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

Current service system

Consideration of any changes to the current service system for meeting the needs of those affected by forced adoption and removal policies and practices need to take into account the current adoption and out-of-home care systems in Australia. Evidence-based decision-making is of paramount importance.

Stakeholders felt that there is currently a strong pro-adoption lobby, with the focus often about “ownership” of the child, not what is in the child’s best interest. Some of the specific concerns raised by stakeholders included:

the lack of consideration of the available evidence relating to the longer term impacts of adoption in the current adoptions environment;

legislative changes to overseas and local adoptions prior to the implementation of the recommendations of the Senate Inquiry;

attempts to increase the number of babies “available for adoption” in some jurisdictions;

the assumption that “open” adoptions solves all the problems for adoptees;

the difficulties in maintaining or enforcing contact with birth families, and the reality that contact diminishes extensively over time; and

the lack of need for adoption where permanent care orders can provide the stability that children/young people need.

Service delivery models that can respond to the diverse needs of people affected by forced adoptions need to include a range of services that:

are attuned to the complex symptoms, needs and responses of all those directly affected;

can provide services across a range of health domains—including mental and physical health, and relationship, social and economic wellbeing;

can provide intensive and ongoing psychological and psychiatric counselling; and

can provide flexible and individually focused care.

Support services need to be trauma-informed, aware of grief and loss, and attuned to attachment disruption so that they can:

complete a thorough assessment and screening process of each client to establish an appropriate treatment plan, which will depend on the individual needs and circumstances of each person;

be aware of and refer clients to trauma-specific services—for example, trauma-focused psychotherapy interventions;

provide a service that is understanding and non-judgemental of the needs and necessary coping behaviours that were required of the trauma survivor to function in everyday life; and

reduce the risk of re-traumatisation among clients.

Options

From the findings of a review of the published literature, an environmental scan of service systems and conceptual models for service improvements in related areas, and findings from the stakeholder workshops and individual consultations, we have developed some detailed lists of options for consideration. The options prioritise coordination and connectivity of existing services and capacity building, rather than creating new services. This will increase the likelihood of sustainability into the future and lay a solid foundation for improved referral pathways.

4A. Enhancing mainstream services

Within mainstream health/mental health and social services, the following have been identified by stakeholders as groups of professionals that should be the target of service enhancements:

medical general practitioners (GPs);

psychiatrists;

psychologists in agencies or private practice (including ATAPS providers);

counsellors and other psychotherapists;

mental health nurses;

clinical social workers;

child/family welfare workers in services funded by the Department of Social Services’ Family Support Program and other Australian Government agencies—including psychologists, social workers, family therapists, counsellors, and other welfare workers;

social support and human services funded by the state and territory governments; and

aged care professionals and service provider organisations (as many mothers and fathers are now reaching their 70s and 80s).

5B. Expand, enhance and build capacity in existing post-adoption support services

Within existing post-adoption specific support services, the following have been identified by stakeholders as agencies or service types that should be the target of service enhancements:

state/territory-funded Adoption Information Services;

peer-support groups;

agencies providing supports for people searching for or making contact with family (including formal intermediary services); and

the government agencies with whom these other services intersect (e.g., Births Deaths and Marriages registries (BDM), Australian Electoral Commission, state child protection departments, Australian Government Department of Human Services (DHS) and Department of Health).

6C. Developing new—and improving existing—resources for professional development and training

For all service providers and agencies covered under A and B options above (i.e., mainstream health/mental health and social services, as well as existing post-adoption specific support services), the following resources, training materials and opportunities for professional development were suggested:

specific training of post-adoption workers, and general awareness and sensitivity training for broader service providers;

resources for agencies such as developing Good Practice Guidelines, evaluation resources, etc.;

regular conferences for post-adoption practitioners, which are also open to mainstream practitioners who find themselves working with people affected by forced adoptions;

empathy/sensitivity awareness training for officers in information agencies—particularly BDM; and

brokerage funding, or grants scheme to enhance capacity of existing agencies and support groups.

