Focusing On The ‘A’ in COPMIA: Supporting family and whānau to thrive

www.matuaraki.org.nzwww.matuaraki.org.nz www.tepou.co.nz
Focusing On The ‘A’ in COPMIA:
Supporting family and whānau to
thrive
Mary Anne Cooke
Anna Nelson

Workforce development centres
• The Werry Centre
• Matua Raki
• Te Pou o Te Whakaaro Nui
• Te Rau Matatini
• Le Va
• Abacus

Involving and valuing children, family and
whānau. It’s our responsibility
Kei a tātou te tikanga

Prevalence figures
◦ Estimate 0.6 children per person with a gambling
problem (Australia)
◦ Conservative estimate: over 32,400 children in New
Zealand living with a problem gambler potentially at
risk of a variety of negative effects*
◦ 50-70 % of people experiencing mental illness are
parents (international)
Productivity Commission (1999) Australia’s Gambling Industries, Report No.10, Volumes 1-3. Canberra: Commonwealth of Australia
*Estimate based on figures from Ministry of Health (2009) A Focus on Problem Gambling: Results of the 2006/07 New Zealand Health Survey. Wellington:
Ministry of Health
Royal College of Psychiatrists: Parents as patients: supporting the needs of patients who are parents and their children. College Report, January 2011.

• Parental problematic substance use: 10-13%
of children (Australian figures)
• 15-30% of all children have one parent with
a mental illness (NZ)
• 21% of a NZ sample of parents met criteria
for a DSM diagnosis (NZ)
National Centre for Education and Training on Addiction (NCETA) (2010) For Kids’ Sake: A Workforce Development Resource for
Family Sensitive Practice in the Alcohol and other Drugs Treatment Sector: Adelaide: NCETA
Oakley Browne MA, Wells JE, Scott KM (eds). 2006. Te Rau Hinengaro – The New Zealand Mental Health Survey: Summary.
Wellington: Ministry of Health

• NZ Children’s teams note that in the Whangarei
Team, approximately 70% of families that are
referred have substance use issues
• In a general population sample of 7000 women
who gave birth between 2009 and 2010, 16%
identified depressive features during
pregnancy; and 10% experienced panic attacks
• Mackwell, S. Presentation at ACCAN conference, 2015. www.childrensactionplan.govt.nz
• Morton, S. M. B., Atatoa Carr, P. E., Grant, C. C., Berry, S. D., Mohal, J., Pillai, A. (2015). Growing Up in New Zealand: A longitudinal
study of New Zealand children and their families. Vulnerability Report 2: Transitions in exposure to vulnerability in the first 1000 days
of life. Auckland: Growing Up in New Zealand.

Data gaps
• NZ does not currently have any data
about the number of parents who are
presenting to mental health, AOD or
gambling services.

Having mental health and
addiction related problems
is not incompatible with
being a good parent, but
can affect parenting
ability…

Gambling
Studies show that problem gambling can cause a number
of difficulties in family functioning including:
• severe financial problems
• emotional and psychological problems and abuse
• relationship problems (partner and parent-child)
• and a negative impact on the psychological
development of children
Problem Gambling Foundation of New Zealand (2012) Children of Problem Gamblers. Factsheet 11. [online] www.pgfnz.org.nz/library
Darbyshire, P., Oster, C. and Carrig, H. (2001). The experience of pervasive loss: Children and young people living in a family where
parental gambling is a problem. Journal of Gambling Studies; 17(1), 23-45
Abbot, D., Cramer, S. Sherrets, S. (1995) Pathological Gambling and the Family: Practice Implications. Families in Society. 76(4):213-219

A single persons problem gambling can affect 5 to 10
other people (Ministry of Health, 2010).
There is growing concern that children may be more
adversely affected as more women are developing
gambling problems, especially through the use of ‘pokie
machines’ (Darbyshire et al., 2001).
Ministry of Health (2010) Preventing and Minimising Gambling Harm: Six year Strategic Plan 2010/11-2015/16. Wellington:
Ministry of Health
Darbyshire, P., Oster, C. and Carrig, H. (2001). The experience of pervasive loss: Children and young people living in a family
where parental gambling is a problem. Journal of Gambling Studies; 17(1), 23-45

