Historic forced adoption - scoping study: final report

Appendix 3: Literature review

This literature review contains two sections. We begin with a context review exploring historic forced adoption including contexts, processes, influences, and practices. Section two presents a needs review outlining the support needs of those affected, recommendations for meeting them, and examples of good practice. These will be referred to further in a separate service delivery paper.

Given the wealth of information available, and finite study resources, this review is not exhaustive. Relevant information has been gathered from research publications, government documents, and campaign bodies.

It is beyond the scope of this review to consider the experiences and needs of adoptive parents and we acknowledge that they may have different views and experiences^[15] which have not been explored here.

Section 1: Historic forced adoption: Contexts, processes, influences, and experiences

Policy contexts and prevalence

As outlined earlier in this report, we define historic forced adoption as practices across the UK, Ireland, Canada and Australia in the 1950s-1970s, “which resulted in newborn babies being unnecessarily taken away from unmarried mothers and placed for adoption, without regard for the mothers' and children's needs or wishes”^[16].

Although occurring informally prior to this^[17],[18], in Scotland, adoption was not legally formalised until the 1930 Adoption of Children (Scotland) Act^[19]. From this time until shortly after the 1968 Social Work (Scotland) Act, most adoptions were legally uncontested and took the form of babies being placed with childless couples^[20]. Their mothers were often young and unmarried^[21]; this differs from today, when most adoptions occur following children being taken into care^[22].

Evidence from across the UK suggests that the adoptions of children of unmarried mothers during much of the 20^th century were ‘closed’. This means children were given new names, identities, and birth certificates, were not informed they were an adoptee, and had no ongoing contact with their families^[23].

According to National Records of Scotland statistics, from 1930 (when official figures began to be kept) until 1979 there were approximately 73,000 adoptions recorded in the Adopted Children Register in Scotland^[24]. There is no data available for this period as to how many of these adoptions occurred without the mothers’ informed consent. Therefore, in the absence of this data, it is not possible to establish an exact figure for the number of forced adoptions during this time.

Societal norms and values

Forced adoption practices existed across several Western nations, including Scotland and other nations in the UK, the Republic of Ireland, Canada, Australia, and the Netherlands^[25]. Although realised differently in each country, the intertwined activities of church, state, and civil society often promoted these practices^[26]. The literature suggests that across these countries during the 20^th century, unmarried mothers were viewed as a social ‘problem’. They were believed to have transgressed morally and spiritually^[27] and their pregnancies outside of marriage were seen as ‘illegitimate’. Such pregnancies were felt to threaten ‘normal’ family life - a post-World War 2 social reconstruction priority^[28].

By the 1950s, psychological language had replaced this moral focus. For example, the literature explains that moral explanations for mothers’ perceived ‘transgressions’ reduced and were replaced by those focusing on their character and family backgrounds^[29]. In Britain, the idea that mothers had transgressed, “was imposed from above by elites and authority figures through discourse and policies, but also realised from below in communities through social stigma and the marginalisation of unmarried mothers”^[30].There were class and gendered elements at play^[31]. Women, in particular, had to conform to traditional gender roles and exercise sexual restraint^[32]. Religious and class factors meant some families were against inter-class or faith couples keeping the baby together^[33].

Women were often sent away to conceal the pregnancy and prevent shaming the family^[34]. “The social and moral stigma... combined with multiple other factors… fuelled a dominant… attitude… that placing the babies of unmarried mothers for adoption… was in the best interests of society, parents, and children^[35].”

Economic inequalities

In the UK, limited social or financial support and lack of access to housing or employment posed additional barriers to unmarried mothers raising their children^[36]. “Raising a child as an unmarried mother without support was nearly impossible at this time”^[37].

During and after World War 2, many mothers who had moved away from family to find better paid work struggled to find childcare^[38]. Domestic service - which many relied on to earn while raising their child - was declining in Scotland; at the same time married couples were being favoured for council housing^[39]. Although unmarried mothers had increased access to healthcare, this was not matched in terms of welfare support^[40].

