Family center A way of integrating existing services from .../media/Europe/TFIEY/TFIEY-5_PP/... · (Mirjam Kalland, Secretary General, Mannerheim League for Child Welfare) Picture:

Family center – A way of integrating existing services from a universalist perspective

Finnish Family Center - A strategic way to provide universal promotion and early support to all children and families

Marjatta Kekkonen Senior Specialist, Ph.D., M.Soc.Sc.

Child, Adolescent and Family services

Structure of presentation

1. Why family centers?

2. What is a family center?

3. What kind of family centers?

4. How to develop family centers?

2

1. Why do we need family centers? Factors that preserve well-being in children and young people … • Safe and stable adults

• A good relationship with parents

• A culture of care in upbringing

• A lifestyle that promotes health and well-being

• Knowing that one can cope

• Friends

• Predictability of everyday life and financial stability

• Parents’ well-being

• Good relationship between parents

• Sufficient family support network

• Time spent with the family

3

Life is not always perfect

• Everyday stress can wear parents down

• Work takes up parents' energy

• Learning is difficult

• There are no friends

• Money is tight

• There are health problems

• Health and well-being seem unimportant

• Parents have problems

• The family breaks up

• There is no-one to turn to for help

Somewhere along the line…

4

Key conclusions of recent research and studies

• Services do not fully meet the needs of children, young people and families

• Mental health problems are common among young people – girls in particular increasingly suffer from depression

• Overall service management is weak

• The service system is highly sectoral, with insufficient co-operation between sectors

• The workload in child protection services has more than doubled since the 1990s

• There are significant differences between municipalities

5

The municipal economy is in crisis

We are spending

less on promotive

and preventive

work

Problems build up

Money is spent on

expensive special,

services

Where do we save in?

6

What does the cost of one placement in an institution equal in basic services?

• Almost 3,000 hours of home care services

• 1,000 meetings with a social worker

• 400 visits to the youth psychiatric outpatient clinic

• More than 400 visits to parenting and family advice clinics

• 7 years intensive family services

Placement in an institution costs 90,000 euro per year.

7

Actions should focus on what happens between first signs of trouble and the intervention of child welfare services

8

What is a family center?

SWEDEN

Family center has been defined as

a complete range of services which are fully co-located

and cover maternal healthcare, child healthcare, open

early childhood education and care and at least

preventive work of social services.

Definition of the Swedish Family center survey

(Socialstyrelsen, Familjecentraler -kartläggningen, 2008).

19.1.2015 Marjatta Kekkonen, erityisasiantuntija, THL/Lanu 9

Norway: Family’s House – an interdisplinary service for children and their families

19.1.2015 Marjatta Kekkonen, THL 10

First floor – Health

promotive and

universal

interventions –

universal support and

knowledge

Foundations Professional competence

NGOs’ contribution

Third floor – indicated

interventions

-particular needs for support.

Second floor –selected

interventions – specified

needs for support.

”Family center provision

is based on the basic

idea that the best way to

to support public health

as a whole in the long

term is to work for a

secure childhood.

(Mirjam Kalland, Secretary

General, Mannerheim

League for Child Welfare)

Picture: Family’s House (Thyrhaug ym.

2011, Norwegian)

Family’s House in Norway

The main goals of the family center are to:

Family centers in Finland / Marjatta Kekkonen, Senior Specialist

• support parenthood – protective factors

• develop social networks

• provide local meeting place

• indentify risk factors at an early stage

• offer a low threshold meeting place

• develop cross-sectional collaboration

• cooperate with NGOs

• deliver information about sercives

• share evidence based knowledge Mothers and babies in Family

Center of the City of Hanko

(2005)

3. What kind of Family centers? The study: Family centers in Finland

The study of Finnish

family centers

A number and types of family

centers

Cooperation with Ngos’ and other partners

Coordination and

management of family center

services

Early support and participation

provided for families and

children


A study: Family centers in Finland

By Nina Halme, Marjatta Kekkonen

and Marja-Leena Perälä. THL. 2012.

Family center models


3 %

47 %

22 %

9 %

19 %

Multidisplinary family center, in whichservices are located in a same building

Multidisciplinary family center, inwhich services may locate in differentpremises

Welfare advice center

Open early childhood education andcare (ECEC) -center

Specialised family support centre

Family center service models


Multidiscip-linary family

center

Maternity health care

clinics

Child health care clinics

Open ECEC -services

Preventive social services

Welfare advice center

Maternity health care

clinics

Child health care clinics

No link Preventive

social services

Open ECEC -center

No link No link Open ECEC -

services Preventive

social services

Specialized family

support center

Child welfare services

Child-/adolescent

mental health

Welfare services for substance abusers

Other specialized

services

Target groups of family centers – according to age of children

19.1.2015 Perhekeskustapaaminen/Nina Halme 15

Services provided to families with Yes %

Children under 12 –years:

