The Four Challenges of Home Visitation Programs: Alcohol and Substance Abuse, Intrafamilial Violence, and Mental Disorders

Abstract

There are many challenges faced by home visitation programs, in terms of costs, sustainability, viability in different cultural settings and contexts, human and financial resources, and cost effectiveness, among others. Additional challenges to the well-being of the child and family include problems related to excessive alcohol consumption and the use of other psychoactive substances, intrafamiliar violence, and mental disorders (including mental retardation or cognitive developmental problems). These challenges to family well-being can interfere with any home visitation program, regardless of its location, posing a risk to the safety of families and providers involved or to the access of affected families to these programs when they are the ones who most need them. These problems sometimes occur all at the same time and occur in marginalized neighborhoods, in which access to education, basic sanitation, public safety and specialized care are not available or do not meet even the minimum requirements of the local community (Kumpfer et al., Strengthening America’s Families (CSAP/OJJDP monograph), 2002; World Health Organization, Substance Use Among Young People in Urban Environments, 2005).