Part 3: Services and support in Scotland for birth parents
Maggie Grant and Jessica Cleary
As part of a wider programme of work to improve the support that parents who have lost a child to care receive in Scotland, the Scottish Government funded AFKA Scotland to carry out research to identify and map support services and explore a range of perspectives from practitioners providing relevant support. This programme of work links closely to the focus on whole family support, which is one of the five priority areas for the change programme set out in Plan 21-24 of The Promise (2020).
The purpose of this third part of the report, which follows a short evidence review (part 1) and research report based on interviews with mothers living apart from their child(ren) (part 2), is to share information about services and practice models identified in the course of the research and promote learning between areas and across different fields of practice. The report aims to provide a starting point by sharing examples and insights from a range of organisations. It does not include an exhaustive list of all services across Scotland but is intended to provide a useful contribution to the on-going work to improve support for birth parents.
It is important to note that some of the services included in this report support a range of people in different circumstances, many of whom will be parents who care for their child(ren) continuously and never live separately from them. We have included such services to illustrate the range of different types of support that birth parents may receive/have received at some point, even where the primary reason for engaging with the service may not be related to their role as parents.
Context and Aims
As the literature review and research with parents that form this report evidence, when the outcome of child welfare processes is that parents live apart from their child(ren) on a permanent basis, the impact is likely to be significant and deeply enduring (Cf. Broadhurst and Mason, 2017). Therefore, the right support is important for parents, children, and other relatives.
Previous research has indicated a range of important messages for practice to support parents living apart from their child(ren) (see part 1). However, the Scottish Government identified a gap in knowledge about the services available throughout Scotland which offer support to families with this experience, and in particular to mothers and fathers.
The information gathered for this part of the report aims to address this gap in knowledge by identifying specialist services that parents can access in Scotland from a range of statutory and third sector organisations and sharing examples of different models of support services. The report also highlights perspectives from a small sample of practitioners working with parents across Scotland in a range of settings, predominantly in social work and maternal health.
This project was supported by a practice group representing a range of professionals working in social work, midwifery, and other areas of practice. The group met three times throughout the early stage of the project, convened by the Scottish Government and AFKA Scotland, and shaped the questions to ask services and the types of information it would be most helpful to identify. The project, and specifically the exercise to identify support services, was also discussed at the Social Work Scotland Fostering and Adoption Practice Forum, to help ensure that information about the project reached a national range of statutory, independent and third sector organisations. Organisations were asked to share information about services they offer, or were in the process of developing, for parents who have lost a child to care, regardless of how the child came into care and where they are living now (for example, in a kinship, foster or adoptive family or in residential care). As the research continued, the range of organisations was expanded to include services, such as in maternal health, that offered support for parents where a child protection concern had been identified. As noted above, this allowed us to include services that birth parents may have received support from at an earlier stage.
A Note on Language
Although ‘birth parents’ is a commonly used name for this group of mothers and fathers, we recognise that there are a range of views on this term. Following discussions with a practice group of professionals, we used the term ‘parents who have lost their child(ren) to care’ in data collection. This term recognises the complex and long-lasting impact of loss and grief parents have described at living apart from their child(ren), although some participants noted that it also risks potentially the stigmatisation of care and/or that it did not fully apply to their service. Participants were also asked about alternative terms or terms that were used within services, and responses included: parents, birth parents, families of origin, parents of care experienced children, parents of looked after children, and at risk parents. Debates about language are on-going, particularly in the context of The Promise (The Promise, 2020), and will continue to evolve over time.
Twelve practitioners from ten agencies participated by providing their perspectives either via questionnaire or online interview. Informed consent was gained from all respondents who completed a questionnaire/interview. The questions were divided into two sections. Questions related to the mapping of services were marked clearly to ensure participants were aware that this information might be shared in a publicly available report. Responses to questions that elicited perspectives on good practice, current practice and challenges were anonymised to encourage respondents to share their views candidly.
Based on the list of services identified in the discussions at the practice group, questionnaire responses and through snowballing, the research team then contacted a number of additional organisations by phone or email to gather descriptions of services and contact information included in this report. As data was collected using a range of methods, the participants for the questionnaire/interviews whose perspectives are outlined in the first section are not necessarily the same as the twelve services described and listed in the second section.
