Past Adoption Experiences

National Research Study on the Service Response to Past Adoption Practices
Research Report No. 21 – August 2012

11. Discussion

The aim of the National Research Study on the Service Response to Past Adoption Practices was to utilise and build on existing research and evidence about the extent and effects of past adoption practices, in order to strengthen the evidence available to governments to address the current needs of those affected.

The aims of the study were to:

  • identify the long-term effects of past adoption practices as they relate to current support and service needs of affected individuals, including the need for information, counselling and reunion services, based on analysis of the information provided by study participants;
  • identify the extent to which affected individuals have previously sought support and services, and the types of services and support which were sought; and
  • present findings based on the analysis of the information from the study that could be used in the development of best practice models or practice guidelines for the delivery of supports and services for individuals affected by past adoption practices.

In order to conduct this research study, the Institute developed and carried out quantitative surveys, and follow-up focus group discussions and interviews, targeting a wide group of those with experience of past practices relating to closed adoption in Australia, including: mothers and fathers separated from a child by adoption, adopted individuals, adoptive parents, wider family members (to look at "ripple effects"), and those servicing current needs (counsellors, psychologists and other professionals). The survey questions and the topics used to guide focus group discussions built on existing research and evidence about the extent and impact of past adoption experiences.

For such a study, the recruitment of relevant sections of Australian society that are not readily identifiable, due to the sensitive and private nature of the issues, was in itself a substantial task. Yet, we were able to reach over 1,500 individuals - a significant result in itself.

The willingness of people to share their stories and accounts is evident in the fact that over two-thirds of the survey participants wanted to tell us more by taking part in the follow-up component of the study. While our focus was on current needs, service usage and possible service response improvements, participants wanted to tell us what adoption has meant for them - including both positive and negative perspectives - in order to paint the whole picture. Many talked about how their participation in this study was an opportunity for their voices to be heard and their journeys to be shared with the broader Australian community. Taking part in a study that is one-of-a-kind at this point in Australia's history has been described by some as a lifelong dream, as they never thought they would get their chance to tell what it has been like for them. In a sense, this means that one of the most important service responses is to create opportunities for those affected by past adoption practices to be heard - to tell their story and have their experience validated. This would seem to be in line with the needs and expectations of other groups who have been affected collectively by past practices (such as care leavers, former child migrants, and the Stolen Generations).

Project staff could not have anticipated the journey that they also have taken through conducting this research. People's willingness to share some of the most intimate parts of their lives, and their thoughts, feelings, hopes and aspirations for the future, has been a humbling experience. As researchers, the privileged position we have held, with people placing their trust in us to tell of their experiences to the broader community, has been nothing less than overwhelming.

The participants in this study asserted their positions clearly in relation to how the effects of past adoption practices have played out in their lives; how they are currently trying to deal with these issues, and what their current needs. What we have discovered is that although every person's experience is, of course, unique, there are some fundamental and core issues that are shared - issues that don't discriminate according to respondent group.

11.1 Why participate?

Persons who were adopted

A common theme underlying adoptee's stated motivations for taking part in the study was that they simply wanted to tell their stories and dispel some of the myths surrounding what it means to be adopted. For many of the adoptees who participated in the focus group discussions, it was also one of the first opportunities for them to actually come together with other adopted individuals, while others participated in the hope that the provision of information about their own experiences would be of benefit for future policy and practices in relation to the current adoption and donor conception environment in Australia. Some talked explicitly about their participation in the research project being a way of passing on the message that they wanted governments to be doing more for adoptees in relation to issues such as inaccessibility of information and the poor availability of appropriate support services. Some also hoped for a change in media portrayals or other public perceptions of adoptees.

The key areas of service provision need identified by adoptees were:

  • access to their own information, such as original birth certificates (preferably through a national, centralised system) and medical histories of their family of origin, regardless of contact/information vetos;
  • opportunities to tell their story to increase public and service professional awareness of their particular experiences and subsequent needs;
  • connecting with other adoptees as a means of validating and normalising of experience;
  • access to Find and Connect-style services staffed by trained and experienced professionals;
  • supportive counselling to assist with responses to making contact, trying to establish a relationship with families of origin, and navigating the complexities of such newly established relationships;
  • ongoing counselling provided by trained professionals that targets the specific needs of adoptees, including issues associated with identity, attachment and abandonment; and
  • further consultation with adoptees as a group by governments in relation to current adoption policies and practices in Australia (including intercountry adoptions) and anonymous donor conceptions.

Mothers

Similarly to adopted individuals, many of the mothers who participated in the study were interested in having their stories told. They wanted the broader community to know what it was like for them to be young, unmarried and pregnant through a period of time in Australia's history when the stigma of such a situation was so powerful that they had few viable options for keeping their children.

Many of the mothers described how their participation in the survey and/or focus groups was a validating experience. The issue of wanting to change public perceptions about mothers who have been separated from a child through adoption was a consistent theme. It relates to the overall message of wanting to tell their stories and wanting to be heard. They also wanted the lessons learned from past practices to inform future policy development.

The depth of feeling around the importance of improved services was articulated well by one mother:

The first question I have is, why now? I mean, look at the age of the women sitting in this room. No one has ever asked me what services I might need. And I have been involved in support groups for 30 years almost. And that's the first question, and it has been asked. And if it's going to be taken on, then that's terrific. (Mother, Qld)

The key areas of service provision need identified by mothers were:

  • access to appropriate and targeted mental and (to a lesser degree) physical health services to deal with the consequences of trauma and other ongoing effects of their adoption experiences;
  • opportunities to tell their story and connect with others affected by past adoptions;
  • access to Find and Connect-style services;
  • access to targeted and specialised counselling to assist with responses to making contact or trying to establish a relationship with their son/daughter from whom they were separated by adoption; and
  • access to their information from the time of their child's birth, including hospital/maternity home records, and original birth certificates.

Fathers

We only had limited participation in the study from fathers who were separated from their son/daughter by adoption. In some ways, this is understandable, as mothers may not have told the child's father that she was pregnant at the time; however, we also know from the mothers who responded that a significant proportion were in a relationship at the time of their pregnancy, which suggests that there is still a significant number of males in Australia who might reasonably know that they are a father of a child who was adopted (see Passmore & Coles, 2008). Despite the small number of fathers participating, the messages from them were powerful, and were given in the hope that their stories would broaden the awareness of other fathers in the community.

One father - who was extremely successful in making contact and subsequently developing a relationship with his daughter - was hopeful of being able to provide a "light" for others who may have not been as fortunate as him in their adoption journey:

A lot went into it, it didn't just arrive. There are some very deep scars to carry, and wounds, and fix them and come back. But the one thing that I would like to come out of it is, other people that have fear in their soul, could take our story and take the risk of going on their own journey … By hearing a story like ours that can maybe go out and touch people's hearts, it's doing two things: it's the social acceptance of it; and more subtly for the person who is afraid that they can identify with what is being said. If you're afraid of making contact, then maybe thinking about it in a way - that there is something that you can add to their lives that has real meaning and importance. And when you add it to their lives, you are adding it to your life as well. (Father, NSW)

The key areas of service provision need identified by fathers were:

  • opportunities for their voices to be heard about their experiences, given the often overlooked/neglected recognition of their place in the adoption circle;
  • opportunities to connect and engage with other fathers;
  • establishment and promotion of support groups for fathers in order to encourage engagement;
  • supportive counselling to assist with responses to making contact or trying to establish a relationship with their son/daughter from whom they were separated by adoption;
  • Find and Connect-style services; and
  • retrospective inclusion of their names on their child's original birth certificate.

Adoptive parents

The motivations for participation in this study were varied among the adoptive parents, and perhaps more divergent than within any other respondent group. Consistent with the other groups, adoptive parents wanted to have their experiences of past practices shared with the broader community to ensure a balanced viewpoint is presented. Some participants were concerned that given the current focus on forced adoptions as a result of the Senate Inquiry, that adoptive parents would be "tarnished with the same brush" as those professionals who were involved in the organisation of the adoption/forced removal of babies from their (birth) parents, or that all adoptions from this period of time would subsequently be viewed by the broader community as being "bad". Some of those adoptive parents reflected that such a focus could indeed be damaging to not only themselves, but their adoptive children, through the questioning of the legitimacy and/or legality of their adoptions.

Conversely, other adoptive parents who participated in the study expressed their concerns about the negative effects of adoption on their children (such as behavioural, identity and attachment issues), as well as how distressing they had found it to learn of some of the practices of the past and the treatment of (birth) mothers. They wanted to participate to show their support and sympathy for those mothers and fathers who had been adversely affected by the policies and practices of the time they were adopting their children.

There were few current service needs identified by the adoptive parents in this study. They did not consistently identify needs for themselves, but rather were focused on search and contact services for their sons/daughters, as well as assistance for them in finding out information, such as medical histories. They were more likely to focus on the time of their child(ren)'s adoption, in that very little support/guidance was provided to them about what to expect as new parents, nor the possible challenges their adopted children may face as a consequence of their adoption. However, some adoptive parents did identify that the option of speaking with other adoptive parents about their experiences, challenges, and successes would be of benefit - if not for themselves, then for those who have faced or are currently facing more difficult situations than their own.

Other family members

The ripple effects through family members are indeed evident from the information provided by these respondents, and indeed, from their level of participation (being the same total as that of adoptive parents who completed the survey). There was a diversity of relatives who completed the survey for those affected by the adoption experiences of a relative (including siblings and spouses of persons adopted, spouses of mothers, and subsequent children of mothers).

Participation in the study was largely viewed by other family members as an opportunity to share how past adoption practices have affected not only on themselves, but also their relatives (although many focused on the needs of their loved one and how they would be best placed to provide support).

