School personnel often take on ancillary responsibilities that extend beyond their role as educational professionals, including supporting students who have parents suffering from substance use disorders (SUDs). Our objectives were to use the experience of these school personnel to better understand how healthcare professionals can support school personnel and affected adolescent students. We recruited 21 school staff from public and private high schools in a metropolitan US city. Interested personnel were then screened and scheduled to participate in either a public urban, public suburban, private, or mixed school virtual focus group. An iterative process was used to generate codes, categories, and ultimately themes from each of the four focus groups. Final themes were grouped into major and minor themes with subsequent comparison between school typologies. Two categories arose from analysis of major themes: (1) school personnel’s perceptions of students experiencing parental substance abuse and (2) school personnel’s personal experiences with these students. Major themes included extreme shifts in adolescent behavior, adolescents’ need for trusted adults, adolescents’ expression of familial shame, school personnel’s desire for evidence-based SUD resources, and feelings of helplessness related to students’ home situations. Minor themes included forced maturity and normalization of substance use. The overarching comparison between typologies revealed difficulty connecting students whose parents abused substances with appropriate resources. Enhanced communication between school personnel and mental health providers, in addition to wider utilization of school-based mental health resources, is needed to recognize and address the gaps in care for youth impacted by familial substance abuse and for the school personnel who support them.
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Ashton, K., Davies, A. R., Hughes, K., Ford, K., Cotter-Roberts, A., & Bellis, M. A. (2021). Adult support during childhood: A retrospective study of trusted adult relationships, sources of personal adult support and their association with childhood resilience resources. BMC Psychology, 9(1), 101. https://doi.org/10.1186/s40359-021-00601-x
National Parent Teacher Association. (2008). National Standards for Family-School Partnerships. https://www.pta.org/home/run-your-pta/family-school-partnerships.
Bachman, J. G., O’Malley, P. M., Johnston, L. D., Schulenberg, J. E., & Wallace, J. M. (2011). Racial/Ethnic differences in the relationship between parental education and substance use among U.S. 8th-, 10th-, and 12th-grade students: Findings from the monitoring the future project. Journal of Studies on Alcohol and Drugs, 72(2), 279–285. https://doi.org/10.15288/jsad.2011.72.279
Bahramnejad, A., Iranpour, A., & Nakhaee, N. (2020). “Students in public and private schools—Which are at higher risk of drug use?”: A survey from Iran. Substance Abuse Treatment, Prevention, and Policy, 15(1), 88. https://doi.org/10.1186/s13011-020-00330-1
Bellis, M. A., Hardcastle, K., Ford, K., Hughes, K., Ashton, K., Quigg, Z., & Butler, N. (2017). Does continuous trusted adult support in childhood impart life-course resilience against adverse childhood experiences—A retrospective study on adult health-harming behaviours and mental well-being. BMC Psychiatry, 17(1), 110. https://doi.org/10.1186/s12888-017-1260-z
Bick, J., & Nelson, C. A. (2016). Early adverse experiences and the developing brain. Neuropsychopharmacology, 41(1), 177–196. https://doi.org/10.1038/npp.2015.252
Calhoun, S., Conner, E., Miller, M., & Messina, N. (2015). Improving the outcomes of children affected by parental substance abuse: A review of randomized controlled trials. Substance Abuse and Rehabilitation, 6, 15–24. https://doi.org/10.2147/SAR.S46439
Children and Family Futures. (2021). Comprehensive Framework to Improve Outcomes for Families Affected by Substance Use Disorders and Child Welfare Involvement. https://www.cffutures.org/files/CFFComprehensiveFramework.pdf.
Dassira, M. (2019). School psychologists’ current practice, training, and interest in the integration of substance abuse training as part of the mental health profession. Educational Specialist, 2009–2019. https://commons.lib.jmu.edu/edspec201019/150.
Dudovitz, R. N., Chung, P. J., & Wong, M. D. (2017). Teachers and coaches in adolescent social networks are associated with healthier self-concept and decreased substance use. The Journal of School Health, 87(1), 12–20. https://doi.org/10.1111/josh.12462
Dwyer, J. B., & Ross, D. A. (2017). The nature of nurture: How developmental experiences program adult stress circuitry. Biological Psychiatry, 81(8), e57–e59. https://doi.org/10.1016/j.biopsych.2017.02.004
Eber, L., Barrett, S., Perales, K., Jeffrey-Pearsall, J., Pohlman, K., Putnam, R, Splett, J., & Weist, M.D. (2019). Advancing Education Effectiveness: Interconnecting School Mental Health and School-Wide PBIS, Volume 2: An Implementation Guide. Center for Positive Behavior Interventions and Supports. https://www.pbis.org/resource/interconnecting-school-mental-health-and-pbis-volume-2.
