Exploring the borders between
residential child care and mental
health treatment
Eeva Timonen-Kallio,
Turku University of Applied
Sciences, Finland
STARTING POINT
Professionals who are working with children
with complex and chronic needs have a
great challenge to pose and share multiprofessional objectives for care and to
benefit the service system in the best
interest of the child.
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AIMS OF RESME PROJECT
• The main idea of the RESME project (2012-2015) is to improve welfare
and mental health of the children who lives in residential settings.
• In project we research the current system of residential child care and
mental health services and practitioners’ professional competences.
• Research aims to identify the multi-professional work practices on the
borderline between child care work and mental health treatment.
• The research results are used in designing and piloting the continuing
educational course for practitioners in child welfare services.
• Developed education course aims to increase the multi-professional
collaboration between professionals working on the borders of these
systems, residential child care and mental health services.
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RESME empirical research
• Literature review: on the borders of mental health and
child care systems
• Comparing mental health and child care systems in
partners countries
• Collecting professional knowledge; experiences and
perceptions generated in child protection and mental
health care practice
• Analysing attitudes, mutual knowledge and cooperation
practices between systems
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Professional identity and roles
• Mental Health system has clear role and function:
– Counselling, assessment, diagnoses & treatment
• Residential Child Care system more ‘general’ role:
– Unpredictable, spontaneous, flexible, demanding
– Everyday life, home routines… totality of life
– Become citizens, social integration… long-term objectives
• Difficult to define professional role in residential care
– no commonly understood conceptual base
Parents? Educators? Specialists? Rehabilitators?
• Differences in qualification in residential care
• Profession undervalued by society
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Methodology
Country
Denmark
Participants
Finland
Germany
1+1 focus group, 3 mixed groups
15 interviews (19 participants)
Lithuania
5 interviews
Scotland
7 interviews
Spain
8 interviews and 1 focus group
Total
43 interviews and 6 focus groups
= 63 interviewees
5 interviews (8 participants)
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Attitudes and expectations
MENTAL HEALTH VIEWS
• Asking miracles:
– unanimous perception CHCARE workers ask for fast results
– demands with lots of pressure and anxiety
• Lack of information:
– No family background, medical history, child development…
– Staff changes in visits or during care
– Lack of information about changes
• Hospitalization as respite resource
– Demanding psychiatric in-patient treatment, moving responsibility to
MHEALHT staff
– Lack of contacts and expectations of long hospitalisation
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Attitudes and expectations
CHILD CARE VIEWS
•
•
•
•
•
•
•
No practical guidance:
Lack of knowledge (children’s homes and staff role)
Academic jargon:
Minimum services (assessment and medication):
Scarce feedback:
Lack of interest in cooperation
Passive attitude, waiting model
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Professional identity and new profiles
• Residential care and young people profiles
– More traumatized, more emotional and behavioural problems
• Need for a more therapeutic model
–
–
–
–
Life space interventions
Therapeutic milieu
Facing severe behavioural problems
Continuous contact with mental health services
• Aware of residential workers need for training on mental
health
– High demand for intervening in areas of no expertise
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Perceptions about the own limits and
difficulties
• Clear awareness of limits in mental health
– Ratio, time, number of patients…
• Also in residential child care:
– Ratios, stability, traumatised children…
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Good practices on cooperation
• Specific programs for children in care:
– Spain: virtual therapy for children in care victims of maltreatment
• Some professionals as mediators:
– Spain, Denmark, some professionals in charge of mediation between systems
• Close contact and support:
– Germany: early detection visiting children’s homes
• All those professionals have a different perception on
child care staff
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CONCLUSIONS
• Very similar attitudes in different countries
• Need for more contact and mutual knowledge
• Need for defining roles and tasks in residential care
– Particularly about working with very demanding children
– “the main tool to do our job is ourselves”
• Need for value and respect for residential workers
– Related to need for qualification in some countries
•
•
•
•
Need for training on mental health issues for CHCARE staff
Need for training on child care issues for MHEALTH staff
Need for knowledge on the other side’s limits!!
Need for shared on-a-job training and forums for discussion
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CONCLUSIONS
• Results support the aims of the RESME project
• Final product is a training course and manual for
multiprofessional training
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Questions for training course ….
• How to incorporate both side’s competencies and
expertise for better collaboration?
• How to promote ’social’ expertice in collaboration with
mental health care …  communities, activities,
togetherness, normality, inclusion, everyday life… with
special children
• What are ’educational’/pedagogical interventions,
models, objectives in practice in everyday life in
residential care?
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Thank you for
your attention!
[email protected]
www.tuas.fi
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