Interprofessional collaboration between residential child care and mental care practitioners: a cross-country study in six European countries

ABSTRACT

The severe mental health problems of many of the young people living in residential settings pose a great challenge and demand on child protection and mental care (MC) services. Drawing on comparative research and debates from six European countries, this study examines demands for integrated care and interprofessional collaboration practices between residential child care (RCC) and MC. In this article, research data will be brought together from Denmark, Finland, Germany, Lithuania, the UK (Scotland) and Spain. In total, 61 practitioners from RCC and MC were interviewed. Given the complexity of the residential care service context and service system differences across national contexts, the original hypothesis was that this would differentiate the collaboration practices. However, the similarity between the countries is greater than anticipated. The concluding findings are organised by matrix technique into a content-analytic summary table. The main finding was that in spite of encouragement for integrated RCC, obstacles for collaboration and lack of coordination between systems remain, often related to understanding the professional role and tasks, lack of shared knowledge, attitudes and ways of communication. One significant finding in the cross-country comparison was the evident and unrealistic expectations for the ‘other’ provider to help and care.

ABSTRAKTI

Lastensuojelu ja mielenterveystyö ovat riippuvaisia toisistaan. Lastensuojelun sijaishuollon laitoksissa asuvien lasten vakavat mielenterveysongelmat asettavat molemmille mittavia yhteistyön haasteita ja vaatimuksia. Tässä vertailututkimuksessa selvitettiin integratiivisten palveluiden edellytyksiä ja moniammatillisia yhteistyökäytäntöjä kuudessa Euroopan maassa: Tanskassa, Suomessa, Saksassa, Liettuassa, Skotlannissa ja Espanjassa. Tutkimuksessa haastateltiin 61 lastenkodin työntekijää ja mielenterveyden ammattilaista. Lastensuojelun monimuotoiset toisistaan poikkeavat palvelujärjestelmät sekä maiden väliset kulttuuriset erot antoivat olettaa eroja yhteistyökäytännöissä, mutta yhteistyön problematiikka osoittautui yllättävän samanlaiseksi kaikissa maissa. Osatutkimusten haastattelujen analyysi on tehty sisällönanalyysillä, joiden keskeiset tulokset on koottu matriisin. Kiinnostava tulos oli se, että huolimatta yrityksistä rajapintatyön käytäntöjen vahvistamiseksi, monet yhteistyön esteet ja koordinaation puutteet ovat edelleen todellisia, liittyen omaan ammatillisen roolin ja työtehtävien paikantamiseen, yhteisen tiedon puutteeseen sekä asenteisiin ja kommunikointitapoihin. Tämä kansainvälinen vertailututkimus osoitti molemmilla osapuolilla olevan epärealistista luottamusta ‘toisen’ sektorin ja systeemin kykyyn auttaa ja tukea lapsia.

KEYWORDS:

• Boundary work
• interprofessional collaboration
• residential child care work
• comparative research
• integrated care

AVAINSANAT:

• Rajapintatyö
• moniammatillinen yhteistyö
• lastenkotityö
• vertaileva tutkimus
• integratiiviset palvelut

Disclosure statement

No potential conflict of interest was reported by the author.

Notes on contributor

Eeva Timonen-Kallio, Lic. Soc. Sc., Principal Lecturer, Research Group Leader , Faculty of Health and Well-being, Turku University of Applied Sciences, Finland. She is finalising her doctoral thesis concerned the professional qualifications for residential child care work. She is a Vice President of FESET – European Association of Training Centres for Socio-Educational Care Work.

Notes

1. Lithuania 91%, n = 4119, Denmark 45% n = 1400, Germany 51% n = 65,367, Finland 38%, n = 6699, Spain 40%, n = 13,820 (foster care is mostly kinship care). In Scotland, 1475 places in residential care, 87 of these were in secure accommodation across six units.

2. Members of the international research group who prepared papers and commented on drafts on this paper: Amaia Bravo, University of Oviedo, Spain, Denise Carroll, Kibble Care and Education Centre, Paisley, UK (Scotland); Heikki Ellilä, Turku University of Applied Sciences, Finland; Gunter Groen, Hamburg University of Applied Science, Germany; Eigil Kristiansen Strandbygaard, VIA University College, Aarhus, Denmark; Astrid Jörns-Presentati, Hamburg University of Applied Science, Germany; Mari Lahti, Turku University of Applied Sciences, Finland; Alina Petrauskienė, Mykolas Romeris University, Vilnius, Lithuania; Jolanta Pivorienė, Mykolas Romeris University, Vilnius, Lithuania; Jan Jaap Rothuizen, VIA University College, Aarhus, Denmark; Mark Smith, University of Edinburgh, UK(Scotland); Jorge F. Del Valle, University of Oviedo, Spain.

3. RCC workers, managers, psychologists, social workers, psychotherapists, psychiatric nurses and paediatricians.

4. Qualified social workers in Finland have a Master’s degree in social work. Every child who is taken into care has a key social worker who makes decisions for all child welfare and health care services for the child.

5. See more reflections of relationship between RCC work and social work as professions in Milligan (1998).

6. In Scotland, RCC includes security units.

7. Some countries as the Netherlands, Germany and Scandinavian countries had developed their RCC training programmes in higher education.

Additional information

Funding

This research was supported by the Lifelong Learning Programme (LLP) [grant number: 2012-3154/001-001].