MARY JOHNSON children’s services manager at the NSPCC on the Families and Substance Support Team (FaSST) in Liverpool, which helps women and children at risk from substance misuse

In 2003 a report called Hidden Harm was published that showed how the needs of children of drug-misusing parents often go unmet. Substance misuse can harm children from conception to adulthood. It was the first time that it had been shown how much children suffer. So the NSPCC decided to form a partnership with the Liverpool Women’s Hospital NHS Trust and a local drug and alcohol action team. FaSST was born.

Pregnancy is often a time when women want to make changes in their lives. They want to make their lives more stable, come off drugs. They are motivated to make changes for their unborn baby. They will get support.

A big problem for [pregnant] substance misusers is a fear of agencies – they are frightened that their children will be taken away from them. But children are best cared for in the family home.

Working with a midwife we did a needs assessment and found a lot of problems. Substance misuse doesn’t occur in isolation – it’s not just drugs. Domestic violence, homelessness or mental health problems often go with them. We spoke to service users and learnt that there were few special services for pregnant women – we needed a multi-agency approach. We have close links with children’s centres and community drug clinics. People think: “Why does the NSPCC support adults with drug problems?” But we need to support the adults to ensure that we help the children. Many have had difficult childhoods themselves. It’s a cycle.

We work individually with women to help them and to promote the welfare of their children. It involves emotional support, education on antenatal care and setting routines – their lives are often chaotic. We also run support groups. These women experience a lot of stigma, more so when they’re pregnant.

Once we have broken down the barriers, we encourage the women into mainstream services such as children’s centres so they are mingling with others who don’t have problems. Some relapse and come back, but we have had good success. We are getting a new community project off the ground and some of the women are helping us. They want to give something back.

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