Despite significant investment in drug treatment in recent years none of this funding has reached residential treatment services. This failure, combined with short-term and sporadic funding processes, has led to England facing the loss of its last residential family treatment service. Tragically, this means that more families will suffer from a treatable condition and children will be separated from their parents, creating unnecessary intergenerational trauma.
Phoenix announced the closure of the National Specialist Family Service based in Sheffield in October. Unless sustainable funding can be secured in the next month, the service will close early in the new year. As we contemplate the loss of the last of these vital services we look back on their history and consider why parents with substance use needs are excluded from effective care.
Repeated evaluations have found that residential family drug and alcohol treatment services are very successful at helping parents overcome their drug and alcohol use, supporting them to become safer and more effective parents and successfully resettling them back into their communities. Longitudinal studies also show that the families stay together in the long term – completion rates for family services are high, at an average of 86 per cent. There is a growing body of research to demonstrate the impact of whole-family interventions for families where parents experience addiction.
There is now only one residential service in England that can provide drug and alcohol treatment to parents whilst they care for their children. That service is at risk of closure despite the evident need for the service and the high quality of provision. The key issue Phoenix faces is that spot purchasing of placements (ie pay-by-night per resident funding) is a block to both access and sustainable provision.
Spot purchasing means that each family has to argue their case for an individual funding package across budgets that span adult and children, rehab and social services. It is complicated for families in need of urgent support and already overburdened social workers. Spot purchasing also means that providers are living hand to mouth, unable to plan for any guaranteed income despite having significant fixed costs. It’s a quirk of history that means – unlike most specialist care services and community drug treatment services – the family service is funded by referrers, with their own budgetary and operational pressures, rather than funding the residential provider directly.
Phoenix Futures opened its first family residential service in 1987. Since then, thousands of parents have been able to address substance use issues in a residential setting while they take parental care of their children. Over the last 40 years Phoenix has developed specialist family residential units in London, Brighton, Bexhill and Sheffield. We established the services in response to the need for parents and pregnant women to be able to access intensive treatment without being separated from their children. This treatment option encouraged more parents to address their addiction, reducing trauma experienced by children and their families.
Family rehab programmes recognise the integral role of family in the recovery process and provide valuable support, education, and resources for both the individual struggling with addiction and their loved ones. By addressing family dynamics and relationships, these programmes contribute to improved treatment outcomes and enhanced quality of life for everyone involved.
The National Specialist Family Service provides a unique opportunity to offer parents the core benefit of treatment alongside specialist parenting and childcare. The service supports families to achieve a range of outcomes specifically for them, such as improved communication skills to help resolve conflicts, rebuild trust, and improve relationships among family members. Addressing underlying issues within families – such as trauma, codependency or enabling behaviours – can establish and reinforce healthy boundaries within the family dynamic.
Addiction often strains relationships and causes emotional pain and conflict within the family. Family rehab programmes provide opportunities for healing, forgiveness, and reconciliation, allowing family members to address past harms, rebuild trust, and strengthen their bonds.
Evidence shows that investment in addiction services for parents delivers safe, effective treatment as well as significant value for money to the public purse. Research shows that these services break the intergenerational transfer of drug and alcohol use from parents to children. These services also create a network of family-focused resources including maternity care, specialist midwives, health visitors, perinatal mental health, GP services and more, all accessed from one residential setting.
It’s devastating that all this will be lost because of a failure to create a simple funding mechanism that works for families and their professional support.
James Armstrong is director of marketing and innovation at Phoenix Futures
Further reading: Five years on and nothing has changed, by Karen Biggs, chief executive, Phoenix Futures