ACUCARE experts will write  and submit
for publishing three international articles:

Lahti, M., Lenk-Adusoo, M., Linno, M.,  Pael, J. & Timonen-Kallio, E
Mental health care actions in child protection: Systematic review of evidence-based literature

Timonen-Kallio, E., Lahti, M., Linno, M. & Pael, J.
Case Study in Finland and Estonia: Good Interprofessional Collaboration Practices
in Child Welfare Services

Purre, M., Linno, M., Lahti,  M., Pael, J & Timonen-Kallio, E.,
Fixing “broken souls” – interprofessional collaboration in Finnish and Estonian Child Welfare Services in regard to children with psychiatric disorders

Lahti, M., Lenk-Adusoo, M., Linno, M.,  Pael, J. & Timonen-Kallio, E
Mental health care actions in child protection: Systematic review of evidence-based literature

Abstract:
Background: Many of the children and adolescents living in vulnerable living environments in child welfare settings tend to be in need of psychiatric treatment as well as child protection services. There is an urgent demand for closer collaboration between mental health and social sector in order to ensure more effective work in child welfare settings regarding to mental health care actions provided. However, it is widely known that collaboration between child protection services and mental health services is not working well and the outcomes for vulnerable children are poor.

Objective: Aim was to describe the evidence-based literature related to mental health care actions provided in child welfare.

Methods: A systematic integrative review were undertaken to describe the mental health care actions provided in child welfare settings. Seven databases (PubMed, EbscoHost, Ovid MEDLINE, Eric, CINAHL, Elsevier Science Direct, Cochrane database) were searched, while search parameters included English-only manuscripts published prior to May 20, 2016. Study appraisals were made independently by 3 reviewers, and qualitative syntheses of data were conducted.

Results: Out of 152 identified records, only eight studies met the inclusion criteria. Participants were children and adolescent between 0-18 years of age. Mental health care actions described varied and were listed as follows: crisis assessment, respite child care, counselling, therapeutic interviews, cognitive and educational screening, different therapies, psychoeducational support, psychological testing, behavioral assessment, individual work and brief interval care.

Conclusion:  Despite using comprehensive searches from seven databases, we found only eights studies related to acute psychiatric services targeted to looked-after children. However, different actions were found to use with looked-after children. Nonetheless, there is not enough evidence to arrive at a definite conclusion on effects of mental health care actions in child welfare.

Timonen-Kallio, E., Lahti, M., Linno, M. &  Pael, J.
Case Study in Finland and Estonia: Good Interprofessional Collaboration Practices in Child Welfare Services

Abstract:
Problems of the children and families’ need to be identified at an early stage to give the necessary help at right time. This means integrated care and multi-agency interprofessional network. In this article good interprofessional practices in Finland and Estonia in family work and residential child care are described.

Starting point for the descriptions is the model developed by The National Institute for Health and Welfare (THL) in Finland.  The model for describing a good practice offers a tool for a concise description of practices that have been evaluated as ‘good practices’. The model is also applicable to practices that have already proved promising and have been evaluated for functionality and/or effectiveness to some extent. Main elements of the model are tat work is acceptable, it is good for clients, it is ethically relevant, it bases on knowledge, it can be described and can be evaluated and it is simple. These descriptions promotes the adoption of other professionals to apply the good practice in their own work environment. In this article promising interprofessional family work and residential child care practices are described and reflected.

The models will be given for effective working together with partner professionals in child welfare services. The questions will be reflected: what kind of knowledge its practical effectiveness is derived from and is the practice functional and effective in its specific context and  is the practice evaluated to achieve good outcomes for the user. The findings will be developed further as ‘acute team’ model which means that immediate interprofessional help and support is available for the family and service is in use for the best interest of the child.

Purre, M., Linno, M., Lahti,  M., Pael, J & Timonen-Kallio, E.
Fixing “broken souls” – interprofessional collaboration in Finnish and Estonian Child Welfare Services in regard to children with psychiatric disorders

Abstract:
Negative or traumatic experiences in childhood can often increase the likelihood of behavioural and mental health problems. For children in residential care, the collaboration between specialists from multiple fields is especially necessary to detect possible psychiatric disorders and for finding and implementing appropriate care.

Focus group interviews were conducted with mental health specialists, social workers and residential child care workers to outline bottlenecks in the current systems, as well as to explicate attributes of successful interprofessional collaboration and networking practices. Qualitative analysis of the interviews revealed attitudes towards psychiatric illnesses, residential child care and collaboration partners, including school and kindergarten personnel, general practitioners and children’s biological parents.

Growing up in residential care can be seen as stigmatising, bringing forth the public image of an orphanage and the children being seen as “broken” or having “broken souls”. Notably, specialists from the social field manifested prejudice towards mental health specialists (especially psychiatrists), and vice versa. Negative attitudes and prejudice can hinder collaboration and the development of efficient interprofessional teams for psychiatric help in residential child care setting. To facilitate interprofessional work and to help tackle stigma and prejudice, the benefits of using case studies and illness narratives in an e-course setting are explored.