NDARC Technical Report No. 320 (2011)
This report presents the major findings from the Child Protection and Mothers in Substance Abuse Treatment study, a three-year study funded by NSW Community Services, Department of Family and Community Services, and the University of New South Wales.
Parental substance use has received particular attention as a child protection concern in recent years, but it is an area in which there has been little research and in which a number of research questions remain unanswered. Evidence has shown that parental substance misuse is associated with high rates of child maltreatment, but substance use by a parent does not necessarily mean that they are abusing or neglecting their children. Research from overseas has also found that families in which alcohol or other drug use is present are more likely to come to the attention of child protection services, more likely to be re-reported, more likely to have children removed from their care, and more likely to have them remain in out-of-home care (OOHC) for long periods of time, than are families with the same characteristics but no substance use. A small number of overseas studies have also found that, among substance-using mothers, factors other than the severity of substance use are associated with child protection involvement. The applicability of these overseas studies to the child protection system in Australia is, however, unknown.
This study provides an enhanced understanding of parenting issues and child protection involvement among women with a history of illicit drug use in Australia.
Methods: Women with at least one child aged under 16 years were recruited through nine public and private opioid treatment clinics across Sydney. One hundred and seventy-one women were interviewed between May 2009 and May 2010. Their drug treatment and child protection records were also used as a source of information where they consented.
Major findings: Just over one-third of the women were involved with child protection services at the time of interview, with one-third of their children (n = 99) in OOHC.
Women who were involved with child protection were compared with those who were not to determine the factors associated with child protection involvement. Logistic regression analysis revealed that those variables which significantly increased the likelihood of being involved with child protection (while controlling for the other variables) were: (1) having a greater number of children, (2) being on psychiatric medication, and (3) having less than daily contact with their own parents. Although women who had a more extensive substance use history were more likely to be involved with child protection (when no other factors were taken into account), this association was no longer significant in the logistic regression model.
Other findings: Consistent with previous research on this population, these women were highly disadvantaged, having little formal education (median 10 years), tending to be single (32.4% married or de facto), on government benefits (87.1%), experiencing financial problems (80.6%) and living in public housing (58.3%). The women had extensive substance use and drug and alcohol treatment histories, again consistent with previous research. A significant number also had mental health problems (54.2% had been recently diagnosed with a psychiatric illness), had a history of criminal involvement (41.9% had prison history) and had some type of physical or sexual abuse as a child (64.5% reported this), with sexual abuse the most common (55.4%). Recent domestic violence was less common (18.0% had recently taken out an apprehended violence order).
Since starting on the New South Wales Opioid Treatment Program (OTP), the women reported improvements in a number of areas, again consistent with previous research. Reductions in substance use, criminal involvement, number of problem areas and time spent with illicit drug-using friends (along with improvements in parenting ability, financial situation and sources of support) were reported by the women since starting on the OTP. Heroin use reduced markedly, both in the number reporting any heroin use in the past month (from 88.3% to 21.6%) and in the number of times used (27.6 to 5.6 days per month). Despite these improvements, women involved with child protection stayed no longer on the OTP than women who were not.
Women generally chose to enter the OTP, and many did so for child-related reasons. Women who were currently involved with child protection services reported receiving more services through the program than did the women who were not involved, the services most commonly received being counselling, legal assistance and childcare. Women who were being treated through public programs were more likely to have a caseworker than women at private programs.
Most of the women were young when they had their first child, the median age being 21 years, much lower than the median age of first-time mothers across Australia (28 years). More than one-third (39%) were teenagers when they had their first child. Surprisingly, 38% of the women in the study started using opioids after they had had their first child.
The women mostly gave birth to two children. One in five of their children were reported to have major health or behavioural problems, and these children were much more likely to be in OOHC.
Many of the women were single (41.8% were not in a relationship) and most were either the only adult living in their household (46.8%) or lived alone (11.7%). They were more likely to spend time with family than with anyone else and particularly relied on their family for help with their children. Support from their parents was particularly important to these women.
Most lived in public housing (58.3%) and they appear to be less trusting of neighbours and feel less safe in their community than do other women, even those living in disadvantaged areas.
The majority of the 99 children in OOHC at the time of interview were in kinship or relative care, generally living with their grandparents. Younger children were more likely to be in care than were older children. Many of the children in care (42%) had been removed from their mother at birth and placed in OOHC, and this was even more likely among the younger children (73% of those under five years of age had been removed at birth). Children placed in foster care had less contact with their mother than those living with relatives and were more likely to have supervised contact visits.
Another 57 children were not living with their mother because of Family Court orders or informal arrangements for family to care for their children.
Around one-third of the women (31.7%) reported having undertaken a parenting course, with those involved with child protection (most of whom had children in care) significantly more likely to have done so. Although half the women acknowledged that their parenting was adversely affected by their substance use, many also reported that they went to great lengths to keep their children unaware of their substance use and/or their being in pharmacological treatment.
Half the women (52.1%) said that their substance use had affected their ability to parent their children, while slightly less than half (45.5%) said that it had not. Where substance use had not affected their parenting, women reported that they had always prioritised their children’s needs and only used substances when the children were being cared for by family.
Discussion: The results of this study are important for the child protection field. They show that, rather than severity of substance use being associated with mothers’ involvement with the child protection system, other factors are of greater importance. Of particular interest was the finding that having greater social support, particularly from parents, significantly reduced the likelihood of being involved with the child protection system. Women made great improvements while on their treatment program, particularly in relation to reduced substance use.
In terms of policy and practice implications, this study supports the call by overseas researchers to intervene earlier with girls who have been abused themselves prior to the escalation of problems associated with abuse, such as mental health problems and substance misuse, and prior to them becoming mothers. The provision of targeted women-only services is essential for girls in such circumstances, and for most women in opioid pharmacological treatment, in order to help them deal with their mental health problems and to enhance parenting, coping skills and social supports. It is important that such services are provided if we are to reduce the high rates of intergenerational abuse, trauma and disadvantage among these women and their children.
Citation: Taplin, S. and Mattick, R. (2011) Child Protection and Mothers in Substance Abuse Treatment, Sydney: National Drug and Alcohol Research Centre.