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Stavnes K, Ruud T, Benth JŠ, Hanssen-Bauer K, Solantaus T, Hilsen M, Skogøy BE, Kallander EK, Kufås E, Weimand BM. Norwegian health personnel's contacts and referrals for children of ill parents: an exploratory cross-sectional multi-centre study. BMC Health Serv Res 2023; 23:649. [PMID: 37330496 DOI: 10.1186/s12913-023-09607-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 05/26/2023] [Indexed: 06/19/2023] Open
Abstract
BACKGROUND In 2010, changes were made to the Norwegian Health Personnel Act. This led to all health personnel being obliged to support the patients' children and families. The aims of this study were to investigate whether health personnel contacted or referred the patients' children to family/friends or public services. We also investigated if there were factors in the family or the services that increased or decreased the degree of contacts and referrals. In addition the patients were asked whether the law had been a help or even a burden. This study was part of a larger multi-site study of children of ill parents conducted in five health trusts in Norway. METHOD We used cross-sectional data from 518 patients and 278 health personnel. The informants completed a questionnaire addressing the law. Data were analyzed by factor analysis and logistic regression. RESULTS The health personnel contacted/referred children to different services, but not to the degree desired by their parents. Only a few contacted family/friends, or the school and/or the public health nurse, those representing the helpers who live closest to the child, and thus well situated to participate in help and preventive efforts. The service most often referred to was the child welfare service. CONCLUSION The results indicate a change in contacts/referrals for children from their parents' health personnel but also reveal remaining needs for support/help for these children. Health personnel should strive to write more referrals and take more contacts than the current study suggests, to secure adequate support for children of ill parents in Norway, as intended in The Health Personnel Act.
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Affiliation(s)
- Kristin Stavnes
- The Regional Centre for Eating Disorders (RESSP), Nordland Hospital Trust, 8092, Bodø, Norway.
- Faculty of Medicine, University of Oslo, Oslo, Norway.
- The Regional Centre for Eating Disorders (RESSP), Nordland Hospital Trust, Kløveråsveien 1, 8076, Bodø, Norway.
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Campus Ahus, Akershus, Norway
| | - Jūratė Šaltytė Benth
- Institute of Clinical Medicine, University of Oslo, Campus Ahus, Akershus, Norway
- Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Ketil Hanssen-Bauer
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Campus Ahus, Akershus, Norway
| | - Tytti Solantaus
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marit Hilsen
- Regional Centre for Child and Adolescent Mental Health, RBUP Øst Og Sør, Postboks 4623, 0405, Nydalen, Oslo, Norway
| | - Bjørg Eva Skogøy
- The Regional Centre for Eating Disorders (RESSP), Nordland Hospital Trust, 8092, Bodø, Norway
- Nordland Research Institute, Postboks 1490, 8049, Bodø, Norway
| | | | - Elin Kufås
- Vestre Viken Hospital Trust, Drammen, Norway
| | - Bente M Weimand
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway
- Department of Health, Social and Welfare Studies, Faculty of Health and Social Sciences, University of South-Eastern Norway, Drammen, Norway
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Stavnes K, Ruud T, Benth JŠ, Hanssen-Bauer K, Weimand BM, Solantaus T, Hilsen M, Skogøy BE, Kallander EK, Kufås E, Peck GC, Birkeland B, Hagen KA. Norwegian health personnel's compliance with new legislation on children of ill parents: an exploratory cross-sectional multicentre study. BMC Health Serv Res 2022; 22:1171. [PMID: 36123688 PMCID: PMC9484080 DOI: 10.1186/s12913-022-08268-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/17/2022] [Indexed: 11/10/2022] Open
Abstract
Background In 2010 the Norwegian Parliament introduced amendments to the Health Personnel Act requiring all health personnel to inform and offer help to their patients’ children and families. We evaluated whether health personnel adhered to their obligations outlined in the Act and investigated whether family and health services characteristics were associated with the degree of compliance with the legislation. Our study was part of a larger Norwegian multi-site study conducted in five health trusts across Norway, assessing the situation for families living with parental illness. Method A cross-sectional study using quantitative data obtained from 518 patients 246 children and 278 health personnel was performed. All informants completed a questionnaire, including an instrument corresponding to the obligations in the legislation. Descriptive analyses, factor analysis and logistic regression analysis were used. Results The legislation was only partially implemented in the clinics of the health trusts. Compared to estimates prior to the introduction of the new legislation, the situation had improved somewhat, but much work remains to be done to fulfil the obligations decreed by law. The more time-consuming the obligations were, the less often they were met. The substance abuse and mental health services followed up on their obligations to a greater extent than did the physical health services. Conversely, children of physically ill parents were better informed by their families than were children of parents with mental health and substance abuse disorders. When asked the same questions, reports from health personnel were more positive compared to those of children and patients regarding the legislation’s fulfillment. Conclusion Data suggest that there has been a change in the support offered to children of ill parents. Additional work is required, however, for the Health Personnel Act to function as fully intended.