Most other family members believed that there needs to be facilitated access to support (counselling and therapy) for themselves and their relatives regarding the issues arising from the adoption. Other needs included assistance with the contact/reconciliation with the "lost" relative, provision of the facts regarding the adoption and improved access to information about the family of origin (such as medical history), having access to peer support groups; raising community awareness and understanding, public acknowledgement, apologies and contrition for those adversely affected.

11.2 Effects of past adoption practices

Participants provided an immense amount of information through both the survey and the follow-up discussions regarding their experiences of the past, as they felt it was integral to the identification of what they are in need of now and into the future. As one participant said:

Without understanding the past, how can we hope to appropriately inform the right actions going forward? (Mother, WA)

In the previous chapters, we have shown that there is a number of common threads that run throughout the various respondent groups in terms of how their past adoption experiences have affected both themselves and, in many instances, those around them; such ripple effects have also highlighted a more general lack of understanding and awareness in the broader community as to what it means to be affected by an experience from the period of closed adoption in Australia, and how to respond accordingly.

In this discussion, we will firstly revisit these effects as they relate to the current service and support needs of study participants. For those who have shared their accounts of more positive and fulfilling experiences of adoption and what has "worked" for them in their journeys, these characteristics will be explored in more detail in the final section of this chapter, where we examine potential models of service and support as reflected in the information obtained in the study as a whole.

Mothers

As described by one mother who took part in this study, the effects of past adoptions for many are "intangible", as well as far-reaching and long-lasting. The common practices around adoption that were viewed by the broader society at the time as a means to provide a solution to both illegitimacy and infertility, were seen by many mothers who participated in the current study as systemic abuses and the betrayal of trust by those who had a duty to care and protect. Part of the service response expected by mothers with this view was the acknowledgement of this by relevant authorities, as well as assistance with finding out more about their history, such as hospital records (including any drugs that were administered) and details of the adoption consent process.

Many of the mothers described how the reasoning used at the time to justify adoption was focused directly around the perception that they were unable to care for their child because of their age, inexperience, lack of financial stability and lack of family support. In counterpoint to this, the responses from mothers to the survey showed that many had been working (such as nurses or teachers), had been financially stable, educated, and had not been teenagers (the majority of respondents were over 19 at the time of the birth). This suggests that the impetus for adoption was more strongly based on social stigma and the needs of infertile married couples (the "deserving"), as opposed to the actual capacity of the young women to parent effectively as a single mother or, with the father, as an unmarried couple. One of the issues that mothers discussed the most frequently was the ways in which institutions and individuals continued to reinforce messages such as their lack of worth or that they were not capable or deserving of raising their own child. Mothers also emphasised how these messages have manifested as beliefs about themselves to the present day. For many, this is 40 years of negative self-assessment that has been internalised.

The effects of adoption experiences on life events for many mothers have been significant, particularly in the areas of engaging in meaningful relationships and social functioning. For others, they have been able to excel in certain areas, particularly academically, despite the trauma so many endured (or indeed, because of it). This would suggest that psychological services are needed to address self-concept, and the ways in which these experiences that occurred at an early and formative stage in their adult development have affected the mothers' sense of self, relationships with others, and engagement with the outside world.

Wellbeing

Quality of life is defined as "individuals' perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns" (World Health Organization, 1997, p. 1). In the survey, the WHOQOL-BREF was used as a measure of an individual's quality of life over four broad domains: physical health, psychological, social relationships and environment (access to resources). Mothers recorded lower than average scores in the psychological, social relationships and physical wellbeing domains.

Respondents were also asked about how satisfied they were overall with their life on a scale of 1 to 10. The average score for mothers was 6.4, which is lower compared with general population data as reported in the HILDA survey, where the mean rescaled value for persons aged 35 years and over was 7.2.29

Both the survey open response items and focus group discussions were consistent in their messages in relation to current service needs, whereby many mothers said they are in urgent need of support to address these wellbeing needs. When asked what would be of most help to them now in dealing with their issues associated with past adoptions, psychological assistance was identified as the second most common response (having their experiences validated and acknowledged was the first).

The K10 mental health measure used in the survey indicated mid- to high-levels of current distress or likelihood of having a mental health disorder among the mothers who participated in our study. While being mindful that the K10 is an indicator of likelihood of having a mental disorder and applies to the previous four weeks of an individual's life at the time of completion, almost half of mothers participating in our study may currently have a moderate or severe mental health issue.30 This presents some significant challenges in terms of the service delivery needs of this group - in terms of addressing their mental health issues and providing other information and supports in a way that is sensitive to the variety of mental health challenges that service users might have.

Mothers' age at the time of birth appears to have had some effect on how likely survey respondents were to be currently suffering psychological distress. Well over half of the women who gave birth before they were 18 years old were likely to have had either a moderate or severe mental health issue at the time of survey completion (rates were even higher for those who had been aged 15 years or younger at the birth), compared with around one-third of mothers who gave birth when they were 20 years and older.

Mothers' perspectives of the adoption process were also associated with current levels of psychological distress. About two-thirds of women who said that they had either placed or gave up their child for adoption were likely to be well, compared with one in five mothers who said that their child had been taken or stolen from them. In addition, mothers who had had some support at the time of the pregnancy and birth were doing slightly better than those who had not had any supports at the time.

Trauma

The detailed accounts of extremely distressing treatment suffered by so many of the mothers who took part in this study are consistent with the findings of the Senate Inquiry, and hence it is appropriate in this discussion to highlight the more intensive levels of intervention that are needed by some who reported that they are still living with paralysing trauma-related symptoms in their day-to-day lives.

Mothers scored very high on the Impact of Events Scale, which is an indicator of post-traumatic stress disorder. Well over half were likely to meet the diagnostic criteria for PTSD based on their responses at the time of completion of the survey.

Qualitative accounts of experiences of pregnancy, birth, the process of obtaining consent and the ultimate adoption of their child were for the most part negative and have had broader implications for the mothers' wellbeing over time regarding:

  • the decision and/or capacity to have more children;
  • the capacity to form and maintain stable relationships; and
  • the capacity to engage fully in social contexts.

The ability to make fully informed decisions regarding the adoption of their child and the emotional, physical and psychological effects directly relating to informed consent triggered the need for many mothers in this study to seek information from their records to confirm their experiences.

Some participants identified the administration of drugs during and immediately after the birth as a continuing issue for their capacity to come to terms with their experience, as it directly relates to whether there could have been informed consent. Whether or not some of these drugs were standard administration for all mothers in the hospitals, is not the point of focus. As one mother articulated:

It may have been true that similar drugs were also given to married mothers, but they weren't then asked to sign a legal document. (Mother, Victoria)

There was strong endorsement of the need for counselling/psychological intervention and support, and the low levels of mothers' wellbeing found in this study support these accounts, and is also consistent with the findings of the Senate Inquiry, as presented in Recommendation 8 of their final report.

Fathers

The limited participation in the study by fathers makes it difficult to draw conclusions that could be considered representative of this population. There is therefore a need for further investigation into this group, with targeted and coordinated recruitment strategies.

The fathers who did participate in this study expressed concern about the lack of support options available to them, as well as concern for the fathers who would have never engaged in a discussion about their experiences. In addition, they spoke about how the lack of choice and control in the decisions that were made at the time of their child's adoption is being perpetuated today, as they felt that they have little voice in the broader public discussion around past adoptions. These results show consistency with the findings of previous small-scale research that has focused directly on fathers, such as that conducted by Clapton (2007) and Passmore and Coles (2008).

The fathers' experiences reflect what many of the mothers who also participated in the study told us: they had wanted to have a say in what happened with regard to the adoption, and many had wanted to keep the baby. Very few of them had had support at the time of the pregnancy and birth, and very few have had support since.

Their current needs centre on an increased awareness and understanding of what happened and why, and a broader understanding from the community as to what the adoption climate of the day was and how this affected their capacity to be involved in the decision-making process about their child's future. Fathers also saw it as important to acknowledge the trauma that occurred from the separation of family.

Persons who were adopted

I guess we want our story to be told, because it's all so "Shhhh, we don't talk about adoption". We are not possessions. (Adoptee, Qld)

Many adopted individuals who took part in this study stated that they have rarely felt that their experiences have been validated or viewed as being of any real consequence, and that the effects of their adoption on their lives (both positive and negative) have, for the most part, not been included in the nation's broader discourse to this point in time.

Some participants described feeling as though they are the forgotten part of the equation. Nevertheless, they felt that they are the living result of how past practices have played out, and therefore want to have the accounts of their experiences, both positive and negative, shared with the broader community.

The feelings of silence and secrecy and the stigma attached to adoption led to many of these study participants feeling like they have been unable to talk about their experiences, because no one ever recognised or acknowledged their loss of their family of origin and sense of identification with their biological kin. Although many have gained richly from their upbringing within their adoptive family, there was still a view held that they have not been provided with the opportunity to have a voice.

Mental health and wellbeing

As with mothers, adopted individuals who responded to the survey had lower ratings than average on three of the four domains for the WHOQOL-BREF measure, and close to 30% were, at the time of the survey, suffering moderate or severe levels of psychological distress (compared with around 10% of the general population). Their overall satisfaction with life was also lower than average population results.

There was some evidence that the adopted individuals in the survey who had had more support when growing up were faring slightly better now.

Qualitative accounts suggest that adopted individuals are facing multiple issues, and having had a positive experience growing up with their adoptive families has not necessarily meant that they have not faced any issues in relation to their adoption. In fact, there was an overwhelming amount of information provided to us as to how their adoption experience has affected many areas of their lives, such as self-identity, family and other intimate relationships, parenting behaviours (including confidence, and questioning their own adequacy as a parent), and issues with abandonment and attachment (or "bonding"). Having their own children has also been a trigger for many participants as to what adoption has meant for them and how it has affected their lives.

