting opportunities to reach out and work with other third sector and statutory services. These included, for example, providing summer holiday programmes and other experiences, health immunisation of teenagers and accessing adult education for parents."

6.7 The intervening 6-year period between studies had found that a number of services had closed due to funding constraints and changes in the procurement arrangements at local level. Some services still existed through spot purchasing arrangements and availability of new streams of resourcing through Attainment funds administered directly by individual Head teachers. This gave rise to even more disparity and differentials in access than had been evident in the earlier study. In remarking on the issue of the importance of sustainability to access and quality, the author notes:

"Families…benefit from services which have more staff and a more settled workforce that feels secure in its work and valued… Investment is needed to ensure consistency of availability of a whole range of types of support for families, while also being redesigned to provide greater accessibility… the current provision of intensive family support is insufficient to meet the scale of need in communities."

6.8 It is imperative we invest and support children and families affected by substance use in a comprehensive and sustainable way. We do this through a comprehensive and integrated approach in Scotland. Whole Family Approaches based on family inclusive practice are key to helping some of the most vulnerable families in our communities in Scotland. The aspiration of Rights, Respect and Recovery, the commitments of the Promise and the principles of GIRFEC provide the direction and the opportunity to address the need for expansion of these types of services across the country.

6.9 Developing and implementing a whole family approach and family inclusive practice is highly consistent with the preventative principles and underlying ethos of The Christie Report^[31] on the future delivery of Public Services. Similarly "The Money"^[32] element of the Independent Care Review, acknowledges the requirement for families to receive the bespoke help each individual in the family needs, at the earliest possible stage – from local authority or third sector providers or a blended support package of both.

6.10 The Scottish Government have provided £3.5 million (per annum) direct investment to ADPs to support implementation of this Framework, and each area's Children's Services Plan must be developed to take into account the best use of locally available resource across its partners. This is in addition to the £3 million allocated to the Children and Families Fund which is being administered through the Corra Foundation. This fund aims to support direct work with children and families affected by drugs and alcohol. Applications for this are based on partnership approaches which demonstrate how they will take a Whole Family Approach which is relational and rights-based when delivering front-line services which support children and families.

6.11 Further information on this fund and other related funds from the additional Scottish Government investment is available here: https://www.corra.scot/grants/drugs-services-funds/