Hidden Harm

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PLEASE SEE THE NEW SOMERSET JSNA:

Joint Strategic Needs Assessment (healthysomerset.co.uk/JSNA)

Hidden Harm is defined as:

"The actual and potential effects of parental substance misuse, domestic abuse and mental health issues on dependent children"

The impact can often be ‘hidden’ in that the children are not the primary service user in the house, yet may be subject to poorer outcomes as a result of the adult’s lifestyle, including safety, health and welfare as an indirect result.

In January 2015, Somerset County Council Public Health produced a Hidden Harm Needs Assessment. The report can be downloaded below: 

• Hidden Harm Needs Assessment
  A summary of the impact of substance misuse, domestic abuse and mental ill health on dependent children in Somerset, and recommendations for prevention

The report presents how the issue of hidden harm is manifested across Somerset, and:-

• Highlights the issue of mental health, substance misuse and domestic abuse in households with children across Somerset, identifying areas of overlap between the three factors
• Outlines the characteristics of families who are at risk of multiple ‘issues’ and their potential impact on children living in the household
• Explores how exposure or experience of parental mental ill health, substance misuse or domestic abuse impacts a children’s development and outcomes
• Makes a series of recommendations for multi-agency action

Key Findings:-

• Between April - September 2014 the total number of children whose parents are in contact with Somerset Drugs and Alcohol Service (SDAS) was 2,118. The number of children with parents in structured treatment with SDAS was 1,426
• The total number of children living in households with domestic abuse across Somerset (all risk levels) is estimated to be 6,300.
• Contact with mental health services is more likely in adults living in urban areas.
• At January 2015 there were 465 children in Somerset with a Child Protection plan in place. Of these, 86 (18%) had all three hidden harm factors

Hidden harm presents a challenge to all services involved in the support and treatment of substance misuse, domestic abuse and mental health. For this reason it is vital that the issue is recognisedand steps are taken across Somerset to tackle this ‘hidden’ harm.

Key messages:

• There is substantial evidence showing that a combination of parental mental illness and problem substance misuse increases the risk to children’s safety and welfare, and the best predictor of adverse long-term effects on children is the co-existence of these factors with family disharmony and abuse.
• Consideration of the needs of all members of the family and extended family (where appropriate) are important for all factors which can contribute to hidden harm. This ‘Think Family’ approach can be incorporated into service design, service delivery and staff training (see Developing local substance misuse safeguarding protocols).
• Early intervention is important, and adult services need to consider the needs of dependent children from initial contact, identifying initial signs of parental risk taking behaviour and its impact on dependent children.

See also:

• Safeguarding and Child protection
• Children Looked After
• Child Sexual Exploitation
• Domestic Violence affecting Children and Young People
• Working Together to Safeguard Children, revised guidance (March 2015) from the DfE on inter-agency working.