Continued secrecy and shame

Negative feelings by some study participants about their adoption experience have been compounded by feeling ostracised from a community who perceived adoption as being something to be ashamed of - that there was and to some degree still is a stigma attached to adoption. These messages have come in myriad forms, such as people's general reactions to hearing that someone is adopted (for example, a "pitying" attitude or displaying an intense curiosity), or the more overt discrepancies in rights to information about oneself that the rest of the community take for granted. An overarching theme was that for many, there is a lack of normalisation, as an adopted individual should be able to speak of their experiences without the need to worry about managing others' reactions.

Some participants also spoke about the effects of secrecy, stigma and shame on their adoptive parents as well as families of origin, and how this has filtered through to ultimately become their own burden to bear. For some, they carry the weight of their mothers having never disclosed that she ever gave birth to them; similarly, many felt the weight of adoptive parents' expectations, who have treated the adoption of their children as something to remain discreet about or entirely hidden.

For many late-discovery adoptees who participated in this study, it has been a matter of "rebuilding a life that has felt like a lie". The effects of non-disclosure of their adoption by their adoptive families have been profound.

Information

For the most part, persons who were adopted who participated in the study considered information about themselves as being of extreme importance, as it is related to issues of identity that everyone else takes for granted. As is evident from the amount of information provided by study participants, the issues of seeking information about oneself and one's family of origin and the subsequent process of search and contact are significant contributors to both past and current experiences of adoption and its associated effects.

Many study participants also reflected that the current system does not provide for ease of access to information; it fails to reflect the significance of the information that is being provided to those who are seeking it. A number of respondents noted a lack of sensitivity to the effect that receiving this information may have coming from those who are in the position of providing it to them.

The main issue for adopted persons in this study in relation to gaining access to their own information is that it should not be viewed as a privilege, but rather as a right. This includes information about the details of their birth and subsequent adoption, as well as their genetic and medical histories. Being able to have access to information that the rest of the community takes for granted (such as original birth certificates) was a central issue for many adoptees. They talked about the absence of choice that they had in their adoption and so were questioning why they have to bear the burden of fighting for information that belongs to them, such as an original birth certificate. A critical element of the service response to adoptees is assistance with obtaining information to support their search for their real legal identity, genealogy (including their father's name), and medical history.

Late-discovery adoptees have faced an added complexity of accessing information, given that for many, both sets of parents have passed away. Many of the mothers kept the birth a secret for their entire life. Similarly, for those whose adoptions were privately arranged, they have had little to no availability of information regarding their family histories.

For some participants, they have suffered extreme distress by discovering the inaccuracies contained in some of their "original" documentation. Many described how they had been lied to about the circumstances of their adoption, or given incorrect information about their birth family:

For me, I don't even believe the information anymore. I look at it and think, "Is this real, or just forged like the rest of it?" (Adoptee, NSW)

A concerning number of participants disclosed abuse they had suffered by their adoptive parents, and felt it was important that the message be communicated more broadly that not all adoptees went to good homes. Their responses demonstrate the variety of ways in which they are still dealing with the lifelong effects of these abuses. Carrying the physical and psychological scars and their need for medical and psychological support has come at great cost, financially and emotionally.

For some, it is a question now of how those responsible for their placements could have let this happen to them. Many adoptees in this position who participated in the study would like to know who was in fact responsible, and are asking for those involved to be held accountable.

Adoptive parents

The effects of past adoptions on the adoptive parents who participated in the study were varied. For many, they focused more on the effects on their children, particularly in their child's search for medical information of their birth families.

Adoptive parents did mention the lack of support that existed at the time of adoption. For many, they hadn't been provided with the information to adequately equip or prepare them for some of the issues they might face. There was limited discussion among participants regarding how the effects of infertility had affected them both physically and emotionally; they had had little or no support through this experience at the time.

Some respondents were concerned that there was too much negative publicity about adoption that was detrimental to their mental health and the mental health of their sons/daughters and grandchildren. Addressing this imbalance was a need identified by some of the adoptive parents.

The efforts that their sons/daughters have made to search for and make contact with birth families has raised a number of complex issues. Some adoptive parents were encouraging and supportive of their son or daughter's search for their family of origin; however, others felt threatened or hurt when the adopted person decided to search. A portion of the comments from the survey reflect an underlying suggestion of an "us or them" mentality - and this is supported by what was found from the surveyed adoptees and mothers.

A small number of study participants spoke about the distress they had felt when their adopted child had died and they did not have any information about the birth mother in order to contact her to inform her of her child's death. This was an issue that they would like to see resolved in current adoption policy.

The main areas of current support needs identified by adoptive parents were:

  • access to medical information for their son or daughter;
  • support for them and their son or daughter during the search and contact process, and beyond; and
  • assisting with emotional responses from adoptive parents, children and other family members to publicity around past adoption issues that has the capacity to hurt or sensitise them, when they felt they were doing the best thing.

Other family members

The importance of hearing from other family members in this study is significant, as it provides us with a broader understanding of the complexities associated with the varying effects of past adoptions in Australia. We had a wide representation of relatives within this group of participants, including spouses, siblings, children and grandparents of those within the core respondent groups.

Interestingly, of the other family members who participated in this study, the majority had engaged in some form of support or accessed services to help them with issues associated with the adoption experience of their relative. Around one-quarter had utilised professional counsellors such as a psychologist, psychiatrist or social worker.

As with the core groups in the study, other family members who are directly affected by adoption (e.g., those who find that their mother had lost a child to adoption and now wish to search for their lost sibling) commented on the effects of not knowing the truth, and having access to the details surrounding the adoption was of significance. Secrecy and lies have a lasting impact, and were the most serious issue, according to many of the family members who participated in our study. For others (such as spouses) providing support to their relative who has been directly affected by adoption, the most significant issue was not knowing how best to support their loved one and that this has affected the quality of their relationships.

Other family members in this study said that support for their loved one, assistance in the search/contact process and having access to information about their relative were all areas in which they thought further support was required.

11.3 Service use

Use of services varied between respondent groups, as did their levels of satisfaction. Search and contact services (both government and non-government), post-adoption services and individual professionals such as psychologists, psychiatrists and counsellors were all examples of where study participants had engaged in some level of support.

Adopted individuals have commonly utilised search and contact services, as well as sought further support from peer groups or one-to-one psychological intervention, to assist in dealing with the broader effects of their adoption (such as identity and attachment, their own parenting, and capacity to engage in trusting and fulfilling relationships).

Mothers had also utilised search and contact services, as well as peer support groups and individual counselling with professionals for assistance with trauma-related issues, grief and loss support.

Although adoptive parents were most likely to have received support from an informal source such as their spouses, friends and church community, a number identified that they would like to have more effective mechanisms for their child(ren) to access information about themselves, particularly medical/genetic information.

Fathers had typically utilised a limited amount of support in the form of formal services. Some had relied on support groups (although very small numbers said they had done this), and others were more likely to have simply used formal search and contact services.

Other family members had a relatively high rate of service utilisation, most commonly in the form of formalised counselling or accessing search and contact services. However, most had relied on the support of family and friends in helping them deal with any issues relating to their adoption experience.

Although most who had utilised more formalised supports found them to be helpful generally, there were some significant limitations identified with regard to the level of knowledge and understanding of adoption-specific issues by those service professionals. The focus group discussions in particular revealed a sense of frustration toward the continued need to "educate the educated", and this was often viewed as a significant barrier to accessing support/ information/referral that appropriately matched the specific needs of this group. This frustration is often compounded for adopted individuals, who have the added complexity of not having knowledge of their family's medical/genetic histories. A simple visit to the GP, which many people take for granted, was described by many study participants as something to be dreaded. For them, there is a never-ending need to inform medical professionals when asked about family medical histories that they don't know because they are adopted.

Information, search and contact services

Over half of the adopted individuals and almost 70% of the mothers had used search/contact services. The most common type of service utilised was a government department (including the Registrar of Births, Deaths and Marriages and the Electoral Commission), followed by non-government organisations (such as Jigsaw, in most instances) or the institution through which the adoption had been organised. Peer support groups and post-adoption resource centres were also used.

Mothers who had negative experiences with search and contact services were largely feeling the frustration of not being entitled to information about their son/daughter due to privacy restrictions such as contact and information vetos. Use of these services largely focused on accessing records from the time of the pregnancy and birth.

For adopted individuals, the search process was mostly undertaken through state government departments responsible for adoptions, who can assist with the provision of original birth certificates and other information (both identifying and non-identifying) when they turn 18, or when a member of their birth family wanted to make contact.

Adopted individuals mostly reported their experience of information and search services as being helpful in some way, even if it was just the provision of information that enabled them to conduct a search or find information themselves. However, there were numerous accounts of the lack of professionalism displayed by some staff with whom they had contact in the information/search process.

Barriers to service utilisation

There were numerous factors identified across respondent groups relating to their experiences of services that were seen as impeding their progress in either the search and contact process, or managing the effects of their adoption experience.

  • Cost was a significant concern for many. The ongoing requirement to pay for information (such as from the Registrar of Births, Deaths and Marriages, where you pay for every 10 years of search information) and copies of original documentation was viewed as an unnecessary, and indeed, unfair burden for those affected by past adoption practices:

It should be free. We pay money in our taxes. Why should we continue to pay for something that is ours? (Adoptee, NSW)

They all want to charge me a fortune to go back and see if they can find [the birth certificate]. I'm just not going to pay it. I'm sick of paying. (Adoptee, NSW)

 In addition, many participants concluded that the costs of psychological interventions were an impediment to their ongoing capacity to engage with this much-needed form of support. Some spoke of having made significant sacrifices in many areas of their lives (such as permanent housing) in order to fund their ongoing treatment with mental and other health professionals.

 This is a significant finding in light of the results of the health and wellbeing measures used in this study. As we have learned, adoption-related issues are often lifelong, and for many, there will be a long-term need for support. The service providers who participated in the study supported this. It is also a key consideration in the development of appropriate service and support models.

