Background
Supporting family mental wellbeing and preventing mental health problems in Finland
Methods
Study design
Setting, participants and recruitment
Data collection
Data analysis
Raw data | Notes | Codes | Sub-themes | Main themes |
---|---|---|---|---|
I4: […] Then it like also becomes an ethical conflict for me. Like, what do I do? Should I dedicate time to many… and not give enough to anyone, or should I dedicate enough time to a few and leave the rest without support? It was impossible and it tore at me terribly, this ethical conflict. […]. But now I have opted to support those that I see as much as I can | Not being able to support all is experienced as an ethical conflict among the practitioners | The supply–demand imbalance is influencing mental wellbeing at work | Resources in public services – challenging proactive and collaborative work approaches as well as professional wellbeing | Interacting within a complex system |
I13: […] But families may not really be aware of what support they can receive from us. Child protective services are often associated with a very negative connotation, it’s like “oh no, they’re coming to take our children”. They don’t consider us a part of this [promotion and early prevention work], that we want to help. Our aim is to help and support the family so they can manage on their own. But the negative connotation is still there. So they don’t want anything to do with child protective services or social services for families | The prejudices regarding child protection services influences families picture of child protection services and can function as a barrier for seeking support | Stigma associated with child protection services challenging reaching families early on | Social norms and stigma among families with young children – inhibiting timely support activities from reaching families | Connecting with diverse families |
Results
Reaching the families in need of support in time—challenges and enablers for supporting mental health among families with young children
Overarching theme | Main themes | Sub-themes |
---|---|---|
Reaching the families in need of support in time—challenges and enablers for supporting mental health among families with young children | Interacting within a complex system | Resources in public services – challenging proactive and collaborative work approaches as well as professional wellbeing Organizational and political support—enabling promotion and prevention work Multi-professional collaboration and teamwork—a challenge and an enabler within stagnant structures |
Connecting with diverse families | Social norms and stigma among families with young children – inhibiting timely support activities from reaching families Initiatives for increasing professional knowledge – a key for promoting mental wellbeing Proactive and accessible services – measures for lowering the threshold for families even further |
Interacting within a complex system
Resources in public services- challenging proactive and collaborative work approaches as well as professional wellbeing
I5: [..].We have a personnel shortage, we have a queue, we have twenty or thirty families in a queue. We have been understaffed for a long time and we still are. This year has been extra turbulent in this regard so […]. The personnel shortage and resourcing leads to us not being able to do this the way we want to.
I3: […] the personnel is understaffed in relation to the population size, which makes it, we could work in much more of a preventive manner and much more, like targeting the general public and perhaps preventing people from needing to come here for individual or family support. If they could come in an earlier stage. Also according to the social services act, that the family counselling services are under, the emphasis should be on prevention. And there is a wish for us to step in earlier in the families situations, but there are these resourcing challenges.
I4: […] Then it like also becomes an ethical conflict for me. Like, what do I do? Should I dedicate time to many… and not give enough to anyone, or should I dedicate enough time to a few and leave the rest without support? It was impossible and it tore at me terribly, this ethical conflict. […]. But now I have opted to support those that I see as much as I can.
Organizational and political support—enabling promotion and prevention work
I5: […].That we have the freedom to make the best of the situation is an asset. I have a freedom as a professional to decide together with the clients what we do, how long the period is, what we are trying to achieve.
I9: Really, the support and trust of the manager is important. If it were not for that, the work would be quite daunting, no matter how great the work is and regardless of the feedback from the parents and families. […].
I3: Perhaps it is more about the political support, to see that it implies actual resources, investing in child and family mental health. […]. You are sort of missing that support, for that to happen, but it’s also an issue which is not easy to influence. Of course we raise the needs within the organizations and so on but..
Multi-professional collaboration and teamwork—a challenge and an enabler within stagnant structures
I12: Every person working with persons who experience mental health problems should work in a team. […]. There is a lot more strength in working in a team. Bringing things up in a team. And to some extent this is done already, but it’s not like”now X and I are meeting this family”,. You don’t have that strength, our system is so vulnerable in a way […]. But you would have to build a system where there is maybe teams with different professions, over the whole field. I would like to see that.
I1: I think, now I’m complaining, I think the implementation of the model is falling short, because they school us in new programs and we’ve attended courses and taken this to heart and thought” ok, we are working in line with this because it’s what you decided”. But then they haven’t, how should I put it […]. We can’t work in line with the new model, not in my municipality, and I see it falling also in other municipalities, so I think that’s really bad.
I13: The mother may gets tips and advice from a contact and the dad gets from theirs and then they receive third party information from the team responsible for the younger children. That’s maybe where it fails. The ideal would be that there would be some kind of, I don’t know, where the whole family receives the support they need. So there is an exchange of information, and a holistic picture of the family.
Connecting with diverse families
Social norms and stigma among families with young children—inhibiting timley support activities from reaching families
I2: […]. And in my experience perhaps it’s, well, those with higher education maybe? Those who already have a lot of information and for whom it’s easy to read information and maybe have supportive networks already, they find these forums more easily.
I13: But families may not really be aware of what support they can receive from us. Child protective services are often associated with a very negative connotation, it’s like “oh no, they’re coming to take our children”. They don’t consider us a part of this [promotion and early prevention work], that we want to help. Our aim is to help and support the family so they can manage on their own. But the negative connotation is still there. So they don’t want anything to do with child protective services or social services for families.
Initiatives for increasing professional knowledge – a key for promoting mental wellbeing
I5: In order to develop, all employees need continual education, in relation to current events and working methods in society. The world is constantly evolving and even though you have an education you need this, in order to be inspired and have confidence in yourself, but also for the knowledge it’s crucial. And that’s something I can say, now that I’m not far from retiring and look back on the courses I’ve attended, they have been absolutely crucial […].
I12: A lot of people come to the health centres with diffuse problems, they may not receive a diagnosis, however it may be a sign of something else. It is perhaps easier with measurable things than those that are more “I have a stomach ache because I am worried about something”. Maybe they [other professionals in primary health care] should receive more education.
Proactive and accessible services – measures for lowering the threshold for families even further
I4: And in this municipality they have recently initiated this service […]. With a low threshold you can contact a family worker that visits the family and can assist where needed. This is quite new. I think it’s a great initiative, and I suspect a lot more of it would be needed.
I8: This is the positive side of the online dimension, not having to be in a certain municipality to participate. Earlier it was in a [specific location in specific municipality] and then it’s much more difficult to participate if you don’t actually live in that community.