There were differences between rural and urban parts of Scotland. “In some Scottish communities… children were absorbed into their immediate and extended family and the community without prejudice. This was more common in certain rural areas… Elsewhere in Scotland, illegitimacy was socially unacceptable because it broke historic and religious codes of moral behaviour”^[41]. These differences have been linked, in part, to local economic differences throughout Scotland, for example, grandparents providing childcare so that mothers could continue agricultural work.

By the 1970s, the number of adoptions of babies of unmarried mothers in Scotland had fallen^[42]. This was likely due to increased availability of welfare support and social housing, the legalisation of some abortions, and the introduction of the contraceptive pill^[43]. There was also greater acceptance of cohabiting couples having babies^[44]. However, it is important to note this was not universal with historic forced adoption practices continuing into the 1980s.

Adoption processes

In 2022, the UK Parliament Joint Committee on Human Rights (JCHR) published a report^[45] of their inquiry into the experiences of unmarried women and their children who were adopted in the 1950s, 60s and 70s. Although not the main focus, due to separate legislation and practices in these countries, submissions from women in Scotland and Northern Ireland were considered.

This inquiry found that mothers were disempowered within the adoption and consent process^[46]. Despite their right to ‘reclaim’ their child for three months post adoption, in reality, it could be extremely difficult to stop the process once it had started; mental health difficulties, trauma, shame, stigma, guilt, lack of information about their rights, and coercive practices - such as mothers being threatened with arrest or having future children taken away - prevented them exploring alternative options^[47].

Many mothers from across the UK who gave evidence to the inquiry felt they would have been able to keep their child with support and advice. However, they were not informed of any available support options, were led to think that adoption was the only possibility or felt coerced into this. There were reports of mothers being marginalised during discussions with professionals such as NHS staff, adoption agency social workers, and church personnel. For some, the presence of their mother during appointments was a barrier to them sharing their wish to keep their baby or asking questions.

These findings are echoed in a Scottish study^[48], which highlighted that despite the legal clarity that existed in the 1950s and 60s, with mothers seemingly having consented to contact with agencies and to ‘relinquishing’ their child, the system was open to substantial abuse.

Becker and colleagues (2021), citing a BBC report, state that many women in the UK faced sustained pressure to place their children for adoption from professionals such as social workers, doctors, midwives, Mother and Baby Home staff, and adoption staff in religious and council-run homes^[49].

The removal of children from unmarried mothers was a “structured approach embedded in central elite decision making, local organisation and the individual action of officials across a welfare state which encompassed both legislated statutory intervention by services and enabled voluntary action by private and charitable organisations”^[50].

Marshall and McDonald (2010) explain that not all mothers felt coerced, with some experiencing sadness and regret but still believing adoption was right and others being content with their decision^[51]. However, an Australian systematic study suggests very few mothers felt they had any choice in the adoption; many felt systematically recruited as ‘undeserving mothers’ to meet the needs of ‘deserving’ married couples^[52].

Echoing reports about historic forced adoption practices in other countries^[53], fathers in Scotland similarly had limited legal rights, were side-lined within adoption proceedings^[54] and tended not to be consulted or considered by the courts as potential carers for the baby^[55].

The JCHR Inquiry^[56] gives examples of a father’s name being unwillingly omitted from the birth certificate and of them being threatened with arrest if they tried to support the mother. Fathers have also described feeling helpless when they were not permitted to visit Mother and Baby Homes^[57].

Family pressure

Lack of support from families may have been an influencing factor in adoption decisions^[58]. For instance, many families sent women to Mother and Baby homes, where they were denied access to their relatives; some report being shunned by their families, sometimes longer term^[59]. Family pressure may also have made it more difficult for Mother and Baby Homes to support mothers and babies to stay together post-birth^[60].

