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
Family centers in Finland / Marjatta Kekkonen, Senior Specialist
A study: Family centers in Finland
By Nina Halme, Marjatta Kekkonen
and Marja-Leena Perälä. THL. 2012.
Family center models
19.1.2015 Marjatta Kekkonen, erityisasiantuntija, THL/Lanu 13
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
Family centers in Finland / Marjatta Kekkonen, Senior Specialist
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%)
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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
19.1.2015 Marjatta Kekkonen, erityisasiantuntija, THL/Lanu 17
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
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Family centers cooperating with NGOs could more often provide
Family centers in Finland / Marjatta Kekkonen, Senior Specialist
Early support and peer group activities
A low threshold meeting places
Parental involvement and participation
Implementation of the family center
Family centers in Finland / Marjatta Kekkonen, Senior Specialist
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
Family centers in Finland / Marjatta Kekkonen, Senior Specialist
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 in Finland / Marjatta Kekkonen, Senior Specialist
Family centers connect families, services and NGOs!
19.1.2015 Marjatta Kekkonen, erityisasiantuntija, THL/Lanu 24
Thank you for your attention!
Appendix: Some examples of Finnish Family Centers
Family centers in Finland / Marjatta Kekkonen, Senior Specialist
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
Family centers in Finland / Marjatta Kekkonen, Senior Specialist
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
Family centers in Finland / Marjatta Kekkonen, Senior Specialist
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
Family centers in Finland / Marjatta Kekkonen, Senior Specialist
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
Family centers in Finland / Marjatta Kekkonen, Senior Specialist
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