Support for foster parents by youth welfare offices in Germany: a nationwide survey

Introduction: Violence against children and young people: recognizing and acting of the Bavarian State Ministry of Labor and Social Affairs (StMAS), physicians are requested to act with the involvement of the youth welfare office (YWO) to protect the child's well-being. The handling of the welfare of children by the YWO may be of relevance for citizens from the USA and European countries in case of joint custody. Methods: The Bavarian State Youth Welfare Office (BSYWO) published on 15.03.2006 recommendations for the local youth welfare offices in Bavaria on how to react to threats to the child’s welfare. Guidelines of the BSYWO set the path for the local YWO on how to analyze and decide in every single case of child welfare endangerment. Examples of how the local youth welfare office doesn’t comply with the guidelines are presented. The analysis of the application may reflect the observance of the recommendations of the state youth welfare office by the local youth welfare office. Since the YWO is designated as the "central contact" in the event of a suspected threat to the welfare of the child, the guidelines of the state YWO are particularly important when implementing the legal requirements and case law. Results: These targets of the BSYWO are suitable to reduce the suffering of the children, provided they are applied correctly by the YWO. However, the guidelines may have been ignored and the child’s welfare may have been damaged. Conclusion: The basic goal of youth welfare, to help young people and their families, would be changed into its opposite, especially if by the measures of the youth welfare office the young person has been harmed to such an extent that his livelihood and future would have been endangered. The credibility of an institution that is important for the family and children would be damaged by a lack of transparency and the embezzlement of files.

BackgroundDue to the increasing rate of children and families who require support from both youth welfare services and from mental health services, a solid cross-institutional cooperation is needed to provide coordinated and integrated help. Studies involving not only qualitative, but also quantitative information from both services regarding not only general, but also case specific views on cross-institutional cooperation and psychosocial needs are lacking.MethodsHence, we collected data from n = 96 children and families who received support from youth welfare office (YWO) and child and adolescents psychiatry (CAP) simultaneously. In a longitudinal survey, we assessed the evaluation of case specific cross-institutional cooperation and psychosocial needs by employees of YWO and CAP as well as descriptive data (including psychopathology of children) over a 6-month period. Repeated-measures ANOVAs were conducted to assess the effects of time and institution (YWO/CAP) on employees’ evaluation of case specific cross-institutional cooperation and psychosocial needs as well as children’s psychopathology.ResultsThe data showed that generally YWO employees rated the case specific communication better than CAP employees. Furthermore, CAP employees estimated psychosocial needs higher than YWO employees did. The employees’ evaluation of total case specific cross-institutional cooperation did not differ between the employees of both institutions; it further did not change over time. The case specific evaluations did not correlate between the case responsible employees of YWO and CAP.ConclusionThe data showed satisfaction with the case specific cross-institutional cooperation in general, but meaningful differences in case specific ratings between both institutions indicate the possibility and need for improvement in daily work and cooperation as well as in regulations and contractual agreements. The implementation of more exchange of higher quality and transparency will ensure smoother cross-institutional cooperation. Future research should pursue this topic to convey the need for further improvement in cross-institutional cooperation into decision-making processes and to evaluate the success of innovative projects in this field.

