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The purpose of this paper is to determine whether the diagnosis of both carers’ mental health problems and substance misuse increase the likelihood of recurrent child maltreatment over and above the individual effects of these factors.

Retrospective secondary data analysis of 29,455 children where child maltreatment was confirmed in the Victorian child protection system between 2001 and 2005. Recorded mental health, alcohol misuse and other drug misuse variables were entered into multivariate logistic regression models predicting repeated child maltreatment. Interactions and a range of other child, carer and socio-economic factors were included in these models.

Carer alcohol misuse, other drug misuse and mental ill health all independently predicted recurrent child maltreatment. The presence of both other drug misuse and mental ill health increased the likelihood that recurrent child abuse was recorded over the likelihood that mental health alone predicted recurrent child maltreatment, and while alcohol misuse had an effect when there was no mental health condition recorded it did not have an additional effect when there was evidence of mental health problems.

Children in families where there is both mental health problems and other drug use problems are at greater risk of repeated maltreatment than where there is evidence of mental health problems or other drug use alone. Where there was evidence of carer mental health problems, alcohol misuse did not add to this likelihood. However, the effect of mental health and other drug use was similar in size to the effect of alcohol misuse alone.

These findings add to understandings of the effects of co-occurring mental health problems and substance misuse on recurrent child maltreatment and differentiate between cases that involve alcohol and other drug misuse.

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.

This paper offers readers a review of the literature on alcohol and illicit drug misuse in people with learning disabilities, focusing on six key areas. First, clarity is provided on the definition of ‘misuse’. Second, prevalence rates are examined along with the methodological difficulties involved in such studies, the authors arguing that prevalence rates are higher than current estimates. Third, the authors explore the relationship between the intra‐ and inter‐personal risk factors. Fourth, the nature of the substance misuse is explored, with a focus on offending behaviour. Fifth, a range of treatment modalities are described with a series of recommendations for more robust evidence‐based interventions. Last, the authors explore the gaps in policy that lead to a dearth in service provision as well the barriers which people with learning disabilities face on entering treatment services. The paper cites four innovative projects that address this population's needs in England, and illustrates how Northern Ireland has positioned the needs of this hidden population within the Department of Health, Social Services and Public Safety (Northern Ireland).

Alcohol misuse leads to a massive drain upon an already stretched NHS budget. High numbers of individuals with alcohol related physical and health needs are being admitted into the secondary health care setting at great financial cost. This paper examines a profile of this population presenting to the secondary care setting over a 12‐month period. It is suggested that the misuse of alcohol does not take place in isolation. It is often accompanied by other problematic behaviours such as domestic violence, inappropriate, neglectful parenting, or child abuse, offending behaviour, and psychological problems. Evidence for the nature and extent of these associated behaviours is reported and discussed. Comparisons are made particularly with data related to tobacco smoking, and the positive aspects of smoking cessation programmes are outlined. Almost all of the population reported on over the 12‐month period were tobacco smokers. The re‐emergence of the incidence of smoking with the reduction of smoking cessation programmes is noted. The challenge for substance misuse services is how best to respond to the needs of this growing population who often present withalcohol misuse together with smoking behaviours. A collaborative model of response is outlined and suggested as the best way forward. This involves substance misuse services working together with professional colleagues within the acute hospital environment and community to ensure sustainable positive clinical outcomes following hospital discharge.

There is growing statistical and research evidence to suggest that the prevalence of alcohol misuse is increasing among older adults in the UK. This has been an under‐recognised problem, but is now a source of increasing concern for health and social care providers. Older adults with mental health problems have increased vulnerability to problematic alcohol use, and this is likely to have a significant impact on older people's mental health services (OPMHS).

This paper discusses some of the problems facing OPMHS in relation to increasing alcohol misuse among services users.

There is also evidence that alcohol misuse in older adults is often poorly identified and untreated within health and social care services including OPMHS. Use of an alcohol‐screening tool as part of a health care assessment is an effective way to improve detection. This paper also reviews the use of alcohol screening tools in the detection of alcohol related illness among older adults with mental health problems and proposes a care pathway for the management of alcohol misuse in OPMHS.

