This is a special year for Adfam, celebrating 40 years of supporting families. Robert Stebbings looks at how far they’ve come.
In its early years Adfam was run by volunteers using the vestry at the back of St George’s Church in Campden Hill, West London. It was established in 1984 by Simon Ann Dorin who could not find the support she needed to deal with her son’s heroin use. Over time the charity has evolved, adapted, and changed, but our mission has always remained the same – to improve life for families affected by substance use. When Viv Evans joined as chief executive in 2001 a key feature of Adfam’s work was its projects in prisons, through support teams in prison visitor centres. This support was groundbreaking at the time and provided a vital lifeline.
Viv’s ambition was to grow the charity further to become a campaigning organisation too, and one that influenced policy. One of the first projects under her stewardship was the development of Guidance and good practice in working with families which was made available to professionals in health and social care sectors. The resource was co-produced with people with lived experience, something which became a key feature of Adfam’s philosophy.
At that time, there were many smaller family support groups based in local authorities in England, largely run by people with lived experience and offering peer support to families. Adfam gradually took on the role of an infrastructure organisation, bringing them together and representing them. Sadly, in 2010 a lot of the funding for family support groups disappeared, with many being absorbed into drug and alcohol treatment services or having to close altogether.
STRUGGLE TO SURVIVE
Adfam itself had to navigate the ever-changing funding environment. Core funding from the Department of Health ceased in 2007, and in 2010 came the additional blow of losing funding for most of our prison services. In more recent years funding from trusts and foundations has become increasingly harder to attain, so we adapted by offering services including training to local authorities.
Our work has taken various forms – delivering direct services, influencing policy, promoting good practice, working with officials to represent and give a voice to family members, working with local family groups, promoting our training, and working in co-production with people with lived experience. The direct services have once again become a key part of our work, such as Adfam@Home, where we offer family members remote one-to-one support with a trained family support professional.
While no longer an infrastructure organisation, Adfam continues to be the voice for families within the sector. We also bring others together and campaign for change by facilitating the Alcohol and Families Alliance (AFA), and Alliance of Family Support Organisations.
COMPLEX NEEDS
While lots has changed in the last 40 years, the need for support for families hasn’t gone away and never will. Needs have become ever more complex, with financial difficulties, the cost of living, domestic abuse and violence, and mental health issues all contributing.
Furthermore, families’ voices still suffer stigma and struggle to be heard. ‘What’s needed, but has so often been lacking, is an integrated approach to supporting these families, as the substance misuse almost always isn’t the only problem,’ says Viv. ‘This doesn’t just apply to adult family members and friends either – we must ensure the needs of children are not forgotten too.’
We’ve achieved some major landmarks throughout the years, breaking new ground with specific groups. For instance, our BEAD project supports those bereaved through substance misuse, and we work with families whose loved ones are veterans, or are experiencing gambling problems, have hepatitis C, or inject drugs. Our families might be experiencing child-parent violence and abuse, be affected by foetal alcohol spectrum disorder (FASD), or they might be supporting a loved one with a dual diagnosis.
We have always believed in working in partnership with others and sharing expertise and knowledge, and our training courses attract participants from across health and social care sectors. We have also achieved success with our policy and influencing work, with families included in the Drug and alcohol treatment and recovery workforce transformation programme, the Commissioning quality standard, and the ten-year drug strategy. Previously, families would not have been mentioned or considered, but because of Adfam’s persistence and resolve in the policy sphere, this is now changing.
SPECIFIC NEEDS
We still need to see more recognition of families within existing health services, with their specific needs integrated across all welfare services, says Viv, ‘And ultimately, we need more recognition across society, with more sympathy and understanding, and less stigma.’
While there are 5m people affected by this issue in the UK, shame and stigma keeps people hidden in plain sight. ‘Whilst we’ve come a long way there’s still more to be done,’ she says. ‘We want to give people the agency and opportunity, the courage, to speak out, because only then will we get the real change that we want.’
POWER OF PEER SUPPORT
Rose, a member of Adfam’s Lived Experience Advisory Group, told Adfam how peer support meant everything to her.
Rose’s daughter has had serious alcohol problems since a young age and the effect of this on Rose and her other three children has been devastating. As the chaos escalated she tried to control her daughter’s drinking, while attempting to cope with the effects of her behaviour and get her the help she needed.
At that time there was a distinct lack of recognition for families. Even when her daughter was engaging with support services, those services did not want to engage with Rose at all or involve her in her daughter’s support.
Her other children were badly affected too, with her youngest daughter frequently bearing the brunt of the aggression and abusive behaviour. As a result, she ran away from home on several occasions in her mid-teens to try to escape, while her younger son withdrew completely, shutting himself in his bedroom. When social services got involved, this added further complexity to an already challenging situation.
Struggling to deal with the situation, Rose felt isolated, overwhelmed, and desperate, with no one to talk to. She knew that she couldn’t be the only person experiencing this and went about a fact-finding mission to see what was there for families in her local area. She met with the local council and also came across Adfam’s guide on setting up a family support group, which gave her the idea of establishing a group in her area.
Like many grassroots organisations she had to build from almost nothing and started by printing and displaying leaflets, while her son helped her design a basic website. She then liaised with a local alcohol support service and was able to use a room at their building for free, one evening a week.
Gradually the word got around, and it started to take off – a vibrant, close-knit family peer support group where family members could meet others with similar experiences. The group met almost every week for about eight years. Members supported each other through all their ups and downs, hopes, and despairs. They were there for each other, no matter what.
Listening to others with similar experiences helped Rose put her own situation into perspective: ‘The relief of being able to talk to other people who understand the chaos, and understand what you’re going through and get it, provides you with that reassurance,’ she says. ‘Family support also gives you the strength to put yourself first and not sacrifice everything for your family member,’ she adds. ‘It gives you the encouragement that you actually matter.’
A couple of young women who came along were living with partners who were violent and abusive towards them. Through the group they were encouraged to put themselves and their safety first, and to get in touch with the local domestic violence services so they could get that support they needed.
HOPES FOR THE FUTURE
Rose’s group came to an end during COVID, but members had already gained so much from each other and felt it was time to move on with their lives. Since then Rose has noticed a positive shift within services, with more willingness to talk to family members. When her daughter relapsed last summer, she was able to refer to Rose as someone supporting her that the service could engage with – an open approach that made a huge difference.
But there is still a burden placed on family members – they are viewed more in terms of recovery capital and someone able to support their loved one, rather than people needing support in their own right.
‘We need much more of a whole-family approach that talks to families, finds out where they stand, and what they can do and can’t do,’ Rose says. ‘Don’t just write us into your care plan without asking us!’
Robert Stebbings is policy and communications lead at Adfam