Introduction: The number of children taken into care by German youth welfare offices has been increasing for years as a result of changes in the law according to publicly known endangerments to child welfare. Due to an increase in petitions from non-German parents to the European Parliament's Petitions Committee against administrative acts that they felt to be arbitrary (e.g. taking into care), the European Parliament repeatedly (2007, 2018, 2022, 2023) dealt with the processes in the German Youth Welfare Office. Material and Methods: Compilation of the documents of the Petitions Committee of the European Parliament in 2007, 2018, 2022, and 2023 on the German Youth Welfare Office. Additional searches in Pubmed, google scholar, and google under the keywords child welfare, the best interest of the child, damage to health through taking into care, harm to children through taking into care, the impact of financial threats to parents to youth welfare, psychological trauma through taking into care by the youth welfare office. Reproduction of the essential questions of the member European Parliament (MEPs) and answers of German authorities and family courts. Structure in: The principle “In the best children’s interest” and “child wellbeing (welfare)”, legal duties of the youth office, taking into care by youth office, the power of youth office, relationship court youth office, control of the German youth office, costs of the proceedings, guardian ad litem, duties and functions of the court. The answers of the German authorities are summarized in the respective sections, supplemented by relevant literature and personal communications. Results: For years, the German youth welfare office has been criticized for either failing to protect the welfare of the child or protecting it too late. Over the past 20 years or so, changes in the law have led to increasing numbers of childcare takings based on undefined norms of the child's best interests and child welfare. In short: the guardian state is increasingly intervening in the family, which is protected by Article 6 of the Basic Law, with the unclear justification that the parents are overburdened or lacking (proof of) the ability to bring up children, precisely regarding Article 6 invoking the guardian state, and is separating parents from their children without having sufficient scientific knowledge about the consequences of taking the children into care. The families receive high bills for this, disregarding proportionality and exclusion criteria. The possibility of changing something by complaining is small. The responsible community decides on the complaint itself. Transparency is reduced with the exclusion of the public and the rejection of requests to inspect files. This led to the expressed suspicion of arbitrary measures and an increase in petitions to the European Petitions Committee, which has been dealing with the youth welfare office since 2007 and even came to Germany for a "fact-finding visit" in 2022. The questions from the MEPs on the above areas were partly answered incompletely or not at all or contradicted the literature and the evidence. The answers of the German community of responsibility prompted the MEPs to ask further questions (Amendments 2023). Conclusion: It cannot be denied that the answers of the youth welfare office were not very convincing for the MEPs of the petition committee, taking into account the scientific literature and known documents. The lack of transparency (e.g., refusal to inspect files) and agreements reinforced the MEPs' negative impression of the youth welfare office (shadow body, where there is smoke, there is fire), and led to the announcement of further controls by the MEPs.

Dermato-oncology patients are often treated in certified skin cancer centers or dermato-oncological specialist offices. Especially in higher tumor stages, patients develop symptoms, either disease-related or due to therapy-related side effects, requiring treatment. Despite a markedly improved prognosis since the introduction of targeted therapies and immunotherapies, advance care planning is required in progressive disease. It is unclear how palliative care of skin cancer patients is currently organized in dermato-oncology. In a nationwide survey, all certified skin cancer centers and dermato-oncological specialist offices in Germany were contacted and asked to participate in this anonymized survey. Overall, 45 responses (42%) were received. The majority (98%) of the respondents screen the patients on a regular basis for distressing symptoms, and all centers are connected to palliative medical care providers. Only 5% of the medical staff members have the additional qualification "palliative medicine". In 68% of the participating institutions, the opportunity for care planning is offered to patients. For 89%, palliative care is relevant for everyday work, and 82% desire more research opportunities on this topic. This survey has shown that palliative care plays a major role in dermato-oncological work. Given that only a small proportion of the staff have received specialized training in palliative care, however, an increase of this proportion would be desirable for comprehensive care.

The high profile cases of child endangerment that receive extensive media coverage demonstrate the necessity for youth welfare offices to develop effective strategies and measures to respond to crises in a manner that safeguards the wellbeing of children and young people. In reference to the case of Kevin from 2006, the author elucidates the challenges confronted by youth welfare offices in instances of egregious child endangerment. She delineates methodologies through which specialized authorities can respond to adverse media coverage without compromising their credibility and formulates guidelines for communication between the youth welfare office and the media in the event of sensationalized and/or erroneous case histories becoming public knowledge.

