Working with Families Who Experience Parental Mental Health and/or Drug and Alcohol Problems in the Context of Child Protection Concerns: Recommendations for Service Improvement

Abstract

Child abuse and neglect often occur within the context of multiple risk factors, in particular parental mental health (MH) and/or drug and alcohol (D&A) problems. Interventions aimed at improving parental MH and D&A issues can have a positive impact on children now, as well as in the future. However, implementing sustainable service models that facilitate positive change for families with multiple risk factors is challenging. The purpose of the present study was to gain feedback from key stakeholders on a service model targeted at families where there are parental D&A, MH and child protection concerns to identify possible strengths and limitations of the model. This identified possible strategies for service improvement from the perspective of discharged clients and clinical staff. Gaining feedback from key stakeholders on service models is increasingly recognised as central to service evaluation and development. Ten interviews were conducted with clinical staff and twenty interviews with discharged clients of a pilot service that works with families where the child or children are at risk of significant harm in the context of parental MH and/or D&A issues. The interviews with clinicians highlighted difficulties working with this complex client group and its impact on staff burnout. Clinicians suggested how the model could be changed to better support clinical staff from burnout. Interviews with discharged clients highlighted the importance of the relationship with the worker in establishing client engagement and facilitating change. The way in which these recommendations informed the design of the service model is discussed.