Abstract
BackgroundThe psychosocial wellbeing of children and adolescents is an ongoing global concern. Despite positive outcomes of child- and family-focused programs, the fragmentation of services presents challenges. To enhance harmonization and diminish fragmentation of service policies, we implement a preventive collaborative service model for children and families. The rationale for our study is based on analyses of national and local data before implementing the service model in the pilot area.MethodsThe need for a preventive service model for children and families was demonstrated using national and local data sources. First, a national school health survey was utilized to screen adolescents' perceptions of their depressive symptoms and support. Second, time trends in child and adolescent psychiatric and child protection service use were investigated. For these aims, epidemiological data of the study area (city of Oulu) were compared with data from the whole country (Finland). Third, local usage data of the preventive stand-alone Let's Talk About Children (LT) intervention before the service model implementation were evaluated. After these analyses, Let's Talk About Children Service Model (LT-SM) implementation in the pilot area is described in detail.ResultsThe background data showed that 17% of the adolescents in the study area had reported depressive symptoms, and almost half of them had not received professional help. Child and adolescent psychiatric outpatient visits had increased during the last decade, but the number of visits remains lower in the study area compared with the country as a whole. The number of adolescent psychiatric inpatient days had increased contrary to a decreasing national trend. The number of urgent child welfare placements was also higher compared with the whole country. The local LT intervention data revealed very low utilization rates. These results indicated a necessity to enhance preventive and collaborative support for children and their families. This article describes the implementation of the LT-SM.DiscussionWe demonstrated excessive use of curative services in social and health care and insufficient usage of the stand-alone preventive intervention. The LT-SM is now piloted in one regional service area of the city of Oulu. Its effectiveness will be evaluated when enough data have been accumulated for statistical analyses.
Highlights
We examined the local usage data of the stand-alone LT intervention before the implementation of the Let’s Talk About Children Service Model (LT-SM) in the pilot area. After these analyses of national and local data, we describe in detail the implementation process of the LT-SM in the pilot area aimed to enhance the psychosocial wellbeing of children and families in Oulu
Psychosocial wellbeing of children and adolescents is an ongoing societal concern [38, 39]
Despite various local and national efforts and programs to promote the psychosocial wellbeing of young people, several child and adolescent health and social care indicators demonstrate concerning trends
Summary
There has been an increase in child protection needs and acts in Finland, some Nordic countries, and in Europe as a whole. Separate policies and lack of collaboration between service providers are associated with inefficiency of the service system [5–7] This is understandable, as it may be difficult to take into account individually varying needs, diverse family backgrounds, and differences between communities when arranging the required services [8, 9]. In response to these challenges, in Finland, government-funded programs for social and healthcare, daycare, and schools have been launched over the last decade, and national and international evidence-based programs and interventions have been implemented [10–18]. The rationale for our study is based on analyses of national and local data before implementing the service model in the pilot area
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