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Affiliation(s)
- Kristin Stavnes
- Nordland Hospital Trust, 8092, Bodø, Norway. .,Faculty of Medicine, University of Oslo, Oslo, Norway. .,The Regional Centre for Eating Disorders (RESSP) at Nordland Hospital, Nordland Hospital Trust, Kløveråsveien 1, 8076, Bodø, Norway.
| | - Torleif Ruud
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Campus Ahus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jūratė Šaltytė Benth
- Campus Ahus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Health Services Research Unit, Akershus University Hospital, Lørenskog, Norway
| | - Ketil Hanssen-Bauer
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Campus Ahus, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Bente M Weimand
- Division of Mental Health Services, Akershus University Hospital, Lørenskog, Norway.,Centre for Mental Health and Substance Abuse, University of South-Eastern Norway, Drammen, Norway
| | - Tytti Solantaus
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Marit Hilsen
- Regional Centre for Child and Adolescent Mental Health, RBUP Øst og Sør, Postboks 4623 Nydalen, 0405, Oslo, Norway
| | - Bjørg Eva Skogøy
- Nordland Hospital Trust, 8092, Bodø, Norway.,Nordland Research Institute, Postboks 1490, 8049, Bodø, Norway
| | | | - Elin Kufås
- Vestre Viken Hospital Trust, Drammen, Norway
| | | | - Bente Birkeland
- Sørlandet Hospital Trust, Kristiansand, Norway.,Faculty for Health and Sports Science, Department of Psychosocial Health, University of Agder, Grimstad, Norway
| | - Kristine Amlund Hagen
- Norwegian Centre for Child Behavioral Development, Postboks 7053 Majorstuen, 0306, Oslo, Norway
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Schumm JA, O’Farrell TJ. A comparison of psychosocial adjustment among children of women who received behavioral couples therapy versus individually based therapy for substance use disorder. J Subst Abuse Treat 2022; 133:108560. [PMID: 34246515 PMCID: PMC8733047 DOI: 10.1016/j.jsat.2021.108560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 06/08/2021] [Accepted: 06/28/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Children of women with substance use disorder (SUD) exhibit elevated risk for psychosocial adjustment problems. However, little research has examined whether women's SUD treatment is beneficial for their children. In comparison to individually based therapy (IBT), behavioral couples therapy (BCT) is superior for reducing women's SUD problems and improving their intimate partner relationships. The current study sought to examine whether BCT is more efficacious than 12-step-oriented IBT for reducing psychosocial adjustment problems among the children of women with SUD. METHODS The study obtained the data from two larger randomized clinical trials, both of which compared BCT plus IBT versus IBT alone for women with SUD. Participants were women (N = 75) and their male partners who had an identified target child between the ages of 6 and 16 years old (M = 10.63). Most (62%) were the biological child of both partners, and 92% lived with the couple. Both partners completed the Child Behavior Checklist (CBCL) in relation to the target child at baseline, post-treatment, and 6-month follow-up. RESULTS Comparisons of CBCL scores from baseline to following treatment mostly showed significant improvement in BCT + IBT but not IBT. Generalized estimating equations, which controlled for baseline CBCL, showed better retainment of treatment gains for mother-reported internalizing CBCL scores in BCT + IBT, but the study found no other between treatment differences. CONCLUSION These findings suggest that BCT + IBT produces more consistent improvements for children of women with SUD versus IBT.
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Affiliation(s)
- Jeremiah A. Schumm
- School of Professional Psychology, Wright State University,Samaritan Behavioral Health, Inc.,OneFifteen, Inc
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Grahn R, Padyab M, Lundgren L. Associations between a risky psychosocial childhood and recurrent addiction compulsory care as adult. NORDIC STUDIES ON ALCOHOL AND DRUGS 2020; 37:54-68. [PMID: 32934593 PMCID: PMC7434189 DOI: 10.1177/1455072519882785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 09/23/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Treatment for substance use disorder (SUD), results, in general, in
improvements in terms of both drug use and social functioning. However,
there are clients who are in need of repeated treatment. The aim of this
retrospective study was to identify, for adults in compulsory care for
severe SUD, the association between reporting having experienced a risky
psychosocial childhood and repeated entries into the Swedish compulsory care
system for SUD. Method: Hierarchical logistic regression and mediation analysis methods were used to
analyse data from the Swedish National Board of Institutional Care (SiS)
database. The sample included 2719 adults assessed at their compulsory care
intake. The study examined the association between history of institutional
care, family with SUD or psychiatric problem and repeated compulsory care
entries as an adult controlling for main drug, age and gender. Results: In the regression model the factor with the strongest association with
repeated compulsory care intakes for SUD, was as a child having been in
mandated institutional care (OR = 2.0 (1.60–2.51)). The
proportion of the total effect that is mediated through LVU (law (1990:52)
the care of young persons (special provisions) act) was 33% for SUD problems
in family during childhood, 44% for psychiatric problems in family during
childhood, and 38% for having been in foster care. Conclusion: Having been in mandated institutional care as a youth was strongly associated
with repeated compulsory care for SUD as an adult. This is concerning since
receipt of services as a child is supposed to mediate against the
consequences of risky childhood conditions. These adults, as a group, are in
need of a well-coordinated and integrated system of extensive aftercare
services to reduce the likelihood of re-entry into compulsory care for an
SUD.