  • Navigation of the search and contact "system" was an area consistently identified by study participants as impeding their ongoing capacity (and often their willingness) to find information about either themselves (such as medical and adoption records) or their family member. Inconsistencies in processes across states and territories was frequently raised in focus group discussions for both adopted individuals and mothers as an issue that placed significant stress and pressure on themselves and other family members, both emotionally and financially:

Government post-adoption services can be frustrating at times, as they have to carefully administer policies for a wide range of stakeholders. (57, 2012)

I do have negative attitudes towards the Registry of Births, Deaths and Marriages, whilst concomitantly recognising that they are bound by laws etc. in place at the time. I think [state's] registry laws are designed to be as difficult and insensitive as possible - a classic bureaucratic system. (206, 2012)

 Participants across all respondent groups were largely in support of developing a nationally centralised database as one way of addressing this issue, and believed that this is a priority area that could readily address the needs of many affected by past adoptions.

  • Staff attitudes, experience and professionalismwere recognised as being of significance in study participants' reflections on the quality of service provision and subsequent effects on their willingness and confidence to engage further in such services. These more negative experiences were not limited to search and contact services, but more particularly to those in the position of information provision, such as the Registrars of Births, Deaths and Marriages. Respondents provided a number of examples of their experiences of search and contact services that raised some concerning issues relating to the basic handling of cases. Similarly, they talked about a number of examples of departmental services that reflected insensitivity, or other poor practices (see section 7.10).

 These accounts demonstrate the potentially devastating effects of poorly devised, implemented and regulated processes within agencies/departments responsible for the provision of information, search and contact services. Training of such professionals was consistently identified as being imperative in order to ensure the wellbeing and protection of individuals seeking information and support.

  • Lack of support/guidance throughout the search and contact process and after was a key issue identified as being a major barrier to either the success of making contact and/or the ongoing wellbeing of those involved, including the wider circle of family members. Adoptees wanted information about the likelihood of reunions succeeding. They wanted support in the follow-up period - both in terms of how to maximise the likelihood of the reunion being positive, and how to negotiate the new relationship - as well as how to manage the pain of rejection if it did not go well.

Professional support

Many participants in this study expressed frustration with their experience of GPs, counsellors and other professionals who were either not aware of or dismissed the effect that separation through adoption had had on their lives. Survey data show that those who had accessed formal forms of support from professionals found them to be largely ineffective.

For many in this study, they spoke of frustrations associated with the ongoing financial cost of trying to get support that meets their needs adequately.

Also, the experiences of those accessing professional supports have been varied in terms of quality, which was generally not consistent or reliable. However, those who had good support found it life-saving. Those professionals understood adoption-specific issues and the trauma lens through which a lot of their issues need to be viewed.

The inadequacy of the Medicare mental health scheme for accessing quality psychological services was raised. The limited number of sessions was seen as problematic, particularly for those with serious mental health issues, such as personality disorders.

Peer groups

Peer support groups have been used effectively in the mental health and alcohol and other drug sectors for a long time. However, there are pros and cons with this using method of "intervention" with people who have been affected by adoption.

Many respondents from across the different participant groups saw the value of peer support. It can be a safe space where there are others with shared experiences. However, some of the issues people have had were if there were competing interests or needs within the group (particularly if both birth parents and adoptees were in the same group),31 the lack of regulation, quality of facilitation, and the distance of the venues.

However, even though one adoptee found that "the dysfunction was being repeated in the group" and found the group experience overwhelming, they still acknowledged that some people found the group very valuable, and thought it was an important option to retain in a service delivery model.

11.4 Current service and support needs

Drawing together the depth of experience across respondent groups, we are now able to summarise the key consistent viewpoints of study participants as to what they view as being of most benefit to them in helping them deal with their past adoption experiences now and into the future.

If we examine the effects of past adoptions on participants in this study through the lens of a public health perspective, then the social and economic costs and consequences of preventable health issues are borne not only by individuals, but also by the entire community. Studies have consistently shown that population-level prevention and early intervention is cost-effective and can positively alter risk and protective factors that affect individuals. For the purposes of this discussion, this will be the lens through which the approaches that were identified by study participants will be viewed. (For more information about a public health approach to child welfare issues, see Hunter, 2011.)

We will firstly examine the key actions identified by study participants that would be of most benefit to them now, in their own words, and then move to a broader discussion based on the analysis of study data and draw conclusions for service and support interventions accordingly.

Acknowledgement and recognition of past practices

Knowing where their thinking came from does not condone their treatment of us. (Mother, NSW).

Although not directly a "service or support need", one of the most important things that participants said would be of benefit to them now and into the future was acknowledgement of the common adoption practices of the past and the subsequent effects that have been experienced by those who participated in this study. This includes acknowledgment and recognition that what happened happened, and that the information that has been gathered in relation to the effects of past practices acts as a point of reference to ensure that mistakes are not repeated.

For some participants, the recognition that one of the consequences of the closed adoption system that had operated in Australia, was the denial of the right for all those most closely affected to grieve - the mothers and fathers who were not allowed to grieve the loss of their child; adopted individuals not allowed to grieve the loss of identity and the separation from their birth family; and the adoptive parents not allowed to grieve their infertility.

Adopted individuals were very strong in their focus on the need for public acknowledgement - both for themselves and the mothers:

Acknowledgement of the wrongs done to the victims of the adoption boom era. Acknowledgement of adult adoptees' right to feel anger for what was done to them in the name of bad public policy. (Adoptee, 704, 2012)

I think the most important thing is that there is acknowledgement of the societal pressure placed on single mothers in the 1970s to give up their children. I am quite accepting of my role of an adopted child, but know that my natural mother is scarred by the decisions that she made and it had significant impact later on her life choices. (Adoptee, 676, 2012)

One adoptee spoke about the effect that learning about the Senate Inquiry had on her, and how being exposed to this information instigated a shift in her understanding of the circumstances of so many mothers.

I think that the Inquiry is essential. I had no idea that this could have happened to me and my (birth) mother. All my life I have thought that she hasn't wanted to make contact with me, and now I find out that she may have been told I was dead? I feel sick about the way she may have been treated. It's appalling that thousands of Australians are in this position and the government needs to reveal the truth. Being adopted never goes away you know. (Adoptee, 441, 2012)

The role of apologies: By whom and for what purpose?

Although this study found some divergent views from participants on the merits of apologies relating to past adoption practices, and many saw a national apology from the government as being of more significance to mothers than adopted individuals in this study, there was generally overall support for this happening.

It is important to note that the question of whether an apology is needed was not asked specifically in the survey; rather, many participants spontaneously identified it as the most important thing that could happen now to help them deal with their experience of adoption. It was then an avenue for discussion in the focus groups when some participants raised it, or drew comparisons between themselves and the Stolen Generations and Forgotten Australians.

In terms of addressing current needs, the themes that emerged from this study suggest that apologies can play a role by:

  • starting a conversation and ending the silence;
  • allowing affected persons to have a voice they have not felt they have been able to have previously;
  • broadening the general population's understanding and awareness of the potential issues people with an adoption story may have; and
  • improving the quality of service provision available to appropriately address adoption-related issues within the broader health and welfare sectors.

Even if individuals did not feel they personally needed, or would benefit from an apology, some still argued that it would bring about a public awareness to the issues. Some study participants spoke about their need for institutions (such as hospitals and maternity homes) to make full disclosure of the common practices to which mothers were subjected:

I would like to see honest and full disclosure of practices in hospitals and maternity homes. In particular, the withholding of information and provision of false information and the forced management of residents' financial benefits … disclosure of all illegal practices by organisations and individuals, and an acknowledgement that closed adoption was a practice of social engineering, and not carried out in the interests of either the mother or children who were separated. (Mother, 146, 2012)

The Senate Inquiry's (2012) final report spoke about an apology to mothers, fathers, adopted individuals and other family members; however, many participants from all respondent groups articulated that an apology is only appropriate if all those within the adoption circle are addressed:

  • mothers and fathers - for their rights and entitlements being withheld and for the violations of care they experienced:

An acknowledgement by the perpetrators of the illegality and the personal wrong done to myself and other individuals due to the practice of taking babies from young unmarried and unsupported mothers who wanted their baby, in order to give them to other women keen to adopt a child, along with an apology at the very least. If there had not been a "market" for these babies, then the horror might not have been so forced on young and vulnerable women who had not done any wrong other than offend some social values of the time. (381, 2012)

To say sorry to the generations of women who felt they had no power over what happened to either their bodies or their future. (Adoptee, 621 2012)

  • adopted individuals - for the lack of duty of care by governments, agencies, or others in authority to ensure that their best interests were central to the decisions related to their eventual adoption; that their rights to information regarding their identities have been withheld; and that the effects of closed adoption practices and policies have in many cases perpetuated a culture of secrecy and shame:

Recognition of the injustices suffered by myself and my three adoptive siblings, including one who suicided, which should include exposure of the system which allowed it to happen. (265, 2012)

I want the government to apologise - I want my adoptive mother to know I was taken by force, not given over legally. (Adoptee, Qld)

Truth, recognition and apology from our government. Adoptees that were given to families and subsequently abused are seeking better services for pain, suffering, grief and trauma. We are seeking an apology not only for being taken from our mothers and family, but for the lack of screening of potential adoptive parents that should have protected us from perceived harm. (50, 2012)

  • adoptive parents - that they were not always advised of the rights of the mothers and fathers and that they were not given the appropriate support to grieve their infertility.
Opposition to apologies

Those who were opposed to or had some reservations about an apology had a number of different viewpoints. These participants tended to focus on other actions that they saw as being more important:

It's just a word. Unless they actually have an action behind the word, then it's not going to mean anything. (Adoptee, NSW)

In some ways I think it would be good, you know, to kind of have some recognition. But I don't want everything to be hung on that. (Adoptee, Victoria)

I don't think I need an apology or anything, but for me it's a personal thing. I don't think that would assist me. I feel personally that it would take away from what I have done for myself. (Adoptee, Qld)

The apology might make some people feel better, but others … Just make sure it doesn't happen again. (NSW adoptee)

For apologies to be meaningful, the Senate Inquiry (2012) identified a number of guidelines that should be followed. Their guidelines are consistent with the key messages emerging from the current study.

