Improving mental health services for adopted children: co-production

The story so far ….

In October 2015 feedback from adopters about CAMHS services was presented to a large meeting of professionals and government officials. The feedback was the result of an informal but substantial consultation with adopters and professionals and the suggestions we made to improve services were cohesive and well thought through.

In March 2017, again in consultation those proposals were boiled down to two core principles that most agreed should be part of a good quality service that would meet the needs of adopted children and their families.

That brings us to now. This week I submitted four detailed proposals to the expert group I belong to. I’ve tried to stick to things that are achievable and affordable.  These are:

Mandatory training (initial and continuing) for all mental health professionals who work with adoptive families in complex trauma and attachment, co-produced by adopted young people and their families.

Adopted young people and their families to be embedded in commissioning and governance of mental health services and in their design, delivery and evaluation. Again, co-production.

Establishment of regional centres of excellence that specialise in complex trauma and attachment, that act as a focus for creating excellence in services and improving skills, education and research. Involve users in the design, delivery and evaluation of services. Co-production.

Development of an app for adoptive parents that encourages and supports self-monitoring of mental wellbeing. acts as a prompt for self care and records data around what helps and hinders. (Not meant as an alternative to professional support). Not very well thought out, so could be a crap idea.

NB I refer to adoptive parents throughout because these are the people who have taken part in this work. I don’t mean to exclude others who parent care-experienced children and young people, although these proposals could work across the board, I’m just taking care not to speak outside my area of experience.

Services that listen to and learn from their users, work best for those users, and adoptive families are no different. Plus we are engaged, committed and well-trained. What’s not to like?

4 thoughts on “Improving mental health services for adopted children: co-production

  1. Becky Poole

    Sally parent carer forums are exactly for this purpose. As an adopter Im also part of one and been banging on for ages. What DFE and CCG seem good at is separating groups off… you get offered a cream custard and think brill we got somewherr but another group gets a triple cream custard and another with Jam on top.
    As part of Parent Carer Forum which is part of a wider forum altogether I urge you to join with Sherann Hillman of NNPCF and tackle this 2 pronged. 1) from Adoption side 2) from PAN disability side. NNPCF should be inclusive which is why as an adopter Im part of this wider network that has official ties to our mate ED. However I see limited evidence as money into LAs for SEN/Adopted kids is not ringfenced…..CAHMS are not prepared to recognise Attachment as MH.
    We bang the same drum but I fear the DfE likes lots of pockets of small drims rather than the roar of one very large

  2. Annabel Wells

    I think you have made some very useful points. As a psych nurse working in CAMHS I think several of my colleagues would agree that training in complex trauma and attachment would be extremely helpful, as we work with a lot of adopted children and their families.
    As to your comment about having adopted young people and their families involved in commissioning and governance, I think this would be very useful and relatively easy to organise, as I know several colleagues who are like me adoptive parents and mental health professionals.
    I personally am not sure I would use the app, but otherwise agree with your suggestions.

  3. Megan

    Hi Sally

    Thank you so much for representing adopters on this project. You have done such a great job. Your recommendations are spot on – I am sure the app will be helpful for some. Its a great idea anyway and good to have such thought given to our needs.

    I set up Adopters Together, a peer supported campaigning group, with another adopter at the beginning of August 2017. We set up this group because a collective voice is so important to protect our identities and our children, and we found there was nowhere else to speak or be heard.

    Having asked for help, as single mothers, we had our disabled adopted children removed under Section 47 Care Orders (but not our birth children), with harrowing court proceedings. Many times we have found we were rubbished and vilified. No one ever imagines this nightmare will happen when they make a lifelong commitment to parent a traumatised child from the UK care system. The phrase ‘forced adoption disruption’ kept coming into my mind. I had asked for help – what I got was the removal of my child and character defamation. My child is, thankfully, back home now. I did not have the violence issues to deal with that many parents experience, and ours was a happy home. Errors were made, which gave me a very different perspective on the system from professionals and experts, and one which I hope can be valued by them. Being viewed as part of the problem instead of part of the solution has given me a great deal of empathy for birth parents. Losing a child to care is really harrowing.

    Parenting from a Distance is incredibly hard emotionally and puts a great strain on any family – and being labelled a disruption or failed adoption when this is not the case makes you feel written off as a person and family. We were powerless to help our children in care and when they tried to take their own lives we weren’t even told by Social Care. Our children could not access the Adoption Support Fund and no one with adoption expertise worked with them, or us – and if they did they weren’t listened to – not even court appointed experts. LAC reviews were mental torment and in one case there was a directive from senior managers to only speak of positive things in the review. There is a denial of distress and trauma. Acts of desperation were not given proper attention. Children who were actively suicidal are described as ‘bright and positive’ about the future. Suicide attempts in care were described as ‘self harm’ and cutting was described as ‘superficial scratches’ by mental health professionals. Allocated workers constantly changed – they were often on long term sick or suddenly left the Authority. Senior managers, who gave instructions to costly barristers but never came to court, seemed to use the Family Courts to shift the focus away from organisational negligence and failings, and onto the parent, using ‘parental control’ and ‘parental capacity’ – to take children away from good, nurturing, loving homes, and from parents who cannot access legal aid.

    More supportive legislative frameworks are needed to safeguard loving parents and vulnerable children from organisations who prioritise their own interests over those they are set up to serve – and remove disabled children, against their wishes, from loving capable parents who underwent lengthy and rigorous assessment, and parented well for many years.

    We are meeting with the SCIE on October 4th for a one to one consultation – after raising serious concerns to chair Peter Fonagy. Its too late for the final recommendations, which have already gone to press but we will have the meeting published on the SCIE website.

    Its hard to stand up to power, and say this is just not working. This is ruining lives. We feel modern adoption needs a rethink in these times of austerity and service cuts, when statutory agencies are in disarray. It certainly should not be that an adopted child must re-enter care to access help and support. This potentially undermines the permanence of adoption. It is hugely problematic when our children must re-enter care for us to just have a break from the intensity of family life, which will inevitably be the case sometimes, when there is trauma in the home – or if the adopter is a single parent. Its potentially re traumatising for our children to suddenly be confronted by Social Care, this potentially acts as a trigger to earlier removals, and in these cases it seriously de-stabilises. My understanding is this situation came about in the 1980s when the Section 20 Care Order was introduced with the best of intentions – to better monitor Foster Care.

    I think it would be better to give families budgets to source and pay for their own respite – right from the beginning of an adoption so the child gets used to being cared for by others, and for parents to source therapy (for themselves rather than their children), that works for them (a wide range of possible choices to include complementary therapies and talking therapies), which should be funded. Therapeutic parenting is a very tough job that should be valued. Adoptive parents need empathy and help, not battle after battle to achieve support. Society will reap the benefits, as well as our children, when there is proper investment in post adoption support and the parental love and care we give our children is appreciated by society – and properly recognised by those that are involved in developing our support.


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