One of the few studies from the time to have explored mothers’ experiences in Scotland^[61] found the likelihood of adoption to be linked to three factors: 1) the mother already having other children, 2) the mother’s parents being unsupportive, and 3) the father being a married man. Many women who submitted evidence to the JCHR Inquiry^[62] explained that their families were involved in the adoption, and that they were excluded from discussions about possible options. Most, but not all, described their parents responding with distress, anger, or shame.

In Scottish central belt industrial and mining communities in particular, “illegitimacy was socially unacceptable because it broke historic and religious codes of moral behaviour. Here, the mothers of illegitimate children were more likely to have been abandoned by their families, and she was left to try and support herself and her child”^[63].

However, evidence submitted by Scottish mothers to the JCHR Inquiry emphasises that: “whether women stayed with their families or resided elsewhere, the vast majority of deliveries took place in NHS hospitals, and local authority social workers facilitated the removal of babies and handled legalities. Many practices within institutions… ensure[d] that mothers felt compelled to have their sons and daughters adopted. These abusive practices continued to operate even in the absence of family pressure or perceived risk to the baby”^[64].

Cruel, punitive, and coercive treatment by professionals

“There is evidence that some professionals at that time considered punishment as part of their adoption practice”^[65].

Mothers who submitted evidence to the UK JCHR Inquiry^[66] commonly described a sense of being punished by staff at Mother and Baby Homes run by the State, religious organisations, and charities. Many gave examples of being made to clean and scrub while heavily pregnant. There was little evidence that they were supported to prepare for birth, and many were afraid.

Greenlees’ (2015) study into Mother and Baby Homes in Scotland suggests a complex picture^[67]. She describes these as providing food, healthcare, and accommodation for pregnant mothers who lacked family support. A mainly non-punitive regime was supported by most providers, some of whom offered longer stays post-birth if needed. However, while some remembered their time fondly, others found the conditions punitive. And although the homes appeared to try keep mothers and babies together, some women still experienced pressure to adopt from the staff, adoption agencies or social services.

For those women who gave birth in hospital, cruel, degrading, bullying, and neglectful treatment was again reported^[68]. Some women were told they deserved labour pain, were ignored by midwives, or received no ante-natal or follow-up medical care^[69]. Testimony from Scottish mothers indicates that some were denied pain relief, left isolated during labour, or given drugs unnecessarily^[70].

Mothers’ contact with their babies was limited post-birth, and some were stopped from seeing, holding, or breastfeeding their babies^[71]. Testimony from mothers in Scotland^[72] describes social workers removing babies without prior notice when, before attending hospital, they had expected to bring up their child^[73].

Critchley and colleagues (2018), reflecting on evidence of cruel and punitive treatment of mothers by Scottish adoption agencies, state that “the legacy of cruelty and lasting shame and grief that some women experienced in the 1950s and 60s on future social work practice in adoption is difficult to estimate”^[74].

Shame, secrecy, and silence

The pervasiveness of silence and shame is a common theme across international research into historic forced adoption^[75]. In the UK, evidence from the JCHR Inquiry^[76] shows that many pregnancies were cloaked in shame and secrecy. There were examples of mothers and families hiding the pregnancy from neighbours. Some women thought that adoption was best because they were shamed into believing they were a ‘bad person’.

There were also reports of mothers keeping their experiences secret for decades and enduring stigma and shame. The Inquiry emphasised “the double-dose of shaming that the mothers suffered: first, the stigma of having been pregnant out of wedlock, and second the stigma of having ‘given away’ their baby”^[77].

Section 2: Support needs review

This section presents a needs review outlining the support needs of those affected and recommendations for meeting them. We cover therapeutic support, support to grieve, trauma support, peer support groups, information and records, reunion and acknowledgement, redress, and learning from the past.

Evidence detailing the support needs of people affected by historic forced adoption is limited^[78]. Adoption UK has also found inadequate service provision for adults affected by adoption in Scotland^[79] - despite the life-long nature of adoption^{[80],[81],[82],[83]}. PAC-UK has found evidence of the ongoing impact of adoption on adult adoptees. For example, 77% of survey respondents reported accessing mental health support as an adult^[84].