Better together? Cooperation between youth welfare office and child and adolescent psychiatry: A methodological approach

Foster child support is an expanding field of work: In youth welfare offices and the foster child services of independent institutions, in guardianship, expert assessments and family courts, specialists have to deal with the key questions relating to foster child support. In addition, there are the people affected: foster children, parents and foster parents, siblings and other family members. This book provides a well-founded introduction to this subject area and links important practical issues to international research findings. It analyses current developments in this respect in Germany, Austria and Switzerland and illustrates the variety of forms of care relationships with case studies. In this way, the importance of professional services and the courses of action open to them become clear.

Every year in Germany, around 200,000 children and adolescents are still before the courts because their parents separate and the right of residence or the entire custody is regulated, or the parents are deprived of custody, contact is regulated or the children live in foster families, residential groups and children's homes and are returned to the family of origin. Despite the new adoption assistance law, does the youth welfare office or the adoption agency now help more effectively to uphold and enforce the best interests of the child? What role do guardians ad litem and, above all, the still often criticized experts play in family court proceedings? Who helps to uphold the rights of children who are circumcised? What should happen in the future to children from surrogacy and intended parents? How do professionals deal empathetically with the child in juvenile and family court proceedings? How do children feel when they are taken away from their parents or foster parents? The 4th, updated edition of this proven handbook shows in a practical way how the best interests of the child can be upheld and child protection enforced.

When unaccompanied minors (UMA) are taken into provisional care by the youth welfare offices, it is legally obligatory to carry out an initial medical examination and obtain a statement as to whether the state of health of minors excludes the implementation of the distribution procedure according to the Königsberg Key and, in the case of 15-year-olds and non-pregnant persons, an X-ray thorax scan to exclude infectious tuberculosis of the lungs. The supreme state health authorities of the German federal states determine the further scope of the investigations. The aim of this nationwide survey is a comparison of the different concepts of the individual states with regard to the scope of the initial UMA investigations. Between September 2016 and May 2018, a survey on the scope of the UMA initial investigations was conducted by e-mail with official contact persons. At the same time, a web-based search of the websites of the supreme health authorities of the federal states for official statements was carried out. In the areas of TB screening of under 15-year-olds and pregnant women as well as screenings for other diseases, the picture across Germany was sometimes very mixed. There was agreement above all in the recommendations for vaccination. Efforts to harmonise the scope of the investigation at the federal level should be pursued further.

Chances of Psychotherapeutic Interventions and Stabilization with Unaccompanied Minor Refugees During Clearing Procedure and During the Transition Phase to Youth Welfare In the present clinical report, the experiences with psychotherapeutic crisis intervention for unaccompanied refugee minors in an initial reception and clearing office in Berlin, which have been financed since December 2016 by the association Spatz e. V. from the St Joseph hospital in Berlin-Tempelhof, is reflected. The financing offer results due to the developments in 2015 - a year with an above-average increase in incoming refugees. The significant increase also led to significantly longer waiting times in the clearing process. The forced persistence in a provisional state often led to instability of the psychic coping capacity of the adolescents. However, although there is a high level of psychological distress, post-traumatic as well as depressive symptoms the refugee adolescents have no access to outpatient psychotherapy during the clearing procedure (or the financial coverage of the discussions by health insurance or youth welfare offices). Despite uncertain framework conditions by an unclear future perspective and the resulting lack of "external safety", psychotherapeutic sessions with a focus on stabilization, empowerment and psychoeducation is nevertheless helpful in order to support young people in crisis situation, to counteract acute crisis and to counteract chronification of existing symptoms.

Mixed Methods Studies, which combine qualitative and quantitative research methods, are widely used across disciplines. However, in health promotion, quantitative methods dominate in most cases and qualitative methods are considered as an ‘add on’. By means of a Mixed Methods Study about the living situation of young people from refugee backgrounds, aged between 11 and 21 years, in an administrative district in Germany, in which quantitative and qualitative research methods are considered coequal, the issue of Mixed Methods Studies potential in health promotion is discussed. In this study, the perspectives of the young people from refugee backgrounds, their social workers from youth welfare office and local providers have been gathered. The young people from refugee backgrounds and their social workers have been consulted with a qualitative interview, whereas the local providers have been consulted in a standardised manner. The combination of qualitative and quantitative research methods to analyse the living situation of young people from refugee backgrounds gives a holistic and comprehensive insight in social, cultural and structural frame conditions, social policy’s challenges as well as individual requirements. Such Mixed Methods Studies prove suitable for health-related research, especially when it comes to quickly changing structural conditions, a difficultly accessible target group and highly personal issues.

