Historic forced adoption - scoping study: final report

8. Conclusions and areas for consideration

In this study, mothers, wider family members, adoptees and other stakeholders shared detailed accounts of their historic forced adoption experience. These provided detailed insight into the lifelong impact of the practice on people affected and their support needs. Many said they welcomed the opportunity to talk about their experiences.

When considering the next steps, we suggest the Scottish Government continues engaging with people with lived experience of historic forced adoption to benefit from their insight and ensure that support services meet their needs. Models such as the Scottish Government’s National Suicide Prevention Leadership Group Lived Experience Panel could be considered. This oversees the implementation of the Suicide Prevention Action Plan and includes people with lived experience of bereavement by suicide.

Research participants identified several support needs for the Scottish Government to address. We have summarised these below along with areas for the Scottish Government to consider when planning support for people affected by historic forced adoption. These are categorised into top, high, medium and lower priority.

The levels of prioritisation reflect the research team’s judgement based on our interpretation of research participants’ feedback from research participants. Considerations classed as ‘lower priority’ are still important points, but our interpretation is that these should be lower priorities based on the urgency with which action is required and the strength or volume of feedback from interviewees.

However, we recognise that individual participants or groups may disagree with this prioritisation. Consequently, we suggest it is critical to engage with people who have lived experience of historic forced adoption to agree next steps and priority action points.

As noted earlier in this report, some of these findings are likely to be relevant to people affected by adoption regardless of whether it was forced. This is in contrast to some of the literature, which states that people affected by historic forced adoption are likely to have unique needs^[13]. However, as our study focused on historic forced adoption, and is not intended as a review of the policy or practice of adoption in general, either now or historically, we cannot comment on the experience of those involved in consensual adoptions or compare their needs with those people affected by historic forced adoption.

Search and reunion

Searching for and reuniting with family members they have been separated from by adoption is an important process for people affected by historic forced adoption. This is an emotional process, and can be distressing, but it can also provide peace of mind for mothers that their child is healthy and happy, and a sense of identity for adoptees.

Research participants were clear that support is required throughout the search and reunion process. This includes preparatory work to help individuals manage their expectations, support to find and access relevant records, help from intermediaries to facilitate and advise on first contact and reunions, and on-going support after contact has been made and reunions taken place.

Search and reunion: areas for consideration

Top priority

1. People affected by historic forced adoption and stakeholders called for emotional and psychological support to be available for people throughout the search and reunion process. This is particularly important when people receive upsetting news, for example, if the other person does not want to meet or has died, or if an adoptee discovers that their adoption was forced.

Medium priority

2. Support is available throughout the search and reunion process, but some research participants needed guidance about searching for their family members. This indicates it is important there is clear and easily accessible information about how to search for family members and about the organisations that can provide support.

3. Some people need financial support with search and reunion activities. For example, there may be charges to access certain records, or expenses to attend reunions, particularly if travelling a significant distance. We suggest the Scottish Government considers whether and how to provide funding to support these costs.

Lower priority

4. Some research participants described the difficulties of searching for family members using commercial websites or social media without support. This shows that ensuring that people in this situation receive information about organisations in Scotland that can support them is important.

Access to records

Access to records is a key part of the search and reunion process, but another reason for accessing records is to help people affected by historic forced adoption to recall or understand what happened at the time of the adoption.

Access to records: areas for consideration

High priority

5. People often require emotional support, especially if records contain surprising or upsetting news or derogatory references to themselves. The findings indicate that providing guidelines for organisations to ensure emotional support is available for people accessing records could help with this.

6. Support to understand records, particularly if they contain professional jargon or outdated terminology, may be required. Approaches to supporting people when they access records varies between organisations, but we suggest the Scottish Government could consider providing guidelines for organisations which hold records to encourage them, if they do not already do so, to help individuals understand the information.

Lower priority

7. Access to medical records is a particular concern for adoptees, who called for support with this issue. Without this, adoptees do not know about their family medical history and risk of hereditary or genetic conditions. There are significant data protection barriers, but we suggest the Scottish Government considers any steps that could be taken to make it easier for adoptees to access information about their family’s health background.

Emotional and psychological support

Research participants described the significant emotional and psychological impact of historic forced adoption. Some reported mental health conditions that they attribute to their experience. Emotional and psychological support is required to help people deal with the impact of the adoption, and throughout any attempts they make to access their records or search for their family members.

Emotional and psychological support: Areas for consideration

Top priority

8. People affected by historic forced adoption and stakeholders called for adequate therapies and treatments to be available for individuals with experience of historic forced adoption. Some suggested a tiered approach may be needed. Some people may require a safe, independent space to share their experience, while others may need more in-depth psychotherapy, psychologist or psychiatrist treatment to address mental health conditions. People may need different services at different times of their lives.

9. Stakeholders and people with experience of historic forced adoption criticised public services, especially mental health support, for professionals’ lack of awareness of the impact of historic forced adoption and the needs of people affected by the practice. While some professionals are aware and understanding, there was broad consensus among research participants that professionals need to be more aware of the impact of historic forced adoption, so they can support and signpost people more effectively. We suggest the Scottish Government considers:

• Introducing a programme to raise awareness among key professionals, including GPs, mental health professionals and social workers, of the impact of historic forced adoption and the needs of people affected by it. Barnardo’s and Birthlink carry out awareness-raising work with local authorities, and their experience could help develop a suitable programme.
• Engaging with professional bodies and educational providers responsible for training, education, continuing professional development (CPD) and standards in key professions. The engagement could focus on the inclusion of topics around historic forced adoption and its impact in professional training.

