Adfam at 40 – Joy Barlow: recognising women, children and substance use

“We’ve got to go for connectedness. We’ve really got to understand that no one set of professionals is going to work this. And working alongside and with the families, hearing the lived experience, hearing the voice. Now that is incredibly challenging, but I think it also has to be said that we’re not going to get anywhere if we don’t do that.”

Adfam at 40 – Joy Barlow: recognising women, children and substance use

2024 marks a special year for Adfam as we celebrate our 40th year. Over the course of 2024 we are releasing a series of monthly articles, reflecting on Adfam’s forty years, where things have improved for families, and where we still have progress to make. Along the way we’ll be speaking to a range of key people that have been active in supporting families affected by substance misuse throughout those years. 

For our third Adfam at 40 article, we speak with Joy Barlow, the former head of STRADA (Scotland Training – Drugs and Alcohol). Joy has, over many years, been a pioneer in developing support and improving understanding and recognition around the issue of parental substance misuse.

Addressing the support gap for women affected by substance misuse
Our conversation begins with Joy’s reminiscence of her initial inspiration, a chat on the streets of Glasgow in 1985 with a woman named Brenda. Joy was working as a Drug Project Officer for the Scottish Episcopal Church at the time and encountered Brenda on an outreach session. Brenda was highlighting the complete sparsity of support available for mothers impacted by substance misuse, many of whom were losing their children, either into the care system, adoption or kinship care. This was a time when the issue of parental use was under recognised, and residential rehabilitation options for all, but especially mothers, were highly limited. It drove Joy to embark on a mission to bridge this gap.

Joy brought the issue to the attention of her colleagues and began conducting further research into the issue, first writing a feasibility study. She drew on American literature to get a better understanding and came across Juliet Denson-Gerber, a psychiatrist and founder of the Odyssey House. Juliet had shared some frightening insights around heroin addiction being a priority reason for the removal of children. But then Joy found another piece of research by Carolyn Eldred which emphasised how children could also be stressors and motivators of change. 

The Aberlour Childcare Trust Board had put their weight Joy’s study and, along with the Episcopal Church, offered funding for her to go to the North America to find out more. In 1986, Joy visited rehabilitation centres in New York, Baltimore, Washington and Toronto. She has fond memories of a visit to a rehab in New York where one of the workers said to her, “McDonalds is not good enough for my ladies!”, and really pushed the women to be something different and do the best they could. However, Joy was also able to learn from some of the shortcomings in the approaches being used. At that centre, for example, the women could only stay for 90 days which was not a feasible timeline to help them cope and overcome their issues. Other practices saw family facilities being attached to long term rehabs that largely consisted of men who had fought in the Vietnam war. 

Brenda House: the first residential rehab of its kind in Scotland for women and children
It was clear a long-term dedicated residential space for women and their children was needed, and upon her return to Scotland, Joy began to drive this ambition forward. By 1989, Brenda House, named after the Brenda who had provided Joy with her inspiration on the streets of Glasgow four years earlier, was opened by Diana, Princess of Wales. The residential centre used a tenement building in Edinburgh and consisted of six flats for six women and their children, plus a flat for the staff.  Later that year similar projects followed, Scarrel Road, the Number One Project and Supportive Accommodation all in Glasgow. Much of the funding stemmed from HIV/AIDS, as Scotland at that time had a very substantial population of both men and women who were infected with HIV. 

The centres offered practical work, therapeutic counselling, group therapy, family therapy, along with play therapy and art therapy for the children. They were accessible to women in various stages of recovery, ensuring support for all who needed it, and providing vital and groundbreaking support that hadn’t been seen before in Scotland. Crucially there was also buy-in from the local community, including local schools, nurseries, GPs, dentists. 

Brenda House unfortunately closed in the early 2000’s, whilst Scarrel Road and the Number One Project were incorporated into a wider family centre, lasting until around 2015. Further funding has more recently been made available for residential treatment for women and their children by the Scottish government following the increase in drug-related deaths, with Aberlour currently in the process of opening two residential units. 

Amplifying the voice of children
Joy highlights the progress that has been made when listening to children too. Initiatives such as Hidden Harm in 2003 shed a light on the challenges many children face when living with parental addiction addiction. Further key reports followed such as Juggling Harms in 2011 and Silent Voices in 2012. Training and workforce development took place around the harms to children and awareness around the importance of listening to children is now far greater than it used to be. The same can be said for relational work with families, with a much-improved understanding of the impacts of trauma, mental health and domestic violence, and an overall greater recognition within services of the impacts of substance use on women and children. We’ve also seen a better understanding of the wider socio-economic factors relating to substance use, such as housing, finance, employment.

One initiative in Scotland we certainly can’t go without mentioning is the Partnership Drugs Initiative, of which Joy was Chair, a partnership between the Scottish Government and the Corra Foundation, of which Joy was a Trustee. The partnership was set up to support children, young people and families affected by alcohol and drugs. Since its inception in 2000 millions have been invested into third sector services, with some amazing work being carried out as a result. 

Despite the brilliant initiatives that have taken place over the years, as Joy puts it – “We’ve not solved it all and there’s still a hell of a lot to do.” A particular myth that Joy is keen to dispel, is that where a parent recovers from their substance misuse, this resolves the situation. This is not the case as it in fact changes the family dynamic. You go from situations, for example, where the children are being the primary carers, to the parent becoming the parent again, telling their child what to do and what not to do, something which can complicate things considerably for the child. She points to the 2015 ‘Everyone Has a Story’ work by Corra Foundation, where children shared experiences of this and not knowing where they were, and in some cases were actually happier when things were more chaotic because it was something they had learned to deal with. Understanding when children are in need and when children are at risk is still vitally important and doesn’t go away with recovery.

Envisioning a brighter future
In spite of the challenges, Joy remains steadfast in her vision for the future. Above all else she emphasises how vital it is that we really listen to the voices of women, children and families, and advocate for services that are responsive to their lived experiences and preferences, based on what they tell us they want, not what we think they want. 

We’ve got to go for connectedness. We’ve really got to understand that no one set of professionals is going to work this. And working alongside and with the families, hearing the lived experience, hearing the voice. Now that is incredibly challenging, but I think it also has to be said that we’re not going to get anywhere if we don’t do that.

As we reflect on Joy’s insights, its evident that while progress has been made, the journey towards comprehensive support and understanding around parental substance use is ongoing. It requires continued investment in services but also a fundamental shift in attitudes. By putting the voices of those directly affected at the centre, we can strive towards a future where women, children and families receive the support they need to thrive amidst the challenges of substance use.

Join us each month for a featured article to mark Adfam’s 40th year, where we speak to a range of contributors who have played a key role in supporting families affected by substance misuse over the years.