Transcript Document 7235398

Reducing Alcohol Problems in the Baltic Sea Region
International Conference on Effective Approaches to Tackle
Alcohol Related Problems in Local Communities
Riga, March 12-13, 2007
Workshop 1: Strategies to reduce harm caused to children
in families with alcohol problems
Supporting children in families
with problems of substance abuse
in St. Petersburg and Leningrad region
Anna Skvortsova, Russia
<[email protected]>
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The problems with substance abuse increased
among women during the last decade:
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Numerous obstacles to reach substance
abusing pregnant women and mothers
Lack of effective interventions to help both
mother and child
Substance abusing mothers fear losing
custody of the child
Mothers tend to withdraw from health care
and social system
Children often taken into custody
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Two projects in Leningrad region in 2006
aimed to prevent the placement of
children into orphanages:
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“Development of an Integrative Program of
Services for Assistance to Families and
Children in Difficult Living Situation in
Otradnenskaya volost of Municipality of
Priozersky District of Leningrad Region”
“Prevention of abandonment of newborn
children in Gatchina”
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New project (2007):
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“Development of the program of
rehabilitation of pregnant women
and mothers who have infants and
small children and are depended on
alcohol or drugs, in St. Petersburg
and Leningrad region”
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“Development of an Integrative Program of Services for
Assistance to Families and Children in Difficult Living
Situation in Otradnenskaya volost of Municipality of
Priozersky District of Leningrad Region”
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Plodovoye village - 1,500 inhabitants; Priozersk
district of Leningrad region (part of
“Otradnenskaya volost” – 14 villages with 2,500
inhabitants total)
Farm “Pervomayskoye”; 350 workers – 1/2 of the
officially employed of the whole village
The absence of workers monitored by the
management of the farm
In 2005 the initiative group started to discuss
how to help the risk families of the village
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Research (2005) to analyze social and
economical situation in Plodovoye:
housing, unemployment, alcoholism:
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Problems of housing and unemployment are
interlaced with alcoholism as a reason, from one
hand, and as a cause, from the other hand.
New phenomenon that occurs more often in recent
times is women’s and children’s alcoholism.
So called “marginal drinking” when person doesn’t
work and lives (and drinks) on parents’ or
grandparent’s pensions or on stealing is also
widespread among the community. Lack of the
resistance towards extension of alcoholism is another
side of the problem.
The most vulnerable group that is influenced by
these problems are children.
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Families in risk:
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Serious difficulties in 90 families with 122
children (extreme poverty and/or
alcoholism of the parents)
Children unsupervised, problems at school
> clients of social services > taken into
custody (shelters and children homes)
No local social or health services for
people having drug or alcohol problems,
all located in Priozersk (30 km)
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27 families chosen as target group by
local project team:
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“Problem families” - different needs, don´t
fit into specific categories used by social
department
This complexness (“multi needs”) is often
a reason why families drop out of the
system of social protection
The initiative group set an objective to
work with adults in order to benefit
children
Main goal: to avoid the replacement of
children to institutional care
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Two main target groups of families:
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1-st: “Problem families” - 17 families
with 27 children – social problems and
substance abuse problems
2-nd: Families in “difficult living
situation” (10 families) – low income,
housing problems, unemployment etc.
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What has been done:
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Individual plans based on family assessment
Key workers for each family; close
relationship
Specialists (social pedagogue and/or
psychologist) visiting families twice a month
Other social services tailored according to the
individual needs of the families
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First results:
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Attitude to the “problem families” has changed
Necessity in support of families in risk recognized by
the specialists
Positive changes in 9 out of 17 families – better care
of the children, Relatives involved in support
Only 1 child placed in the social-rehabilitation center
(shelter) temporarily
Cooperation with rehabilitation center for alcoholics
started
Further need in training in community social work
and in basic knowledge on alcoholism
Further need in setting special program for
supporting families financed by local authorities
Neighboring village interested in cooperation
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“Prevention of abandonment of
newborn children in Gatchina”
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Amount of abandoned infants keeps
growing in Russia, not enough places in
orphanages!
Social policy changing from institutional
care to alternative forms of care
(fostering, family children homes).
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20-40 newborn babies in a risk of
abandonment every year in Gatchina:
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Babies left in the hospital till
hospital finds a place for them in
the orphanage
Babies in hospitals for several
months because of poor health
Children are suffered from early
deprivation
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In 2006 local team in Gatchina started to work with 16
women who wanted to abandon their babies in
Maternity Hospital and provided the intervention:
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Age: 7 women – age under 18, 6 women –
age 20-30, 3 women – age 30-40
First baby – 7 women, second – 5 women,
third – 1 women, fourth - 3 women
All single mothers
Living in countryside – 10 women
11 women without secondary education and
any qualification
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Four stages of intervention when
a woman is planning a refusal:
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Crisis period in the hospital (5 days): intensive intervention in
the hospital and at the woman’s home (assessment including
her family members)
Immediate post crisis period at home (1 month after leaving
hospital): intensive intervention and support
Medium term support at home (6 months): less intensive
support once crisis has been resolved and immediate needs
met.