Fazel, M., Hoagwood, K., Stephan, S., & Ford, T. (2014). Mental health interventions in schools 1. The Lancet Psychiatry, 1(5), 377–387. https://doi.org/10.1016/S2215-0366(14)70312-8
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M., Edwards, V., Koss, M. P., & Marks, J. S. (1998). Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study. American Journal of Preventive Medicine, 14(4), 245–258. https://doi.org/10.1016/s0749-3797(98)00017-8
Franklin, C. G. S., Kim, J. S., Ryan, T. N., Kelly, M. S., & Montgomery, K. L. (2012). Teacher involvement in school mental health interventions: A systematic review. Children and Youth Services Review, 34(5), 973–982. https://doi.org/10.1016/j.childyouth.2012.01.027
Ginsburg, G. S., & Drake, K. L. (2002). School-based treatment for anxious african-american adolescents: A controlled pilot study. Journal of the American Academy of Child & Adolescent Psychiatry, 41(7), 768–775. https://doi.org/10.1097/00004583-200207000-00007
Griffin, K. W., & Botvin, G. J. (2010). Evidence-based interventions for preventing substance use disorders in adolescents. Child and Adolescent Psychiatric Clinics of North America, 19(3), 505–526. https://doi.org/10.1016/j.chc.2010.03.005
Halliday, A. J., Kern, M. L., Garrett, D. K., & Turnbull, D. A. (2019). The student voice in well-being: A case study of participatory action research in positive education. Educational Action Research, 27(2), 173–196. https://doi.org/10.1080/09650792.2018.1436079
Hartwell, S. (2004). Triple stigma: Persons with mental illness and substance abuse problems in the criminal justice system. Criminal Justice Policy Review, 15(1), 84–99. https://doi.org/10.1177/0887403403255064
Hatzenbuehler, M. L., Phelan, J. C., & Link, B. G. (2013). Stigma as a fundamental cause of population health inequalities. American Journal of Public Health, 103(5), 813–821. https://doi.org/10.2105/AJPH.2012.301069
Hsieh, H.-F., & Shannon, S. E. (2005). Three approaches to qualitative content analysis. Qualitative Health Research, 15(9), 1277–1288. https://doi.org/10.1177/1049732305276687
Kataoka, S. H., Vona, P., Acuna, A., Jaycox, L., Escudero, P., Rojas, C., Ramirez, E., Langley, A., & Stein, B. (2018). Applying a trauma informed school systems approach: Examples from school community-academic partnerships. Ethnicity & Disease, 28(8), 417–426. https://doi.org/10.18865/ed.28.S2.417
Knight, J. R., Sherritt, L., Shrier, L. A., Harris, S. K., & Chang, G. (2002). Validity of the CRAFFT substance abuse screening test among adolescent clinic patients. Archives of Pediatrics & Adolescent Medicine, 156(6), 607–614. https://doi.org/10.1001/archpedi.156.6.607
Lee, C. A., Smith, D. C., Lanker, A., & Clary, K. L. (2021). Sensitivity and specificity of the CRAFFT to identify heavy cannabis use: Evidence from a large statewide adolescent sample. Addictive Behaviors, 122, 107006. https://doi.org/10.1016/j.addbeh.2021.107006
Lipari, R. & SL Van Horn. (2017). Trends in substance use disorders among adults aged 18 or older. SAMHSA. https://www.samhsa.gov/data/sites/default/files/report_2790/ShortReport-2790.html.
Lowthian, E. (2022). The secondary harms of parental substance use on children’s educational outcomes: A review. Journal of Child & Adolescent Trauma. https://doi.org/10.1007/s40653-021-00433-2
Substance Abuse and Mental Health Services Administration. (2022). Project AWARE (Advancing Wellness and Resiliency in Education). https://www.samhsa.gov/grants/grant-announcements/sm-22-001.
Merry, S., McDowell, H., Wild, C. J., Bir, J., & Cunliffe, R. (2004). A randomized placebo-controlled trial of a school-based depression prevention program. Journal of the American Academy of Child & Adolescent Psychiatry, 43(5), 538–547. https://doi.org/10.1097/00004583-200405000-00007
Mitchell, S. G., Gryczynski, J., O’Grady, K. E., & Schwartz, R. P. (2013). SBIRT for adolescent drug and alcohol use: Current status and future directions. Journal of Substance Abuse Treatment, 44(5), 463–472. https://doi.org/10.1016/j.jsat.2012.11.005
National Institutes on Drug Abuse. (2020). Common Comorbidities with Substance Use Disorders Research Report. http://www.ncbi.nlm.nih.gov/books/NBK571451/.
National Center on Substance Abuse and Child Welfare. (2015a). Online Tutorials: Tutorials for Child Welfare Professionals. https://ncsacw.acf.hhs.gov/tutorials/tutorialDesc.aspx?id=27.
