Welfare Authorities Research Articles

A prospective examination of offending trajectories in men and women with out-of-home care experience followed up until retirement age.

It is widely recognized that out-of-home care (OHC) is associated with criminal behavior, yet less is known about how this behavior unfolds in the OHC population over the life course and whether it is marked by desistance or persistence. This study examines offending trajectories from age 15 to 64 in men and women with and without OHC experiences. It also investigates how different ages of placement, types of placements and reasons for placements affect representation across these trajectories. Swedish prospective longitudinal data come from the Stockholm Birth Cohort Multigenerational study (SBC Multigen, n≈14,000). Sex-stratified group-based trajectory modeling was employed to identify offending trajectories and multinomial logistic regression to analyze the associations between OHC experiences and these trajectories. A comparison group of children investigated by the child welfare authorities but not placed in care was included. Individuals placed during adolescence in multiple types of care due to individual behavior or a combination of individual and family circumstances, faced a significantly higher risk of persistent, high-rate offending patterns compared to those without such experiences. Those investigated but not placed also showed an increased risk of chronic offending patterns, though typically lower than that of individuals with OHC experiences. This study provides valuable insights into the dynamics of offending within OHC populations and emphasizes the need for interventions that can prevent the initiation of criminal behavior, as well as disrupt or alter ongoing offending trajectories within this disadvantaged group.

From outsider to participant: a qualitative study about attaining and retaining work among persons with mental illness

BackgroundIn Norway, the number of people on sick leave and health-related absence from work has increased over the last few years, and mental illness is one of the main contributing factors. Individual Placement and Support (IPS) and the Qualification Program (QP) are two work-oriented measures offered by Norwegian labor and welfare authorities, aimed at increasing labor market participation among people with health-related problems. The aim of this study was to explore which factors people with mental illnesses found helpful for attaining and retaining work, and their experiences with taking part in IPS and the QP.MethodsThe study had a qualitative explorative design. Eight semi-structured interviews with individuals who had attained and retained work after receiving IPS or taking part in the QP were conducted. The data were analyzed using systematic text condensation, a thematic and descriptive, cross-case analysis strategy.ResultsThe analysis revealed three main themes, each related to the contexts of work and daily life: (1) inclusion and support, (2) structure and routines, and (3) motivation and self-confidence. The participants emphasized the importance of feeling included and supported both at work and by their family and friends. Furthermore, structures and routines at work and in the participants’ daily lives kept them engaged and made them feel better, which was important for retaining work. Having the motivation to attain and retain work was essential and seemed to increase over time together with improved self-confidence as a result of being able to stay at work.ConclusionInclusion, support, structure, routines, and motivation are decisive for people with mental illnesses in changing their view of their health and increasing their independence and experiences of coping in work and everyday life. Taking part in work-oriented measures seemed to function as a “gateway” to changing behavior for the participants, both in work situations as well as more generally in life.

Children's right to participation in Swedish child welfare – The extent, nature and determinants of child interviews during investigations

BackgroundChildren's right to participation in child welfare decision-making is highlighted in law and research. However, there is a lack of comprehensive empirical research on how such participation is actually fulfilled. ObjectiveThis article aims to describe and analyse the extent, nature and determinants of children's participation in child welfare investigations in Sweden as well as to discuss barriers to participation. Participants and settingThe dataset comprises a cohort of 2123 children investigated during 2022 across eight municipalities in Stockholm County, Sweden. MethodsThe study is based on cross-sectional data where the responsible child welfare workers served as informant in a survey focusing child and case factors concerning 2123 children subject to child welfare investigations. The data is analysed by using descriptive and binary logistic regression analyses. ResultsIn approximately 75 % of the child welfare investigations, child welfare workers held interviews with the child (with or without parental presence) while individual child interviews were carried out in about 50 % of the cases. Multiple interviews (≥3) occurred in 14 % of the cases. Reasons for not interviewing children included finding interviews to be unnecessary, perceiving the child as too young, and reluctance by the child as to participation. Investigations involving older children and referrals related to abuse increased the odds for participation. ConclusionsThe study suggests that more children are interviewed by child welfare authorities than found in previous studies, but that there still is a gap between the legislative intention to facilitate child participation and the actual state of child welfare practice.

