Alcohol and drug problems affect not only those using these substances but also family members of the substance user. In this review evidence of the negative impacts substance misuse may have upon families are examined, following which family‐focused interventions are reviewed. Several family‐focused interventions have been developed. They can be broadly grouped into three types: (1) working with family members to promote the entry and engagement of substance misusers into treatment; (2) joint involvement of family members and substance misusing relatives in the treatment of the latter; and (3) interventions responding to the needs of the family members in their own right. The evidence base for each of the three types is reviewed. Despite methodological weaknesses in this area, a number of conclusions can be advanced that support wider use of family focused interventions in routine practice. Future research needs to focus on (1) pragmatic trials that are more representative of routine clinical settings; (2) cost‐effectiveness analyses, in terms of treatment costs and the impact of interventions on costs to society; (3) explore treatment process; and (4) make use of qualitative methods. In addition, there is a need to define more clearly the conceptual underpinnings of the family intervention under study.

Background: Barriers to accessing mental health care during pregnancy and the first postnatal year (perinatal period) seem to be greater for ethnic minority women; however, there is no reliable large-scale data about their actual use of mental health services during this period. Our study aims to explore access rates to secondary mental health services, including involuntary admissions to psychiatric inpatient care and patterns of engagement for ethnic minority women aged 18+ who gave birth in 2017 in England, UK. Methods: Two datasets from the National Commissioning Data Repository, the Acute Inpatient Dataset and Mental Health Services Dataset, were linked. Datasets covering the full perinatal period for each woman were included. Rates were standardised by age and deprivation. Results: Out of 615,092 women who gave birth in England in 2017, 22,073 (3.5%) started a contact with mental health services during the perinatal period. In total, 713 (3.2%) were admitted to inpatient care, and 282 (39.5%) involuntarily. Ethnicity data was available for 98% of the sample. Black African, Asian and White Other women had significantly lower access to community mental health services and higher percentages of involuntary admissions than White British women. Black African, Asian and White Other women had a higher number of attended community contacts and fewer non-attendances/cancellations of appointments than White British women. Conclusion: Access to mental health services during the perinatal period varies significantly between women from different ethnic groups. Access to community mental health services should be facilitated for Black African, Asian and White Other women during the perinatal period, which may reduce rates of involuntary hospital admissions for these groups. The pattern of engagement with community services for women from these ethnicities indicates that access appears to be a problem rather than utilisation.

Recent developments in research and practice have highlighted the effectiveness of family interventions in substance misuse treatment. The present paper will critically review studies of family approaches published over the past 12 months, assess the current state of this field and suggest future directions. Family interventions lead to positive outcomes for both misusers and family members. Some recent interventions have widened the focus also to include other members of the user's social networks and have focused on a range of treatment goals. An increasingly robust evidence base supports family-focused and social network-focused interventions in substance misuse treatment. Recent studies have continued to show that family and network approaches either match or improve outcomes when compared with individual interventions. Research needs (and is starting) to consider a broader set of outcomes relevant to family and network interventions, besides simply making an impact on substance use. The major challenge involves implementation of family approaches in routine service provision; interventions with most evidence supporting them are not used routinely in practice. Research studies and policy initiatives need to focus on dissemination of family approaches and their integration into treatment services.