Improving Pathways to Assessment and Care for Infants of Substance Abusing Mothers: Are We Getting It Right?

Abstract

There is documented correlation between parental substance abuse, child maltreatment, and poor outcomes. In two health districts in Sydney, Australia (Site A and B), specialised clinics were established to provide comprehensive assessments for infants of substance abusing mothers (ISAM). We aimed to determine whether there was a difference in outcomes between infants who attended clinic versus those who did not; and to identify differences in the pathways to care between sites. We analysed child protection reports and available health markers of all ISAM referrals in 2011. We held stakeholder meetings with services involved with ISAM in both sites; to describe service components; strengths and weaknesses of pathways. Fifty-five per cent (11/20) attended clinic in Site A; 80% (25/31) in Site B. Three-quarters of ISAM had at least one referral to child welfare; child protection service involvement was more common in those who attended. Immunisation status was lower than the national Australian average; approximately half were seen by community nursing services. Gaps in services, lack of database, and differences in pathways between sites were identified. Attending clinics correlates with child protection service involvement and may afford health protection. Transparent communication, service integration, and shared learning can improve outcomes for this vulnerable group. Soc. Sci. 2015, 4 193 OPEN ACCESS

Designing Initiatives for Vulnerable Families: From Theory to Design in Sydney, Australia

“…Secondary analysis from the child and family indicator data-sets was made available for participants of the Vulnerable Children’s Forum and the Supporting Children and Families Forum. That analysis focused in detail on data available for each of the LGAs in SLHD, and was supplemented by a SLHD population needs analysis, and concurrent reviews of perinatal coordination and Infant of Substance Abusing Mothers (ISAM) Pathways [37].…”

“…The critical realist approach requires the inclusion of an analysis of pre-existing structures and mechanisms that may be contributing to the observed maternal, child and family outcomes [15]. The use of research findings from neighbouring South Western Sydney introduced a weakness into the design process which was only partly offset by the local forum, stakeholder interviews and the perinatal drug health study [37]. A further limitation of the analysis and design elements was the strong health sector focus despite the collective approach to planning.…”