Empowerment strategies of the Mentor Mother peer support program among mothers who have migrated to Sweden: a photovoice study

IntroductionA peer support intervention using ‘Mentor Mothers’ was implemented for mothers who had migrated to Sweden, living in socially disadvantaged communities. The Mentor Mothers had a high degree of freedom to develop strategies for facilitating empowerment of their clients according to perceived needs. This study aimed to investigate which empowerment facilitation strategies that Mentor Mothers perceived to be relevant, feasible and effective.MethodsPhotovoice was used to generate qualitative data. Participants took photographs of their work which were then discussed during a focus group discussion and six individual semi-structured interviews. Data were analysed using thematic analysis.ResultsFour overarching strategies to facilitate empowerment were identified, corresponding to distinctive perceived needs in the target group: (1) Informative support responded to a need for making sense of the external context, by helping mothers navigate society, the process of parenthood and cultural parenting norms. (2) Practical support addressed a need for managing challenges in daily life, by facilitating contacts with welfare services and authorities and to enhance parenting practices. (3) Psychosocial support addressed a need for improved mental wellbeing, by instilling feelings of safety and security in daily life, relationships and in contacts with public institutions. (4) Motivational support responded to a need for finding fulfilling purpose, by promoting social interaction, encouraging civic engagement and sharing the challenges and successes of others to inspire hope.ConclusionsThese results highlight various aspects of peer support for empowerment facilitation that future interventions targeting immigrant parents can use in their intervention design.

Recognizing and responding to children with suspected exposure to intimate partner violence between caregivers.

Children's exposure to intimate partner violence (CEIPV) between parents and other caregivers accounts for nearly half of all cases investigated and substantiated by child welfare authorities in Canada. The emotional, physical, and behavioural impairments associated with CEIPV are similar to effects of other forms of child maltreatment. The identification of children and youth who have been exposed to intimate partner violence (IPV) can be challenging due to the non-specific behaviours sometimes associated with such exposure, and the stigma and secrecy that often characterize IPV. Also, responding safely to children and youth with suspected CEIPV can be complicated by the need to consider the safety and well-being of a non-offending caregiver. This position statement presents an evidence-informed approach developed by the Violence, Evidence, Guidance, Action (VEGA) Project for the safe recognition and response to children and youth who are suspected of being exposed to IPV.

Kainuun sosiaali- ja terveydenhuollon kuntayhtymän ja kuntien hallinnon toimijoiden kokemuksia yhteistyöstä COVID-19-pandemian aikana integroiduissa sosiaali- ja terveyspalveluissa

Kainuu Social Welfare and Health Care Joint Authority’s and municipalities’ administration actors’ experiences of collaboration during COVID-19 pandemic in integrated social and health services This qualitative descriptive study aimed to describe social and healthcare and municipalities’ administration actors’ experiences of collaboration during COVID-19 pandemic in integrated social and health services. A systems theory was applied as a theoretical framework. The data were collected in thematic interviews of eight actors in Kainuu between November 2021 and February 2022. The data were analyzed using inductive content analysis. Seven main categories were formed: 1) experience of the history of collaboration, 2) roles and leadership in collaboration, 3) interactive collaboration, 4) effective collaborative process, 5) challenges of collaboration, 6) coherent and interactive communication and 7) structure of collaboration. Integrated social and health services are perceived as a resource of collaboration in a crisis because there are not many boundaries between organizations.