Introduction: The number of children and young people being taken into care and placed in out-of-home care has been increasing in Germany for years - despite or perhaps because of child protection reforms. Child protection is always questioned when cases of child abuse become public. Child protection without taking children into care is hard to imagine. Child protection can be violated through unjustified detention. This usually receives little attention. Methodology: Examination of the keywords “taking into care”, “out-of-home care”, “effect” and “side effects” of “taking into care” by the “Youth Welfare Office” in “Germany” in Pubmed, Google Scholar, and Google. Results: The number of people taken into care increased after the change in child protection regulations for the youth welfare office in 2005: from 25,664 in 2009 to 66,400 in 2022. Apart from the unaccompanied entry of children in 2022 (28,600), 22,900 cases were due to excessive demands and relationship problems of the parents, and 18,500 cases were due to neglect, and physical and psychological abuse as the reason for being taken into care. The classification of cases varies greatly depending on the social worker's opinion. There are considerable differences in the assessment of the risk situation and the resulting decision to take someone into care. Depending on the federal state, the number of times taken into care and the duration of out-of-home care vary due to different interpretations of guidelines and the requirements of service instructions. The main problem is the high number of false-positive assessments of threats to children's well-being in connection with the ignorance of the effects and side effects of taking children into care, which is described as a social-educational measure. Anglo-American studies of children in foster families and homes found these children to have post-traumatic stress disorders, an increased risk of serious illnesses, hindrance to participation in social life with inability to go to school, and limitations in their ability to work. Many illnesses only appear in adulthood. The effects of being taken into care can endanger a young person's existence. Even the Federal Constitutional Court 11/2023 points out the negative effects of being taken into care. This causes material and immaterial damage to children and families and puts a strain on the public health system and the national economy. Conclusion: Child protection must be oriented towards children and not adults, authorities, and institutions. Taking children into care, without even knowing or taking into account the effects of false-positive risk prognoses, that is described as a social educational measure, that is stigmatizing and associated with the loss of basic rights of children and parents, given the damage to children and families, as well as the burden of the public health system and the national economy, cannot be accepted.

The law regulating confidential childbirths came into force on May 1, 2014. With this, the legislator sought to create a legally secure alternative to baby hatches or anonymous births. The regulations allow pregnant persons who wish to keep their identity secret at birth to have a medically assisted delivery and at the same time secure the child's right to know its origin as well as its placement. In addition to legal questions, the author also exam-ines the application of the regulations in practice on the basis of her own surveys of family courts and youth welfare offices. The focus of the research is related to the question of whether confidential childbirth has been able to establish itself as a legally secure procedure in comparison to completely anonymous child deliveries.

Determination of siblings: A special case report from Halle

Physicians are sometimes confronted with cases of child-maltreatment where they suspect that parents have harmed their child. In such cases physicians are typically confronted with two conflicting duties: on the one hand they have to report cases of child-maltreatment to the youth welfare office. On the other hand they are bound by their professional confidentiality which entails that they have to keep intimate information especially from public institutions like the youth welfare office. This paper points out that this situation is particularly awkward in cases of insufficient evidence where still parents seem to have maltreated their child. Such cases are called cases of family-dilemma because both duties apply at the same level. This paper firstly analyses the structure of the family-dilemma and secondly discusses a possible solution to it. The upshot of the discussion is that a solution of the family-dilemma is only within reach when core values of the liberal society like ‘parental autonomy’ and ‘privacy of the family’ are redefined.