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Affiliation(s)
| | | | - Lena Lundgren
- University of Denver Graduate School of Social Work, USA
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Grahn R, Padyab M, Hall T, Lundgren L. The Associations between Risky Psychosocial Environment, Substance Addiction Severity and Imprisonment: A Swedish Registry Study. Subst Use Misuse 2020; 55:697-706. [PMID: 31813334 DOI: 10.1080/10826084.2019.1696823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Both childhood and adult psychosocial stressors have been identified as links to both increased risk for substance use disorder (SUD) and increased risk of imprisonment. The aim of this retrospective study is to identify, for a sample of 14,914 adults who all were assessed for risky substance use or a SUD, the importance of having a history of psychosocial stressors compared to current addiction severity. The analyses control for age, gender and education on the likelihood of future imprisonment. Method: Baseline Addiction Severity Index data (ASI) were merged with national registry data on prison sentences from 2003 to 2016. In the analysis, a Cox regression was used to study the association between independent variables and the likelihood of future imprisonment. Results: In the regression, five variables showed significant association to increased risk of imprisonment: ASI drugs other than alcohol Composite Score (positive relationship), ASI alcohol Composite Score (negative relationship), age (younger), education (lower) and parental problems with drugs other than alcohol. The factor with strongest association with imprisonment was the ASI drugs other than alcohol Composite Score, which showed the highest HR = 10.63 (3.50-32.31) for women and HR = 5.52 (3.77-8.08) for men to predict the likelihood of imprisonment. Discussion: Research is needed on why individuals with history of psychosocial stressors have a higher likelihood of imprisonment compared to their counterparts. Findings indicate that a high ASI Composite Score for drugs other than alcohol are strong predictors of future criminality and criminal justice system involvement.
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Affiliation(s)
| | - Mojgan Padyab
- Department of Social Work, Umeå University, Umeå, Sweden
| | - Taylor Hall
- Bridgewater State University, Bridgewater, Massachusetts, USA
| | - Lena Lundgren
- University of Denver Graduate School of Social Work, Denver, Colorado, USA
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Oei JL. Adult consequences of prenatal drug exposure. Intern Med J 2018; 48:25-31. [PMID: 29314518 DOI: 10.1111/imj.13658] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 06/07/2017] [Accepted: 06/30/2017] [Indexed: 01/07/2023]
Abstract
Maternal drug use is not new but over the last few decades, the number of mothers using drugs of addiction has escalated to epidemic levels. These drugs are both legal (e.g. prescription medication) and illegal (e.g. heroin) and all will cross the placental barrier into the developing infant. The most immediate and obvious consequence of intra-uterine drug exposure is newborn withdrawal or the Neonatal Abstinence Syndrome (NAS) which is now, with prompt recognition and treatment, an uncommon cause of neonatal death. Thousands (if not millions) of adults most likely would have had a history of passive drug exposure during gestation and the outcomes of these people are unknown. Most are physically healthy and do not need extra medical attention but the effects of prenatal drug exposure may be subtle and extensive. Drug-use disorders are accompanied by a myriad of other adverse problems, including poverty, mental and physical health problems and inadequate parenting ability that may compound the negative effects of drugs. Emerging data suggest that vulnerability to health and neurocognitive issues are pervasive and long-lasting as are lifestyle issues. This review will address current evidence in this area and highlight the knowledge gaps that must be addressed in order to optimise the outcomes for this vulnerable and marginalised but rapidly expanding population of adults.
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Affiliation(s)
- Ju Lee Oei
- Department of Newborn Care, The Royal Hospital for Women, and School of Women's and Children's Health, University of New South Wales, Sydney, New South Wales, Australia
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A review of recent literature on the impact of parental substance use disorders on children and the provision of effective services. Curr Opin Psychiatry 2018; 31:363-367. [PMID: 29794556 DOI: 10.1097/yco.0000000000000421] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE OF REVIEW To provide an update of recent studies of the incidence and impact of parental substance use disorders (SUDs) on children, and to identify effective treatment programs to assist parents with SUDs and their children. RECENT FINDINGS Children of parents with alcohol and drug use disorders (COPADs) suffer from physical, mental and behavioral problems at higher rates than other children and are more likely to develop their own SUDs in adolescence. Parenting styles and familial dysfunction contribute to the intergenerational transmission of SUDs. Studies of the negative effects of parental SUDs on children identified the effects of inconsistent, disengaged or harsh parenting practices on mother-child bonding. Exposure to violence and father's hostility contribute to children's externalizing and internalizing behaviors. Family- based intervention programs, as well as programs for mothers with SUDs and their young children, have shown positive results. For high-risk families with multiple needs, the ongoing support of multidisciplinary services is required. SUMMARY Parental SUDs have a profound impact on their children, including intergenerational transmission of SUDs. A variety of interventive programs are being studied in order to devise effective programs to assist these children.
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