The research for this report has benefitted from information provided by services working in a range of settings and from a number of experienced, committed, and knowledgeable practitioners sharing their perspectives. However, the small sample size – particularly in comparison to the number and variety of services that work with this group of parents in some capacity – means the report captures only a partial view of the full landscape of services. In particular, further work is required to understand more about services that work on a regular basis with parents at the key stages described in Part 1, even where that is not the primary aim of the service, and how support is coordinated across services.
In section one, we present an overview of insights from the perspectives of ten services with experience of working with birth parents. This section focuses on key themes identified across their responses, building on the experiences shared by women in the previous strand of the research.
In section two, we share examples of a range of organisations and services that provide support for this group of parents. These descriptions are based on self-reported information from the services, either directly or via publicly available information, although many were highlighted by other organisations as examples of good practice. Contact details for each service are included for further information, and wherever possible these have been confirmed directly with the service to ensure they are current.
Section 1: Views on current provision and improving support services for birth parents
In total, 12 professionals from 10 services participated and shared their perspectives on current practice, challenges and what good support looks like for birth parents. The sample of participants was comprised of professionals from local authority children and families teams (n = 4), local authority family placement teams (n = 4), maternal healthcare (n = 2) and third sector organisations (n = 2).
Overview of service provision
In response to the question of what good support for parents looks like, most participants focused on relationships and support tailored to parents’ individual circumstances, as in this response from a professional working in a local authority family placement context:
“A trusting relationship with a service/workers that understands and can emotionally support them with their own challenges and acknowledge the grief and loss that they experience. From this base the support required may be different for each parent.”
It was also acknowledged that individual practitioners who make a tangible difference to parents’ lives can be found across a wide range of organisations and roles:
“I'm not aware of strategic approaches [to good practice] rather sensitive practitioners across all organisations who go the extra mile to reaching out and ensuring support at times of vulnerability for particular individuals.”
Professionals, particularly those based in local authorities, indicated a long list of other services they could refer parents on to as appropriate, either as part of their on-going role or at the end of their period of working with a parent. Services included support related to:
- welfare, financial and material needs
- mental, sexual and/or physical health
- substance and/or alcohol use
- advocacy and support during legal proceedings
- domestic abuse and intimate partner violence.
Some services also offered, either directly or via referral, support for parenting, either at an earlier stage where concerns about child welfare had been raised or in relation to caring for other children, as well as practical support at home.
However, professionals emphasised that following referral, they often had little oversight of the support being provided by other services, even those offered within the same local authority or health and social care partnership. Coordinating support was not always straightforward. The acute distress and extremely challenging circumstances parents may experience around separation from their child(ren), as evidenced in parts 1 and 2 of this report are likely to require a flexible approach to engagement, and practitioners highlighted concerns about the risk for parents if, for example, adult support services discharged them for missing appointments.
A lack of consistency across the country was also a recurring theme, highlighting that parents living in different local authority or health board areas often have different access to services and experiences of support. These responses echoed discussions within the practice group for the current project, highlighting concerns about a service landscape that is fragmented, complex and inconsistent, making it difficult for parents or professionals to identify potential sources of support for specific needs. These concerns were a strong motivating factor for participants involved in the current research to be directly involved in improving practice in their areas and at a national level.
It is worth recognising the links and potential shared learning with other work being undertaken across the UK. A mapping exercise in England undertaken in 2021 identified a small but growing number of services there supporting parents who have experienced repeat care proceedings (Mason and Wilkinson, 2021; see resources on the Research in Practice website), while also noting that as a relatively new area of practice such services are often vulnerable to budget cuts.
Timing and availability of support
A number of practitioners noted that parents whose children go on to be permanently cared for away from home require immediate support at some key points in the processes involved. These responses echoed the finding in part 2 of this report, with mothers highlighting that support was particularly needed at the point of registration of a child or children for ‘permanence’, where it became clear that reunification with the parent(s) was no longer the plan. Some services structured their engagement with parents around key points, in recognition of the greater likelihood of need for additional support and that services may lose the opportunity to work with parents once a crucial moment passes. One respondent from a local authority, reflecting on their own service, noted:
“I would like to develop the service in a way that ensures family members have immediate access to therapeutic and counselling services as required. There have been a number of times the referral process or waiting list has been the barrier, I strongly believe we have moments where we can intervene, and a parent or family member will take this support, but their lives can change so quickly we lose the opportunity.”