Current evidence indicates that the prevalence of alcohol misuse among older adults is increasing and is likely to rise further due to the reasons discussed in this paper.

Alcohol misuse is injurious to health, and commonly associated with suicide. However, correlation is not proof of causation: it is valid to consider that social inequalities, such as unemployment and poverty, underlie alcohol misuse, ill health and suicide. Making alcohol misuse strategies central to health promotion and suicide reduction risks a victim‐blaming culture, in which health consequences are viewed as being solely related to an individual's behaviour, ignoring external social conditions; the majority of suicides not related to alcohol misuse being failed by such a policy; and further abdication of political intervention at a societal level.

The purpose of this paper is to explore current practice, barriers and facilitators to identifying and responding to alcohol problems in memory clinics.

A questionnaire sent to professionals in 55 memory clinics in England, Wales and the Isle of Wight and two focus groups with professionals from three memory clinics in England.

Only 1/35 clinics that responded to the questionnaire was using a standardised alcohol screening tool but all attempted to gain some information about alcohol use. Without screening tools, practitioners found it difficult to determine whether alcohol use was problematic. Barriers to identification/intervention included cognitive impairment, service-user being “on guard” during assessment, presence of family members/carers, time constraints and a perception that brief interventions were not within the remit of memory clinics. Facilitators were obtaining visual clues of problem drinking during home visits and collateral information from family members/carers.

Focus group participants were recruited through convenience sampling and a small number of professionals took part. This means that the findings may be subject to selection bias and limits the generalisability of the findings.

Memory clinics should provide guidance and training for practitioners on how to intervene and respond to alcohol misuse. Further research is required to determine the most effective way to identify alcohol problems in people with cognitive impairment and how to deliver brief alcohol interventions that take account of cognitive deficits.

This is the first study to examine alcohol screening and interventions in memory clinics and identifies a need for guidance, training and further research.

Drawing on the social cognitive theory, this study investigated the effect of mentors' drinking norms on their protégés' alcohol misuse by focusing on the mediating role of conformity drinking motives and the moderating role of moral disengagement. We conducted a three-wave survey of 148 mentor–protégé dyads and found that mentors' drinking norms were positively related to their protégés' alcohol misuse and that this relationship was fully mediated by conformity drinking motives. Moreover, the moderated mediation model revealed that moral engagement strengthens the main effects of mentors' drinking norms on conformity drinking motives and the indirect effects of mentors' drinking norms on protégés' alcohol misuse via enhanced conformity drinking motives. The theoretical and practical implications are discussed.

During the past few years public concern in Britain has periodically moved from one health or social problem to another. Topics such as youthful heroin use, child abuse, and the upsurge of AIDS have, quite rightly, received a considerable amount of interest. Although media — popular and political — interest tends to single out particular ‘topical’ issues for attention, the sad fact is that, although health and social problems ebb and flow, they exist concurrently and some of the oldest and greatest problems often receive relatively scant concern. This is certainly true in relation to the misuse of alcohol and of the massive mortality attributable to tobacco smoking. The latter exceeds the health damage due to all other drugs (both legal and illegal) and it has been estimated that over 100,000 people in the United Kingdom die of tobacco‐related diseases each year. Fortunately, although tobacco is the cause of a horrifying toll of health damage, the use of this drug has declined dramatically and smokers are now a beleaguered and dwindling minority, roughly a third of the adult population.

Problem drinking includes a spectrum of drinking habits ranging from excessive alcohol intake to alcohol dependence. Numerous risk factors are thought to increase the susceptibility to such drinking patterns ‐ genetic, environmental and constitutional. Although alcohol misusers are frequently stereotyped, from interviewing numerous patients it is evident that there is no ‘typical alcoholic’. Alcohol consumption screening is widely used; however, it is important for healthcare professionals to understand the social and psychological aspects of problem drinking before advising abstinence. With this understanding, it is clear that governmental legislation with regards to alcohol is more likely to cut down the number of social binge drinkers than the number dependent on alcohol. The onus of reducing the number of individuals developing diseases as a result of chronic alcohol misuse, therefore, lies with the healthcare profession; early screening of alcohol consumption and early psychological intervention for susceptible individuals is key in this prevention.