Financial compensation

For adopted individuals, the right to financial compensation was mainly raised by those who suffered abuse at the hands of their adoptive families; in addition, there were small numbers of participants who wanted to be compensated for their loss of inheritance rights (from both birth family and adoptive family), as well as medical costs for issues relating to the trauma they have suffered.

Mothers who identified financial compensation as something they were seeking were generally identifying it as recognition of the trauma/abuses that were suffered in some of the hospitals and maternity homes, and compensation for the physical and psychological impacts that have been lifelong and debilitating, and the costs of medical and psychological services that have been incurred.

The broader view held by respondents, however, was that, rather than compensation, access to support services such as professional counselling, funding for ongoing psychological care and access to information should be freely available or heavily subsidised for all those affected. A suggestion was also made about the possibility of having travel allowances to enable contact between themselves and their loved ones. Another innovative suggestion for a service provision model to address past adoption effects was to offer free private medical cover for life for all those with a substantial complaint. As one respondent pithily put it:

I don't give a shit about money and compensation; I just want to be heard. I want some changes so you feel like you've been heard - someone acknowledging the fact that what was done was wrong. They can make it up to us by giving us the services and information we need. They're simple things - it's not like we're asking for a lot. (Adoptee, NSW)

Education and awareness

Education of the wider community about the effects of past adoption practices was seen by many study participants as being integral to their own capacity to begin the journey of healing. While fostering community education and awareness is not explicitly part of what would normally be considered a "service delivery model", for participants this was a strong theme for them in what would help them. Some of the key messages that participants wanted communicated included:

  • adoption changes lives forever and that it's not about being grateful or lucky;
  • there are untold stories of grief and loss in the adoption community (across all members, including adoptive parents);
  • it wasn't a case of mothers not wanting their babies and being happy to give them up ("I was not a 'bad girl' and that giving up my son was not my 'choice'.");
  • it hurts people to deny the effects of adoption;
  • the issues are difficult and complex for all parties; and
  • the effects of past adoption policies in Australia are widespread, with wide-ranging repercussions.

Increased public awareness was viewed by many participants as being a way of enabling the issues associated with adoption to be heard and discussed more openly, which would then allow affected individuals to feel what they feel without guilt, shame or stigma. These types of sentiments were shared across respondent groups. Broader education and awareness would remove some of the stigma attached to adoption and provide a balanced viewpoint of adoption experiences.

As was seen in respondents' articulation of their reasons for participating in the study, for many - across the different respondent groups - it was about feeling relief that they were not alone, especially for those who had never sought support, and it was about providing information to other parties in the adoption circle so that others can be made aware of experiences from different perspectives.

The sharing of personal stories in the public arena was viewed by many as being a powerful tool for validating people's adoption experiences: it allows people to see, beyond the stigma attached to adoption, how it actually affects people. An education and awareness campaign can therefore play a strong role in opening up the conversation within the community that adoption needs to be de-stigmatised and not considered a taboo subject. An aware community was seen by many of those affected as being integral to feeling they can come forward and receive better, informed services and practices by service providers.

One of the positive expectations that respondents had of public awareness campaigns - in addition to educating the professional and broader community - was also to "normalise" the experiences for people affected:

I think it would be useful for people to normalise it a bit more. It is quite enlightening when you do read about other people's experiences and you go, ah, I'm not the only one that has felt that or experienced that. I think that's what's missing - that commonality and common experiences - and for people to realise it is quite normal to be paranoid about being rejected in interpersonal relationships, or not being able to relate to your children as well as you would like to. Those sorts of things are quite common. We all think that we are the ones that are broken. (Adoptee, Tasmania)

There is a lot of stuff out there now about how families are made up of endless, different combinations - same-sex couples, step-families - adoption fits very neatly into that because people affected by adoption are just another type of family. So bring it into the normal range and just make it as another one of those mini combinations that families are. Take the stigma out of it, take the secrecy out of it, take the blame and shame. (Adoptee, Qld)

Workforce training and development

Adoption is obviously a smaller proportion of the population, but it is still something that professionals should have some recognition of and know what some of the potential issues are. (Adoptee, Tasmania)

Before we look in more detail at the types of support services that participants have identified as being most needed, the issue of workforce capacity, and the development that is required to deliver such services appropriately and adequately, requires further reflection.

Participants provided their accounts of both positive and negative experiences of services, government departments, other organisations and individual professionals in their adoption stories. One of the most pertinent issues raised was the risk of re-traumatising individuals who are presenting for support, given some participants' experience of professionals as being dismissive, misinformed, or completely inadequate. As one mother articulated:

The understanding and empathy of the wider community … would especially include those working in the psychological professions, who too often see adoption as just a tick-a-box and so do not recognise the possible long-term impact of separation loss for both mother and child. (71, 2012)

GPs can play an integral part in an individual's search for appropriate supports and interventions, usually by way of referral. Their role is vital, as they often act as "gatekeepers" to information and sources of support. Some participants spoke about the importance of GPs having a thorough understanding of adoption-related issues, as there is the potential for misdiagnosis of mental health issues in particular, given the similar symptomology of conditions such as borderline personality disorder and the commonly seen attachment and identity issues for adopted individuals.

Given the accounts of the broad effects of adoption on physical, emotional and psychological wellbeing, it makes sense to target for workforce training and development those working in the fields that those affected would be utilising to help deal with such issues (such as GPs, psychologists, psychiatrists, mental health workers, alcohol and other drug clinicians, etc.):

Just one question saying, "Have you or anyone in your family been affected by adoption?" That's really all you need to know in the initial assessment where you can explore further down the track. (Adoptee, Tasmania)

It is important that the experience of asking for information be normalised; for example, by incorporating it into standardised screening and assessment tools, or by simply starting the conversation, by asking a question such as, "Do you have an adoption experience?" And if there is an affirmative answer, to follow up with, "Do you believe that your adoption experience in any way relates to your presentation at this service today?"

11.5 The service system

Information

For many adopted individuals in this study, access to personal information that the broader community takes for granted, such as birth certificates, was viewed as being an important issue. Yet according to our respondents, access to this information and documentation was often frustratingly difficult and expensive. They didn't want to have to beg for what they feel is rightfully theirs. Not being provided with information about their background has had a direct effect on adopted individuals' sense of identity and place within society:

The law says, because I am adopted by her, I am not her daughter, but the birth certificate says that I am. So who am I? (Adoptee, WA)

Similarly, for the mothers who were subjected to the forced adoption of their son/daughter, the desire for obtaining their records, from the time of their pregnancies through to when their child was placed with their adoptive families, appears to be integral to their ongoing healing and recovery from their experiences.

Access to the medical histories of the adopted individuals' birth family was one of the most frequently stated issues by study participants (including from the perspective of adoptive parents), who felt that such access should be available regardless of contact status. For those who have attempted to find information about the medical histories of their family of origin and either been unable to connect or had obstructions to finding such information (such as contact/information vetos or non-disclosure of identifying information about fathers), this may literally be a case of life or death. We heard from adoptees and their other family members about cases where potentially life-threatening illnesses were unable to be appropriately detected or diagnosed because in some cases they weren't aware at the time that they were adopted, or more commonly, because they lacked personal and/or family information. The effects of not having this information are widespread, both for their own health issues and the capacity for accurate screening and diagnosis, and for subsequent generations' health issues.

A centralised information system or register is highly desired by those affected. The barriers presented when attempting to navigate an often complex and bureaucratic system across states and territories appears to have ramifications for individuals' ongoing efforts to piece together their identity personal histories.

Governments and non-government agencies responsible for the holding and distribution of adoption information require specialised training in how to sensitively and effectively manage the sharing of this information.

The abolition of processing fees for adopted individuals and mothers wishing to access their own records, particularly original birth certificates, was strongly advocated by study participants, particularly adopted individuals:

Why should we have to pay for something that everybody else can readily achieve or obtain? (Adoptee, Qld)

Some participants spoke about contact registers in that they would like to see that they are regularly updated, giving people the opportunity to revisit their decisions to be or not be contacted. This was seen as being of particular importance for those whose parents/children have contact vetos in place. Adopted individuals in particular voiced their frustration with how this affects their right to medical/genetic information. For many, it is simply about having the information available to them, and the need for actual contact as being something they can accept not having:

It's not about meeting her as such, it's about having the lineage. (Adoptee, SA).

Search and contact

Management of information searches

Study participants made it clear that the process of search, contact and navigating new relationships needs to be managed from the very first stage when information is being sought. Suggestions included having a referral to a support agency prior to and upon receipt of information from any government department or other agency that is holding records. Others suggested that information packages could be made available that contain information such as what to expect when searching; how this may affect self and other family/loved ones; and how to manage expectations around search outcomes.

Another option was the allocation of a case manager to all those engaging in the process of search and contact, who can assist in the often complex navigation of varied systems and who can act as a single point of contact for both the person searching and the external parties providing information. This role could also extend to the coordination of support to other family members - such as spouses, children and parents (including adoptive parents) - in order to remove/displace some of the pressures on the person at the centre of the search who may be going through an emotional and trying time. Given the discussions from all respondent groups regarding the effects of divided loyalties, having access to a person in such a role who can act as a mediator, would perhaps address many of these issues. As one participant said, there are psychological benefits to "outsourcing the search and thus removing myself from discovering possible rejection of my enquiry" (Adoptee, 189, 2012).