Another respondent from a different local authority expressed a similar view, and linked this to the need highlighted earlier to coordinate effectively across services to ensure support can be provided for parents, dependent on their specific needs:
“It should be a coordinated approach and plan that occurs automatically at the point a child comes out of their care. The care plan should be formed and continue for the parent for as long as they require. For those parents who opt out of more tiered interventions this support should be coordinated by universal services, for example the GP.”
These responses also recognise that support may be required over a period of years or even decades, in line with research on the long-lasting impact for parents living apart from their children (Cf. Broadhurst and Mason, 2017). A participant from a third sector organisation echoed the need to recognise the long-term nature of support that may be required:
“We recognise that this journey is undertaken at the pace of the individual and that this process can take many, many years.”
Two practitioners also directly echoed the views of mothers’ interviews noted earlier: that timely, appropriate, and consistent support for parents and families at key points could prevent some children being removed from their care.
Continuity of relationships, support, and knowledge
Some practitioners in family placement teams were working directly with parents on a regular basis but this varied widely between services and by individual parent or family. To avoid parents having to return to places associated with losing care of their child, services were using strategies such as offering parents a choice of where to meet, for example at home, a local community space or going for a walk. Other professionals felt support was most effective when provided, or at least led, by a separate professional, such as a different social worker, a support worker or a health visitor, and the examples from international research noted in part 1 provide important messages about what this may involve for practitioners. A number of participants noted that in their experience, it was too painful for parents to continue to work with a professional and/or organisation that had been involved in making the decision that their child(ren) should be removed from or not return to their care. Particularly complex challenges may arise in planning for and providing support when there are tensions between children’s and parents’ needs.
As the women’s accounts in part 2 of this report indicate, respectful efforts to ensure continuity of relationships with particular workers post-separation may be experienced as helpful and have benefits for parents including in retaining positive links, either directly or via indirect communication, with their child(ren). Individual experiences are likely to vary significantly and this is an important area for parents’ individual wishes and preferences to be heard and acted upon in planning support.
Where relationships were working well, the potential for a change (or in some cases multiple changes) of worker to damage trust and relationships between parents and practitioners was widely acknowledged and described in some services as an on-going challenge. In addition to the impact on individual relationships, and the impact for parents having to re-tell painful parts of their stories to new people, staff turnover means services often lose the skills and knowledge of experienced practitioners.
Practitioners, including those in managerial roles, also discussed practical barriers to providing and improving support for parents. Financial pressures were a recurring theme, including short-term and cyclical funding arrangements for some services that made longer-term planning difficult, particularly where staff were employed on the basis of funding for a particular project or development. These messages are important for those involved in the planning and distribution of funding for services to hear.
Service development and priorities for the future
The role of parents in planning, shaping, and providing support was highlighted from a number of angles. Two services reported that parents had been involved in co-designing some aspects of the support provided, and that changes continue to be made on the basis of parental feedback. While some services asked parents for feedback at the end of interventions, this approach fails to capture the views of parents who either chose not to attend or stop attending partway through an intervention. The majority of participants described this as an area for further development in their service. Some had previously worked for services that had included initiatives co-developed with parents or that were shaped around ideas that had proved popular with parents and were keen to introduce something similar in their current service.
All services had experienced disruption due to the Covid 19 pandemic, although the majority had continued to provide services remotely where face-to-face support was not possible, due to restrictions and in some cases impact on staff availability. The impact was not only directly on the services that participants worked for, but the other services that parents accessed including mental health services, support for substance or alcohol use and face-to-face peer support. The financial impact of the pandemic for parents was also raised as a concern, including loss of access to income or previous material support and the increase in certain types of expenses. The longer-term implications of the pandemic, paired with on-going and acute financial pressures for families, need to be reflected in the planning and delivery of current and future services.
Many of the themes highlighted in part 2 of this report, drawing on interviews with mothers, overlapped with aspects raised by practitioners who participated in via questionnaire/interview for this part of the research. Around half of the services included some form of peer support, an area that was highlighted by parents as an important opportunity to spend time with people who had similar experiences and where their parental identity was clearly recognised. Professionals also shared similar concerns around lack of access to support for mental health, and particularly support available at the right time and accessible over the long-term. In addition, they raised lack of services for fathers, identifying this as a shortfall within current practice despite many fathers’ involvement in and care for their children’s lives pre-separation, in line with findings from recent research in Scotland (Critchley, 2021; Cusworth et al, 2022).
Reflecting on the national picture, practitioners also advocated for equity of support across Scotland. At the same time, their experiences indicated that support needs to be offered in local and easily accessible venues, not necessarily in the same building or area as where services are based.
All participants were keen for more opportunities to share experience, skills, and knowledge about good practice between agencies, both locally and nationally. The key messages from parts 1 and 2 of this report provide useful evidence for further consideration by services.
Section 2: Support services
This section includes examples of services across different areas of Scotland. It aims to provide a starting point for sharing information about how services are set up, delivered, and developed. Between them these services represent a range of different practice models, settings, and specialist areas of support. As noted earlier, some are specialist services for parents who have lost a child to care, and others support people in a range of different circumstances.
Descriptions of support services
Barnardo’s Scotland Family Placement Service offers a range of services related to fostering and adoption, including services for birth parents. In the adoption support service, interventions include counselling support, access to records, search and reunion, training for local authority partners, input for local authority birth parent groups and support for letterbox contact/information exchange. They offer support related to search and reunion between birth parents and adopted adults, including facilitating face-to-face meetings. They work with parents whose children came into care historically and more recently on behalf of a range of local authorities. Parents are referred by statutory services or in some circumstances parents can self-refer. Services are offered in the following local authority areas: Argyll and Bute, Clackmannanshire, East Dunbartonshire, East Renfrewshire, Falkirk, Glasgow, Highland, North Ayrshire, North Lanarkshire, Renfrewshire, South Ayrshire, South Lanarkshire, Stirling.
Barnardo’s in partnership with Inverclyde Council are also running a research consultation project in Inverclyde, which aims to consult with parents with lived experience of having their children removed from their care on a permanent basis. The project will also include consultation with wider family members, and practitioners who have been involved in Child Protection processes. This consultation aims to gain a wider understanding of the needs of parents during this process and learn what could be improved as well as improving their current networks by implementing a range of tests of change in relation to the consultation feedback. The consultation is in partnership with Inverclyde Council and the findings will be used to inform future service delivery to improve the resources and services available to parents whose children are going through the permanence process.
For more information please contact Yvonne Coyle: firstname.lastname@example.org
Birthlink works with all people affected by adoption with a Scottish connection. They operate the Adoption Contact Register, where birth parents and other birth relatives, as well as adopted people aged 16 years or over and adoptive parents, can register their details to provide a potential link for future contact. There are currently over 11,000 people whose details are entered on the register. Birthlink also run the After Adoption Information Line which is available to birth parents and other birth relatives, adopted adults, adoptive parents and other relatives and professionals engaged in adoption work. In some circumstances Birthlink can provide an intermediary service to trace and make initial contact with the adopted person. Their team of social workers also provide emotional and practical support for birth parents, for example with letters/information exchange or direct contact if the birth parent(s) and adopted person want to meet in person. Birthlink also holds a database with information on the location of adoption records from some Scottish local authorities and other approved adoption agencies.
Birth Ties, Inverclyde HSCP
The Birth Ties Support Project has a primary focus on supporting parents who have lost their child/ren to care through adoption. It is part of the Adoption Service within the wider Health and Social Care Partnership. Birth Ties provides support to all birth family members, and works particularly with mothers and fathers from the point where a child is registered as requiring permanence out with their birth family. There is no specific time limit on provision of support. Services include peer support, practical support (e.g., to attend health appointments), support to keep in touch with their child(ren), support for parents to contribute to life story work and help children have a good understanding of their birth family, creating memory books for parents to keep, and support to access other services and welfare rights, including financial and material support. They also offer support for parents considering relinquishing a child into care.
For more information about Birth Ties Support Project Paula Harkins, Team Lead, email@example.com and by phone 01475 715020.
Change is a Must, Perth, and Kinross Council
Perth and Kinross Council’s Children and Families Services has established Change is a Must project to deliver distinct support to mums and dads who may be at risk of losing their child(ren) permanently to care. Parents are predominantly referred to this team for assessment and support from the unborn baby multi-agency screening group. The project is delivered by a multi-agency team that works across children and family social work, mental health and drug and alcohol health services to deliver holistic support, assessment, and early intervention to parents from as early as possible pre-birth until up to 1-year post-birth. They aim to support parents so that their child(ren) can remain in their care, through pre-birth interventions including one-to-one reflective parenting support, drug and alcohol and mental health support (where necessary) and coordinating collaborative support with other services across the HSCP based on individual needs assessments, including health, welfare, and housing services.
For more information, please contact the team by email firstname.lastname@example.org or by phone on 01738 472260.
Martha’s Mammies, Glasgow
Martha’s Mammies is a newly establishing service in Glasgow working with women who have lost care of their children, on a recent, short term or long term basis. It aims to work to develop a relationship-based partnership with women which helps women to identify their needs and goals in order to stabilise personal and social circumstances through practical assistance, advocacy and support to secure resources such as stable housing or benefits or treatment for substance use difficulties. Martha’s Mammies will have a multi-disciplinary team who will work with small caseloads of women to be able to offer flexible, intensive and adaptive support to respond to the needs of individual women but also to support through periods of crisis into stabilisation: it also shares in-reach physical, sexual and mental health and wellbeing services, and other in-reach services such as housing support, with its sister service, Tomorrow’s Women, who work with women in the justice system.
Martha’s Mammies will work with women towards emotional wellbeing, repair and recovery and to assist them to find ways of making sense of their experiences and living with their loss of care of their children. It will use trauma informed approaches, in partnership with individual women but also influenced by our developing reference group with lived experience. It also plans to work with women to identify support networks and using reparative methods, to work to repair and rebuild supportive family relationships.
For further information please contact:
Team Leader Stacey McLeary email@example.com,
Maternity Services Argyll and Bute HSCP / NHS Highland
Argyll and Bute has maternity services located within the children and families and criminal justice service in Argyll and Bute HSCP. They offer pre-birth support, support with caring for babies at home, practical support for family life and support to develop parenting skills before another pregnancy. The team includes midwives, health visitors, maternity care assistants, child and family social workers and support workers, and has access to other specialist input including an infant therapist and perinatal mental health. They also coordinate referrals into other parts of the HSCP or externally, including GPs, welfare support, services related to domestic abuse and/or intimate partner violence, support for parents with experience of criminal justice and support to address alcohol and/or substance use. The team covers the majority of the Argyll and Bute area and offers direct services up to six weeks post-birth, with some flexibility where required.
North Ayrshire Council HSCP
North Ayrshire Council’s Children and Families Service have introduced a Team Around the Parent approach to offer additional tailored support from the point a parent loses their child(ren) to care and prior to the Parenting Assessment being undertaken. This is in recognition of the level of distress that results from this event and desire to recognise this. Support is provided over a 6-8-week period and has moved away from sessions having a professional focused outcome, to listening to the parent, offering them a space to discuss worries, fears, and hopes. This helps us work together to identify how we can best support each parent recognising all parents needs will be different at this time. A practical toolkit is provided that we developed when working with parents in our Pathways parenting assessment team. This toolkit includes adult fidget spinners, adult sensory toys, adult colouring books, hand massage and is aimed at building knowledge of self- soothing strategies. The approach was developed because of the feedback and voices of our parents and in collaboration with a small group of parents with lived experience who had been involved with our Parenting Assessments team. We identified a group of health visitor (not the same one as the child’s health visitor) who works alongside colleagues in the Children and Families Parenting assessment service to provide and coordinate support. As much choice as possible is given to Parents who can chose a location where they feel comfortable to meet, such as in their house, a health setting, social work office or to go for a walk or a coffee. The health visitor provides support over a 6–8-week period including where appropriate helping parents develop a communication plan around what will help them participate and identifying what the service can do to facilitate parents’ sharing their views and being heard. In addition to the health visitor’s role, the wider team continues to provide support and referrals to other services based on the adults needs. Parents’ participation is voluntary and their decision about whether to participate has no impact on any other services they receive.