One in six New Zealanders say a family member
has gone without something they needed or a bill
has gone unpaid due to gambling. This
percentage was higher among Māori (38%) and
Pacific (28%),and among those in more deprived
(deciles 8-10) neighbourhoods
National Research Bureau Ltd. (2007) 2006/7 Gaming and Betting Activities Survey: New Zealander’s knowledge, views and
experiences of gambling and gambling-related harm. Wellington: Health Sponsorship Council.

Family violence
• Domestic Violence as a coexisting condition to
problem gambling offers insight into the potential
impact on the children
• Research indicates that children may be subjected to
displaced violence from both the gambler and the
non-problem gambler
• Childhood maltreatment is prevalent in problem
gamblers, especially female gamblers
• The addition of substance problems and mental
health disorders increase risk for family violence
Abacus (2015). Ministry of Health Strategy Think Piece: Domestic Violence as a Coexisting Condition to Problem Gambling.
Petry N, Steinberg K (2005) The Women’s Problem Gambling Research Group US. Psychology of Addictive Behaviors, 19(2), 226-229.

Canadian study, 2010
“Little attention has been given to
prevention of gambling problems as a
factor in reducing child abuse and IPV
(intimate partner violence), but
these data suggest that the link
between the two should be
considered.”
Afifi T, Brownridge D, MacMillan H & Sareen J (2010) The relationship of gambling to intimate partner violence and child maltreatment in a
nationally representative sample. J Psychiatric Research, 44, 331-337.

Children of parents with
gambling problems report
feeling:
• Unloved
• Losing trust in their parents
• Not having their essential
needs met
• Finding it difficult to
concentrate at school
Public Health Association of New Zealand (2013) Problem Gambling: A
resource for local elections. New Zealand: Public Health Association of
New Zealand.
Shaw, M., K. Forbush, J. Schlinder, E. Rosenman and D. Black (2007). The
effect of pathological gambling on families, marriages and children CNS
Spectrums 12(8).
Lesieur, H. and J. Rothschild (1989). Children of Gamblers Anonymous
members. Journal of Gambling Behavior 5(4): 269-281.
Children of parents with problem
gambling more likely to:
• Problematic AOD use
• Experience anxiety and
depression and eating
disorders
• Have trouble sleeping
• Experience asthma, allergies
and gastrointestinal disorders
• Experience their own
gambling problems in later life

And…
• A 2012 systematic
review of
preventative
interventions in
COPMIA concludes
that the risk of
mental illness in the
child can be reduced
by 40%
• Siegenthaler E, Munder T, Egger M. Effect of preventive
interventions in mentally ill parents on the mental health of the
offspring: systematic review and meta-analysis. J Am Acad Child
Adolesc Psychiatry2012; 51: 8-17. <PubMed>

What children want…

What parents want:
• To be asked about their families and
whānau
• To be offered knowledge of positive
activities and supports in the local
community
• To be supported to talk with their
children about what’s going on

• To ensure that it is safe to talk about our
their children
• To be supported to attend to the
practicalities

The Guideline
Supporting Parents, Healthy Children
Supporting parents with mental illness and or addiction and their children
A guideline for mental health and addiction services

In order to:
• Support and promote positive family
relationships and the social and
emotional development of all children of
parents with mental health and/or
addiction issues:

We want a mental health and
addiction sector that:
• Is family and whānau focused
• Takes responsibility for promoting and
protecting the wellbeing of children
• Makes the rights and needs of children a
core focus of all that they do

• Employs a strengths-based approach that
protects and strengthens parenting
capability and builds the resilience of
children
• Provides interventions that are informed
by evidence about what works

• Provides services that are culturally safe
and appropriate for all families and
whānau
• Finds, includes and when necessary,
connects family and whānau to
community supports and services ensuring
a coordinated response to addressing the
needs of the whole family and whānau

• Provides a safe and competent workforce
that is confident and able to recognise
and respond to the needs of children and
their family and whānau.

