Professionalised, hybrid, and layperson models in Nordic child protection - actors in decision-making in out of home placements

ABSTRACT

Decisions about child protection and interventions in families are one of the most difficult responsibilities of welfare states. The aim of this article is to describe and analyse the commonalities and differences in the child protection decision-making systems in Sweden, Norway, Finland, and Denmark. We focus on the actors involved, especially the laypersons, and their role in the decision-making process when deciding on out-of-home placements, both on voluntary and coercive grounds.

The study is based on a comprehensive analysis of official documents, legislation, guidelines, and reports about child protection in each country together with a review of recent research in the area. This is complemented by 12 interviews with key informants with knowledge about the child protection systems in their respective countries.

We found that there is an expanding influence from external experts and dwindling influence from laypersons. We discuss the organisation in terms of three different decision-making models – a professionalised decision-making model in Finland, a hybrid decision-making model in Norway and Denmark, and a layperson decision-making model in Sweden. One conclusion is that all of the countries aim for children to be involved and for decisions to be made in compliance with the rule of law, but this is realised quite differently when it comes to which actors should be given the authority to make the decisions. Which model is the best would have different answers depending on which perspective the models are evaluated from. However, the consequences of decision-making models for children need to be studied further.

KEYWORDS:

• Child protection
• decision-making
• laypersons or experts
• Nordic countries

Introduction

Decision-making in child protection is a complex and challenging phenomenon worldwide (Munro 2008; O’Sullivan 2011). General challenges involve formal aspects of ensuring that the overall processes work in accordance with the rule of law and thus that the legislation is clear, the decision-making body is impartial, the decision-making process is transparent, and the decisions can be appealed. The challenges also relate to material aspects, and the decision reached should be ethically defensible, should serve the best interest of the child, and should honour, or at least not violate, the rights of the parents (cf. Mattsson 2015, 2016). In addition, the views and wishes of the individuals involved, not least the children’s themselves, should be taken into consideration. In many cases, lack of crucial information of the child’s situation, conflicting goals and values (Budd 2005; Fluke et al. 2010; Gambrill 2005; Webb 2002), having to take decisions quickly (Helm 2011), and under-developed knowledge about the effects of available measures and interventions (Duffy and Collins. 2010) lead to an uncertain foundation for making well-informed decisions. The actors responsible for making such decisions must anticipate the child’s future development through a more or less formalized and articulated calculation of risks (Power 2007). To manage multiple uncertainties requires a difficult balancing act on the part of the decision-makers because there is a risk of either intervening when it is not necessary or of not protecting children when they are in need because this can lead to high-stakes consequences for children, their families, social workers, and the agency (Munro 2008).

Because child protection involves decision-making that might intervene in fundamental relations between children and their parents, and might involve decisions that depend on risk calculations of uncertainties in which it is often difficult to foresee what the best decision should be, there is a constant risk of making mistakes and being exposed to harsh criticism. This might threaten the trust in the agency of having the right competence and a tarnishing of the organisation’s reputation (Power 2007). Because the organisation of the decision-making bodies is a way to fulfil the intentions of the law (Svensson 2012), reforms of the decision-making bodies might be seen as a way to ensure the quality of the decisions made, and by that be a response in order to protect the public and maintain political trust.

The choice of actors who are given formal authority of decision making indicates what knowledge and competencies that are assumed to give or uphold the legitimacy (and good quality) of child protection decisions. Decisions for an out-of-home placement refer to the removal of a child from his or her home (often the parents’ home) and their placement in substitute care, such as a foster home or in an institution. The decisions are often the toughest decisions to make because they dramatically intervene in families, but they also provide a way to understand and compare different decision-making models because they necessitate a negation between multiple, perhaps even contradicting, goals and values, several stakeholders, and legislative demands and interpretations (Bacchi 2009; Webb 2002). Actors such as social workers, judges, and different kinds of child experts, as well as laypersons, all play a role in regulating the process at different procedural steps. The influence of laypersons has in all Nordic countries been strong and motivated from ensuring a democratic influence and ensuring that there is a local connection to the decisions made (Hultman, Forkby, and Höjer 2017; Liljegren, Höjer, and Forkby 2014). Interestingly, their influence has decreased over the last few decades as part of reforms in the sector in most Nordic countries, and the motivations for this are clearly connected to the perception of and policy for child protection. So, even though child protection services to a great extent have a common history and still have many similarities in the Nordic countries, the organisation for the decision-making and the actors involved have been changed and now vary between countries. An analysis of what motivated the reforms and the current status of the decision-making system enables a discussion of whether there is a Nordic child-protection model.

Aim

The aim of this article is to describe and analyse the commonalities and differences in the organisation of the child protection decision-making systems in Sweden, Norway, Finland, and Denmark and thereby identify accounts for the current status of regulations and organisational structures. We focus on the actors involved and their role in the decision-making process when deciding on out-of-home placements, both on voluntary and coercive grounds. A specific focus is on the influence and role of laypersons in these processes because they traditionally were the decision-makers in all of these countries. The arguments for their presence and replacement can shed light upon the challenges and changes of the systems more generally. In relation to this, we discuss the potential consequences of different decision-making models for the social workers who in different ways are part of the process. We also discuss potential consequences with diverse decision-making models for the children affected by the decisions.