Feasibility and Acceptability of Implementing a Transdiagnostic Cognitive Behavioral Therapy for Children Impacted by Trauma Within a Residential Treatment Facility

The Unified Protocol (UP) is a flexible, transdiagnostic form of cognitive behavioral therapy that effectively treats diverse psychiatric conditions in children, adolescents and adults. However, the UP has not been rigorously evaluated among children who have experienced severe trauma and may have limited caregiver involvement in their life. The present research project was a single arm, open trial examining the feasibility of utilizing the UP within a residential treatment facility in Calgary, Canada for children involved with child welfare authorities who often have limited caregiver involvement. Children (n = 19; age 9–13) and their caregivers (n = 18; age 32–60) participated in 15 weekly therapy sessions of the UP for Children with minor structural and content modifications. Trauma exposure was high among children, especially physical neglect and emotional abuse (89% exposed to each). Fidelity to the manualized intervention was high (88% for children; 89% for caregivers), indicating the intervention was feasible to deliver and that the adaptations did not interfere with fidelity. All children and caregivers completed the intervention, suggesting high acceptability for recipients. Improvements over time in maladaptive cognitions and behaviors (among children and caregivers) provide preliminary evidence for efficacy. The present study provides support for the notion that the UP for Children can be utilized for children who live in residential care and/or those who have experienced high levels of trauma.

The Law and Concept of Fiscal Devolution in the United Kingdom

Fiscal devolution is a multifaceted and evolving concept that plays a pivotal role in the governance of the United Kingdom, which is still under an ongoing development process. At the end of the 1990s the subnational governments achieved various stages of autonomy since the 1998 devolution acts, which ratified the administrative and fiscal devolution, provide the formal structure for revenue-raising and expenditure powers. The devolutionary process was facilitated after the Great Recession, assigning different income raising and welfare authorities to Scotland and Wales, while the same progress was dampened in Northern Ireland, because of the looming political instability. The system is complex, consisting of several essential elements that are closely linked to each other: devolution acts, fiscal frameworks, block grants, tax devolution, tax-varying powers, borrowing powers and the reserved matters. The results are not the same or uniform, each country has its own set of rules, negotiated with and enacted by the Westminster Parliament. It reflects the evolving nature of governance and the recognition that one-size-fits-all policies may not be suitable for a nation as diverse as the United Kingdom. It can be regarded as a testament to the adaptability of the constitutional and legal framework in response to changing political and social landscapes. The fiscal devolution experience in the UK underscores the need for a delicate balance between local autonomy and national cohesion. The legal and conceptual framework underpinning fiscal devolution has profound implications for economic policy, public finance, and intergovernmental relations and it is still subject of ongoing debates and reforms and not without complexities and challenges.

Quality of care as perceived by caregivers and residents in aged care homes in Sri Lanka: a qualitative study

ObjectiveQuality of care determines the physical and psychological wellbeing of aged care residents. The study aims to explore barriers and facilitators of quality of care in aged care homes (ACHs) in Sri Lanka from the perspective of older adults and caregivers.MethodsThis qualitative descriptive exploratory study was conducted in selected five ACHs in Galle District, Sri Lanka, from May 2021 to January 2022. We recruited a purposive sample of residents and caregivers and conducted ten in-depth interviews with ten caregivers and nine focus group discussions with forty-five residents. The data were analysed using the thematic analysis.ResultsThe majority of caregivers and residents were females. Caregivers and residents were aged 25-35 years and 70-80 years, respectively. Two major themes emerged: (a) barriers of quality of care and (b) facilitators of quality of care. Both residents and caregivers reported a lack of referring system facilities; a lack of financial support on the infrastructure; a lack of financial support in supplying medication and employing human resources; insufficient knowledge of gerontological care and geriatric syndromes for both caregivers and residents; and lack of interest in being a caregiver at the ACHs as barriers in providing quality care. Moreover, caregivers and older people reported donations by philanthropists; supportive leadership; and welfare benefits from the government authorities as facilitators of quality care. Additionally, caregivers reported a lack of in-service programmes for caregivers as a barrier and positive institutional values as a facilitator for providing quality care.ConclusionThe available human and physical resources are insufficient to address the demanding needs of residents in ACHs, apart from the received donations. There is a simultaneous need for healthcare policymakers' and social welfare authorities' attention to implementing necessary measures to uplift the quality of care for residents in ACHs to enhance their quality of life.