Long-term support in the community: until the child is 2 years
of age several home visits, self-help groups attending, other
necessary services that help mother to care for her baby
Regular supervision (twice a month) for local project team by
the psychologist and social worker from St. Petersburg Korchak
centre
The work on description of standards of evaluation and support
for families who are at risk of abandon their newborns by the
local team together with SPRILO consultants
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Reasons of abandonment:
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Emotional problems
Social problems
Substance abuse
Living with substance abusing relatives (parents), conflicts
with relatives
Low income
Housing problems
Living in countryside – far away from social services
Social helplessness (poor knowledge about rights and
social allowances available, need for assistance in getting
registration and buying things for the baby etc.)
Social patronage of the family necessary at least for 2
years
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Results:
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Project team succeeded to re-ensure mothers
in 13 cases and babies came back to the
families
Work continued also after project has been
completed
Local administration provides financing of
prevention service (salaries of 2 specialists
who support families) for 2007
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Difficulties:
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In 4 other cases mothers agreed to cooperate
but didn’t manage with different odds and
children were placed into the orphanage later
The main reason - mothers were heavily
depended on heroin and couldn’t stop it
Children placed into the orphanage
temporarily (until 2 years age) and local team
try to help mothers and grandmothers with
visiting children there
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Needs addressed to local community
and authorities:
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Crisis center / social services for
pregnant women and young mothers in
crisis in local community Day center
(shelter) for the children
Preventive programs for the schools
Programs for improvement of parenting
skills
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Challenges:
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To show to the local authorities that prevention of
baby abandonment is realistic goal and it helps
strongly decrease the number of children placed into
orphanages
To calculate effectiveness of this kind of work (that
it’s cost effective that children stay in families instead
of institutional care)
To complete development of prevention service
structure and system of standards in social and
psychological support for families who are at risk of
abandon their newborns babies
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“Development of the program of rehabilitation of
pregnant women and mothers who have infants and
small children and are depended on alcohol or drugs, in
St. Petersburg and Leningrad region”
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Based on 6 years cooperation between
the Finnish NGOs (The Mother and
Child Home of Helsinki, The Federation
of Mother and Child Homes and
Shelters) and St. Petersburg city shelter
for young mothers with newborn babies
“Little Mother”
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“Little Mother” (Маленькая мама):
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The only shelter of this profile in Russia
Provides short-term (max. 1 year) support
for pregnant girls and mothers under 18
with the babies
Half of the clients of the “Little Mother”
are graduates from the children homes.
Many of them have used drugs. But staff
doesn’t have skills to take care of the
mothers who are substance abusers, and
their children
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“Hold On” project:
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Implemented by The Federation of Mother
and Child Homes and Shelters from 1998
7 mother and child homes in Finland that
have specialised in the care of pregnant
women and mothers who are substance
abusers, and their babies.
Ten beds (5 mothers and 5-6 children) in one
home
Three-month to one year programme for
women with a drug or alcohol problem
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Forms of intervention:
Residential treatment units (Mother and
Child Home)
 Open Care Units
 Home visit based intervention
The treatment is developed in
collaboration with researchers and child
psychiatrics
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Child protection and treatment of drug abuse
problems are combined in the treatment:
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The first primary task at the home is to give support
to pregnant women over from intoxicants. Taking
intoxicants is chemical violence against the baby. If
woman has consumed alcohol during pregnancy, the
child may be born with some degree of damage
The second primary task is to give support to
mothers in their motherhood over a longer period at
time after the birth of the child, and the aim is to
help the mother (and father) achieve a standard of
parenting that is "good enough". Support the mother
and child interaction is given
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First results:
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The relationship of a drug-dependent mother and her child
needs an active and secure care environment from the
beginning
The first six-month period after birth seems especially crucial
The mothers who have entered interaction and care during
pregnancy have the best prognosis for both a drug-free life and
adequate parenthood
First results are positive: mothers from the control group didn’t
have serious relapses during the first year of the life of the child
Best progress have those mothers who think about their
children, and life experience of the child is their concern
Research proved that parenting skills are possible to be
improved with well-tailored treatment and training
Ability to comprehend has been chosen as special direction of
rehabilitation work with parents
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The mothers have problems of various
dimension besides drug and alcohol:
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Problems regarding identity, incest and
problems coming from experienced violence,
and problems caused by their own childhood
with neglect, abuse etc. Many of our mothers
have problems related to alcohol or drug
addicted husband/boyfriend
The second main problem is social problems
with loneliness and lack of relationship.
Mothers have often bad housing and
economic poverty. The homes do a lot of
work with these problems
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Finnish and Russian specialists will develop
together a program of support of substance
abusing mothers with children
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Firstly, research will be made in order to
analyse a scope of a problem and possibilities
for development of specialised care of
mothers who are substance abusers, and
their babies, in St. Petersburg.
According to a preliminary agreement of the
city of St. Petersburg, this care system is
supposed to became a part of city crisis
center for women.
Local community teams from Plodovoye and
Gatchina will take part in this project.
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