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Hidden harm: Reflections from a researcher

Why undertake this research?

I am a mother, a partner, a family member, a friend, a co-worker, a community member, and a researcher. I know how fragile my hold on each of these profound roles is (and how hard it is to balance them all). I discuss here how alcohol affects our roles, and indeed how alcohol affects a majority of Australian families at least a little and many Australians a lot.

I view my role as a researcher as one in which I objectively document and analyse social problems, and look for and test their solutions.

Doing this research on alcohol’s harm to others has been time consuming but rewarding. However the most significant outcome will be if our findings result in changes that mean that Australians are more free from harm.

Alcohol’s harm to others

In 2008 we conducted a large national survey to examine how Australians were affected by others’ drinking, which was published in the 2010 report The range and magnitude of alcohol’s harm to others.

In the past, researchers had studied how respondents have been affected by their own drinking. Our survey took a novel approach and asked those we telephoned how they had been affected by the drinking of other people they came in contact with.

This included strangers on the street and in other public places, as well as their partners, family members, workmates and friends.

We found that three-quarters of Australians reported specific incidents or negative effects from others’ drinking in the last year.

Many of the most serious problems were ascribed to the drinking of people in respondents’ close social networks, often those in their household or family members.

Seventeen per cent of respondents (an estimated 2,791,964 Australians) had been affected by an intimate partner or relative in the last year.

Twenty-two per cent of carers reported that children had been adversely affected by others’ drinking.

Since the publication of that first report, we have continued working in this area and have compiled our latest findings in the new report The hidden harm: Alcohol’s impact on children and families.

Key findings from The hidden harm

The hidden harm considers the ways in which children and families are affected by others’ drinking.

The most severe cases of harm show up in the service and social system data; as police and child protection agencies attend to these incidents.

In the child protection systems across Australia, pockets of research indicate that between 15 and 47 per cent of child protection cases involve carer alcohol abuse as a significant risk factor.

If you look at the alcohol-related statistics from the child protection system, in 2006-07 there were 10,166 children with a carer whose alcohol abuse had been identified as a problem.

In 2011 there were almost 30,000 incidents of alcohol-related family or domestic violence reported to police. And that’s just in the four jurisdictions for which there is data.

Looking beyond these figures at the general population, 140,000 Australian children were substantially negatively affected by others’ drinking, with many more (1.045 million children) affected in some negative way.

We also interviewed people who indicated their children had been affected by alcohol-related harms to get a more detailed picture.

For some participants these harms were frightening and severe – situations like a knife at the throat, or children being driven by a drunk family member.

For others the harms were more about lack of care or concern, such as a parent or family member drinking heavily and swearing or behaving in concerning ways in front of their children.

People were often too embarrassed about the family member’s drinking to turn to friends, and found it difficult if they tried to get help from a health or social agency as their problems didn’t fit easily in the agency’s mandate.

What can and should be done?

My hope is that these findings will be useful in planning and implementing policies and services to address problems at each of these levels.

This has already begun, with FARE releasing a Policy Options Paper that looks at the issues raised in The Hidden Harm and proposes policies and programs that should be pursued by Governments across Australia to prevent and reduce alcohol-related family and domestic violence.

A public health model is critically useful in examining options to prevent alcohol harms in families. This approach specifies universal interventions to large populations, progressive targeted strategies for families and children at greater risk, and tertiary services to prevent repetition and further consequences to those already harmed.

Primary or universal prevention should include initiatives that support all families. For example, adequate single parent pensions, well-funded maternal and child health care, positive parenting programs and supports, as well as more restrictive alcohol policies that increase price and decrease availability.

At the secondary level, it’s essential that we see service innovations and improvements, along with better communication between family support and alcohol treatment agencies, general practitioners and other professionals in positions to identify alcohol problems of parents.

Effective secondary interventions will prevent future harms and ensure children do not enter the child protection, police, hospital or coroner’s systems.

Finally at the tertiary level, specific multi-faceted intensive parenting programs interlinked with alcohol and other drug services are crucial.

Anne-Marie Laslett

Dr Anne-Marie Laslett is a social, epidemiological and public health research fellow with the Centre for Alcohol Policy and Research (CAPR). She has worked in the area of alcohol and drug epidemiology at Turning Point Alcohol and Drug Centre for the past 17 years, joining CAPR in 2008. She currently directs the award-winning project entitled, 'The Range and Magnitude of Alcohol’s Harm to Others'. Her research on the project has examined harms from others’ drinking both as reported in general population survey respondents and as recorded in the caseloads of social and health response agencies. In particular, in 2011/12, Anne-Marie’s research has focused on a study of alcohol’s involvement in child abuse, using data from the Victorian Child Protection System and the national Alcohol’s harm to others survey. This research for her PhD has been supported by a Sidney Myer Fund and ARF PhD scholarship. She is also a co-investigator and technical advisor to the World Health Organization/Thai Health International Collaborative Research Project on ‘The Harm to others from drinking’. Dr Laslett originally graduated as a dentist, and went on to complete degrees as a Master of Preventive and Community Dentistry (Oral Epidemiology) and a Master of Public Health.

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