New system responses to juvenile crime

AbstractIn the Nordic countries, social work and child welfare interventions have traditionally played a central role in preventing children’s involvement in future crime. Hence, child welfare authorities, rather than the criminal justice system, have handled cases with children involved in crime. However, in 2019, Denmark enacted a new policy reform that constitutes a radical break with this long-standing tradition of welfarism. The policy reform introduced court-like proceedings for children under the minimum age of criminal responsibility. Cases concerning juveniles aged 10 to 17 who commit serious offences are now handled by Youth Crime Boards and the Youth Probation Service. In this article, we explore the complexities of these new responses to juvenile crime in Denmark. We do this by combining quantitative analyses of administrative data with qualitative interviews with case managers. We argue that the new Danish system is highly complex and targets a diverse group of children with punitive measures. With this, we hope to provide insights relevant to policy makers and practitioners implementing new juvenile crime prevention strategies.

A qualitative study on the implementation of a transdiagnostic cognitive behavioral therapy for children in a child welfare residential treatment program

BackgroundYouth with severe emotional or behavioral issues who are involved with child welfare authorities are sometimes placed in intensive care services in a residential treatment program. Evidence-based psychotherapies are often used in residential treatments, but there is very little research on how to adapt psychotherapy for residential treatment. ObjectiveTo describe the implementation of a transdiagnostic cognitive behavioral therapy (the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children) in a residential treatment program for children. Participants and settingStaff (n = 20) at a residential facility in Calgary, Canada. MethodsA combination of qualitative interviews and focus groups were conducted before and after therapy to identify barriers and facilitators to implementation. Data were analyzed and reported using the Consolidated Framework for Implementation Research and the Framework for Reporting Adaptations and Modifications to Evidence-based Implementation Strategies. ResultsModifications were made to the program including creating inclusive language, integrating relevant content targeting pediatric irritability, delivering sessions online for caregivers, and using additional staff to support youth to learn and practice the application of the content and behavioral interventions. Key barriers to implementation of the Unified Protocol included staff turnover and the difficulty of sustaining a critical mass of knowledge surrounding the Unified Protocol. The major facilitators to implementation were the perceived quality of the program and advantages of the program to children and their caregivers. ConclusionsThis study supports the feasibility and acceptability of providing transdiagnostic cognitive behavioral therapies for children in residential treatment and provides a template for how to implement evidence-based practice in residential treatment.

Struggles over social rights: Restricting access to social assistance for EU citizens

The legal category under which EU citizens exercise their right to free movement – worker, jobseeker, student or economically inactive - determines access to social rights in the host state and leads to differential inclusion in the welfare state. The right to equal treatment in relation to welfare entitlements has been subject to constant litigation before the European Court of Justice, leading to the refinement of the conditions under which migrant EU citizens can access welfare and the implications of such requests for their right to reside in an EU state. Moreover, while the conditions of access to an EU host state's welfare system are set at the EU level, the delivery of welfare takes place at the national and local levels, making national administrations and bureaucrats important actors in the governance of welfare. The aim of this article is to tease out the relationship between different levels of jurisdiction in the governance of access to the welfare state. We rely on data from 11 Member States in which we monitored the application of the relevant EU legislation and case law during the time frame 2016–2020. The main trends we discern are a growing interdependence between immigration and welfare authorities and a move towards the systematic control of all EU applicants for social assistance in several states. We argue that these developments are facilitated by the turn in the CJEU's jurisprudence that limits entitlement to welfare for economically inactive EU citizens and emphasises conditionality and legal residence as the main axes determining access to the welfare state.