Recently, there have been attempts to understand such needs better. For instance: the Adoption Research initiative (Ari) explored UK first families’ experiences of support services^[85]; the Scottish Government’s ‘Supporting Roots’ project examined the needs of parents separated from their child by care proceedings^[86]; and Adoption UK’s Adoption Barometer - a UK survey of the lived experience of adoption - has outlined the needs of adopted people, including those adopted in past decades.

However, none of these studies have focused explicitly on those with experiences of historic forced adoption^[87]. As Higgins and colleagues (2014)^[88] explain, the experiences, impacts, and therapeutic needs of this group are unique.

Again, much of the evidence is international. Becker and colleagues (2021)^[89] summarise global reports and inquiries to identify common recommendations for support, including:

· Acknowledging past adoption practices and their impacts and providing an apology.

· Counselling or mental health services to support with the impacts of adoption and search and reunion processes.

· Search and contact supports, including financial assistance, and - as Kenny and colleagues (2012)^[90] suggest - possibly taking the form of a national, centralised system.

· Improved access to records and information such as medical records and birth certificates.

· Awareness raising among the public and health professionals about people’s experiences, their impacts and support needs^[91].

The Australian National Research Study on the Service Response to Past Adoption Practices^[92] sought the views of more than 1500 individuals including adopted persons, parents, wider family, adoptive parents, and service providers^[93]. It recommended: training the workforce such as mental health and welfare professionals; creation or development of post-adoption support services; and incorporating lessons learned within current child welfare practices^[94].

In the UK, JCHR recommendations echoed many of those outlined above and included: improved access to therapeutic support; more straightforward and timely access to paper records, with greater consistency across local authority areas; increased availability of information including transparency on birth certificates; establishing a system to allow parents to pass on medical information; improved intermediary services to support with tracing and contact; visa rules to enable easier travel overseas for reunions; and notifying mothers when their child has died^[95].

Some of the recommendations from the Scottish Government’s ‘Supporting Roots’ project^[96] mentioned above may also be pertinent to those affected by historic forced adoption, including that services attend to the needs of fathers and the gendered elements of societal expectations of parents^[97].

Some of these identified support needs are discussed below in more detail.

Therapeutic support

Higgins and colleagues (2014)^[98] discuss the different types of therapeutic support called for by participants in the Australian National Research Study^[99]. Mothers, for instance, wanted access to specialist physical and mental health supports to cope with trauma and other lasting impacts. Ongoing specialist counselling in identity, attachment, and abandonment was requested by adoptees and in trauma, grief, attachment, and guilt by mothers. Fathers, mothers and adopted persons felt supportive counselling while making contact and trying to build relationships with family members would also be helpful. Wider family members said they would benefit from support to assist them with traumatised family members.

However, specific interventions are lacking to support parents whose children are adopted^[100]. Many struggle to find counsellors who understand the nature of their losses or mental health professionals adequately trained in the issues^[101],[102]. “Unless professionals have a deep understanding of the long-term impact of adoption separation, they may not recognise the consequences of shame in the lives of clients”^[103].

Adult adoptees in the UK have also reported low confidence in the accessibility and appropriateness of therapeutic support; they do not feel statutory services understand their needs well^[104]. Baden (2016) emphasises the importance of therapists understanding the impact of adoption^[105], while McSherry and McAnee (2022) call for mental health support for adopted people^[106].

Many have accessed therapy privately, but costs are a barrier to this for others^[107]. SAAM recommends establishing government funding of free-to-access adoption- and trauma-aware counselling and therapy^[108].

Offering choice and a range of support options has been identified as key^[109]. As well as traditional talking therapies, alternative mental health supports, such as art therapies, body-focused therapies, and communal events and retreats, have been advocated for^[110]. Higgins and colleagues (2014)^[111] call for an integrated approach to meeting the, sometimes multiple, needs of those affected by historic forced adoption - such as mental health, substance use, attachment and parenting, and trauma support.