Characteristics of search and contact services that reflect best practice

Participants stated that one of the most helpful aspects of search and contact services was the attitude of service staff - their capacity to be understanding, sensitive, respectful, professional and knowledgeable on the issues. The broader view of study participants was that professionals do not necessarily have to have a personal adoption experience, but they do need to have training and be adequately equipped with the necessary specialised knowledge. Having said this, study participants were generally also in favour of all those providing such services being required to undergo some level of training to ensure an appropriate standard of practice. This was viewed as being one measure of accountability for those who do have a personal adoption experience who are in a position of providing support, so that their own issues are not transferred to those seeking assistance and that appropriate boundaries are established.

A number of key elements of good practice emerged from the data we collected in the current study. These elements of good practice include:

  • requests for information from departmental/organisational staff are responded to in a timely way;
  • information is delivered in a sensitive and respectful manner;
  • advice and information is given about what to expect throughout the entire journey, not just about how to search;
  • formalised complaints processes are made known and readily available to service users as a means of accountability to address some of the concerns raised by participants regarding poor levels of professionalism;
  • staff are available - being a point of contact when/if needed and that there are flexible hours of operation to accommodate the varying needs of service users, including meeting the needs of those living in more remote locations, where access to a physical site may be impossible;
  • service providers are well-informed and understand the issues associated with adoption for all members of the adoption circle;
  • ongoing support and follow-up from the agency involved is provided in acknowledgement that for those affected, it's not just about getting the information and then being left to deal with the outcomes of contact; and
  • support, education and information for the other family members is readily available.

Ongoing support options

It's always been for me, desperately trying to find someone you can talk to who has some kind of knowledge or experience or understanding. (Mother, Qld)

As articulated by many in this study, and supported by the findings of the Senate Inquiry (2012), apologies are of little value if they are not followed by actions. The view of study participants is that both government and institutions involved in past practices have an obligation to provide funding for the development of appropriate support systems and to enhance the capacity of existing services.

Key support options that were identified in this study include:

  • adoption-specific support services (post-adoption support) offering a "one-stop shop" for accessing information, search, contact and ongoing support/referral to appropriate professionals, including support for the wider circle of family members and mediation services for new family relationships, as well as managing existing relationships;
  • availability of professional one-to-one support/counselling/therapeutic interventions, delivered by psychiatrists, psychologists and other professionals who have had specialised training or experience in adoption-related issues such as trauma, relational interactions, attachment, abandonment;
  • peer support groups that offer a variety of options, are monitored for quality and accountability, and can accommodate the diverse needs of those affected by past adoptions, such as "mixed" groups; "silo" groups; and those targeted at people at different "stages" of their adoption journey (e.g., contact versus no contact etc.); and
  • primary and allied health services professionals having training and access to information regarding adoption-related issues.
Specialist counselling

At present, we rely upon service providers who have little or no knowledge of this country's appalling history of adoption and the way in which we were treated. We are unable to find or afford skilled, therapeutic therapists that have extensive knowledge and comprehension of adoption and abuse that causes deep psychological scarring and manifests into complex mental health disorders that are often left untreated or misdiagnosed … because it is believed that we all went to good homes. (Adoptee, Qld)

Specialised counselling was seen as being integral to meeting the current needs of those affected; that is, counselling by professionals who have specialised knowledge of the issues associated with adoption (including trauma and relational and attachment-focused therapy). Specialised counselling needs to remain available to those affected throughout the life span - adoption-related issues can be triggered at any time, and often the individual is left in a very vulnerable state when events trigger an emotional response:

I think that ongoing support through not just the immediate adoption and reunification, but the ongoing - as in the next generation parenting, inter-personal relations, educational outcomes - all those sorts of things. Employment, substance abuse, all those things that apparently we are over-represented for. Those supports need to be there and those professionals need to know, potentially what issues come out of adoption. (Adoptee, Tasmania)

I have four children and there are various ages and stages when I have struggled a bit with parenting, in terms of showing affection and that sort of thing. And I found a Facebook adoption support group and I talked to other adoptees at my work and found that's quite a common experience to have difficulty relating to your children. So I think parenting in general and interpersonal relationships are an issue for a lot of adoptees and that's where the support is also needed. Not just the immediate adoption experience, but also the ramifications of that long-term, and how that affects the next generation. (Tasmania)

Participants expressed frustration with not knowing where they can get advice, support, information or referral at the time they need it. The need for timely contact with someone in a supporting role is a significant issue. Many participants suggested a 24-hour telephone line staffed by trained professionals as one way to address the issues of immediacy and accessibility. However, the ability to physically go to a place where they could see a counsellor that they know is knowledgeable about adoption issues was also seen as important.

Specialist services would need to offer a range of support options, such as information and referral to more in-depth counselling by trained staff. Another option in this vein would be online counselling options, such as those that are currently used in the mental health and alcohol and other drugs sectors.

Peer support

I think a diversity of support groups: one about the search, one about the track-down issues and navigating two families. And the tricky birth mother relationships. Dealing with emotions, dealing with society's responses of what you are going through. (Adoptee, Victoria)

The findings of the study suggest that there is a role for peer support models, with a diversity of options within this type of support seen as necessary. Peer support is a viable option for people living in all locations, and can provide the opportunity to meet other individuals who have shared experiences, which acts to normalise their own experience. Peer support can also support those who are at different stages of their adoption journey, and can be a useful source of information and advice from those who are further along the continuum. Peer support also seems to work well as an avenue of support that is available when required (i.e., it is easy to engage and disengage as necessary). The Senate Inquiry (2012) also acknowledged the valuable role that peer support models can play for those affected by forced adoptions.

Some participants were also aware of the different benefits that can be obtained from peer versus professional support:

Both [peer and professional support] can benefit an enormous amount. It is beneficial to share experiences in a supportive way and it is really validating to know that someone else has gone through that as well. But certainly you need that sort of professional person there, and ideally professionals that are working on adoption stuff and they know all those issues. (Adoptee, Queensland)

Our experience of conducting the focus groups, in terms of how easy it was to coordinate, how much participants valued it, and how the vast majority were in favour of such avenues for peer discussion being available in their local area, provides a strong indication that such groups could be readily established and supported (see Box 11.3 on page 217). There are and have been a number of groups established in metropolitan areas; however, data from our study suggest a high level of need for such groups in regional and rural areas. One possibility of how this could be achieved is through the introduction of a "travelling road show", whereby the establishment of a support group is facilitated in rural and regional communities and sufficient guidance provided to let the community lead the way from there. Local community houses could be appropriate venues. It only takes someone to get it started, and with the appropriate level of connection to more formalised support services staffed by trained professionals, this could well be a viable option for providing a solution to an identified support need within this cohort.

Another option that was suggested is to incorporate adoption-related support into existing services, such as family support services, parenting services, or existing phone line services. This was seen as being a particularly useful option for adopted individuals in relation to strategies to deal with issues in their own parenting that are associated with their adoption experience:

Rather than a standalone agency, I think you could incorporate that into the support that is already there for families. So incorporating that into family support resources that are already up and running, and educating those professionals would probably be the most sensible approach. (Adoptee, Tasmania)

Information and support resources

There were many creative ideas that participants suggested as to how better information and support resources could be provided. Some examples included:

  • publications that explain the history of adoption, the common reasons for adoption and the common emotional outcomes:
  • a series of short easy-to-read well-presented fact sheets on key aspects (such as the mothers' experiences, the adopted persons' experiences, the adoptive parents' experiences, other family members' experiences, how to find information about your birth family, and so on);
  • for the wider circle of family members, information resources with advice on how to best support their loved one who is affected by adoption;
  • a booklet that contains stories of people affected by past adoptions, in their own words, that gives insight into a variety of experiences, and which could be distributed widely for doctors' waiting rooms and the like; and
  • a comprehensive website with all the issues relating to adopted people through the different life stages (such as giving birth) linked up to the most up-to-date research, fact sheets, help sheets, information resource sheets, appropriate contact details (for seeking help, such as counselling), and links to government and non-government agencies where people can find assistance with making contact with birth parents.

Current adoption environment and donor conception

Although not included within the scope of this study, current adoption policies and donor conception in Australia were raised on a very frequent basis, both within the survey open-response items and the focus group discussions. As these are areas that study participants identified as being issues of concern, we will therefore present some of the more pertinent points within this discussion. As we highlighted earlier in this chapter, one mother's viewpoint, which we will use again now, encapsulates the broader sentiments of study participants who spoke of these issues.

Without understanding the past, how can we hope to appropriately inform the right actions going forward? (Mother, WA)

Both adoptees and mothers in particular raised their concerns regarding broader community attitudes to current overseas adoptions in Australia; in particular, that the needs of the child aren't necessarily at the centre of people's motivations to adopt. The issues of identity, attachment and "knowing where you come from" were all highlighted as being potential effects on children adopted from overseas if there is a failure to properly inform the child of their heritage and integrate that knowledge and culture into their everyday life. The view of the child as a commodity; something that is "acquired", ran parallel to the stories of many of the adoptees who participated in this study's own adoption experience. The attempt to assimilate the child into Australian culture without recognition of their family and country of birth is a major concern for many who are concerned that history will indeed repeat itself.

While not raised by all adoptees, a fairly common theme was the parallels between their past experiences with adoption, and current issues with intercountry adoption, donor conception and surrogacy. Their concerns are that children are being put in similar situations where they will never know who both their parents are, and where the focus is on the needs of the parents, not the child. Adoptees often talked about how adoption should be the last resort and only for children who don't have anyone who is fit to raise them:

It is still something that people believe is the right thing to do. Intercountry adoption is seen as quite acceptable; to go to another country and bring that child over - pay someone $5,000 to take the child. It's huge, and I think we need to - for those people [intercountry adoptees] to have a voice and say, this is what it did to us. (Adoptee, SA)

Why aren't we supporting them to keep their own children instead of changing somebody's name, changing their cultural heritage, changing everything, creating a false identity, putting them in a family that's nothing like them. I don't think adoption makes sense unless it's really severe circumstances, or they are actually completely orphans. (Adoptee, Qld)

The education of potential adoptive parents was seen as being imperative for many study participants - in terms of what has transpired for those who have been affected by past adoption experiences - so that they can be better informed about the potential issues.