Its about systemic change
◦ Service Specs
◦ DHB Annual Plan’s
◦ Data collection
◦ Guideline for services

It’s about a phased
implementation process that
supports everyone
• The Guideline will support services in
outlining expectations of service delivery
• The Workforce Development Programmes
will support implementation processes as
able

Guideline structure
• Focuses on change at Organisational,
Service and Practice Levels
• Phased Implementation over 5 years
• Phase one: Essential Elements (3 years:
2018)
• Phase two: Best Practice Elements (5 years:
2020)

Example: Organisational Level
• Phase 1: Family and whānau focused
implementation plans are in place
practice KPI’s are in place and
performance against these in regularly
audited and reviewed.

Example: Service Level
• Phase 1: A COPMIA champion is in place to
support leadership, training, support and
advice
• Phase 2: Written pathways for support
and treatment are available

Example: Practice Level
• Phase 1: Conversations about children,
parenting, family and whānau are
routine.
practice is embedded in all aspects of
service delivery

Ideas for workforce development
Training in:
• Family-Inclusive practice
• Single-Session family work
• Child care and protection
• Supervision
• COPMI-E-Learning (Let’s Talk etc)

Ideas for workforce development
• Resources to support the workforce
working with children and families
• Organisational support to implement the
guidelines and for workforce planning
• The Beacon implementation strategy

Understanding whānau ora
Te kotahitanga o te whakapapa:
Preserving the whānau as a whole
The concept of whānau ora provides a
context for the delivery of COPMIA-focused
initiatives

What we want to see…
• Jill, a 33 year old mother of 3,
whose youngest child is 18 months
old, and oldest 6 years old, has
been referred to her community-
based problem gambling service for
an appointment by her GP
• Jill is phoned by a person from the
service and invited to suggest
appointment times that suit her
and her whānau.

• The appointment can occur at home, or
anywhere suitable to Jill and her whānau
• The person on the phone asks Jill who is
in her whānau as part of the phone
conversation. She is also asked her
ethnicity, and if there are other people
she would like involved in the contact
with the service.

• Jill decides to come into the service. She
brings her 18 month old and her 3 year
old children. Her partner is working and
is unable to attend
• She arrives, along with her children, all
are welcomed warmly

• She and her children are shown to a whānau room with
a kitchenette with fruit, snacks and drinks available.
The room has bean-bags, toys and games, and
comfortable chairs, and family posters on the wall
• Jill and her children are introduced to the practitioner
for the appointment. The practitioner checks if there
is anything Jill needs for her children.
• Jill is offered that the children may stay in the whānau
room with a worker if she would prefer, or is told they
are welcome in the practitioners office with her.

• The practitioner’s office is equally well
equipped for Jill and her children
• The practitioner engages Jill in a conversation
about the reasons she has attended.
• The practitioner is clear about what she would
need to do if she had any concerns for the
children, but she is equally clear that Jill can
be a good mother even if she has addiction
issues.

• The practitioner hears that Jill is engaged
with a service that offers her whānau support,
and that Jill has let this service know of her
appointment today.
• The practitioner is confident talking to Jill
about mental health and addiction problems
as well as her family and whānau, parenting
and any concerns she might have about her
children

• The practitioner is confident in talking to
the children in a friendly and welcoming
way (if they were older she would be
able to help them understand their
mothers issues in an age appropriate way)
• Jill feels that it is OK to continue
contact with the service and feels able to
talk about her children and her partner,
who is able to attend the next
appointment.

It’s all about whānau…

Please contact
ma@acts.co.nz
anna.nelson@matuaraki.org.nz
To let us know the workforce centres might
be able to support you!

Focusing On The ‘A’ in COPMIA: Supporting family and whānau to thrive

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