It has been suggested that ongoing support should also be available on a flexible basis - to acknowledge the enduring impacts of historic forced adoption and ensure responsivity to people’s changing needs^[112]. For instance, people’s need for support may increase due to life events such as birthdays, births, and deaths^[113].

Finally, MAA Scotland has urged caution around who delivers therapeutic support: “There is a massive power imbalance between those who are trained/experienced in facilitating family separation (i.e. social workers) and those who have been victims of it… specialist counselling, and psychological services must be delivered by mental health professionals who have no connection with past and forced adoption practices”^[114].

Support to grieve

Robinson (2001)^[115] highlights a need for counselling and support groups which recognise the disenfranchised grief of mothers and adopted people alike: “the grief experienced... (should) be seen… as a healthy response... in the same way that grieving a bereavement is seen as a positive, productive response and one to be encouraged and supported rather than suppressed”.

However, Robinson (2001)^[116] sees ‘grief resolution’ as an unhelpful aim as it insinuates that those who do not achieve this have somehow failed; she argues instead that people be supported to manage their grief and assimilate this into their lives. She describes using a Post Adoption Grief counselling model while working in South Australia. Founded on a narrative approach, this works to empower mothers, support their sense of self and lessen feelings of guilt and shame, before assisting them to prepare for search and reunion.

Fathers similarly need support that understand their ongoing grief and emotional connection to their child^[117].

Trauma support

Despite the diversity of needs and symptoms among people affected by historic forced adoption, there is a growing recognition that trauma-focused support is essential^[118]. Higgins and colleagues (2014)^[119] call for both trauma-informed support and trauma-specific services to be offered.

Rather than just being delivered by traditional therapeutic support providers, this should be offered by a wider range of stakeholders, including substance use services, mental health services, prisons, community health care, older adult services, and care homes^[120].

Higgins and colleagues (2014)^[121] discuss that services must understand trauma, grief and loss, and attachment disruption and be able to: offer appropriate assessment, develop a person-centred treatment plan and refer people to trauma-specific services if required. Such understandings are also necessary for services to provide a non-judgemental approach, with awareness of the needs of coping behaviours that may have developed due to trauma^[122].

A non-judgemental approach may be essential for those with experiences of historic forced adoption, given that: 1) secrecy, shame, and social stigma can be a barrier to help-seeking^[123] and 2) people who have experienced historic forced adoption may mistrust and be suspicious of doctors and nurses, or support services more broadly, due to their past treatment by professionals^[124],[125]. Training for staff in wider community services has therefore been called for to avoid re-traumatising people when they access services today^[126].

Trauma-specific interventions are those delivered by highly trained specialists^[127]. They may include psycho-education, individual therapy, cognitive behavioural therapy, exposure therapy, eye movement desensitisation and reprocessing (EMDR), psychodynamic therapy, neurofeedback, mindfulness and acceptance-based therapy, supportive therapy, psychopharmacology, creative therapies, group therapy and peer support groups^[128].

Peer support groups

The Scottish Government recently announced funding for peer support for those affected by historic forced adoption^[129]. This is pertinent, given the current national provision of peer support networks for people who have been adopted has been assessed as inadequate by Adoption UK^[130].

Peer support is recognised as a key element in trauma recovery generally, and people affected by historic forced adoption similarly endorse this^[131]. Australian mothers, fathers, and adopted persons identified a need to connect with others with similar experiences including peer support options^[132]. Reasons for this included validating and normalising their experiences (adopted persons) and promoting engagement (fathers)^[133].

While there are reports of peer support groups offering much comfort and guidance, some have expressed concern about their potential to re-traumatise ^[134].

In line with this, Robinson (2014)^[135] identifies internalised shame as a possible risk, impacting the way people perceive themselves and interact with others: “while these groups can provide a safe and nurturing environment, there is also the danger of them suffering from the influence of those who have not confronted and managed their own shame and who exhibit blaming, bullying and controlling behaviour”.

