Kerrie Tucker: Thank you. The first two speakers are on time! It’s fantastic.

And the last speaker in this section is Sue Mickleburgh and she’s the Director of Marymead. She’s been a social worker for 25 years and the areas of interest are child protection and family support.

Sue Mickleburgh: Thank you Kerrie. Now as you mentioned in my introduction, my areas of interest have been child protection and family support and that’s the area that Marymead focuses on.

We undertook a recent staff survey of what were the areas that our staff felt least prepared to provide services to families and working with families who were affected by drugs and alcohol came out unanimously as an area in which staff generally felt that they had insufficient training. Now I think that on the one hand that is a very real problem in that Marymead works with the most disadvantaged and vulnerable families in Canberra. And by that very definition many families that we work with are going to be affected by substance abuse. On the other hand, it is important that we deliver our services by looking to support whole families and not families who are defined by the problems that they bring with them. So I am very conscious that most people in this room are going to know a lot more about the issues relating to families affected by substance abuse. Nevertheless, I hope that I can share with you some of our experience of what we see as some of the tragedies that children and families are trying to overcome.

Child protection research has long been concerned with the link between substance abuse as a possible explanation for child abuse and certainly over the centuries in the western world there has been a focus on that connection both in the arts and then social-political sciences. So I think many of us would be aware of that really compelling engraving of Hogarth, Gin Alley, where there is a mother who’s intoxicated and dropping her baby. And Norman Lindsay here in Australia did a series of cartoons about wowsers that depicts the insensitivity of people to these social issues. There were the periods of prohibition and I, having been raised in Adelaide, have memories of the Women’s Temperance Union being quite active and being on the one hand quite titillated and shocked by the saying that "Lips that have sipped wine shall never touch mine" and really wondering quite what that meant.

So there has been a concern for a long time about what the impact of alcohol and drug usage can be on a family’s child rearing practices. The statistics from the US are quite firm. They suggest that roughly 50 per cent of families who have contact with the welfare system have a problem with drug or alcohol use. Unfortunately the statistics in Australia are much less clear and we don’t have reporting mechanisms to make that link but it would seem that there is still that connection.

That doesn’t address what the complexity is around child abuse. A whole myriad of factors will result in one family abusing their children. Another, in similar situations, have other ways of dealing with problems. Still it does seem that all types of child abuse can be affected by substance abuse. And the research looks at what some of those reasons might be. With sexual abuse, it is suggested that substance abuse acting as a disinhibitor can be a risk factor or can reduce a parent’s capacity to supervise their children responsibly. The impact on family relationships and communications is also suggested as resulting in stress and frustration which can result in sexual violence.

I was a little more dubious about the research which links physical abuse and substance abuse: looking at substance abuse as part of a set of anti-social personality traits frequently associated with abuse. And so they’re looking at traits like impulsivity, aggression. I’m not sure there is a direct causal relationship.

Emotional abuse and neglect. It’s easy to see the impact of substance misuse. A parent who’s pre-occupied by drugs overlooks – they often overlook their child’s needs. And that often results in parentification: that children actually take on adult roles within their family; by necessity assume inappropriate adult responsibilities. And often chaotic, unpredictable households don’t have the routine, the stimulation and nurturance that every child needs to grow, to develop into a full human being.

And lastly the research on in utero and newly postnatal abuse looks at how children inherit the consequences of their parents’ behaviour; that that can result in spontaneous abortion and premature births, foetal distress, physical and intellectual disabilities, actual withdrawal from drugs at the time of birth and SIDS and then longer term issues such as impulsive behaviours, learning difficulties and behavioural difficulties. And that cohort of issues can mean that a child is additionally difficult to care for and that that can add a stress and strain on a family perhaps less equipped than others to care for their child.

So how do we at Marymead see these sort of factors playing out in the children and families that we are attempting to support? We see children who are 8 years old or even younger who really I can only describe as feral. They often have been exposed to multiple adults and the behaviours of those adults. Often they have been exposed to direct or indirect sexual experiences. They’re often very grossly inappropriate in the way they seek attention and affection and they often cause grave offence to people in the community. I can remember a child who came to live with us in one of the residential cottages and who was very unhappy about his separation from his mother, giving a very graphic account of what he would do to my mother if he ever bumped into her. And all of this places them at extraordinary risk in the community at large.

We see toddlers who are often looking after themselves for significant periods of time when their parents are either physically or mentally unavailable to them. They have inadequate food and sleep. Terrible accidents sometimes happen to them. They suffer burns, have falls from quite high places. And the chaos of the household often means that health needs are not met. We had a little girl who had had hearing difficulties diagnosed. Hearing aids had been provided to her but the hearing aids could never be found in the morning before going to school so she would go to school. She wouldn’t hear anything. She wasn’t learning anything.

We also see some quite entrenched anti-social behaviours in some of our kids. Now they’re survival techniques. But again we had a new foster carer who was quite perturbed when she went shopping for the first time with a little boy. They were going to buy shoes and he said: "Do you want me to nick them?" He didn’t have a concept of purchase. Consider the impact for that carer and her children having to learn where this child was coming from and accommodate that.

Also we have many children in our foster care program for whom one parent or both parents are dead. Many parents are in prison and many have just disappeared. And sometimes we hear of those disappeared parents when they come to the attention of another child care agency when they’ve given birth to another child who has been removed from their care. And personally I find that one of the most painful prospects – the life that those parents are going through but also the sense of abandonment that those children experience.

So the parents that we’re working with are also terribly needy. They often come to visit their children, unwashed, unfed, unwell, physically hurt and sometimes it is just not possible for them to come and have contact with their children if they haven’t been able to get their methadone, if they haven’t been able to organise themselves to come.

Working with these families is extremely difficult. They’re often living for the "now" rather than having any hopes or plans for the future. They’re very clever at hiding what they’re facing and, as I suggested before, we don’t know all the signs to look for so we fall into some of the traps.

The implications for the children that we’re working with are that they’re extremely traumatised. They need long term counselling and support to rebuild their life experiences and build support networks. And those support networks often include foster care or extended family. And the challenges that people who are caring for children who are not their own, who have had these traumatic experiences are quite extraordinary. And there isn’t much support out there for them recognising the hard job that they’re doing. Again I get back to the need for training of workers supporting these families, not just recognising what the issues are but balancing that with how to remain compassionate with what can be a very frustrating area of work.

Then for the agency also there are safety issues that we need to be constantly aware of when we are working with families who are in pain, who are desperate, who don’t have boundaries. When we are going out into the community, perhaps unaccompanied or are talking about difficult and painful things with these families, violence is a prospect for workers, quite constantly.

And then the community. The challenges there are that we’re now certainly seeing second generation families. Of course, there are children who are resilient, who will break out of the lifestyle of drug abuse but there are others who have not been able to escape that and it’s really quite difficult to imagine how they’re going to find their way out of that.

I’m picking up on the points of both Maureen and Fiona. I think outreach services are vital and also being aware of the particular needs of dual diagnosis clients because they are ever so more vulnerable than others.

So I think the biggest challenge for our community is to maintain a sense of hope, that things can change. People certainly do change and that’s my experience. And we need to pursue every avenue to facilitate that.

In looking at some of the research I noticed a name that kept cropping up was Gellies, a US researcher right through the ‘90s. He was actually here a week or so back and is now talking about permanency planning and not giving families a second chance saying that for children to break free of this sort of life style they need to be placed in alternate care. That’s a very difficult question. I certainly wouldn’t take his position but there needs to be a balance between giving parents a chance to make good; giving kids a chance to be raised by their family and yet also giving them a chance for a future. OK. I think that’s where I’ll finish.