Relevant social work policy

Social work policy has been lacking in relation to alcohol and drug use. However, recent research relating to the impact of substance use on the family has placed the issue higher up the political agenda. At a local level there are a growing number of policies often led by the LCSB (Local Safeguarding Children's Board). For example, in Birmingham there are policies relating to alcohol and drug use by people in residential care, and parental drug and alcohol use. The following are brief summaries of what policy currently exists in relation to the delivery of social services:

• Our Health, Our Care, Our Say (2006) “sets a new direction for the whole health and social care system”.  Its focus is on better access to health care within the communities and maximising independence and choice.  It acknowledges that people with alcohol or drug problems often have longer term health needs as well as finding it difficult to access appropriate medical care.  It therefore provides a policy framework within which you can advocate for better health care for people with alcohol and drug problems.
  
• National Service Framework for Children, Young People and Maternity Services (2004) – acknowledges issue of drug and alcohol problems and the need to provide information and services for parents with substance problems
• The Children Act 2004 – Part 2 of the Act requires improved integration and partnership working among children’s services in order to ensure children’s safety and wellbeing is prioritised. It places a duty on key agencies to co-operate and establishes the Local Safeguarding Children’s Boards (to replace the Area Child Protection Committees) as a vehicle for doing this.  It also says that professionals need support to work together, share information and identify any difficulties in doing so.  This means that joint working with alcohol and drug specialists is underpinned by duties and legislation where a child, or parent, may be at risk from substance use.
• Every child matters: change for children 2004 clearly identifies “substance misuse” among young people as an area that needs improved service provision and the need for early identification and intervention.
• NSF Mental Health (1999) – acknowledges alcohol and drug misuse as closely related to mental disorder and ill health.
• Carers (Recognition and Services) Act 1995, s.1, requires an assessment of a carer’s ability to provide and continue to provide care for a person. This can be used where there are young carers, or adult carers, of people with substance problems.
• The Children Act 1989 does not specifically mention alcohol or drugs. However, focusing on a child’s needs and/or potential harm resulting from parental substance problems fall within existing provision, ie. s.17: children in need – impairment of development without intervention and s.47, where a child is suffering or at risk of suffering, significant harm. The key issue for social workers here is to ensure you have a good knowledge of substance use and have reflected on your value base in relation to alcohol and drug use and users. The risk of not being informed and reflecting on practice might result in some social workers believing that any alcohol or drug use will be damaging to the child resulting in inappropriate action. Ultimately s.20 of the Act, accommodating children due to unsuitable care or accommodation, can also be used.
• Mental Health Act 1983 - definitions of “mental impairment” and “psychopathic disorder” exclude behaviour that solely results from drugs or alcohol dependence (s1 (3)). However, alcohol and drug problems can fall into provisions of MHA if psychosis results from substance use. There needs to be a mental disorder alongside alcohol and/or drug effects which is difficult to assess. However, the MHA can be relevant and applied if appropriate. The Draft Mental Health Bill 2004 fails to mention alcohol or drugs at all.
• National Assistance Act 1948 requires local authorities to promote the welfare of people aged 18+ who are blind, deaf or dumb or who suffer from mental disorder of any description… (s. 29). Treatment for people suffering from alcohol and drug problems has been firmly located within mental health services. Thus the NAA could be applied. Similarly, s. 21 of the Act imposes a duty to provide residential accommodation for people who are in need of care and attention which is not otherwise available to them. Anecdotally this Act has been used to secure temporary housing for people who are homeless and ill as a result of their substance problems.
• NHSCCA 1990 - s.47 imposes a duty on social workers to assess need. This does not exclude need related to drugs and alcohol. Further, Local Authority Circular (LAC) 93/2. ‘Alcohol and Drug Services within Community Care.’ required LAs to conduct a needs assessment of the local population in relation to alcohol or drug problems, include alcohol and drug services in community care plans, conduct social care needs assessments of individual alcohol and drug misusers and arrange appropriate care packages.

Footnote: it is worrying that the Human Rights Act 1998 has the power to exclude people with alcohol or drug problems. Article 5, ‘Everyone has a right to liberty and security of person’, contains some exceptions (providing due legal process). These include “the lawful detention of persons for the prevention of the spreading of infectious diseases, of persons of unsound mind, alcoholics or drug addicts or vagrants”.

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