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Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and...

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www.hertsdirect .org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence
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Page 1: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

www.hertsdirect.org

Families with multiple needs:

parental mental ill-health, substance misuse and domestic violence

Page 2: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

www.hertsdirect.org

The Toxic Trio• Research shows that the environment in which a child lives is crucial to

his or her health, safety and well-being.

• The term 'Toxic Trio' has been used to describe the issues of domestic abuse, mental ill-health and substance misuse which have been identified as common features of families where harm to children has occurred. They are viewed as indicators of increased risk of harm to children and young people

• Work in this area has shown that there is large overlap between these parental risk factors and cases of child death, serious injury and generally poorer outcomes for children across all ages (Brandon et al, 2008).

Page 3: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

www.hertsdirect.org

Domestic abuse

1,796,244 children in England live in households where there is a risk of domestic violence

Source: How safe are our children? NSPCC 2014

Page 4: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

www.hertsdirect.org

Substance misuse

250,000 to 978,000 children have a parent who misuses drugs 920,000 to 3.5 million children in England are affected by parental alcohol

problemsSource: How safe are our children? NSPCC 2014

Page 5: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

www.hertsdirect.org

Parental mental ill-health

50,000 to more than 2 million children are affected by parental mental ill-health

Source: How safe are our children? NSPCC 2014

Page 6: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

www.hertsdirect.org

Parental mental ill-health

The following risk factors may justify a referral to Children's Services for an assessment of the child's needs.

Page 7: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

www.hertsdirect.org

Co-morbidity

“A clear co-occurrence between the ‘toxic trio’ risk factors of domestic abuse, substance misuse (alcohol and/or drugs) and parental mental ill health. Nearly a third of mothers (31%) and a third of fathers (32%) in these families experiencing domestic abuse disclosed either mental health problems, substance misuse, or both.”

CAADA Research Report, February 2014

A review of Serious Case Reviews (2007-2011) found nearly ¾ of children lived in families where two or more of these issues were present.

Ofsted 2011

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Page 8: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

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Indicators

During meetings in school, the victim either does not attend or takes a passive role –e.g. waits for her/his partner to speak first

School behaviour and academic attainment may be impaired due to difficulties in concentrating

Evidence of single or repeated injuries with unlikely explanations;

Children may blame themselves for parental behaviour. Self-blame may result in low self-esteem.

Regressive behaviours – such as soiling Running away

School absence Involvement with drugs or early

Adult appears frightened, ashamed or evasive

Children may take on too much responsibility for self, parents and younger children.

Emotional and behavioural difficulties- often aggressive/sexualised

Self harm

Lack of trust in adults Not being able to take part in extra-curricular activities

Visible injuries on parent

Domestic abuse*Some victims may be 16 – 18 years and in violent relationships (see presentation on teen relationship abuse )

Page 9: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

www.hertsdirect.org

Parental mental ill-health

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Indicators

The parent / carer's needs or illnesses taking precedence over the child's needs

A child acting as a young carer for a parent or a sibling

Child presenting as worried /anxious/preoccupied and withdrawn

Child having restricted social and recreational activities

Child finds it difficult to concentrate- impacting on educational achievement

A child missing school regularly as (s)he is being kept home as a companion for a parent / carer

Have low self-esteem and becomedepressed

Child's physical and emotional needs neglected (may be associated with parental depression)

Show behaviour difficulties, violentor self-destructive behaviour.

Possible alcohol/substance misuse and self- harming behaviour

Adopt paranoid or suspiciousbehaviour as they believe theirparents delusions.

Page 10: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

www.hertsdirect.org

Substance misuse

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Indicators

Parent presents as increasingly irritated, emotional unavailable or irrational

Inadequate food, heat and clothing for children (family finances used to fund adult’s dependency)

Visible injuries on parent Substance misuse or experimentation

Lack of engagement or interest from parents (e.g. non-attendance at parents’ evenings)

Behavioural difficulties- inappropriate display of sexual and/or aggressive behaviour

Bullying (including due to poor physical appearance)

Isolation – finding it hard to socialise, make friends or invite them home

Tiredness or lack of concentration Child talking of or bringing into school drugs or related paraphernalia

Injuries /accidents (due to inadequate adult supervision )

Taking on a caring role

Continued poor academic performance , including difficulties completing homework on time

Poor attendance or late arrival

Depression, anxiety, and withdrawal Poor self-esteem and low self-image

Page 11: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

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Serious Case Review:Daniel Pelka

Assaulted, starved, neglected

•Tragically, Daniel died in 2013. The circumstances of Daniel’s death suggested that he had been suffering abuse and neglect over a prolonged period of time. Daniel's arm was broken at the beginning of 2011 and abuse was suspected but the medical evidence was inconclusive. As his time in school progressed, he began to present as always being hungry and took food at every opportunity, sometimes scavenging in bins. His mother was spoken to but told staff that he had health problems. Daniel also came to school with bruises and unexplained marks on him.

•Between 2005 -2008 the first reported incident of domestic abuse took place. Both parents were intoxicated and violent and Daniel’s mother pregnant with Daniel.

•From 2008- 2011, Daniel's mother had relationships with 3 different partners . During this time, the Police responded to a total of 27 reported domestic abuse incidents often fuelled by alcohol and violence.

• It was also suggested that Daniel’s mother could not live without cannabis and amphetamines but this information was never recorded or shared.

•Daniel’s mother was suffering with depression and was regularly misusing alcohol; on two occasions she took an overdose resulting in hospital treatment..

Page 12: Www.hertsdirect.org Families with multiple needs: parental mental ill-health, substance misuse and domestic violence.

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Keanu ; Major injuries received over a period of days

Hamzah; Neglected; lay dead for over 2 years.

National cases


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