Forced adoption support services scoping study Daryl Higgins, Pauline Kenny, Reem Sweid and Lucy Ockenden Report for the Department of Social Services by the Australian Institute of Family Studies February 2014

66.1Accessibility

The most common means for improved accessibility that stakeholders raised was through the development of a high profile, central website, which is regularly resourced and maintained, and is complemented by a Freecall (1800) telephone number (if clients need to call out of hours, the telephone line could be linked to an alternative service such as Lifeline; however, staff of Lifeline and other crisis lines are not trained in adoption issues. This would need to be a consideration in resourcing such an option (i.e., training for generalist crisis helpline staff, so clients can always speak to an understanding person trained on adoption issues rather than an answering machine).

Some of the key themes relating to improving the accessibility of services were:

addressing cost—in particular, of BDM searching;

central access points, because both obtaining information and the subsequent searching covers multiple jurisdictions, and a link to this from the National Archives website;

online—can be great, but there are risks (e.g., conflict between different support groups who have different views about how their experiences should be understood and the appropriate responses from services/governments). Internal standards need to be established by agencies and groups regarding acceptable behaviour on social media. All staff or peer-support members should be expected to sign and agree to these;

post-adoption support work, as well as mental health services need flexibility, and longer-term work; and

stakeholders felt there was value in having a consistent person being the point of contact for a person throughout their journey of seeking information and making contact.

Is it sequential? You are on the journey all the time. You need different types of support at different times in your life. New events spark things. It never ends. It’s sequential and ongoing.

66.2Quality/efficacy

A strong theme in the consultations was the quality and nature of the services provided by state/territory registries of Births, Deaths and Marriages (BDM).

67Births, Death and Marriages registries

BDMs often came under criticism for the variable quality of their interactions with clients. Service providers and peer-support coordinators described how valuable it was when they knew of a contact person in BDM who showed empathy to whom they could refer people. But often they move on, and its hard to find a new person who has that rapport and sensitivity to the issues—so that someone who has experienced trauma isn’t “triggered” by their actions.⁷

Clients experience frustration in the variability in the information that is provided (“too many redactions” was a common theme from stakeholders). Better supports and explanations for clients around the nature of the information that might be available, and feedback around the reasons why information can’t be provided is important. Clients feel marginalised if they think it is just a rapacious, mean-spirited or vindictive worker (in BDM, or for that matter in a state department) exercising their power. Understanding of the laws (vetos), but also the principles of how they are applied would be helpful. Even to be told “yes, that information exists, but I am not able to pass it on to you, because …” is better than not knowing.

For example, one peer-support coordinator explained:

Every year I send a letter requesting information—for 40 years. And every year I get a different result. I was told my sister had died—then I found out she’s alive, and we used to play together at the same squash club.

Although the ideal would be alignment of laws, most stakeholders were pragmatic, and felt a more realistic option was for a centralised or coordinated process (one central application form for all state/territories, or a centralised service that coordinated multiple applications on behalf of clients or other agencies⁸), free or reduced cost, and standards for BDM information services to ensure uniformity and high quality, trauma-sensitive service delivery.

Evidence from the AIFS National Study (Kenny et al., 2012) revealed that some adopted persons first become aware of their adoption when naively seeking their birth certificates from BDMs. Stakeholders at the consultations gave similar reports of the experience of late-discovery adopted persons. BDM offices in each state hold sensitive adoption information but stakeholders fairly consistently felt that staff currently lacked the skills and training around trauma, grief and loss to deliver the information appropriately. This lack of sensitivity when delivering information can be re-traumatising for clients. Participants reported that the way information is given varied widely depending on the staff member and their knowledge of the impacts of forced adoption.

Service needs identified by stakeholders included:

trauma-sensitive and general adoption awareness training for BDM staff; and

specialist adoption staff member(s) who handle adoption requests at each jurisdiction’s BDM registry.

68Training

Training was one of the most significant needs, and where many stakeholders felt resources could be usefully spent. Critical training needs were identified for increasing sensitivity to the issues associated with forced adoption and removal policies and practices, and knowing how to create an environment that empowers clients to tell their story. Better understanding of trauma, grief and loss, and attachment disruption specifically in relation to forced adoptions, as well as more general training in treatment of mental health disorders, were consistent themes throughout the workshops and consultations. Another important training need is in relation to transference and counter-transference for those therapists who have a personal adoption experience.

In terms of how to improve the counselling services currently available, one stakeholder said:

The blocks are individuals having to train their healthcare providers in adoption issues.

There are opportunities for sharing professional development resources and conducting training in common with other service sectors, such as with:

other post-adoption and peer-support services nationally (ideally, coordinated through the National meeting);

workers from Forgotten Australians and Stolen Generations services—given that many of the issues have similarities, in terms of identity, past trauma, grief and loss, attachment, and the sensitivities of search and contact—particularly where a veto has been placed on release of information;

other community health workers, especially those in regional areas;

current adoption (“relinquishment”) workers and permanent care workers; and

the broader human services workforce:

People need the opportunity to discuss and sharpen their thinking. I wonder if some of our drug and alcohol or gamblers help workers see the connection. Even individuals don’t see the connection. They may be a drug addict, but not realise that it’s related to their adoption history.

69Evidence-based psychological and psychiatric interventions

Surprisingly, there was not a strong focus among stakeholders about the need to identify and promulgate evidence-based interventions. Partly, this could be due to the lack of empirical research to show what works with these specific client groups. It could also reflect the fact that evidence-based interventions are usually categorised in terms of the presenting diagnostic category (i.e., depression, anxiety, PTSD, etc.⁹), not the historical circumstances that has given rise to the mental health diagnosis.

70Standards

Stakeholders recognised that a significant opportunity existed to improve consistency both within and across organisations. One solution suggested was to develop and promote good practice principles, as well as more explicit “standards” for post-adoption services, including search and contact services. This would need to be supported by resources for evaluation, as well as resources to assist with identifying and demonstrating service delivery outcomes. The value of clinical supervision and “secondary consultation” was also emphasised.