Substance-using parents account for around 60% of parents in verified child maltreatment cases. Parents’ continuous substance use can cause safety threats to their children who stay at home or return to home from out-of-home care. Substance-using parents complying with treatment increases their likelihood of reunifying with their children. However, their treatment completion rates have been consistently reported as lower than 25%. Previous studies found that co-occurring problems, such as mental illness and domestic violence, are the barriers to their treatment completion. Therefore, they need ancillary services to address their co-occurring problems. But in reality, many of them did not use ancillary services. Few studies examined factors related to their usage of ancillary service. This study examined individual and environmental factors related to ancillary service use.
The study was conducted in the Miami metropolitan area. We collected qualitative data from 5 substance-using parents from a family preservation program and 14 professionals who provide services to these parents. The professionals were recruited from 4 agencies: 1 family preservation, 2 substance use treatment, and 1 case management. These agencies were purposely chosen to capture substance using parents’ involvement with multiple agencies. Most participants were interviewed separately, except that 3 professionals participated in a focus group meeting. Structured interviews and the focus group meeting covered five areas: housing, domestic violence counseling, mental health, medical care, and job training. The questions asked about service needs, the process of service referral and access, organization factors associated with service accessibility. All the interviews and the focus group meeting lasted for an hour each, and were recorded and transcribed verbatim. The authors used a conventional thematic content analysis to analyze the data and identify common themes
The findings showed that housing, domestic violence counseling, and mental health services are the common needs among substance-using parents. Many of them experienced homeless and evictions. When asked about domestic violence, they shared their experiences with domestic violence as well as violence in general, such as childhood experiences with abuse and neglect, community violence, and adulthood experiences with sexual violence. The most common mental illness are PTSD, anxiety, and depression. The parents reported using marijuana as a way to cope with their trauma and mental symptoms. Regarding ancillary service usage, they reported receiving limited services on housing and domestic violence counseling, for which professionals acknowledged that limited services are available. In comparison, mental health services are more available, since the agency that provides family preservation services also provides mental health services. The internal service referral and access are usually timely.
Conclusions and Implications
Substance-using parents experienced multiple problems: housing instability, violence exposure and trauma, and mental illness. Without resources to address these problems, many of them use substance to cope with stress caused by these problems, and have limited motivation for abstinence. Their access to ancillary services is impacted by service availability. The findings have implications for macro practice regarding service provision and micro practice regarding trauma-informed intervention.