Some participants commented that the "solution" to infertility has shifted from adopting Australian babies of unmarried mothers, to adopting those living in communities where the economic disadvantage is so devastating that those families find it difficult to afford to keep their children in their care. It is not about their families "not wanting" them:

Now we have overseas adoption and I think the problem has just been transferred to other societies. There will be the same problems, but they will be harder to solve. (Adoptee, 407, 2012)

The Senate Inquiry (2012) also highlighted the complexities of the current adoption climate in Australia and determined that the findings of their report be considered in any discussions about local adoptions (section 13.16), and the information provided to the Committee is consistent with the contributions made by participants in this study.

11.6 Summary of implications for best practice models

If a government can't support these sorts of initiatives, then they shouldn't be supporting the practices. (Mother, WA)

The following summarises the information arising from the study that can be used in the development of best practice models or practice guidelines for the delivery of supports and services for individuals affected by past practices.

The feedback from the service providers corroborated what mothers and adoptees told us about their experiences of accessing services. The predominant issue was that there were not enough services, and when they were available, the professionals were often not knowledgeable on adoption-specific issues. Furthermore, many clients were not aware of the services available and those who were aware often found that the cost of the services made long-term involvement prohibitive.

The service providers involved in the survey had very similar perceptions of the service system, its strengths and its weaknesses, with the strongest message from them being the need for support for counselling. Financial support to assist people affected by past adoption experiences to afford counselling, as well as training support to assist in the development and cost of training counsellors in adoption-specific issues. One respondent suggested implementing a model similar to Find and Connect, which is a service developed to address the needs of people who have been in out-of-home care as children, whether as Forgotten Australians or former child migrants.

Service professionals also held similar views in relation to there being a need for more awareness around the issues stemming from past adoption experiences and promotion of the services available. Respondents advocated for public awareness campaigns involving the media, government agencies and other organisations. As with the mothers, service providers believed that validating the experiences of those affected by past experiences of adoption was fundamental and a first step to addressing the stigma associated with adoption.

Many respondents were mindful that the inadequate availability of information on adoption-related issues also needs to be tackled. This included the availability of information on best practice models for organisations as well as information about birth families for clients themselves. They advocated for the facilitation of access to information, and wanted increased funding for search, contact and reunion services; funding; training; and inter-agency cooperation.

Respondents supported the development of a system-wide network that can connect clients with services, and support services with other related services. Furthermore, search and reunion organisations advocated for a better relationship with government agencies to assist in the sharing of information.

Funding is a key issue that overlaps many of the previous discussion points. Primarily, funding for counselling was strongly advocated.

There were divergent views about the capacity of existing systems to effectively meet the needs of people affected by past adoptions. Some common strategies that were identified within both the core group as well as service provider components of the study around how the needs of those affected by past adoption experiences could be addressed include:

  • Improving education and trainingof professionals who work with people affected by past adoption practices, such as counsellors, social workers, mental health professionals. Respondents believed that better professional development and training in adoption-related issues would assist in meeting the needs of those affected and that this could be addressed through improving education and training. Respondents frequently suggested one way this could be achieved is to include education about adoption in tertiary education for a range of welfare professionals so they are capable of helping clients deal with issues such as grief and loss, identity, shame, trauma, excess feelings of guilt, rejection, emotions of anger/hurt, difficulty maintaining friendships or close relationships with family (attachment issues), anxiety, and self-confidence problems.

 Other suggestions of how this could be achieved were by:

  • publishing good practice guidelines;
  • funding conferences for national post-adoption workers;
  • dissemination of information and research; and
  • conducting research into topics of adoption (especially longitudinal studies).
  • Enriched awareness and information in both the professional community and in the general public would be beneficial in addressing the needs of clients. A "concerted effort" is needed so that the "lifelong impacts of adoption" can be addressed. Respondents proposed increasing promotional material, with information about adoption issues and relevant services being made available to people affected by past adoption experiences.

 Broader "advertising" of the past practices of adoption as well as the availability of services for those in need could improve the general public's understanding of issues resulting from past adoption experience and strip the shame and stigma associated with it. Suggestions of how to achieve this included:

  • educating teachers, hospital staff, allied health practitioners, mental health workers, counsellors, social workers, ministers of religion etc.;
  • government awareness campaigns; and
  • interviews/discussions in the media.

 The media was seen as playing a role in this broader awareness raising. Many respondents asserted that television programs such as Find my Family encourage an inaccurate perception of adoption issues.

  • Improved funding for specialised adoption services, as well as funding to assist people on a fixed or low income who struggle to afford the costs of adoption-related services. A large proportion of service providers who participated in the study believed that their clients are in need of counselling and support services; however, the current availability of such services was considered to be inadequate and too costly.

 Study participants were for the most part supportive of the provision of funding to make counselling more affordable for those affected. Improved funding encompasses all aspects of investment: funding to support ongoing or intermittent counselling as well as for training more counsellors and publicising the availability of these services. Access to counselling services for all people affected by past adoption practices could be delivered in a format similar to that offered to the Forgotten Australians and former child migrants.

  • Better networking would improve the liaison between organisations, agencies and state/territories around best practice issues. This could be achieved through an improved interagency network that facilitated this communication. Suggestions on how to achieve this included:
  • developing a practitioner network similar to the Mental Health Practitioner Network; and
  • standardising legislation across jurisdictions.
  • Support with search, contact, and mediation, which was identified as an issue across all respondent groups as well as service providers. This included assistance with the contact phase and with mediating between families, and informing families of their adoption experience (mothers) or their intent to find their birth families (adoptees). Intermediary and mediation services are needed for clients who require assistance during the reunion process in managing the contact with the birth family.
  • Facilitating access to information - Suggestions on how to achieve this included:
  • ensuring consistent access policies from Births, Deaths and Marriages departments across all states;
  • digitising records and housing a searchable database in each state;
  • simplifying the process of accessing information;
  • waiving fees for accessing records;
  • reviewing privacy laws in the context of adoption;
  • employing more caseworkers, researchers administration support and staff;
  • providing materials to share with clients on adoption-related issues, including simple fact sheets with information about which agencies offer which services in each state, through to material describing the effects of adoption and sharing stories about reunion, and healing journeys;

 Other suggestions for improving the services provided included:

  • offering online and telephone support services to provide access to clients in rural and remote areas;
  • encouraging face-to-face interactions with clients when providing adoption information, allowing counsellors who have established a relationship with client to pass on sensitive information;
  • providing external clinical supervision and support;
  • promoting awareness about past adoption practices from government/community; and
  • enhancing cooperation between various agencies providing support for people affected by past adoption experiences.

11.7 Conclusion

Across the various respondent groups, despite the range of views and issues raised, there are some important areas where the majority of participants aligned in relation to the needs and priority actions for responding to the ways closed adoption has affected their lives. These include:

  • acknowledgement and recognition of past practices (including the role of apologies and financial resources to address current service and support needs);
  • raising community education and awareness of past practices and subsequent impacts;
  • providing specialised workforce training and development for primary health carers, mental and broader health and welfare professionals to appropriately respond to the needs of those affected;
  • reviewing the current search and contact service systems, with commitment for improved service models;
  • improving access to information through the joining of state and territory contact databases, governed by a single statutory body;
  • improving access and assistance with costs for mental, behavioural and physical health services; and
  • ensuring that lessons from past practices are learned, and translated where appropriate into current child welfare policies, and that adoption-specific services are created or enhanced to respond to the implications of past practices.

11.8 Strengths and limitations of the current study

There are some serious limitations to the study that should be noted.

Most importantly, data were collected from a self-selected sample as there is no identified database or other sampling frame from which to randomly invite people to participate. Therefore, we cannot say with confidence that our findings are representative of all people who have experienced closed adoption in Australia.

Also, the data were collected "within the shadow" of the Australian Government's Senate Community Affairs References Committee's inquiry into former forced adoption policies and practices, which ran from November 2010 to February 2012 (data collection for our study ran from August 2011 to May 2012). The publicity surrounding the inquiry may have influenced people's decision to participate, as well as the issues that were "front-of-mind" for them in responding to our survey or discussing issues with fellow participants in the focus groups. For example, we found that some topics - such as the role of a national apology - were raised spontaneously, which may have been influenced by the public discourse and interest group activism around the Senate Inquiry.

Finally, the purpose of our study was not to discern the "truth" of any one respondent's historic circumstances. It was a psychologically focused study - looking at people's reports of their experiences, but most particularly, on the ways in which they see their adoption experience as having affected them and with which issues they need services and supports. Therefore, the study identifies the strength and variety of views that participants had about past events and their impact on them now, and what they want to assist them in leading stronger, happier lives.

