I worry when […] insights into dual diagnosis from those who treat mothers misusing alcohol

Alcohol misuse and mental health problems in parents are both known to contribute to impaired outcomes in children, although little is known about the specific parenting behaviours that might be affected. Mental health problems in parents who misuse alcohol may impact parenting in specific ways, and these may be different for mothers and for fathers. The purpose of this paper is to make a preliminary investigation of alcohol misuse and mental health problems in mothers, and explore ways in which these might affect their parenting.

Semi-structured interviews were carried out with professionals involved in services for mothers who misuse alcohol, including those working in addiction psychiatry, in primary care, and in the provision of parenting services. These interviews were then examined using thematic analysis.

Themes emerged including specific mental health problems (depression, anxiety and personality disorders), and related issues, such as self-medication. Particularly relevant for mothers were post-natal depression, the effect on maternal alcohol misuse and mental health when children are removed, the role of domestic violence, and the importance for identification of home visits by services. Different types of alcohol misuse were linked to different mental states and different parenting behaviours in parents. Findings in the general parenting and substance misuse literature were confirmed, and a new addition was that expressed emotion may play a role in families where mothers misuse alcohol.

The findings increased the understanding of the relationships between maternal alcohol misuse, mental health issues and parenting, raising several new points for consideration.