Alcohol advice for parents and carers

What: A public health initiative to reduce alcohol-related harm in families

Who: Liz Burns – Public Health Development Advisor

Background: Liz Burns is a mental health nurse. Following a career in alcohol services working across a range of primary care and criminal settings, she gained ten years’ experience as a public health practitioner, focusing on population approaches to reducing alcohol harm and individual behaviour change interventions. While working as a Public Health Development Advisor in Manchester’s Health & Wellbeing Service, she contributed to a number of partnership strategies, clinical protocols and training programmes including alcohol identification and brief advice, managing alcohol withdrawal in community and inpatient settings, early help/safeguarding, domestic abuse, as well as self-care and personalized care planning. She is now a Lecturer in Nursing at the University of Salford.

Approach: Prevention

Location: Health & Wellbeing Service, The Manchester Mental Health and Social Care Trust

Speciality: Alcohol and Public Health

What initiative or project are you involved in?

The aim of the project was to reduce alcohol-related harm in families and improve access to information and self-help advice to parents and carers at risk levels.

The initiative, which was commissioned by Public Health Manchester, integrates two of the High Impact Changes to reduce alcohol-related harm by:

  • providing more help to encourage people to drink less through alcohol Identification and Brief Advice (IBA)
  • amplifying national social marketing priorities to engage higher risk drinkers and nudge them towards lower risk drinking behaviour.

What prompted the work?

Parental alcohol misuse has been highlighted as a ‘striking’ feature in a number of serious case reviews in the city by the Manchester Safeguarding Children Board. Reducing alcohol-related harm in families is also a key factor in Manchester’s Early Health Strategy.


In the UK, it is estimated that:

  • 2.6 million children live with at least one parent or carer who drinks at increasing or higher risk levels
  • 705,000 children live with a parent or carer who is alcohol dependant
  • one in three children live with at least one parent who binge drinks (OCC, 2012), which if applied to the last census population for Manchester would equate to an estimated 32,500 children aged 0-5 years living in the city with a binge drinker
  • research suggests that the majority of parents may have misperceptions of the risks attached to their own drinking; whilst existing alcohol reduction programmes were in place, a gap was identified in targeting messages to parents and carers.

How did you initiate the work?

The project supports delivery of the Manchester Alcohol Strategy; one of the objectives for 2012 to 2015 is to develop parents’ understanding of the impact that their alcohol use can have on their children. The project was planned and delivered over a two-year period enabling a more comprehensive programme of work to be produced within a limited budget.

Other organisations and services were involved throughout the process of the project such as:

  • frontline staff in universal services
  • specialist services working with children affected by parental alcohol misuse
  • adult services working with parents or carers
  • engagement of other organisations and services was managed using existing networks and opportunistic contact with frontline staff at training events, as well as maximising high profile times of the year for alcohol advocacy, for example Alcohol Awareness Week.

As a public health initiative, this project was primarily aimed at parents and carers who drink at a non-dependent risk level, with one in three children potentially affected. The aim was to promote early help, in order to safeguard and promote the welfare of children.

One of the challenges to implementing the interventions has been to shift attitudes of frontline staff away from extreme ends of the spectrum; from alcohol harm, to alcohol dependency syndrome and from safeguarding children, to child protection.

We achieved the right balance by listening carefully to the results of our focus groups with staff and parents, and seeking continual feedback on the design and style of the messages produced.

What difference has the project or initiative made?

A number of measures have been used to assess the impact of the project, including:

  • monitoring web activity:
    – 939 web visitors and 2,500 page views in the first six months
    – a Twitter reach of 22,000
  • staff training:
    – 88 alcohol IBA training sessions delivered to 497 individuals from multi-agency groups across the city
    – messages focused on the impact that parents’ alcohol use can have on children, as part of a ‘whole family’ approach
  • leafleting:
    – over 2,000 leaflets were distributed to local organisations and services
    – leaflets supported conversations and brief advice around the impact of alcohol on parenting.

As an extension of this campaign, the school’s alcohol policy was revised and updated to discourage the sale of alcohol on school grounds. Event organisers were asked to decide firstly whether it was appropriate and secondly whether it was necessary.

What are the long-term objectives?

It is important to ensure that organisational systems support routine implementation of alcohol Identification and Brief Advice (IBA) with parents and carers about their own drinking habits, as part of an early help approach. The project also contributes to alcohol advocacy by encouraging the wider health community to support long-term policy changes. This includes:

  • tighter restrictions on alcohol marketing and advertising
  • ending pocket-money pricing by calling for a minimum unit price for alcohol
  • adding Public Health as a fifth licensing objective.