Nevertheless, there are numerous strengths to this study that mean the data will be a reliable source of information on the experiences and current needs of Australians affected by past adoption practices. These strengths include:

  • the large number of respondents in the study (n = 1,528), which represents a small but significant proportion of people currently alive who are likely to have been affected by closed adoption from the mid- to late 20th century in Australia;
  • the use of online surveys to facilitate ease of participation, supported by hard-copy surveys (as requested) and/or phone interviews, and supplemented by a very large in-depth follow-up series of focus groups and interviews with participants (n > 300);
  • the wide-ranging approach to recruitment of participants, supported by a comprehensive communications strategy designed to raise awareness among all Australians of the existence of the study, and the opportunity for people with a closed adoption experience to participate and tell their story;
  • our national perspective, with participants coming from all states and territories;
  • the integration of quantitative and qualitative data to give quantifiable statistics, as well as rich accounts of people's lived experiences of closed adoption;
  • the use of standardised measures of wellbeing, which allows comparison with other nationally representative data;
  • the integration of different perspectives from the "adoption triangle" (as it is often called, or as we suggest here, the "adoption circle"): including mothers, fathers, adoptees, adoptive parents, and other family members;
  • supplementing information on the current service needs of respondents with data from service providers and agencies responsible for specific adoption-related services (such as the Find and Connect service);
  • reflecting the views of a wide variety of respondents, including those who are part of a support or advocacy group and others who are not affiliated in any way, and those who saw their experiences of adoption as being positive, neutral, or negative; and
  • the use of neutral questions, and adopting an open and questioning approach to the topics (e.g., rather than assuming people's adoption experiences had been singularly negative or positive, we asked people to describe or rate it for themselves, so that we did not bias their response one way or another).

Our hope is that the rich detail provided of individuals' journeys through the period of closed adoption in Australia, through to the issues they now face, and to whom services and supports could be better targeted is reflective of the variety of perspectives that were shared with us. We also hope that the trust that more than 1,500 Australians placed in us to hear their journey and convey their messages is well placed, and that this report honours the pain, courage, joy, anger, energy and commitment that was so evident in the people who contributed.

Box 11.1: Key service system implications

Mothers
  • Mental health professionals - including psychologists, psychiatrists and psychotherapists - will require specialised education and training to respond effectively to the needs of those affected by past adoptions. The two key issues mothers talked about that related to professional education were: (a) knowledge about the events that surrounded closed adoption and the range of experiences that those affected may have encountered; and (b) training in specialist therapeutic skills to address the ongoing effects of trauma, identity issues, negative self-concept, and relationship issues that relate specifically to the adoption experience. This suggests that development of appropriate training modules that are readily accessible to those working in such professions is needed.
  • Many current service provision agencies and professions (e.g., church-based agencies, social workers) are strongly associated in the minds of many mothers with their experiences of trauma. Any expansion or creation of new services should be undertaken with sensitivity to this.
  • As well as developing a specialist workforce, health and welfare professionals in the broader services would benefit from education about the effects of past adoptions on mothers (including potential physical, social and psychological effects), and training in how to provide appropriate assessment, diagnosis and referral to specialists.
  • Post-adoption support services would be obvious places that could act as central points for the provision of information and referral to the broader health and welfare sectors.
  • With appropriate resourcing, existing post-adoption services could provide ongoing engagement with those who are at all stages of their adoption journeys. Continuity of care (i.e., not having to repeat one's "story" or build rapport with a new service provider) will play a significant part in the likelihood of those affected feeling adequately supported.
  • Addressing current physical and mental health problems that mothers attribute to their past adoption experiences is closely linked to recognising their need for acknowledgement, restitution and positive self-identity.
Fathers

Fathers' accounts suggest areas of improved service provision relate to:

  • inclusion of their names on birth certificates;
  • access to "search and contact" services;
  • advice and assistance with managing ongoing contact with son/daughter, including assistance with helping sons/daughters understand why they were adopted, and that it wasn't necessarily the fathers' choice;
  • funded, professional counselling by qualified counsellors who have an understanding of adoption issues and its effects (including post-traumatic stress);
  • coordination of peer supports for fathers who have been damaged by their experience of adoption; and
  • increased societal awareness and understanding of what happened and why, and acknowledgement of the injustice of past practices.
Persons who were adopted
  • Addressing the variability between state and territory-based systems and laws regarding adoptees' access to information would be of significant benefit. The difficulties in navigating often complex systems, along with the associated costs, has been identified as a barrier to the formation of sense of self and identity, as well obtaining potentially life-saving information regarding medical histories. The centralisation of all state and territory databases would be the most efficient way of addressing this issue.
  • Reviewing and potentially harmonising state and territory laws relating to contact and information vetos was seen as a high priority. Currently, vetos are seen by many adoptees to deny them access to medical/genetic information that they regard as their right, and differences in state/territory laws also create difficulties for situations where the two parties live in two different jurisdictions, or a different jurisdiction from where the adoption occurred. Harmonisation would still need to take into account the needs of those adoptees and birth family member(s) who do not wish to be personally identified in the information provided.
  • Mental health professionals, including psychologists, psychiatrists and psychotherapists, will require specialised education and training to respond effectively to the needs of those affected by past adoptions. Key issues adoptees talked about that related to professional education were: (a) knowledge about the range of experiences that those affected may have encountered, including abuse and neglect and late discovery of adoption; and (b) training in specialist therapeutic skills to address the ongoing effects of identity issues and negative self-concept, and relationships that relate specifically to the adoption experience. This suggests that development of appropriate training modules that are readily accessible to those working in such professions is needed.
  • As well as developing a specialist workforce, health and welfare professionals in the broader system would benefit from education about the effects of past adoptions on adoptees, and the potential physical, social and psychological effects. They would also benefit from training in how to provide appropriate assessment, diagnosis and referral to specialists.
  • With appropriate resourcing, existing post-adoption services could provide ongoing engagement throughout the adoption journey. Continuity of care (i.e., not having to repeat one's "story", and build rapport with a new service provider) will play a significant part in the likelihood of those affected feeling adequately supported.
Adoptive parents

Adoptive parents talked about the need for ongoing support at the time of the adoption, so were less focused on current service needs. Their accounts suggest areas of improvement to current service provision relate to:

  • managing contact with birth parents;
  • managing their own emotions when children decide to seek information or make contact with birth parents;
  • assistance with medical information/family history for their son/daughter;
  • public awareness of adoption issues to be balanced with positive stories, and reflecting the motivations of adoptive parents (e.g., many assumed they were doing a service by keeping a baby out of institutional care); and
  • some (limited) need for peer support or professional counselling services for themselves, but more so for their sons/daughters (especially during the search/contact process).
Other family members

Other family members who completed surveys or participated in focus groups talked about the need for ongoing support for themselves, as well as their family members. Their accounts suggest areas of improvement to current service provision relate to:

  • support to help them deal with traumatised family members;
  • wanting help and direct support for their family member affected by adoption; and
  • public acknowledgement of (including an apology for) past experiences and its effects to create awareness and greater openness.
Service providers

The most common suggestions by respondents for enhancing the services provided by the support system were:

  • improving access to information and awareness on:
  • services operating and a referral list of trained colleagues;
  • available training;
  • developments within the adoption community; and
  • best practice and procedure;
  • increasing funding for:
  • employing more caseworkers, researchers administration support and staff;
  • subsidising counselling and other relevant services for people affected by adoption;
  • allowing professionals more time to work with clients;
  • promoting the services offered by agencies;
  • arranging training, seminars and workshops; and
  • research into issues relating to adoption and the various healing modalities that can be employed to assist the professionals providing support;
  • providing materials to share with clients on adoption-related issues:

Materials and resources to share with people affected by adoption, from simple fact sheets with information about which agencies offer which services in each state, to material describing the impact of adoption and sharing stories about reunion, healing journeys.

Other suggestions for improving the services provided included:

  • offering online support services to provide access to clients in rural and remote areas;
  • encouraging face-to-face interactions with clients when providing adoption information, allowing counsellors who have established a relationship with their client to pass on sensitive information;
  • providing external clinical supervision and support;
  • promoting awareness by government and other relevant agencies about past adoption practices; and
  • enhanced cooperation between various agencies to provide support for people affected by past adoption experiences.

 

Box 11.2: Key features of good practice

The implications from our study for "good practice" when implementing improvements to service provision are summarised in terms of information delivery; search and contact services, and other professional and informal counselling and supports.

1. Good information services (including identifying information and access to personal records) are:

  • delivered by trained staff;
  • responsive to requests in a timely way;
  • accessible through moderated websites, and/or 24-hour phone lines;
  • provided with sensitivity to the needs of those seeking it (confidentiality, discretion, language used, etc.);
  • relevant to the "stage of the journey" of individuals; and
  • provided with a range of support levels (e.g., access to support person - onsite and follow-up).

2. Good search and contact services:

  • enable access to counselling and ongoing support during the search and contact journey;
  • provide advice and information about what to expect throughout the entire journey, not just about how to search;
  • use an independent mediator to facilitate searching for information and exchanging information; and
  • address expectations before contact is made and provide ongoing support afterwards.

3. Quality professional and informal supports:

  • incorporate adoption-related supports into existing services (such as Family Support Program funded services, or Medicare-funded psychological services);
  • provide options for both professional and peer supports; and
  • address trauma, loss, grief and identity issues.

Across all three types of services, the following elements of good practice also apply:

  • Formalised complaints processes are made known and readily available to service users to ensure service accountability.
  • Staff are available to be a point of contact when/if needed and there are flexible hours of operation to accommodate the varying needs of service users. This also includes meeting the needs of those living in more remote locations, where access to a physical site may be impossible.
  • Service providers are well-informed and understand the issues associated with adoption for all members of the adoption circle.
  • Ongoing support and follow-up from the agency involved is provided, in acknowledgement that for those affected, it's not just about getting the information and then being left to deal with the outcomes of contact.
  • Support, education and information for the other family members is readily available.

 

Footnotes

29 These data are taken from Wave 8 of the HILDA survey. The survey uses an 11-point scale (0 to 10) for its life satisfaction scale. To make this more comparable with our 10-point measure, we rescaled the HILDA scores by a factor of 10/11.

30 Our methodology does not allow us to conclude whether all mothers have this same risk profile, or whether there were fewer mothers with positive mental health who chose to participate in the current study.

31 The potential for - and the reality of - these conflicts was similarly noted in the Senate Inquiry report (2012).