Notice the Children Notice the Children Project 2003-2005Project 2003-2005

Project Workers:Project Workers:Veli-Matti Saarinen and Hilkka RäisänenVeli-Matti Saarinen and Hilkka Räisänen

18.5.2005 Project Workers Veli-Matti Saarinen and Hilkka Räisänen

Notice the Children Project 2003-2005According to many studies, parental mental illness burdens the whole family and is a risk to children´s mental health The child's risk is estimated at 30 – 70%

Ten years ago we become concerned about the children of mentally ill parents what to do, who to consult or whose responsibility it is to deal with

the situation?In Child psychiatric care we noticed that sometimes the children's parents suffered from psychiatric disordersWe suggested further measures to 56% of the children who were assessed during the earlier “Unnoticed Children Project” 1992 - 2002.

The study showed us the importance of prevention while noticing the children's situation. Notice the Children project is focusing on that fact

If we want to notice the children systematically we need education and consultation to the adult psychiatric staff and collaboration between adult and child psychiatry

Notice the Children Project 2003 - 2005

Own motivation

Voluntary basis

Referral

Assessment of the child and family

•Interviews ofparents /children

• YSR, CBCL, TRF-tools

•Home visits•Multiprofessional

negotiations

Training, consultation,work supervision• Beardslee family intervention 8 days

•Mini-intervention training 1day

Beardslee’s family intervention6 –8 sessions

• parents and children

Concern about the children’spsychiatric health or

family’s welfare

Concern aboutthe other parent

Feedbackmeeting

• Informal support netwand multiprof

team •Immediatelyand 6 months

later

Negotiations on further examinations, care or

support to the child/familyVarious therapies FCC, OM, CPC • Child protection

The other parent’sreferral to care

18.5.2005 Projectworkers: Hilkka Räisänen and Veli-Matti Saarinen

Notice the Children Project 2003-2005Methods:

Assesment of the child´s and family´s situation- CBCL,YSR,TRF (Achenbach/Almqvist)- home visits, interviews of parents and children- observation of the family systemBeardslee´s Family Intervention/Mini Intervention

- supporting parenthood, promoting protective factors in the child’s life, supporting family interaction- psychoeducationProviding examinations, care and support services- multiprofessional collaboration, follow-up negotiationsTraining, consultation, work supervisionTraining and work supervision for project workersCollaboration between project workers, child and adult psychiatric units

18.5.2005 Projectworkers: Hilkka Räisänen and Veli-Matti Saarinen

Notice the Children Project 2003 -2005

Results:- The participants (1.9.2003 - 11.4.2005) were 48

families including 119 home-living children aged 0-21- Further measures

Child/adolescent psychiatric clinic 8%Family counselling clinic 33%Child social welfare clinic 41%Other measures: primary health care, follow up etc 13%

- In 11 out of 48 families, the other parent was referred to care

- 2 adult children were referred to psychiatric care

18.5.2005 Project Workers Veli-Matti Saarinen and Hilkka Räisänen

Notice the Children Project 2003 -2005Conclusions:

Both the families and the collaborating partners have experienced the project positively

To ensure that the children of psychiatric patient are noticed, we need intensified multiprofessional collaboration, further training, a supervision and consultation system and a set of quality criteria and instructions to notice the children

In clinical work, the families’ multiple problems and great child protection needs have been surprising

Work with informal support networks and multiprofessional work have increased from the time of the earlier project, and a further increase is indicated

Families appreciate the long term support; plans are made for follow-up negotiations even one year after ending the intervention

The project revealed the lack of recourses in primary psychiatric and social services. Resources in primary services should be an essential part of prevention