Supervising a family or a service? Social worker approaches to foster care supervision in six Swedish authorities

ABSTRACT In many countries, local supervision is the main activity to control foster care. In Sweden, the legislation stipulates that foster parents have a supervising social worker (SSW) and the foster child an assigned social worker (CSW). This article describes and analyses how child welfare authorities organize and social workers handle the supervision of foster care. The study is based on data (policy documents and 18 individual/group interviews with 43 managers/social workers) collected from six Swedish child welfare authorities. Analytically, the study assumes that the position of foster care between the private and the public spheres paves the way for different ideas regarding how to conduct supervision that can be broadly based on trust or control vis-à-vis foster homes. The findings show that supervision is differentiated and varies more between foster parents and children than between authorities. Supervision approaches are identified that can be analysed as being more or less trust-based (discreet and affirming) or control-based (compensating and interfering) towards foster parents and children, but overall trust-based approaches dominate. The approaches imply different levels of involvement in care and vary regarding emphasis on the private and the public aspects of fostering. The discussion focuses in particular on the potential impact of different supervision approaches on the foster care service.

Long Farewell: Bureaucracy of Transnational Death in (Post)-Mortal Practices of Russian-Speaking Immigrants in Finland

The article analyses the confusions around dealing with death-related bureaucracies that Russian-speaking immigrants living in Finland’s border areas have to carry out. Death of their loved ones puts migrants in contact with officials of different levels in their Finnish localities of dwelling and Russian localities of origin. The fulfilment of all bureaucratic requirements feels unfamiliar and laborious and turns to a “long farewell” in the experiences of immigrants. The study makes use of different ethnographic materials by the authors and presents them in a form of “typical story” that is compiled from diverse, but yet alike experiences of Russian-speaking immigrants. Main confusions derive from the digitalization of bureaucratic services in Finland and the need to present paper certificates in Russia, as well as the dominant role of Lutheran church in Finnish burial administration. These encounters and experiences add to our understanding of Russian-speaking migrants’ transnationalism, which seems to be highly dependent on both Finnish and Russian welfare services and authorities, as well on the deteriorating conflict between Russia and “the West”.

Empty cradles: medical authority and disappeared children

During the creation of the state of Israel, thousands of babies and young children were removed from their Jewish immigrant families by welfare and medical authorities. New to the state of Israel, these families from the Middle East, the Balkans, and north Africa spoke little Hebrew and were often living in poverty or transit camps. Children were removed on the belief that their parents could not look after them. Their children would be taken to hospitals and nurseries and never seen again. The parents were told their children had died.

Does India need a new pharmaceutical policy? Examining the implications of the drug price control order.

This article aims to analyse the impact of the pharmaceutical policy on the availability, accessibility and affordability of medicines to the Indian populace. The article delves into the shortcomings of the Drug Price Control Order 2013 and highlights its real-world implications. Published literature in the form of scientific articles on the proposed reforms that took place in the pharmaceutical policy was reviewed. The study used the memorandums, laws and government decisions published by the Department of Pharmaceuticals, Ministry of Health and Family Welfare and National Pharmaceutical Pricing Authority|National Pharmaceutical Pricing Authorities. The pharmaceutical policy in India underwent several changes during 2013-2020 to enhance the affordability and accessibility of drugs. The stringent policy hampered innovation due to the lack of profitability to the Multinational Companies. Moreover, it was found that the impact of the price control order on the low-cost local generic manufacturers affected much of the country's price-sensitive population. The pharmaceutical policy of India needs to be amended to extend its benefit to its stakeholders. The government should shift its attention to improving the quality of drugs, increasing competition amongst manufacturers and enhancing the accessibility of medicines through state/centre sponsored initiatives.

Child maltreatment investigations: Comparing children, families, and reasons for referral in three European countries

BackgroundAlmost all countries have developed measures to ensure that children do not suffer from violence in their families. However, the legal framework, definitions of maltreatment, and institutional structures differ. Whereas in other areas of social policy comparative research is very common, child protection research falls behind. Research questionsThe article examines the differences between cases referred to local child and youth welfare authorities due to concerns about abuse or neglect in Germany, England and the Netherlands, comparing the characteristics of the child, the family, the person reporting the suspected maltreatment, and the type of maltreatment. Method1207 case files on children investigated due to suspected child maltreatment from the Netherlands, England, and Germany were analyzed using a standardized coding scheme. ResultsThe family backgrounds of the children reported differed substantially, with more lone parents in England and more children living in two households in the Netherlands. The persons and institutions reporting their concerns to the local child and youth welfare authorities also differed, with more reports from children and family members in Germany and more from health services in England. In England, physical abuse, sexual abuse, and sexual exploitation were more frequently the reason for referral than in the Netherlands and Germany. DiscussionDifferences between countries can partially be explained based on differences in policies and relations of other systems to the child protection system.

