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State of the Sector: Drug and alcohol family support

In order to gain an understanding of the current state of the family support sector, Adfam created two surveys. The first, Drug and Alcohol Family Support – 2014 Health Check (HC) ran between August 2014 and March 2015. The second, State of the Family Support Sector 2015 (FSoS) was open for responses between September 2015 and October 2015. The surveys sought to explore current trends and developments in drug and alcohol family support in terms of sustainability, funding, networks, partnerships, client needs and the delivery of services.

The Care Act, which came into force in April 2015, created new rules and eligibilities for carers and those they care for, including those who care for someone because of drug and alcohol problems. It placed a new duty on local authorities to take a proactive approach to identify those in need of support, and provide a range of services to meet local needs. Under the Act, a carer of any age who provides unpaid support to a family member or friend who could otherwise not manage is eligible to receive a carer’s assessment. The UK Drug Policy Commission (UKDPC) has recognised this group of carers affected by drugs and alcohol as one with significant needs, in view of the stress of living with and/or caring for someone with such complex problems. Carers of those who use drugs and alcohol can experience severe stress and physical and mental health problems, as well as an impact on their employment, social lives, relationships and finances.

Families are often an unpaid and unconsidered resource in providing care to their relatives. Indeed, the support provided by families would cost the state an estimated £747million a year if it were instead to be provided by health and social care services. Families commonly provide ‘services’ such as routine care and support, home detox, accommodation and day-to-day care. We know that family members and friends can be an incredibly useful source of support to the substance user, and there is an increasing amount of evidence that family support can positively influence outcomes for drug and alcohol users, including encouraging and supporting them to enter treatment and increasing the likelihood that they remain in treatment. It is therefore important for the whole family to be supported in their own right. When families are supported themselves, they are more able and better equipped to support and encourage the user’s recovery journey.

The government has recognised that ‘treatment is likely to be more effective, and recovery sustained, where families…are closely involved.’ Furthermore, the Care Act is a positive recognition not only of the crucial role family members play in providing care and support to substance users, but of their need for support in their own right. However, the surveys did not capture services’ experiences of implementing the Act, and the findings are perhaps too premature to be able to gauge the impact for family support services.

It must be remembered that there is significant diversity in the provision of family support: it can be provided by integrated services with drug and alcohol treatment services, a standalone family support service or generic carers services, and can operate in the voluntary, statutory and private sector.

Generally family support services are still feeling the effects of the significant restructuring of health and social care structures, brought about by the Health and Social Care Act 2012 which, as well as setting out new structures, stated that mental and physical health must be treated with equal importance. The loss of a ring-fenced drug and alcohol treatment budget and its wider inclusion in the public health budget may similarly be affecting a number of family support services delivered as part of an integrated service with treatment, compounded by recent cuts to local authority budgets. Changes over the past several years will have led to positive opportunities for some and significant challenges for others. This report will provide an overview of the state of the sector, highlighting examples of some of those experiences.