Birth mothers' experiences of support before, during, and after adoptive placement.

Birth mothers, or women who have relinquished parental rights of their child, are an understudied and stigmatized population. Prior literature has suggested that protective factors, such as supports (e.g., practical, emotional, peer, informational), are beneficial for birth mothers. This study qualitatively explored perceptions and experiences of support before, during, and after placement among 51 birth mothers whose children were adopted as infants via private adoption in the United States 8 months to 50 years (M = 15.39 years) from the time of data collection. Thematic analysis revealed six overarching themes: (a) impact of lived circumstances, (b) importance of early adequate support, (c) an emotionally complex process, (d) access to timely information, (e) feeling ready to utilize resources, and (f) coping with ongoing adjustment needs. Prevalence of Themes pre-, during, and postplacement were shared among participants. Time since placement and adoption openness (e.g., contact with adoptive families) were also important factors related to these themes. We discuss implications of these results for policy and practice related to birth mothers' well-being and adjustment. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Birth relatives' perspectives about same-gender parent adoptive family placements.

Little research exists about the experiences of birth relatives connected to lesbian and gay (LG) parent adoptive families. Using mixed methods, we examined the perspectives of birth relatives and other adoption triad members (adoptive parents, adoptees). First, from interviews with birth relatives (N = 62) in the USA, we explored openness to same-gender parent adoptive placements. Next, we conducted a thematic analysis from interviews with a subsample (n = 24) whose child was placed with LG adoptive parents about why LG parents were chosen. Finally, eight (of these 24) were connected to seven LG adoptive parent families who were participants in a larger study. Among these adoption triads, we investigated how members described their contact experiences. Results showed that most birth relatives were open to placements with same-gender couples, and those who had done so often made this decision intentionally for various specific reasons. Birth relatives tended to be satisfied with adoptive family contact and desired more in the future. Adoption triad members generally reported warm feelings toward each other and commitments to continued contact. These findings provide insight about diverse conceptualizations of kinship, how contact can be effectively navigated across complex family relationships, and implications for adoption practice and policy.

Adapting inpatient addiction medicine consult services during the COVID-19 pandemic.

BACKGROUND: We describe addiction consult services (ACS) adaptations implemented during the Novel Coronavirus Disease 2019 (COVID-19) pandemic across four different North American sites: St. Paul's Hospital in Vancouver, British Columbia; Oregon Health & Sciences University in Portland, Oregon; Boston Medical Center in Boston, Massachusetts; and Yale New Haven Hospital in New Haven, Connecticut. EXPERIENCES: ACS made system, treatment, harm reduction, and discharge planning adaptations. System changes included patient visits shifting to primarily telephone-based consultations and ACS leading regional COVID-19 emergency response efforts such as substance use treatment care coordination for people experiencing homelessness in COVID-19 isolation units and regional substance use treatment initiatives. Treatment adaptations included providing longer buprenorphine bridge prescriptions at discharge with telemedicine follow-up appointments and completing benzodiazepine tapers or benzodiazepine alternatives for people with alcohol use disorder who could safely detoxify in outpatient settings. We believe that regulatory changes to buprenorphine, and in Vancouver other medications for opioid use disorder, helped increase engagement for hospitalized patients, as many of the barriers preventing them from accessing care on an ongoing basis were reduced. COVID-19 specific harm reductions recommendations were adopted and disseminated to inpatients. Discharge planning changes included peer mentors and social workers increasing hospital in-reach and discharge outreach for high-risk patients, in some cases providing prepaid cell phones for patients without phones. RECOMMENDATIONS FOR THE FUTURE: We believe that ACS were essential to hospitals' readiness to support patients that have been systematically marginilized during the pandemic. We suggest that hospitals invest in telehealth infrastructure within the hospital, and consider cellphone donations for people without cellphones, to help maintain access to care for vulnerable patients. In addition, we recommend hospital systems evaluate the impact of such interventions. As the economic strain on the healthcare system from COVID-19 threatens the very existence of ACS, overdose deaths continue rising across North America, highlighting the essential nature of these services. We believe it is imperative that health care systems continue investing in hospital-based ACS during public health crises.