Initiated by the Nordic Council of Ministers in 2017 and managed by the Norwegian Directorate for Education and Training, the Nordic 0−24 collaboration has been a three-year cooperation, sharing experiences and models from local projects in all the Nordic regions. The aim has been to improve efforts and services towards vulnerable children and young people under 24 years of age. The lessons learned from the collaboration are based on the final report from the Nordic 0−24 project Mind the gap! Nordic 0−24 collaboration on improved services to vulnerable children and young people. Key findings are:
LISTEN TO THE CHILDREN AND YOUNG PEOPLE: Place the child or young person at the forefront. Include their perspectives and approach them as equal competent partners in order to develop services designed to their specific needs. The individual should be approached as a “whole person” in a context and not by predefined and generalized categories.
This document summarizes the main results from the Nordic 0-24 collaboration. A project initiated by the Nordic Council of Ministers in 2017 and managed by the Norwegian Directorate for Education and Training. The project has been an effort to improve the follow-up of vulnerable children and young people and their families through increased cross-sectoral cooperation between services.
The most important findings are to place the needs of the children and young people at the forefront and strengthen cross-sectoral collaboration.
Link to final project report: https://fafo.no/zoo-publikasjoner/fafo-rapporter/item/mind-the-gap
Tobias is 12 years old and struggles with several challenges. He and his family are in contact with numerous people, like teachers, the school health service, or other municipal healthcare professionals such as his general physician or psychologist to mention some. Several specialized services, mostly at municipal level, but also at government level are there to help Tobias. They offer various provisions, priorities and initiatives, directed by different laws, guidelines and directives, grant schemes and experts. In short, the puzzle is complicated.
Nordic citizens benefit from a highly specialized welfare system, but when issues are more complex these services seem to struggle. In Tobias’s case, with multiple needs, the structures are strained as they are organized in single sectors with strictly defined areas of responsibility. The sectors may have little knowledge about each other, and the responsibilities can be overlapping and unclear.
The objective of this document is to present results and key lessons generated from the Nordic 0−24 project. A project aimed at improving support for vulnerable children and young people like Tobias, by enhancing cross-sectoral collaboration between different service providers. Presentation of key success factors for strengthening collaboration across services are therefore at the core of this summary (see figure 1).
All the Nordic countries face challenges because too many children and young people are falling outside the school system. By working together, we can help each other to find good ways to give children and young people a better start in life
Secretary General, Nordic Council of Ministers
The Nordic initiative is part of the effort to reduce the dropout rate from secondary education and subsequent social marginalization and poverty. Several insights have been gathered from representatives in direct responsibility of improving the lives of vulnerable children and young people. The project has thus gathered valuable and useful lessons directly of relevance for those working in the front-line services. But to bridge the gap, part of the future implementation efforts need to be lifted to a national level.
LISTEN TO THE CHILDREN AND YOUNG PEOPLE
The perspectives of children and young people should be included to develop services more designed to their needs. This has been referred to as an individual centered and holistic approach, found to be essential for identifying relevant follow-up initiatives and early intervention. The approach demands a user-oriented methodology, both at system and individual level with
System level: Develop systems, structures and routines that promote low threshold access to services and efficient follow up based on the needs of the user, not restricted by specific mandates, criteria or diagnosis.
Putting the children and young people in the center is a way to overcome the so called ‘institutional logics’, and instead reveal the total situation of the individual. Providing a joint platform for all services
Individual level: Involve the person (the child, youth, parent) in the process of defining relevant follow-up and strive to acknowledge the persons in need as equal competent partners.
Implement methods for empowering the child, young person and parent in encounters with professionals, to ensure that their perspectives are taken into consideration.
The Children's Voice
The Children’s Voice in Copenhagen builds on the Scottish model, Getting It Right for Every Child (GIREC). The initiative emphasizes that children have a right to participate in decisions that influence their lives and learning, and where acknowledging children (and parents) as experts in their own lives are crucial. They have developed guidelines for dialogue with the kids about their situation and made systems for empowering children and parents as equal participants in meetings.
Now we emphasize speaking with the children and their parents, rather than about them.
KINDERGARTEN & SCHOOLS AS CORE ARENAS OF INCLUSION
Kindergartens and schools are core arenas for identifying children at risk, achieving early intervention and initiating coherent follow up:
STRENGTHENING CROSS-SECTORAL COLLABORATION:
I. Leadership: A clear and competent leadership represents a vital factor for anchoring collaborative projects and is essential for supporting and incentivizing all the following key success factors linked to strengthening cross-sectoral collaboration.
Secondly, in addition to leadership on an administrative and operative level, the political support over time is critical. The Finnish municipal cases are based on their anchoring at a high level and they consider coordinated leadership as a success factor for collaborating across regional and municipal authorities. The Finnish municipality of Lohja has also established management teams in their new reform work to improve services, where managers, leaders or headmasters from all services are represented.