National Center on Substance Abuse and Child Welfare. (2015b). Module 6: Understanding the Needs of Children of Parents with Substance Use or Co-Occurring Disorders. https://ncsacw.acf.hhs.gov/files/toolkitpackage/mod6/module-6-children-slides-508.pdf.
O’Malley, P., Johnston, L., Bachman, J., Schulenberg, J., & Kumar, R. (2007). How substance use differs among american secondary schools. Prevention Science : THe Official Journal of the Society for Prevention Research, 7, 409–420. https://doi.org/10.1007/s11121-006-0050-5
Ojeda, V. D., & Bergstresser, S. M. (2008). Gender, race-ethnicity, and psychosocial barriers to mental health care: An examination of perceptions and attitudes among adults reporting unmet need. Journal of Health and Social Behavior, 49(3), 317–334. https://doi.org/10.1177/002214650804900306
Operation Prevention. (2020). Operation Prevention. https://www.operationprevention.com/.
Raitasalo, K., & Holmila, M. (2017). Parental substance abuse and risks to children’s safety, health and psychological development. Drugs: Education, Prevention and Policy, 24(1), 17–22. https://doi.org/10.1080/09687637.2016.1232371
Reinke, W. M., Stormont, M., Herman, K. C., Puri, R., & Goel, N. (2011). Supporting children’s mental health in schools: Teacher perceptions of needs, roles, and barriers. School Psychology Quarterly, 26(1), 1–13. https://doi.org/10.1037/a0022714
Simmons, C., Graham, A., & Thomas, N. (2015). Imagining an ideal school for wellbeing: Locating student voice. Journal of Educational Change, 16(2), 129–144. https://doi.org/10.1007/s10833-014-9239-8
Solis, J. M., Shadur, J. M., Burns, A. R., & Hussong, A. M. (2012). Understanding the diverse needs of children whose parents abuse substances. Current Drug Abuse Reviews, 5(2), 135–147. https://doi.org/10.2174/1874473711205020135
Stringer, K. L., & Baker, E. H. (2018). Stigma as a barrier to substance abuse treatment among those with unmet need: An analysis of parenthood and marital status. Journal of Family Issues, 39(1), 3–27. https://doi.org/10.1177/0192513X15581659
Substance Abuse and Mental Health Services Administration. (n.d.). Practitioner Training. https://www.samhsa.gov/practitioner-training.
Sulkowski, M. L., & Michael, K. (2014). Meeting the mental health needs of homeless students in schools: A Multi-Tiered System of Support framework. Children and Youth Services Review, 44, 145–151. https://doi.org/10.1016/j.childyouth.2014.06.014
The Jed Foundation. (2021). Jed’s Comprehensive Approach to Mental Health Promotion and Suicide Prevention for Colleges and Universities. https://jedfoundation.org/wp-content/uploads/2021/07/JED-Comprehensive-Approach_FINAL_July19.pdf.
Trucco, E. M. (2020). A review of psychosocial factors linked to adolescent substance use. Pharmacology Biochemistry and Behavior, 196, 172969. https://doi.org/10.1016/j.pbb.2020.172969
Velleman, R., & Templeton, L. J. (2016). Impact of parents’ substance misuse on children: An update. Bjpsych Advances, 22(2), 108–117. https://doi.org/10.1192/apt.bp.114.014449
Whitley, J., Smith, J. D., & Vaillancourt, T. (2013). Promoting mental health literacy among educators: Critical in school-based prevention and intervention. Canadian Journal of School Psychology, 28(1), 56–70. https://doi.org/10.1177/0829573512468852
Wojnar, D. M., & Swanson, K. M. (2007). Phenomenology: An exploration. Journal of Holistic Nursing, 25(3), 172–180. https://doi.org/10.1177/0898010106295172
Wolmer, L., Hamiel, D., & Laor, N. (2011). Preventing children’s posttraumatic stress after disaster with teacher-based intervention: A controlled study. Journal of the American Academy of Child & Adolescent Psychiatry, 50(4), 11. https://doi.org/10.1016/j.jaac.2011.01.002
Yamaguchi, S., Foo, J. C., Nishida, A., Ogawa, S., Togo, F., & Sasaki, T. (2020). Mental health literacy programs for school teachers: A systematic review and narrative synthesis. Early Intervention in Psychiatry, 14(1), 14–25. https://doi.org/10.1111/eip.12793
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Cantu-Weinstein, A., Fischer, M., Garb, M. et al. Perceptions from School Personnel on the Impact of Disordered Parental Substance Use Among Adolescents. School Mental Health 15, 202–219 (2023). https://doi.org/10.1007/s12310-022-09544-z
- Substance use disorder
- Parental substance abuse
- Teacher support
- Adolescent psychiatry