Peer support has therefore been recommended as one of a range of options, including one-to-one support^[136]. The need for appropriately trained group leaders has also been highlighted^[137],[138]. MAA Scotland also emphasises the importance of peer support being facilitated by people with lived experience^[139].

Information and records

MAA Scotland argues that “in order for most people to address the traumatic effects of forced adoption, they must first be able to access all of the information that is held about them and the process that was foisted upon them”^[140].

SAAM recommends that “the NRS or other data-holding body will store documents securely, but give full access to adoptees… If adoptee identifying information is requested by first parents, safeguarding measures will be enacted and a period of protection and support provided for the adult adoptee and/or their descendants, as required”^[141].

For many affected by historic forced adoption, there can be a powerful need to ‘fill in the missing pieces’. They want to access information about their family heritage to help them make sense of their identities, understand their medical histories, and learn what happened to or reunite with family members^[142],[143].

For mothers, accessing information can help alleviate the distress of not knowing what has happened to their children”^[144]. For adoptees, there may be a need to explore why they were adopted^[145].

Historically, adopted people who were curious about, or searched for their first family, were depicted as unusual but, since the 1970s, there has been growing recognition of the importance of adopted people having access to information about their origins^[146]. This is evidenced in findings from the UK Joint Committee on Human Rights, where children described a strong desire to understand their adoption circumstances and struggling emotionally when their adoptive families did not support this^[147].

Unfortunately, accessing such information in Scotland is often emotionally and practically challenging^[148]. Barriers include: a private register of adoptions, meaning that details of adoption certificates are not publicly available; lack of records relating to the adoption - especially if arranged privately via a doctor, priest or solicitor; adopted people having no legal right to access adoption agency records, with the amount and type of information shared being at the agency’s discretion; lost or destroyed adoption agency records; and lack of knowledge about the type of information available or where to seek support^[149]. The culture of secrecy about adoption can also act as an internal barrier to seeking information^[150].

Clapton (2008)^[151] explains that, for those adopted in the 1950s, 60s and 70s, the often long and arduous process of searching for information can raise feelings of powerlessness mirroring those linked to the adoption. He strongly argues against people being denied their own data: “good practice in adoption means dismantling secrecy… Adopted people may have been treated like children all their lives in relation to the ‘secret’ of their origins… (they) need the same access to their histories that everyone else enjoys”.

In line with this, adoptees in Australia felt access to their own information should be available despite information vetoes^[152]. Fathers also wanted the records to be accurate by including their names on the birth certificate^[153].

The Victoria Inquiry into responses to forced adoption^[154] advocated streamlining information access, ensuring appropriate family search support, and providing emotional and practical support by well trained staff during these processes.

In Scotland, improved nationally agreed standards for access to records have been called for^[155]. MAA Scotland has also suggested a secure national database of all historic forced adoption records run by an independent central body without ties to past adoption practices^[156], while SAAM has called for a secure national database of all b irth, foster and adoption records^[157].

Reunion

Reunions can be hugely therapeutic for those affected by historic forced adoption^[158],[159]. For instance, these have been linked to better longer-term outcomes for some^[160], with UK mothers reporting reduced guilt, sadness, and grief and increased self-esteem following contact with their child^[161]. For adoptees, contact with first families can be similarly protective^[162]. Reunion or information exchange can help communicate their mother’s circumstances, countering the belief that they were unwanted^[163]. Evidence from a small sample of UK fathers in contact with their children also suggests this can lead to improved self-esteem and outlook among fathers, some of whom described feeling happy to know their children were well^[164].

Reunion can be a positive experience for many^[165], but it can also be complex^[166]. Struggles with self-worth, fears and experiences of re-abandonment, feelings of guilt and of letting others down, difficulties maintaining ongoing relationships, and rejection of contact attempts have been reported^[167].