Under 3-years 100

3 – 6 - years 100

7 – 12 –years 61

Children over 12 –years:

13 – 16 -years 52

17 – 23 –years 31

A well-organized coordination

• Most family centers (80%) had written goals or an action plan

• Crossectional cooperation was more effective in municipalities, which had

• family center coordinator (32%)

• Management or steering group (34%)

• Family center teams (30%)


A succesfull cooperation

• 70 % of family centers had agreed upon

• multiprofessional cooperation

• 80 % of FCs had agreed upon

• support provided for everyday life in minor concerns

• principles of early interventions

• Principles of interventions with families in risk

• Family centers had less often agreed upon

• Strategic development of family center

• Cooperation with Ngos and other partners

• Involvement of families and children


Support provided to families

• Family centers were in general effective in

1. Providing early support for parenthood

• Supporting parents’ strengths in everyday life

• Helping parents to create social networks

• Ensuring peer group activities

• Promoting early interaction between child and parent

• Providing low treshold meeting places for families

2. Providing more focused interventions in form of counseling and

guidance in issues concerning

• upbringing

• parenting and

• relationship

19.1.2015 Perhekeskustapaaminen/Nina Halme 18

Family centers cooperating with NGOs could more often provide


Early support and peer group activities

A low threshold meeting places

Parental involvement and participation

Implementation of the family center


Multiprofessional

cooperation

Dialogic cooperation and service

culture

Crossectional coordination

between different services and

NGOs

Municipality/ regional based

coordinator

Family center –

integration of services

Integrative management

Commu-nication and customer orientation, partnership, digital skills

Problem-solving and the ability to be innovative

Cultural knowledge, language knowledge, subcultures

Professional role; leadership, cooperation and teamwork

Education; pedago-gical skills, special needs, intercultural issues

Competence needs in family centers

Backman & Nordström 2012

Family center work goes strong in Finland

The National Development Programme for Social Welfare and Health Care (Kaste)

Family center

network

School health and

welfare network

Child welfare network

The Family center learning network: Open for all interested municipalities and other partners

Family center NGO -

network

Family center training network

Family center development work on the municipal level (Kurikka)

DIALOGIC CULTURE

APPROACH

MULTISECTORAL INTEGRATION

APPROACH


Conclusions • The multidisciplinary family center is an effective model.

• Integration of universal, selective and indicative services must be further elaborated in order to strengthen the health promotion approach.

• Parental involvement, peer support, low threshold meeting places and social networks can be best promoted in multidiscplinary family centers

• NGOs and parishes are the key partners in the family center -model

• Family center requires structures for crossectoral cooperation

• Integrative management and steering structures of child and family services on the whole are needed in order to coordinate the family center services

• The competence of professionals should be improved by structured parent support programmes and practices

• The role and involvement of parents, families and children needs to be strengthened.


Family centers connect families, services and NGOs!


Thank you for your attention!

Appendix: Some examples of Finnish Family Centers


Parainen

Family Center

Ankaret

Imatra

Welfare Advice

Iisalmi

NGOs’ Family

House

Kurikka

Multidisplinary

Family center ?

Family Center Ankaret: primary health care, ECEC –services and early intervention services located in the same premises


Universal services: - Maternity child health clinic

- Child health care clinic (0-6)

- Primary health care nurses

- Contraceptive advice

-

Early intervention services - Family counseling

- Speech therapy

- School welfare worker

Services open to all children

and families: - Open Day Care Center

- Open Family Cafe (run by

NGO)

Welfare Advice Center in Imatra - maternity and child health care services reinforced by family workers


Welfare Advice Center

Services of the Welfare Advice

Center contains of:

- Maternity health care services

- Child health care services

- Family worker services.

The aim of the welfare advice

center is to promote the well-being

of families and offer them support in

every day life.

The arget group of the services are

all families with children 0-6 years

old.

NGOs’ Family House in the city of Iisalmi - local NGOs partners with promotive services


The NGOs’ Family House provides

promotive and preventive services

and activites for families with children.

The aim and leading idea of the

Family House is to stabilize a new

kind of PARNERSHIP MODEL

between NGOs and municipalities.

The Family House provides place for

local civic and voluntary organizations

to operate in an integrative way to help

families.

Activities in The Family House are

professionally coordinated and they

complement the municipality child and

family services.

Family center in Kurikka municipality – progressing towards multidisplinary model


Kurikka municipality is heading towards

more integrated multidisplinary family

service and family center model.

The multidisplinary family center integrates

child and family services:

1. Maternal health care

2. Child health care

3. Social care (family work and home help)

4. Preventive child welfare work

5. ECEC – and Open ECEC –services

6. Early intervention and support services

(family counselling, therapy services)

1. A low-threshold meeting place for

families

2. A net-based family center

Documents

Family center A way of integrating existing services from .../media/Europe/TFIEY/TFIEY-5_PP/... · (Mirjam Kalland, Secretary General, Mannerheim League for Child Welfare) Picture: