Internationally adopted people must receive more professional conversational support

Establish specialist care and support for transnational adoptees with trauma-informed staff trained in adoption and racism. This is suggested by Natte Hillerberg, ST doctor in psychiatry and board member of Doctors against racism.

Care for internationally adopted people has long been neglected by Sweden's regions. Nowhere in Swedish health care is there specialist psychiatric care for internationally adopted adults, despite the fact that the patient group is strongly overrepresented in terms of mental illness, substance abuse, suicide attempts and suicide. Statistics that show this have been available for decades.

In 2020, the Swedish Agency for Family Law and Parental Support (MFoF) arranged a procurement for conversational support for adult adoptees. The conversational support would not be regarded as care, but as a complement to regular health and medical care. Several players made bids and MFoF chose the supplier that was the cheapest, Apoteksgården cognitive center in Dalarna, over more expensive alternatives with more experience and more qualifications. Apoteksgården is very inaccessible to most of Sweden's population.

Of all conversational contacts that took place during the years 2020 and 2021, only two people were physically present according to an evaluation reported on MFoF's website. The rest of the contacts have been made digitally or by telephone. The evaluation is based on a questionnaire completed by clients.

The design of the survey leaves a lot to be desired. The evaluation states that more than 50 percent of the respondents considered that the support was only to a small extent helpful in issues of racism and adoption-related issues. It has not been possible to answer that the support has not been helpful at all, but with the answer alternatives have been forced to state that the support has been helpful to some degree. It is also noteworthy that a large proportion of clients have chosen to quit after only 1-5 calls.

I have long been active in issues related to racism and mental illness among adoptees. Several adoptees have contacted me with stories about their experiences of Apoteksgården. They have said that their stories about adoption and racism have been dismissed and they have on several occasions, when they have verbalized their experiences on these issues, been completely disabled and / or encouraged to think differently.

They experience that the therapists lacked knowledge about separation, trauma, exclusion and rootlessness. When clients have tried to address this, they have not been met or further guided. They have also not experienced support in processing and issues related to racism, on the contrary, the therapists have lacked knowledge in this area as well.

They have said that it felt as if they were the ones who needed to educate and inform the therapists about trauma, separation and adoption instead of receiving conversational support. In light of the above, it is easy to understand that clients eventually refrain from raising further thoughts about the traumas they sought at Apoteksgården to have the opportunity to process.

It is extremely serious that a service that has been procured specifically to help and guide in matters concerning adoption and racism not only lacks knowledge of precisely those topics, but also disables people's legitimate feelings of harm and injustice in connection with this. The conversational support then becomes no support, but additional trauma for the victim. One can also ask why there is only one free alternative in the whole of Sweden, and why no new procurement was made before 2022 given the outcome of the evaluation.

As a doctor working in psychiatry, I am badly affected and deeply concerned about how to treat this patient group in Swedish healthcare. The lack of support is exacerbated by the invisibility of the adoptee's vulnerability. Sweden has a particularly great responsibility as one of the world's largest recipient countries for children through international adoptions, to ensure their safety and health throughout life. There must be change.

Establish specialist care and support for transnational adoptees with trauma-informed staff trained in adoption and racism. As long as Apoteksgården is the only free agency for help and support in adoption issues, the alarming figures for mental illness and suicide among transnational adoptees will not change. At least not for the better.

.