7D. Increasing accessibility and coordination through development of a national web portal

Options canvassed in workshops and consultations included community-based service hubs, one-stop-shops, case management, and a national website. The literature recommends case management for clients who are experiencing severe symptoms, particularly when their symptoms inhibit them from functioning in everyday life or attending scheduled appointments. For these clients, case management helps to aid the effective organisation and delivery of services. Service hubs or one-stop-shops are an option for addressing the fragmentation problems of the current service system; however, due to costing constraints, they would be difficult to implement. An alternative option may be the “gateway” approach, where specific centres are established to act as “gateways” to appropriate services, providing information, advice and referrals. This option facilitates access to the services and information that clients need from a central service centre.

The most consistently supported option was a national web portal, which would:

provide integration, enhance referral pathways and reduce duplication in service;

promote evidence-based practice through development and dissemination of resources;

be a “virtual” one-stop-shop; and

centralise resources, databases and points of contact.

For such a web portal to be effective (both in terms of developing content, having it “acceptable” to stakeholders, and keeping it maintained), it needs to be housed in a suitable environment and appropriately resourced. Functions such as increasing accessibility and translating research into meaningful information to meet the needs of practitioners are known as “knowledge translation and exchange” (see Section 9.1).

8E. Community awareness and action

One of the major findings of the AIFS National Study, the Senate Inquiry and the current Scoping Study in relation to the current service and support needs of those affected by forced adoption, was the certainty that this would never happen again—a guarantee provided in the National Apology for Forced Adoptions. However, the current national discussion regarding the streamlining of processes for inter-country adoptions, and state-based legislative changes to increase the number of children from the out-of-home care (OOHC) system who are “available for adoption” has featured prominently throughout this study and directly relates to the consideration of how to most effectively meet the support needs of those affected by forced adoption.

There are inherent contradictions in what has been committed to as part of the government’s response to the findings of the Senate Inquiry (including increasing community awareness of forced adoption and removal policies and practices) and current inter-country adoption policies and practices. Further, any such progress in this matter is occurring before the recommendations of the Senate Inquiry have been fully implemented.

Specific considerations for the current government that stakeholders in the Scoping Study identified include:

Increasing community and professional awareness of the transferability of practices of the past and their potential long-term impacts to the current adoptions (local and inter-country) arena in Australia, and that this awareness is transferred into action legislatively.

Ensuring that any legislative changes are informed by evidence, not the motivations of parties with vested interests (e.g., new adoption programs—including privatisation of adoptions).

Reviewing the appropriateness of allocating funding for provision of services to those affected by forced adoptions to organisations who are also involved in current adoptions.

The act of adoption is permanent and lifelong, and the implications of altering the identity of a child through modified birth certificates perpetuates the falseness of a child’s biological and social history.

9Strategies for implementation

Across these five broad areas for enhancing and expanding services, there is a range of different strategies for how to implement these. In the table below, we outline six strategic options that draw together suggestions raised by stakeholders during consultations.

Strategic options for enhancing and expanding services

Strategy	Similar area of service delivery	Domain of influence
1. Local post-adoption networks	Family Law Pathways Network	Enhance quality, coordination, flexibility, and diversity of post-adoption support services
2. Grants to expand existing services focused on outreach; training; and increasing capacity to meet demand	Funding for Family Law Pathways Network to provide training, networking events	Enhance existing services Expand services
3. National web portal	For individuals: Forgotten Australians, Stolen Generations For professionals: Family law, child protection, sexual assault, family violence, family relationships, ACPMH, etc.	Accessibility and coordination Training Resources
4. Knowledge translation and exchange (KTE)	Many areas of child/family welfare work rely on the work of KTE agencies to improve access to research and resources in order to facilitate evidence-informed quality service delivery	Information sharing; resources; coordination for adoption-specific services Access and quality of mainstream services
5. New national services, such as: Contact database DNA testing & matching International searching	Find & Connect Link Up	Expand services
6. Expand membership, and formalise role of the National Committee of Post-Adoption Service Providers or establish other coordinating body	Most service delivery areas have a strong, national body or committee that provide a coordinated voice and liaison point, set standards, etc. (e.g., NASASV, WESNET)	Training, standards, coordination