Trauma and grief can resurface when reunions do not go well or relationships subsequently break down, although, among mothers, some have still reported a sense of comfort from finding their child^{[168],[169],[170]}. Adoptees may experience feelings of loss associated with not knowing siblings or extended family members, and even in cases of successful reunions with siblings, a fragility to relationships can remain^[171],[172].

“Some people find each other and maintain a relationship, while others are not able to do so. The pressure and stress on all parties can be immense and overwhelming… Both mothers and their now‐adult children are often living with ongoing impacts created through forced separation... mothers have carried the trauma of their experience and adopted people have lived with questions about their identity and innate feelings of abandonment”^[173].

Given these challenges, personal recovery work has been identified as an important precursor to reconnection, increasing the likelihood of acceptable outcomes for the involved parties^[174]. There have also been calls for support to be available both during and beyond the initial search and contact phase to help people cope with the emotional impacts of this and in their developing relationships^{[175],[176],[177]}. All groups who participated in the Australian National Research Study on the Service Response to Past Adoption Experiences highlighted support from trained professionals to reconnect with family as key^[178].

Some have recommended increased access to professional intermediaries or mediation services^{[179],[180],[181],[182]}. It has been suggested these may increase the likelihood of families maintaining ongoing contact^[183].

However, Robinson (2005)^[184] believes intermediaries may dilute the positive impacts of reunions, such as empowerment and building self-confidence. Instead, she suggests the person seeking contact be appropriately supported and prepared by professionals. She argues that if a mediator is used, direct communication between family members be established as soon as possible^[185].

Thoughtfulness around service models has also been emphasised. Some feel services should be separate from those assisting adoptive parents; others believe they also need support within reunion dynamics, for their own benefit as well as for that of adoptees^[186]. Becker and colleagues (2021) refer to the Irish Government's Investigation into Mother and Baby Homes^[187] and recommend: “that most families adopting the child believed it to be in the best interest of the child, and great care needs to be taken that such families (or their adopted children) are not disrupted where positive relationship dynamics are present”^[188].

Higgins and colleagues (2014)^[189] also highlight that there may be a ‘conflict of interest’, where agencies involved in past adoptions now support those affected. They discuss the “deep feelings of mistrust” that individuals may feel towards these agencies and the potential for them to be associated with re-traumatisation, uptake barriers, or the re-enactment of past power dynamics^[190]. They urge careful consideration about which providers are allocated funding to deliver support services, to prevent further distress or anxiety. MAA Scotland recommends that mediators should be offered through an independent central body^[191], and SAAM recommends they “have no past or present connection to forced adoption practices”^[192].

Acknowledgement, redress, and learning from the past.

On 22 March 2023, the First Minister, on behalf of the Scottish Government, formally apologised to people affected by historic forced adoption.

This is significant because validation and acknowledgement through processes such as apologies, awareness raising, retellings, and education is a further support need of those affected by historic forced adoption^{[193],[194],[195]}.

In the Australian National Research on the Service Response to Past Adoption Practices^[196], mothers and adoptees called for opportunities to share their stories to increase awareness among the public and professionals. Wider family members similarly felt increased awareness among the public would be beneficial. Fathers, whose experiences and needs are often neglected, wanted their voices to be heard, and service providers advocated for increased understanding among the media and government agencies.

MAA Scotland has recommended an exhibition about historic forced adoption experiences as a means of commemoration^[197]. “Physical spaces (such as a memorial/statue, or a museum) can support education and awareness, as well as providing opportunity for a therapeutic space for those affected”^[198].

Stakeholders in Australia^[199] and those with lived experience in Scotland^[200] have also called for acknowledgement and apologies from agencies and institutions involved in past practices, such as social work and medical professional bodies.

Finally, redress has also been identified as part of acknowledgement and healing for those affected by historic forced adoption^[201],[202]. It acts as a means for governments and institutions to enact their apologies^[203]. “Redress schemes are about acknowledging wrongs that occurred in the past and often provide affected individuals with financial compensation, public recognition, acknowledgement, counselling and support”^[204].