Niemelä Mika, Kallunki Hannu, Jokinen Jaana, Räsänen Sami, Ala-Aho Birkitta, Hakko Helinä, Ristikari Tiina, Solantaus Tytti
Center for Life Course Health, Research, University of Oulu, Oulu, Finland.
Department of Psychiatry, Oulu University Hospital, Oulu, Finland.
Front Psychiatry. 2019 Feb 18;10:64. doi: 10.3389/fpsyt.2019.00064. eCollection 2019.
Families with parental mental health issues often have numerous problems needing multilevel measures to address them. The "Let's Talk about Children Service Model (LT-SM)" is a community-based service approach aiming at collectively impacting population needs regarding child protection services. Three municipalities in the Raahe District (RD) of Finland requested implementation of the LT Service Model. This paper describes the model and first results. The LT Service Model connects relevant stakeholders with families and their social networks aiming at the shared goal of supporting children's everyday life at home, kindergarten, school, and leisure environments. Parents, teachers, and other caretakers are supported by LT interventions. An infrastructure for collaboration, decision making, monitoring, training, and feedback is established, embracing health, social and educational services, and other stakeholders. Referrals to child protection services were compared with national data before (2009-2013) and after implementation of the LT Service Model (2013-2016). Analyses were conducted using the joinpoint regression method. There was a significant decrease in the underage population referred to child protection services in RD (AAPC = -6.9; = 0.013) between 2013 and 2016, in contrast with an increased rate nationwide (AAPC = 1.9; = 0.020). In the LT Service Model, prevention starts in children's everyday life as the uniting, common goal for multiple stakeholders and an integrated service structure is developed to support this effort. The first results are promising, showing an appreciable decrease in referrals to child protection services, although further research with longer follow-up and across other municipalities is needed.
有父母心理健康问题的家庭往往存在诸多问题，需要采取多层次措施来解决。“让我们聊聊儿童服务模式（LT-SM）”是一种基于社区的服务方法，旨在共同满足儿童保护服务方面的人群需求。芬兰拉赫蒂区（RD）的三个市镇请求实施LT服务模式。本文介绍了该模式及初步成果。LT服务模式将相关利益攸关方与家庭及其社会网络联系起来，旨在实现支持儿童在家庭、幼儿园、学校和休闲环境中的日常生活这一共同目标。LT干预措施为家长、教师和其他照料者提供支持。建立了一个协作、决策、监测、培训和反馈的基础设施，涵盖卫生、社会和教育服务以及其他利益攸关方。将LT服务模式实施前（2009 - 2013年）和实施后（2013 - 2016年）转介至儿童保护服务机构的情况与全国数据进行了比较。使用连接点回归方法进行分析。2013年至2016年期间，RD转介至儿童保护服务机构的未成年人口显著减少（AAPC = -6.9；P = 0.013），而全国范围内的转介率有所上升（AAPC = 1.9；P = 0.020）。在LT服务模式中，预防工作从儿童的日常生活开始，这是多个利益攸关方的共同目标，并且建立了一个综合服务结构来支持这一努力。初步结果很有希望，表明转介至儿童保护服务机构的情况明显减少，尽管需要进行更长时间随访以及在其他市镇开展进一步研究。