For more information contact Children and Families Service Manager Corry McDonald by email firstname.lastname@example.org or by phone 01294 317780.
Parents Advocacy and Rights (PAR) Parents Advocacy and Rights (PAR) is a parent led group seeking to support parents with children in the care system, child protection, children’s hearings, and other situations where they have lost care of their children, or risk losing care. They are a group of parents, families and concerned professionals who offer peer support, advice and advocacy to parents and families who need to be heard and respected. Their website includes a number of reports on surveys, research, and personal experiences of parents in Scotland.
Pre-birth Planning Service/Willow Team, NHS Forth Valley
The Pre-birth Planning Service/Willow Team is part of NHS Forth Valley Women and Children's Directorate, which provides maternity care to families where a child protection concern for an unborn baby is identified. The Willow Team offer women a Named Midwife and provide antenatal care at home with additional appointments if required. Midwives work closely with women and their families throughout their pregnancy journey offering an increased level of care and support with the aim of reducing/mitigating risks that may be present. Midwives also work closely with multi-agency professionals in relation to these families. The service also offers support to women and families who may require additional support throughout their pregnancy journey; and will often sign post and refer to appropriate services including third sector services. Women engage with maternity services from early in pregnancy until around 14 days post-birth. The service covers Falkirk, Stirling, and Clackmannanshire.
For more information please contact the team by email email@example.com or by phone on 01324 618358.
Pause Dundee provides intensive support to women who have had children lost to care. The programme is relationship based and offers an intensive, trauma informed model of support to women to prevent the removals of children in the future. Most women remain with the programme for around 18 months before being supported to move on to less intensive or universal support. A programme like Pause is most effective when a woman has no children in her care, and she is in a position to focus on herself and her own needs. Following the initial 16-week engagement phase, we ask women to commit to a pause in pregnancy. If they are ready to take a pause in pregnancy, women will work with their Pause Practitioner and local sexual health service to understand more about their sexual and reproductive health. If, after the 16-week engagement phase women choose not to take part in Pause they are supported by their practitioner to access and engage with other services.
For more information contact Kathryn Baker firstname.lastname@example.org or by phone on 01382 456012.
TCA Women only Mentoring (WoM) & Beyond Mentoring (BM)
TCA’s gendered mentoring services work in partnership with Dundee City Council’s Community Justice Teams to support women involved in the justice system. Although this service does not specifically target parents who have lost a child to care, this descriptor applies to a significant number of women who use the service. A mentoring approach is used to support increased use of community-based disposals and bail options to reduce use of custody. Women receive intensive, trauma informed, relationship-based support from their mentor. They are encouraged to explore the factors linked to their offending and supported to set achievable, personal goals which enable positive change.
Beyond Mentoring is available to women who no longer need the level of intensive support offered by WoM. BM has been developed in partnership with the women who use WoM, and offers lighter touch support, including activity groups. In 2022 we will be developing a lived experience post within the team, with a specific remit to support those women who are involved with this service and who have lost a child or children to care.
For more information contact Kathryn Baker email@example.com or by phone on 01382 456012.
Willow Project, Edinburgh
Willow Service is a partnership between NHS Lothian and the City of Edinburgh Council that works with a number of different partners to address the social, health and welfare needs of women in the criminal justice system. The service is not aimed specifically at women who have lost a child to care but some of the women who use the service may have had experience of child welfare involvement from services and/or be living separately from their child(ren). Willow aims to improve women’s health, wellbeing, and safety, enhance their access to services and reduce offending behaviour. They offer a wide range of services to women aged 18 years or older in Edinburgh, including 2 days a week programme involving groupwork and key work support. The programme is designed to meet the specific needs of women and is delivered by a multi-disciplinary team, including criminal justice social workers, criminal justice support workers, a nurse, psychologists, and a nutritionist. The team provides a range of interventions including to help cope with the effects of trauma and abuse, consider women’s pasts, and support them in planning safely for the future, address offending behaviour and substance use problems, and develop new skills and strategies.
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