Dr Sue Armstrong Brown on Children’s Mental Health Week 2018 Adopted children are just like other children. You can’t spot the difference just by looking at them. And they live with the same pressures as the person sitting next to them at schoolExams, relationships, social media... it’s all bubbling away in their brains as they grapple with phonics and fractions and irregular verbs. It can be tough being a child. Children who are adopted are also living with their ‘back story’ – the story of the abuse and neglect that caused most of them to be removed from their birth families, and of what happened to them afterwards. Home might have been violent and scary but you loved your parents. You might have been cold and hungry but it was familiar. But it wasn’t safe to stay, and you were taken away from everything you knew. You left most of your belongings behind, along with your school, your friends and maybe your brothers and sisters. Then you went to live with your ‘forever family’. Lots of smiles for the camera but by this stage your sense of yourself and where you belonged in the world were in shreds. The risk of mental health problems is extremely high. Many adopted children deal admirably with their story, with the support of families who learn on the job how to parent like a therapist and in some cases with professional help. The feelings are still there, and they leap out at all sorts of expected and unexpected moments, triggered by anniversaries, birthdays, the sound of a Velcro strap on a coat, the first frost of winter, the smell of creosote. But they are manageable, and the children cope with the lifelong legacy of the trauma they’ve experienced. Some don’t. They’re the ones we hear most about – the children who spin out of control, the family lives that are shattered, the adoptions that break down. In England, the Adoption Support Fund was set up in response to the emerging recognition of the need to provide better post-adoption support. In 2016, the Department for Education announced that demand was more than twice the level forecast. The size of the Fund has been increased, partly due to lobbying by adoption organisations including my own, Adoption UK. The fund is a lifeline for many adoptive families, with more than 80 percent saying that the therapy they have received via the fund has had a positive impact for their family. So far, it has funded over £50 million of support for 18,000 families. Despite these advances, huge numbers of adoptive families are unable to access the right support for their child, and themselves. Families may fall between the stools of the equally overstretched Children and Adolescent Mental Health Service and the adoption services, or outside England where there is no ASF, their local authority may not have the resources to help. This may mean going without, or having to try and fund treatment for mental illness themselves. Therapy is expensive and most families can’t afford it. Getting early help for adoptive families is absolutely crucial. If left unaddressed, attachment and developmental trauma in early childhood turn into behavioural and mental health problems. These affect school careers and social relationships, bringing significant challenges in adulthood, with knock-on impact on social care, health services and the workplace. We need to see more recognition that children who have been in care have experienced trauma, and that they and their parents and carers are more likely to need support than not. There should be early and comprehensive assessments, not just for mental health but for attachment and related conditions such as FASD and ASD, all tied into a comprehensive care plan. Only by acting early and across silos will we be able to help rebuild the lives of these most vulnerable children in our society. The increasing profile of mental health is fantastic, and initiatives like Children’s Mental Health Week are a very good thing. Raising awareness of the many consequences of neglecting mental health needs in childhood is the only way to improve provision. Adopted children need more support than most. It’s definitely time to talk about the mental health crisis facing adopted children and their families. Adoption UK is preparing some input into the government’s Green Paper on Children and Young People’s mental health. We’d love to hear from adopters and adoptees about their experiences. Please get in touch by email to [email protected].