II. Geographical proximity: Geographical proximity is essential for cross-sectoral collaboration. However, bringing involved actors together does not necessary entail co-location. The essence is to establish arenas for the actors to meet and work together. This could be:
ComUng – a ‘one-stop shop’ for young people
The municipality of Lund has established a one-stop shop for young people neither in education, employment nor training. The service is a collaboration between the Swedish Public Employment Service (State) and several municipal services. The aim is to provide coordinated information, guidance and support. Locating several services in the same place has made it easier to collaborate and work more effectively together. The geographical proximity benefits both the youth and the professionals. The young people do not have to visit several different offices and repeat their stories. The service providers, in turn, are able to discuss the young person’s case with one another because they have his/her consent to share information
III. Professional knowledge, culture and trust: Different services usually have their own way of working; with distinctive professional knowledge and culture often organized in isolated “bureaucratic silos”. Professionals see the world through their own lenses, which means that what one experts finds relevant, might not be the most appropriate solution for another. To confront the challenges of these “institutional logics” the involved experts should:
Swedish response to the mapping of factors important for promoting more coordinated services:
Several of the young people who have interrupted or are at risk of interrupting their studies are in need of follow-up from several actors – which calls for an effective and clear cooperation. Systematic coordination must be built into systems and structures and not rely on the efforts of one person and one relationship. Collaboration between different professionals and services demands understanding of the context and knowledge of each other´s mandates, assignments and roles. Trust and confidence are important. This is about a change of perspective from the services to the person in need of the services – to what is the best approach seen from the his/her perspective. A holistic view and someone who takes responsibility for the totality is essential.
IV. Building relational capacity and competence: Kindergartens and schools, family centers and other public services involved need to improve the relational capacity of the organization they present. Equally important is the development of relational competence among professionals. These skills must be continuously encouraged and maintained by:
V. Collaborative culture and change of mindset: To succeed with cross-sectoral collaboration, fostering a collaborative culture and mindset is necessary. It is of significance to develop a common awareness on how we understand the problem, how we think about the problem, and how we as a consequence of our particular mindsets act upon it.
To strengthen the collaborative culture, professionals cannot simply be brought together, they need to spend time together with the aim of establishing knowledge of each other’s competence and contributions (Anvik and Waldahl, 2018). Regular, compulsory and structured interdisciplinary meetings are experienced as a valuable tool to create a bridge between professionals.
Training to arrange interdisciplinary meetings: views from the Norwegian case
To develop good structures for interdisciplinary meetings have been a major task in the Norwegian case. The experience is that interdisciplinary meetings are challenging. The Norwegian case thus emphasizes training as key for the professionals to become competent collaborators. It is necessary to spend time on planning and clarifying each participant’s role, as well as making their contributions and expectations explicit. The goal is to create a collaborative, inclusive and respectful atmosphere, both among the professionals and for the service user.
In the Norwegian case, they have used role play as one method to optimize cross professional meetings and meetings with the users. Their approach is based on their awareness of the need to practice how to conduct good meetings, and for the participant to reflect on his/her own actions and approaches.
VI. Regulations The Nordic countries have different regulations with regards to collaboration between services, coherent plans for follow up, and for sharing information. Current regulations are not always conducive to a more collaborative practice. These issues should be addressed in cooperation with authorities at a national policy level.
In the Icelandic case, the service center in Breidholt has implemented procedures for acquiring consent from children and families for sharing of information. This initiative increased the collaboration between the services, and combined with new structures and systems they found that they have increased success with early intervention. Between 2011 and 2020 referrals to the Child and Youth Psychiatric Department in Breidholt have been reduced by 56 prosent.
We see that the Nordic countries are struggling with the same, that we face the same types of barriers in solving the challenges of vulnerable children and young people, related to laws, regulations, confidentiality.
The Icelandic response related to efforts to promote better cross-sectoral collaboration:
Mapping of national cases, spring 2019.
The Nordic 0−24 project has generated increased attention to the importance of placing the perspectives of children and young people at the center and to the significance of strengthening cross-sectoral collaboration between services and professionals to succeed with this work.
Six key success factors are highlighted to achieve strengthened collaboration. These elements interrelate, and will have implications at different levels in the work on better coordination. A clear leadership (one of the six factors) is an overarching driver essential for developing new practices. It will also require time and resources to develop new collaborative systems, but initiating processes for better collaboration might result in the creation of more effective services in the future.
Moving forward, increased attention from the national levels to facilitate good cross-sectoral cooperation will be necessary. We cannot just mind the gap – we need to bridge it. We must use the experiences and knowledge that is gained and embed these lessons into the national structures and policies. It demands that we take a closer look at the entire system, especially our governance models − how we are organized and what barriers or silos that are created. Are our models adapted to the needs of children and young people or the bureaucrats?
The Nordic region should be the best place in the world for children and young people. The Nordic Council of Ministers will therefore continue to facilitate work at a Nordic level, where cross-sectoral collaboration is an important part of the continuation.
Anvik, C. H. & Waldahl, R. H., Sustainable Collaboration to support Vulnerable Youth: Mental Health Support Teams in Upper Secondary School. Social Inclusion 6 (3) (2018)
Hansen, I. et al., Nordic 0– 24 Collaboration on Improved Services to Vulnerable Children and Young People. First Interim Report, Fafo-report (2018)
Hansen, I. et al., Nordic 0– 24 Collaboration on Improved Services to Vulnerable Children and Young People. Second Interim Report, Fafo-report (2019)
Hansen, I. et al., Mind the Gap! Nordic 0– 24 Collaboration on Improved Services to Vulnerable Children and Young People. Final report from the process evaluation, Fafo-report (2020)
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© Nordic Council of Ministers 2021
This publication was funded by the Nordic Council of Ministers. However, the content does not necessarily reflect the Nordic Council of Ministers’ views, opinions, attitudes or recommendations
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