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With women hard-hit by spending cuts and often invisible in treatment
services, A Brighton Oasis Project conference looked at how women and
children could be supported through the austerity agenda.
DDN
reports
‘I
t’s vital to put women’s perspective into the
picture,’ Caroline Lucas MP told delegates at
the Brighton Oasis Project’s
The road to
recovery for women and children
conference.
The government’s austerity measures and cuts
to local authority services were hitting women hardest,
she said. ‘We’re in the midst of a record 25-year high
in women’s unemployment – women are paying a much
higher price for the austerity agenda than men.’
When substance use was added to the mix the
odds were even more stacked against women, she
continued, further exacerbated by the tendency of
payment by results to encourage a ‘bulk-buying’
approach. Despite around a quarter of service users
being women, services were not designed for them
nor did they get a mention in the 2010 drug strategy.
‘The irony is, if you’re just looking to reduce costs
it’s the preventative, early intervention stuff that gets
results, yet that’s exactly what’s being cut,’ she said.
There was also a ‘profound moral’ argument to help
people with substance issues, and women’s
substance problems were often more complex than
men’s, with issues of childcare, domestic violence,
stigmatisation, prostitution and more. While
parenthood could act as a barrier to treatment for
some women it could be a strong motivation to
engage with services for others, underling the
importance of a ‘truly flexible, partnership-based’
approach, she said.
One example of partnership working was the
Community of Practitioners (CAP) model – groups of
professionals with shared concerns or passions,
Michelle Cornes of King’s College told delegates. It
was vital to work towards longer-term care, she
stressed, and her organisation’s Community of
Practice Development Programme had set out to
determine if CAP could help the move from
‘sequential handovers’ to more meaningful
collaboration, as well as support workers in ‘what is
an emotionally pressured and stressful job’.
Shared leadership, agreed work priorities and
frequent communication were all vital, she said. ‘But at
a time of austerity, collaboration is what tends to fall
off the agenda. Joint working doesn’t happen on its
own – you need to really work at it.’ In the development
programme, efforts to get criminal justice, drug and
alcohol, mental health, housing and social workers –
along with employment and training advisors – around
the same table had been ‘really hard’, she said. ‘One
group didn’t get beyond meeting three.’
Nonetheless, the final feedback had been
overwhelmingly positive, with ‘genuine integration’ –
often despite, rather than because of, management.
‘What emerged were unofficial, “secret caseloads”,
as workers were wary of telling their managers that
they’d strayed off their patch,’ she said.
‘One question we asked was “is this just a talking
shop – are we wasting our time?” The answer was
overwhelmingly “no”. It genuinely kept people
engaged and motivated.’ It was vital to be realistic
about outcomes, however. ‘It’s about having a system
that’s balanced. Maintenance and prevention
outcomes linked to resilience and continuous
practice over the longer term should be valued just
as much as recovery outcomes.’
*****
Mary Lagaay, a postgraduate at the London School of
Economics and Political Science, described the
findings of another research project into long-term
support, in this case the experiences of mothers
after completing the intensive, 16-week POCAR
(Parenting Our Children, Assessing Risk) intervention
for maternal substance misuse.
Around 40 per cent of mothers with children in
long-term foster care had them returned after the
programme, but anxieties about having children
removed by social workers had made initial
relationships with professionals tense, she said, with
feelings of being ‘coerced’ even if women later said
they’d ‘wanted to attend all along’. Relationships with
social workers tended to remain adversarial, she
pointed out, despite an acceptance of why they’d had
to intervene, while the women were acutely sensitive
to stigma and would try to promote themselves as
good mothers even if they later acknowledged the
damage they’d caused their children.
Maintaining structure in their lives was seen as a
key element of long-term recovery, along with
continued strategies around relapse prevention and
parenting. However, self-confidence and self-esteem
remained barriers to full reintegration, and the
research endorsed the need for women-only services
and awareness of the ‘complex blend of social,
cultural, community and material resources’ that
could support or hinder the recovery process.
One of the most important lessons when it came
to safeguarding children when there was problematic
substance use in the family was that risk was
inevitable, independent social worker Gretchen
Precey told delegates. ‘It goes with the territory of
child protection. People behave in idiosyncratic and
unpredictable ways – we can learn how to improve
our practice to manage risk, but we aren’t going to
eliminate it.’
A stark illustration of this was a serious case
review she’d carried out, the harrowing story of ‘T’. T
was a three-year-old girl, the fourth child of
‘entrenched substance users’, who’d died of a drug
overdose in 2006, she said.
The case had been closed in 2005 but reopened
later the same year after an incident of ‘serious
domestic violence’. A shoplifting expedition that
ended in a police car chase – with the child
‘bouncing around in the back seat’ – then led to T
being taken into police protection and placed in
foster care for five days, with the foster mother
raising further concerns about the little girl’s welfare.
‘Those five days were the missed opportunity,’ Precey
told the conference.
The girl was returned to the care of her mother
but ‘things began to deteriorate again’ and she was
placed on the child protection register. ‘A legal
planning meeting was called in October 2006 as a
result of escalating concerns about her care,
parental domestic violence and substance misuse,
and the decision was made not to take her into care
and apply instead for an intensive support package,’
she said. ‘Five days later she was dead.’
One key lesson was to be wary of the ‘start again
8 |
drinkanddrugsnews
| October 2013
Cover story |
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