In Whose Best Interest? Balancing Mothers' Plights and Children's Rights in Harm Reduction Programs: Frontline Support Workers' Perspectives

Abstract

This study explores frontline support workers’ perspectives on how mothers’ needs and children’s rights are balanced in harm reduction programs in an urban centre in Alberta, Canada. Interviews were conducted with five (5) workers employed at harm reduction programs supporting mothers and/or children facing circumstances related to substance use, domestic violence, mental health, poverty, homelessness, and criminal justice system involvement. The interviews, along with content from publicly available (web-based) program descriptions, were analyzed through a theoretical framework that mobilizes theories of intersectional stigma (both on symbolic/interactional and structural levels). Participants revealed that intersectional stigma emerges from an abstinence-based child welfare system (namely, Children’s Services (CS) in Alberta), which constitutes a major barrier to ensuring the best interests of both mothers and children. Such stigma manifests based on the intersecting identities that women hold as mothers, as substance users, as partners who face violence, as criminalized persons, and more. Experiences of these barriers disproportionately impact mothers who do not meet idealized standards of mothering—standards which seem to be upheld and reproduced by the medicalization of motherhood. These families are more vulnerable to interventions including child apprehensions, which have severe impacts for both mothers and their children. The perspectives of the frontline support workers point to the importance of a harm reduction approach as an alternative to the current harm elimination one, but identified tensions between harm reduction and harm elimination remain a barrier to balancing the best interests of both mothers and children. Despite these tensions, the participants discuss their own practices of self-awareness and reflection and point to relationship building, non-judgment, and client-centering as essential to the role of the frontline worker who adopts a harm reduction approach.