Three minutes can make a difference for children at risk

Early intervention when children are small is the best way to influence children’s health and development in a positive direction – even small effects on an individual level can lead to change on a societal level over time. For many years, a questionnaire has been used at Sweden’s Child Health Centers (BVCs) for the early identification of mothers who have developed, or are at risk of developing, post-partum depression, so that the right help and support can be provided. Research has shown that depression is also common among fathers, but they are seldom screened in a preventive capacity. Mental illness, abuse, domestic violence and parental stress (for example, regarding the state of the family’s finances) are some of the risk factors that increase the risk of neglect and abuse of children.

Questionnaire for new parents

A prerequisite for protecting children from violence and abuse is that vulnerable children can be identified as early as possible. Although we have a well-established safety net in Sweden, too many children still fall between the cracks. That is why we at Childhood have supported the BarnSäkert (Child Safe) research project, where we are contributing to the development of a new work method for Child Health Center nurses to identify and intervene as quickly as possible when children are at risk in their families. The first results were presented this week.  

Three minutes that make a difference

The Barnsäkert project is a collaboration between Region Dalarna and Uppsala University. Together, for a period of two years, they have tested a model in which parents, in conjunction with routine Child Health Center check-ups, respond to a number of questions in a questionnaire, to draw attention to families who need extra help and support. All Child Health Centers in Dalarna have participated in the pilot project, which has reached more than 24,000 children and their parents. More than 10,000 questionnaires, in eight different languages, have been submitted by participating parents.

Have the courage to ask

When the results of the project were presented in Falun at the end of September, it was clear – it doesn’t take much to identify families at risk: Three minutes per family is the extra time that the Child Health Center nurses have spent using the BarnSäkert questionnaire to systematically ask parents about factors that affect children’s security within the family – everything from smoke detectors to alcohol abuse, mental illness, financial concerns and experience of domestic violence.

Spreading to other regions

As a result of the research project, the BarnSäkert questionnaire is now a set activity at all Child Health Centers in Dalarna and is also spreading to other regions in Sweden. Pilot projects that are financed by the regions themselves are in progress in, for example, Uppsala, Jönköping, Gotland and Blekinge.

A mother took her child to the Child Health Center for a routine check-up. Her “Barnsäkert” questionnaire showed no reason for concern. The nurse talked to her in general terms about how violence and problems at home can affect children’s health and development. Some time later, the mother returned to the Child Health Center and filled in the form once again, which displayed no cause for concern this time, either. On a further visit, already before the BarnSäkert form had been offered, the mother reported that she had been subjected to violence by her partner and that now she understood how much it affected the children, she could no longer keep quiet; the oldest daughter, in particular, was suffering very badly. The mother and her family quickly received assistance to get out of this violent situation.

– We have long seen a need for a more systematic way of identifying vulnerable children. This is where we at Childhood have an important role to play in enabling development and evaluating new methods. We chose to invest in the development of the BarnSäkert method because we see a major need for methods that enable early identification and intervention when children are at risk in their families – and ensure that they receive help from the right agency. The result shows that this is an effective model that has the potential of being scaled up and employed at all Child Health Centers in Sweden. In a long-term perspective, it will help us prevent a large number of children suffering,” says Britta Holmberg, Program Director at Childhood.

Text: Åsa Andreasson Åkerström, photo: private