In this unique rehab project, women get treatment without their newborns being taken into care
Jenny Stallard
“If you talk to a new mum, they often won’t even let a grandparent take their baby out for the afternoon; such is the need to keep close physical proximity to their child. So imagine how difficult it must be for a mother to know her baby is in the care of a stranger.”
This is Hannah Shead, CEO of Trevi House in Plymouth – a clinic that works only with mums who have a drug or alcohol addiction.
“I work every day with mums who are addicts, women who are trying to get clean so they can keep their baby from being taken into care.”
Hannah is firm but fair when she speaks about the women who she works with. Trevi, which is profiled in a new Panorama documentary Addicted: Last Chance Mums, offers them a last chance to get clean while with their baby – if they relapse, their baby will be taken away. No second chances.
“In the six years I’ve worked here, I’ve seen the difference treatment makes. I see the women’s and babies’ lives that it saves,” says Hannah.
The treatment is a combination of detox therapy and parenting support. There’s observation around the clock from a 30-strong team, including nursery workers, therapists, and support staff. Women here can be juggling sleepless nights, learning to nurse and comfort their baby while going to group therapy and taking methadone. It’s a world away from the cosy new beginnings shown in a nappy advert.
“At full capacity, we can accommodate 10 mums,” Hannah explains. “Anyone can come here, referred by their local authority or adult and children’s services.” But it’s not cheap: around £38,000 for a six-month placement. And, much like the IVF postcode ‘lottery’, some authorities have different criteria for a mum to be considered for help. In some cases, women have had her babies taken away before Trevi can help them.
The Panorama documentary explains that one in four mothers who have a child taken into care go on to have more children – many of whom are also removed from their care. And around one in 500 babies in England is born dependent on substances. If mothers don’t get clean, children will be taken into care.
“Many women who need our help are coming from situations involving abuse or domestic violence. They need shelter from that to try to get clean. We work just with the mothers; that’s an important part of the journey,” says Hannah. “The majority have been on heroin or crack cocaine or both. If a woman uses alcohol or drugs during her placement with us, the placement is ended. There’s no negotiating around that. There’s no discussion.”
There is no sugar coating the challenge and the risk. But there are success stories. Women like Leanne, 37. “I get more of a buzz off her [my baby’s] smile than I did off any drugs,” she says in the film. “It’s not easy here, it’s not a holiday camp. They put you through a lot of dealing with your problems and you get a lot of negative feedback, because obviously, to get here in the first place a lot of bad stuff has happened.”
Leanne’s methadone is slowly reduced while she’s at the centre, and then she has to cope on her own. It’s similar for Hayley, also 37. “I was a greedy addict,” Hayley says. Three of her six children are in care. Her struggles through the therapy are emotional, as she faces up to those who’ve abandoned or abused her in the past. She was living on the streets, and didn’t know she was pregnant until 24 weeks.
“When I had my other kids, giving up wasn’t an option,” Hayley adds. But when she found herself living on the streets, 24 weeks pregnant, she knew she had to “grow up” and “turn wrongs to rights”. She smiles at her son as she says it, motherly love clearly driving her urge to get clean for him.
Many of the women who come to Trevi aren’t just fighting addiction, but also underlying traumas, such as issues in childhood or domestic violence, Hannah says. It’s impossible to ‘make’ mums finish the course and leave with their child.
“But we’ll have given 10 out of 10 mums an opportunity, and kept 10 out of 10 children safe. If the programme doesn’t work for a mum, we’ve given them the best possible chance.”
But what of those cases where the process doesn’t work?
“What we find is when placements break down, it’s usually because of a breach of rules – that is to say a mum takes drugs or drinks alcohol. It’s devastating when that happens, of course. But if women aren’t able to prioritise the needs of their children in test conditions, then we have to think about what’s in the best interests of the baby. Thinking about the interests of the child – putting the child at the centre of the decision – gives you a framework to make these decisions.”
Sadly, many women (four in 10) don’t complete the programme. That’s where things get tough, as Hannah is part of the team that decides if the baby will be taken into care. There are no ‘three strikes’ – once a mum relapses, the child is taken into care. It’s hard, but it has to be that way for them to take the placement seriously. And many do. Of those who don’t make it (and have their child taken away from them) some will re-start the process and return to Trevi and if successful have their child awarded back to them.
The crux to helping the women rehabilitate, Hannah says, is keeping the mother and baby together – mums who have their child with them, instead of worrying how the baby is coping with a stranger, in care, have their true focus there with them, all the time. “It’s hard to imagine the trauma involved in being in hospital, your baby is five days old and being taken into care. You’re so traumatised by that harrowing experience, and then you are back out there with bad relationships. For me, it’s no wonder women can’t get clean. Women can be referred to Trevi when pregnant, deliver their baby in a hospital locally, then return here knowing they can nurse and be with their baby.”
And when the mums do leave, with their child, for a new life, clean from drugs, the joy can come back even decades on.
“I’ve also seen countless mums leave with their babies. Their lives transformed as they work through a programme while becoming a new mum, to find a path ahead that doesn’t involve having their child taken away,” says Hannah. “For example, recently, the child of a former patient came to see us. She’s 19 now, and doing a degree. Many people don’t know about us – but then there are lots of families that would say if it wasn’t for us, then ‘I wouldn’t be with my mum’. Like with that girl’s mum, we find that, given that chance, most women grab it with both hands.”
Panorama, Addicted: Last Chance Mums is on iPlayer now.