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Post adoption contact with birth relatives who have mental health problems.

Post adoption contact with birth relatives who have mental health problems. Dr Elsbeth Neil School of Social Work and Psychology University Of East Anglia, Norwich, . Today’s presentation. How many birth relatives of adopted children have mental health problems?

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Post adoption contact with birth relatives who have mental health problems.

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  1. Post adoption contact with birth relatives who have mental health problems. Dr Elsbeth Neil School of Social Work and Psychology University Of East Anglia, Norwich,

  2. Today’s presentation • How many birth relatives of adopted children have mental health problems? • Are there differences between mothers, fathers and grandparents? • Are mental health problems caused by adoption or vice versa? • Do mental health issues affect the quality of post adoption contact? • What are the special considerations in planning contact and supporting contact?

  3. Underpinning research • 130 birth relatives of adopted children • Birth mothers, fathers and grandparents • Time since adoption varies from 0-10 years • Most people had some post adoption contact, for the majority this was indirect • For majority of people, the child was adopted via care system

  4. Measuring mental health: the Brief Symptom Inventory (Derogatis, 1993) • 53 item self-report questionnaire • People rate the distress experienced in the last seven days in relation to various symptoms e.g: • Have trouble concentrating • Feeling inferior to others • Feeling no interest in things • Feeling tense or keyed up • Feeling that you are watched or talked about by others • Feeling afraid in open spaces or on the streets

  5. Measuring mental health: the Brief Symptom Inventory (BSI) • Comparisons can be drawn with non patient sample, psychiatric inpatient sample, and psychiatric outpatient sample. • People are considered to meet the criteria for a psychiatric diagnosis if their ‘global severity index’ (GSI) score is in the top 10%

  6. How many birth relatives have mental health problems? • 59% case positive • Mean birth relative GSI = 1.2 • Mean non patient GSI = 0.3; • Psychiatric outpatients = 1.32, • Psychiatric inpatients = 1.19 • Scores particularly elevated for birth relatives close to the adoption

  7. Differences between mothers, fathers and grandparents • - Mothers: 70% case positive • - Fathers: 59% case positive • - Grandparents: 33% case positive • - Statistically significant differences in GSI scores by birth relative type

  8. How do mental health issues relate to adoption of the child? • From both social worker and birth relative report, mental health issues are strongly related to need for child’s adoption in about one third to one half of cases • The mental health problems of parents are rarely the only reason for the child's adoption. • Self reports suggest most common problems are depression, post natal depression, anxiety and stress, personality disorder, bipolar disorder, but many people do not fit clear categories

  9. Birth mother: They said I had mental health, but they didn’t give me an illness for it. They gave me all sorts of labels and then came to one decision this year of Borderline Personality Disorder. Oh but I had loads, I had stress disorder, I’ve had post-natal depression, I have had everything really they said and I have been on a lot of medication.

  10. How does the loss of the child relate to people’s mental health? • Birth relatives commonly report high levels of psychological distress as a result of the child's adoption There was a lot of pressure on my head…I felt like I was going to explode We were lifeless for months Every time I tried eating I was physically sick…the doctor gave me Prozac and sleeping pills…every time I went to sleep I just had these flashbacks…of the last contact I was on self destruct mode for a long time …all I wanted to do was die

  11. Implications for practice: planning contact • When planning post adoption contact, birth relatives may be at a particularly low level of psychological functioning • High levels of mental distress can impede birth relatives’ constructive participation in planning • Support is needed during (not just after) adoption • Support needs to be available to all birth relatives, not just mothers

  12. Quality of contact: birth relative factors • Sustaining letters or meetings • Quality of interaction with child • Accepting and supporting adoptive placement • Constructive relationships with adoptive parents

  13. The adoption kinship network Birth family Adoptive family child

  14. Practice issues: supporting contact • Help for children and adopters in understanding mental illness • Ongoing support for birth relatives • Facilitation not supervision of meetings • Role of independent birth relative support services before and after adoption • Involvement of adult mental health services • Involvement of wider birth family

  15. More information http://www.uea.ac.uk/swp/rass/ Our current research looking at support for direct contact and for birth relatives http://www.uea.ac.uk/swp/ Information on research and teaching at the School of Social Work and Psychology http://www.uea.ac.uk/swp/people/eneil My webpage e.neil@uea.ac.uk

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