How can we best help vulnerable young people?

Working with children and young people: Vulnerable children and young people are entitled to obtain help from the municipalities in which they live. However, there are major differences in the ways municipal measures work and are integrated together.

SINTEF has recently completed a research project involving the evaluation of five different municipal projects targeted at vulnerable children and young people. This group struggles with problems related to their parents’ substance abuse and mental health issues, social problems, learning difficulties and truancy, as well as their own illnesses and substance abuse problems. There are also young people who have ended up outside the school system and are now in the hands of the Norwegian Labour and Welfare Administration (NAV).

“In 2016, 55 Norwegian municipalities received state funding to support a variety of initiatives designed to help vulnerable children and young people”, says SINTEF researcher Line Melby. “These initiatives vary somewhat in character, and our aim in this project was to look into what types of measures had the most positive impact. In short, to find out what constitutes best practice”, she says.

After reviewing the content of five quite different initiatives, combined with interviews of children, young people, their guardians and staff, the researchers’ analyses are complete and their report has been published. Among other things, the results demonstrate that low threshold support services have the greatest impact, provided that the young people are heard by the adults they are in contact with about the “way forward”.

Different approaches

The five sets of care services evaluated in the report were carefully selected as relevant objects for study in collaboration with the Health Directorate. Selection required that a project should be aimed at a broadly-defined target group involving a large diversity of service provider groups including health visitors, psychologists, NAV and the child and family health services. Most of the services involved the provision of coordinated substance abuse and mental health care for children, young people and their families.

Three of the projects involved so-called “low threshold” support services, in which recipients are given the opportunity to seek out staff without an appointment for a chat or advice, and in which participation in decision-making on the part of the children and young people was given great emphasis during follow-up. The two other projects each involved a more comprehensive set of service provision in which the children passed through a system involving a fixed follow-up process over a given period of time.

Many success criteria

The research team concluded that in order to achieve the greatest impact, three clear success criteria for successful care services must be in place.

“Among all the projects we examined, there was always one thing that stood out – the initiative gave children and young people the chance to be heard”, says Melby. “Young people are good at expressing their needs when they feel that someone is listening, and so their active participation is the key success criterion”, she says.

The other criterion highlighted by researchers is the importance of offering an “open door” policy with a low entrance threshold. In practice this means that a child or young person can feel free to come and have a chat with an adult whom he or she can trust without having to make an appointment in advance.

“Spontaneous consideration for his or her needs means that a child will experience getting in touch with an adult as a less formal procedure”, explains Melby. This means that the service has a preventive effect, which is very important”, she says.

“In general we find that preventive initiatives are not assigned the priority they should be”, she continues. “It is more common for funds to be targeted at acute initiatives for those who have developed serious problems. But a lot of evidence suggests that low threshold support can prevent the development of major problems and interventions involving high levels of services at a late stage”, says Melby.

The third factor that stands out clearly from this research is the need for service continuity.  Initiatives should not be run with fixed start and finish dates, but should be organised as permanent services in which staff maintain their involvement and where funding stability is built in.

“Our finding is that there is a need for municipalities to adopt longer-term perspectives”, says Melby.  “It is vital that support services are mobilised promptly and that they offer continuity in their work to help the child or young person in question”, she says.

Barriers too

As well as identifying success criteria, the research has highlighted the existence of common barriers that act to prevent initiatives from working as they were intended. Such barriers include a lack of collaboration between various agencies such as the upper secondary schools, NAV and the child protection services. Complex municipal organisational systems were found to be a factor highlighted as challenging because they undermine collaboration, especially in the larger municipalities.

Some of those interviewed said that this type of work required support from the hierarchy and continuous motivation, as well as efficient levels of information flow between the different agencies involved. This issue was however less evident in the low threshold support initiatives.

A lack of shared ICT systems was also highlighted as a drawback that made collaboration between the various agencies more difficult. A desire simply and easily to be able to share written information among the service providers was clearly expressed by many of those interviewed. 

Identifying with the conclusions

Inger Sønderland is Project Manager for the Ung Arena (Young Arena) initiative in Oslo. This is a low threshold informal dialogue-based support service for children and young people. The initiative focuses on user participation in decision-making and dialogue at all stages.

“Reading this report is very interesting, and its conclusions agree with our experience”, says Sønderland.  “Here, young people participate in absolutely every decision – from how a dialogue should be conducted to how our offices are furnished, and how we provide them with information. They even decide how we use Snapchat”, she says.

She explains this by pointing out that this approach ensures that everyone has access to support. If support services are pre-defined and inflexible, there is a risk that there will be young people who don't fit into the “box”, and end up with nowhere to go for help.

“In this initiative we want to turn the traditional model on its head, and our experience is that it works very well”, says Sønderland. “But we also spend a lot of energy talking up the other services provided by the municipality”, she says. We see that many of the young people have a complex set of needs and that they require services other than those that we can provide, such as health visitors, contact with NAV and suchlike. So, getting all the support services to work together is also very important to us”, she says.

Facts:

The five projects that were evaluated as part of this project were:

• Familiens hus og samhandlingsteam (Family house and support service team), Nøtterøy municipality
• Når bekymringsfullt skolefravær blir alvorlig funksjonstap (When worrying levels of truancy lead to loss in psychosocial functioning), Trondheim municipality
• Lavterskelteam, (Low threshold team) Tromsø municipality
• Ungdomshjelpa, (Support for young people), Lier municipality
• UngArena i Bydel Gamle Oslo (Young Arena in Oslo Old Town) Oslo municipality

The project was commissioned by the Norwegian Health Directorate. SINTEF Technology and Society was responsible for both project management and implementation.