Mainstreaming NUDGES in public health behavioural sciences in Saudi Arabia – seven steps to success

Introduction: Nudging by government health and welfare authorities has increased in popularity given the potential to add-value to the current arsenal of behavioural research tools and approaches. A needs assessment was conducted for the Health NUDGE Team, Ministry of Health, Kingdom of Saudi Arabia, with the intention of mainstreaming and institutionalizing NUDGES within the behavioural sciences in the Gulf State and the region. Needs assessment aims included identifying global progress, impact and lessons learned for continuous improvement. Method: A rapid evidence literature review was implemented, and standardised discussion agenda developed for consultations with sixteen stakeholders from leading global NUDGE Units from 9 country programs. Data was analysed with NVivo 2020 qualitative software. Results: The Benchmarking and SWOT analysis identified a number of challenges and opportunities for NUDGE Units in their infancy to consider. “Seven Steps to Success” are proposed. Discussion: Important considerations are provided for fine-tuning NUDGE organisational, functional and technical capacities, leveraging of activities, and advocacy and promotion of best-practice approaches. The steps can assist in optimising NUDGE performance as the strategy evolves in Saudi Arabia and the Eastern Mediterranean Region. Benchmarking with other providers plays an important part in continuous improvement as well as flexibility to adapt behavioural science processes and approaches to better reflect the needs of country and regional stakeholders.

Exploring State Level Factors Associated with Short-Stays in Child Welfare: The Role of Systemic Risk and Surveillance.

Growing attention has been directed toward children who are placed in out-of-home care by child welfare authorities for less than 30 days, deemed "short-stayers". This exploratory study uses multiple national child welfare and population data sources to identify macro level factors associated with short-stays. Two-level logistic regression modeling was conducted to explore how state-level factors were associated with risk of short-stays. Factors associated with lower odds of short-stays included living in a state with a centralized child welfare reporting structure and with greater food insecurity. Factors associated with greater odds included living in a state with a higher percentage of the state's population enrolled in the Supplemental Nutrition Assistance Program and states with more police per capita. Multiple state level factors were associated short-stay risk, which suggests broader systemic factors contribute to these brief removals. Findings suggest greater surveillance by police and social services increases risk of short-stays, which likely have implications for child welfare policy and practice.

Improving Parenting Competency and Permanency Awareness for Kinship Foster Parents Through In-Service Licensure Training.

Child welfare jurisdictions increasingly place foster children with kinship foster parents as a means of meeting their need for stability, family connection, and behavioral and emotional support. However, the lack of financial and educational assistance provided to kin by child welfare authorities often undermines these caregivers’ ability to provide effective and lasting care for the children in their homes. This study uses a mixed-methods approach to understand how formal training and licensure processes can aid kinship foster parents in facilitating positive outcomes for children and youth in the foster care system. Specifically, we investigated the barriers experienced by kinship foster parents while trying to access existing licensure-based training and supports, as well as the initial outcomes of a kin-tailored licensure training curriculum alternatingly administered in in-person and virtual delivery formats. Participants reported that incomplete or inaccurate communication about licensing processes, practical difficulties in attending training, irrelevant session content, and stringent licensing requirements acted as barriers to accessing these resources. However, participants in the kin-specific licensure training administered in this study reported high levels of learning related to key parenting competencies and increased awareness of kinship permanency supports, although these outcomes appeared to be less pronounced among those receiving the training in a virtual format. These findings suggest that researchers and policymakers should consider developing, implementing, and evaluating further initiatives to provide accessible and tailored supports to kinship foster parents as a means of improving outcomes for the children in their care.