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Toolkit for general practice

   Supporting children affected by a problem drinking parent

There are a number of problems for practice staff:

• Practice staff generally see their role as responding to what the patient in front of them brings to their consultations and do not necessarily see it as appropriate to seek out problems and issues
• The time they have available with any one patient is very limited
• Along with other generic professionals, they have little training on alcohol related problems and may feel reluctant to approach this issue
• They are unlikely to know of the range of services available to draw upon locally.

Despite these uncertainties, practice nurses and general practitioners are, nonetheless, in a position to support and help children who may be affected by a problem drinking parent in a number of ways. If it is known that a patient has a problem with alcohol and they have children it might be possible to:

• Provide information to parents about reducing/eliminating immediate risks
• Provide information to parents about reducing risk of long term harm to their children
• Provide information on building resilience within their children
• Bring in support of other professionals such as the Health Visitor
• Support the development of parenting capacity or referring on to other services that would be able to do this.

Practice Nurses and General Practitioners will also identify children who are at risk and take appropriate action, in line with their protocols on patient confidentiality and child protection. The question of when to invoke child protection procedures is a difficult one for a whole range of professionals; some guidance on this is set out below in the section on Referral to Social Services .

For the parents themselves, staff can

• Provide brief interventions to those for whom it is appropriate (see above)
• Refer on to specialist alcohol services
• Provide ongoing support and encouragement

It is important then that practice staff feel comfortable talking about alcohol-related problems, can offer appropriate information and advice to problem drinkers and other members of their families and, where appropriate, offer interventions including referral on to specialist alcohol services. Although these guidelines and the toolkit focus on the problems experienced by children of problem drinkers, in view of the fact that practice staff will often be working with parents, information about alcohol problems can be found in the section Alcohol and alcohol-related problems.