10. This research has identified the crucial role of peer support for many people affected by historic forced adoption. Informal networks are valuable for adoptees and mothers, and the Scottish Government has commissioned Health in Mind to deliver a more formal service. We suggest monitoring this service’s impact carefully to ensure it provides effective support and the Scottish Government identifies lessons learned from delivery.

11. Participants highlighted that historic forced adoption can have an emotional and psychological impact on wider families, including fathers, siblings and extended family, as well as the adoptee and the mother. The consensus was that support must continue to be open to all family members.

Medium priority

12. Some people affected by historic forced adoption described the cost of private talking and creative therapies as prohibitive. Based on this, we suggest the Scottish Government could consider how far these services could be integrated into the NHS or if funding could be provided directly to individuals to spend on therapies that they would find helpful.

Lower priority

13. A few research participants described the importance of creative and alternative therapies such as art, music, drama, music and hypnotherapy. Participants reported these are not available on the NHS currently, but we suggest that the Scottish Government considers how these could be made more widely available.

Other support needs

Some participants suggested other support needs and actions. These include:

• A memorial to the experiences of those affected by historic forced adoption and a commitment to ensure such cases never happen again.
• Education for people affected by historic forced adoption to help them understand and deal with the trauma it has caused.
• Introducing a ‘tick box’ in public services’ systems and paperwork so professionals know when an individual may be affected by adoption-related trauma.

14. Area for consideration (lower priority): We suggest that the Scottish Government considers the suggestions listed above.

Other recurring barriers and challenges

Participants reported challenges in accessing and delivering support for people affected by historic forced adoption. These include the following.

Inconsistencies in the services available across different organisations and different workers

Service availability varies across different organisations, but we found no clear evidence of any particular geographical locations where services were notably lacking or abundant, compared to other areas. Sometimes the services offered can vary depending on the awareness and skills of the individual worker involved or fluctuations in the organisation’s capacity.

15. Area for consideration (high priority): Based on our findings, we suggest the Scottish Government prepares clear guidelines for organisations about the types of services that should be offered to people affected by historic forced adoption to ensure a consistent and standard approach. Local authorities have a statutory obligation to provide post-adoption support, but the findings indicate that requirements around historical cases need to be clarified.

Challenges around service capacity and funding

16. Area for consideration (high priority): Support organisations reported concerns around capacity, so we suggest the Scottish Government considers providing enhanced funding to services to help them build capacity and support people affected in greater numbers.

Reservations around adoption agencies’ role

Some research participants expressed reluctance to access support via adoption agencies because of those agencies’ involvement in historic forced adoption cases. Some others, however, praised these agencies for their support and expertise.

17. Area for consideration (high priority): We suggest the Scottish Government could consider holding discussions with key campaign groups such as MAA Scotland and SAAM along with the adoption agencies to discuss what, if anything, could be done to make people more willing to access support from these organisations given their extensive expertise in adoption and its impact. If these discussions are unsuccessful, the Scottish Government must ensure that support is available from agencies not linked to historic forced adoption so that people with these reservations can access assistance.

Lack of awareness of support services

18. Area for consideration (medium priority): We suggest the Scottish Government works with support organisations to raise awareness of their services, possibly through adverts and flyers in settings such as GP surgeries.

Feeling they have no right to support

Some participants felt they were not entitled to access support. This view was often held by mothers due to the paperwork they were given at the time of the adoption and, in some cases, threats of criminal action if they ever attempted to contact their child.

19. Area for consideration (medium priority): We suggest that any publicity materials or public awareness campaign must emphasise that anyone affected by historic forced adoption is entitled to support.

Lack of services for adult adoptees

Some adoptees reported that support is available for adopted children, but there is less assistance for adoptees who are now adults.

20. Area for consideration (high priority): We recommend that services ensure there is support for adoptees who are now adults, where this does not already exist, and the Scottish Government provides funding where possible, and required, to support this.

Meeting mothers’ and adoptees’ needs

Mothers and adoptees have different experiences of historic forced adoption, but the impacts for both groups is significant. Mothers can recall the trauma of their baby being taken away. Adoptees may not remember the experience, but some research participants reported that the impact of being removed from their mother has a life long resonance.

Both mothers and adoptees reported needing assistance with searching for, contacting and reuniting with family members they have been separated from by adoption, help with accessing records, and support with the emotional and psychological impact of historic forced adoption.

There were, however, a few areas of difference:

• Adoptees reported issues around accessing parents’ medical records.
• A feeling of not being entitled to support was more common among mothers than adoptees due to the paperwork they had to sign when the adoption occurred.
• Mothers can have more difficulty accessing records and searching for their child than adoptees because adoptees have access to their original birth certificate, which contains their mother’s name and address at the time of the birth.

Some interviewees felt that one group received more support than the other, and in some cases identified specific services they felt were focused more on one group than the other. However, there was no clear consensus – a few felt that mothers were ‘better off’ for support, while a few said the opposite.

Stakeholders expressed commitment to supporting both groups, and it is clear from this research that both groups need support. They have similar support requirements and need to feel equally entitled to support.

Further reading

This report has focused on the support needs among and improvements advocated by people affected by historic forced adoption who took part in our study. These align with many recommendations made by campaign groups such as MAA Scotland and SAAM, but these groups have also urged further action, as laid out in documents available on their websites^[14].

Final thoughts

Overall, this research has found that support is available for people affected by historic forced adoption. However, provision is inconsistent and sometimes lacking in capacity. Challenges like these must be addressed to ensure that people affected by historic forced adoption can access the support they need to deal with the significant and lifelong impact of the practice on them and their families.