Post-adoption depression needs to be normalised, expected and proactively addressed

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Adopted children are vulnerable and need a strong start in their new families. As a paediatrician and designated doctor for looked after children, I've seen the impact of post-adoption depression (PAD) on parents and children. Unfortunately, PAD has played a role in some serious safeguarding cases in the UK. 

My Churchill Fellowship allowed me to study how different agencies address PAD, specifically in the United States, and support adoptive parents. I will bring these insights back to the UK to improve adoption processes and help adoptive families thrive. 

I have reflected on my research trip thus far in previous blogs about culture, transport and terminology and tiredness. But now, the suitcase is packed away and the Report is published. That must be the end of the journey?  

How wrong can I be! It appears to have been just the beginning. I have spent time this year travelling both in person and virtually to present my findings to a wide range of people who are interested in improving the lived experience of adopters and adoptees. I have found that post-adoption depression, and more widely the impact of adoption on emotional health and wellbeing, needs to be explored by adopters and the professionals who work with and support them in multiple different ways and at different points along the adoption journey. It needs to be normalised, expected and proactively addressed. This includes in adoption preparation, home study and post-adoption support. Health professionals, including health visitors and general practitioners, also need to be more aware of it so they can better support families.  

Of course, I am keen to spread my findings with anyone who will listen! I have had some robust conversations which have helped me connect and clarify my desired pathway. I have been asking practitioners to think about what they already know about post-adoption depression? What they or their service could do differently with regards to the emotional wellbeing of adopters? And if there is anything I or we could be addressing at system level to create change?  

The pathway I am actively pursuing in health is that of a new ‘adoptive parent emotional wellbeing package of care’ embedded in the health visiting service which replicates the new ‘birth parent emotional wellbeing package of care’ ( which also screens for postnatal depression ) Put simply the health visitor will proactively visit families with a new child placed for adoption, they will offer support and use a standardised assessment tool which will include the ‘Whooley questions’ (or the PHQ2) to check in about their emotional health and wellbeing. The pathway then clearly lays out actions if concerns arise. The health visitor will be encouraged to learn more about adoptive parenting to ensure advice and support is consistent with that from social care. 

I am really pleased to say that our Healthy Together Team in Leicester has adopted this pathway and along with Public Health we will be piloting it. I hope next year to share the findings of the pilot. 

This is indeed the next small step along the journey to realise the national change that is needed. 

Dr Lynn Snow, Churchill Fellow & Community Paediatrician working as Designated Doctor for looked after children for Leicester, Leicestershire and Rutland.   

Read my Churchill Fellowship Report here.

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