| dc.description.abstract | Background:
Globally, the problem of hidden harms to children of parents who use drugs and alcohol has been
recognised, yet international literature has highlighted the difficulties with estimating the prevalence
of this challenge. There exists a clear information gap at local level in relation to the numbers of
children potentially adversely affected by parental substance use. However, it is at a local community
level that resources must be allocated. There is a particular concern for the potential risks for these
children and a desire to build upon and understand protective factors and enablers for children.
Aim: The overall aim of this research was to identify and explore lived experiences of the risks and
protective factors of children of parental substance misuse from an intergenerational and service
provider perspective. The objectives of this research were to estimate of the prevalence of children
impacted by parental substance misuse, across the communities of a regional area; identify and
explore lived experiences of the risk and protective factors of children of parental substance misuse
from the perspective of their parents, and from the perspective of adult children of parental drug
misuse, and grandparents; and to Identify and explore experiences of the risk and protective factors
of children of parental substance misuse from child and family service and drug service providers.
Method: This study design was based on a concurrent quantitative and qualitative multiple method
design, with the qualitative aspect dominant and informed by Bronfenbrenner’s framework. The
design measured quantitatively the prevalence of children of parental substance misuse, and,
qualitatively, explored intergenerational (adult children, parent, and grandparent) and service
providers lived experiences of the risk and protective factors for children of parental substance use.
Multisource enumeration and benchmark multiplier methods were used for the prevalence estimates,
and semi structured interviews and focus groups were used to explore the lived experiences.
Results: Using an indirect benchmark multiplier method we found that a minimum of 2% of children
were estimated to be possibly impacted by parental substance use and a maximum of 13% children
were estimated to be possibly impacted by parental illicit drug use in the region. With regards to
alcohol use we estimated that 14.5% of children in the region may have a parent who is alcohol
dependent. A total of 37 people self-selected to take part in the qualitative aspect of the study.
Sixteen parent service users, 2 adult children, and 7 service providers took part in one-to-one
interviews. Twelve grandparents participated in two separate focus groups (N=7, 5). The multiple
stakeholder perspectives of the lived experience of risk and protective factors for children of parental
substance misuse provided an in-depth holistic insight into the area under investigation. Risk and
protective factors were reported across multiple levels of the Bronfenbrenner’s ecological system.
Risks identified for the child across stakeholders included trauma, children being taken into care,
children acting as carers, and emotional and physical neglect. While risk factors from parental
substance misuse reported by the adult children echoed those of the other stakeholders, in addition
to this, the participants also highlighted the critical role of factors not specific to the parental
substance misuse per se, that exacerbated their lived experience. These risks included more than one
parent misusing substances, mental health issues, parental death, community environment, and
peers. Existing protective factors for children consisted mainly of one good adult, and of community
level interventions including youth clubs, sports, and community services. Scarcer but highly valued
protective factors included peer support, trauma informed interventions and targeted support for the
children in terms of having someone to talk to. A significant risk factor for children that transcended
all stakeholder interviews related to the service level response for parents who misuse substances,
with many stakeholders reporting a service system under immense pressure, operating from siloes of
expertise, manifesting from historical origins, differing models of addiction, a lack of understanding of
how to respond to parents and or children respectively. The issue of stigma was reported by all
stakeholders, with a specific targeted stigma reserved for mothers who misuse substances, a stigma
often perpetuated by a negative media, policy and professional narrative. Grandparents similarly
reported significant challenges with child service systems, limited capacity to assist child in school
settings, and significant challenges with justice systems. Supports for grandparents were reported as
being extremely limited and impacted by a culture of being taken for granted by services, resulting in
differing supports being available for kinship care relative to non- relative carers.
Conclusion: The findings from the study contextualise our knowledge of risk and protective factors
that influence children of parental substance misuse, from multiple perspectives. While both policy
and practice have made steps in recognising children of parental substance misuse as one in need of
prioritisation, with promising ways of supporting these children being designed and implemented to
varying degrees. Future research is needed to explore and monitor the extensive implementation
challenges of the systemic change initiatives currently recommended. The widening of the focus of
the lens through which we examine risk and protective factors of children of parental substance
misuse is imperative. This study’s findings have practical implications and recommendations for social
service. agencies and other contexts such as early childhood environments, schools, and community-
based programs. | en |
