Supporting young people whose parents use substances : A qualitative exploration and co-production approach

Abstract

Background: Parental substance use is highly prevalent worldwide, presenting major child safeguarding and public health concerns, with young people often experiencing adverse impacts. Evidence-based interventions principally focus on the parent themselves aiming to reduce the risk to children or aim to affect change at the family level. Whereas interventions that are child- and young person-focused are limited and have low quality effectiveness. Aim: To explore and develop a child- and young person-centred understanding of their lived experiences with parental substance use, perceived impacts, and coping strategies as well as young peoples’ and practitioners' views on supporting young people whose parents use substances, to inform the development of future co-produced intervention(s) that address the needs of young people with experience of parental substance use. Methods: A qualitative systematic review examined current published evidence on young people’s experiences of parental substance use, their perceived impacts, and coping strategies. In-depth, semi-structured interviews and focus groups were conducted with young people whose parents use substances and health and social care practitioners. Data were analysed thematically to understand how experiences of parental substance use related to young people’s support needs and how practitioners currently support young people. Co-production workshops with stakeholders were conducted online to prioritise intervention ideas for supporting young people whose parents use substances. Results: Findings from the systematic review and qualitative interviews highlighted strategies children and young people used to manage and mitigate vulnerabilities and be resilient to unpredictable, adverse, isolating, and often stigmatising experiences. Three co-production workshops with young people and practitioners found that interventions that target loneliness, overcome stigma, and enhance agency are prioritised. Discussion: Ensuring young people feel connected to other young people who experience parental substance use can help develop young people’s resilience, reduce feelings of isolation and loneliness, and overcome stigma. Strategies within the school environment, including developing storybooks depicting common emotional and social experiences of children who experience parental substance use, as well as developing specialised training for practitioners to understand what it feels like to be a young person living with parental substance use could prove useful. Digital interventions may also support and develop agency amongst young people and empower them to engage in support earlier. Further co-production is necessary to develop intervention(s) that are acceptable, feasible, and effective.