Questions

1. How are the decision-making processes in child protection organised, and what competencies are demanded?

2. What knowledge do the involved stakeholders represent, and what motivated the changes of the composition of the actors involved, with special attention to the balance between social workers, child experts, and laypersons?

By the term child protection services or agencies, we mean the part of the public social services that handle the exercise of formal authority, such as investigations concerning if children should be placed outside of his/her home. Coercive interventions/care are interventions without the consent of the guardians and, depending on age, the child, also labelled involuntary decisions, whereas voluntary decisions are made with their consent.

Background

Decision-making and control under conditions of uncertainty

Child protection agencies are responsible for governance systems in order to ensure the quality of the decisions that are made (Taylor 2010). Challenges in how to organise decision-making in child protection systems include the sometimes high-stakes character of the decisions, the often uncertain/insufficient knowledge supporting them, conflicting ideas about the current situation, limited capacity to make an accurate prognosis, and limited options within a specific organisational and political context (Budd 2005; Gambrill 2005; Webb 2002). Additionally the decision-making takes place in stressful situations where action is required quickly and without the benefit of time for reflection (Helm 2011). There is a blurred border between formal knowledge, personal experience, and common sense that often interplay in decision-making processes in a manner that is hard to predict (Keddell 2011; O’Sullivan 2011). Looking at the practice, some have suggested that decision-making in child protection is best described as intuitive decision-making (Klein 1998; van de Luitgaarden 2009) in which decisions are made on an ad hoc basis and solutions are tried out one at a time (Simon 1983). This is in contrast to the expectation of decision-making in child protection to be made in an informed and rational manner, i.e. that problems are examined from different perspectives and that all possible options in a situation are considered before reaching a proposal (Proctor 2002; Munro 2008) and that the solution that best meets current needs within the limits of available resources is chosen (Simon 1983).

This means that child protection agencies are at high risk of suffering from legitimacy crises that might arise from not being able to cope with their specific tasks (e.g. not being able to help the clients), and such crises can be a threat to the reputation of the organisation as a trusted agency (Power 2007). Trust is a coveted capital for organisations in general, but especially for those professions working in areas characterised by uncertainty, not at least because trust refers to confidence and credibility for expert knowledge systems (Kemshall 2002, 83). With reasonable trust, a profession or an organisation can function without the kinds of interference that waste energy and might re-direct focus, and the lack of trust can easily lead to legitimacy crises. Thus trust (and legitimacy) is something that must be carefully built, maintained, and protected.

When uncertainty is transformed into an organisational context, it is realised as risks to be assessed, evaluated, and calculated (Power 2007). Expert knowledge is considered crucial in order to interpret and control the social world, as long as this knowledge is used and understood correctly (Kemshall 2002). As Webb (2002) argues, ‘Risk, trust and security are bound up with the development of expert systems which emphasize the scientist-practitioner’ (48). However, professionals/experts might be wrong, and in some areas such as child protection, it might be very hard to define what is a correct and good decision because such decisions are based on uncertainty, a lack of knowledge, and a lack of control of future developments. The reformation of monitoring systems of professional conduct and auditing systems can be seen as responses at the organisational level to control areas where decisions might be highly contested and where both professional and organisational trust and reputation are evaluated against misconduct and/or ethically debated decisions (Power 2007).

The kind of expert knowledge that is demanded and who these trustworthy experts should be is part of the challenge involved in organising child protection decision-making. Kemshall (2002) argues for judicial processes as a way to introduce greater accountability and to bring child-protection services under control. He writes, ‘Audit has become an essential mechanism for holding practitioners to account and for eradicating the inherent uncertainties of social work […] thereby the autonomy and professional status of workers is reduced’ (83). The social workers’ autonomy and status is reduced even more if actors in the judicial system who are supposed to cooperate with them do not respect them and their work (Ellet and Steib 2005).

Intra – or interprofessional teams in child protection has been another way to give legitimacy to decisions in cases regarding children. These teams are often used to both broaden and deepen the analysis of a case, and they can be a strategy for reaching well-informed consensus on decisions (cf. Huxham 2000). However, inconsistency in assessments and the fact that professionals often evaluate cases and possible outcomes very differently have been found within professional groups (Keddell 2014; Schuerman, Rossi, and Budde 1999; Taylor and Donnelly 2006). One reason for this could be cognitive biases, for example, by holding on to an image of the client and ignoring new information that challenges this image (Munro 1999). Additionally, groupthink can occur in which the social workers’ ‘collective memory’ of previous cases biases the perception and proposals made regarding the present problem (Forkby and Höjer 2011). In order to control professional groups and as an argument for transparency and involvement of the public in these difficult decisions, arguments to involve laypersons are made (Liljegren, Höjer, and Forkby 2014).

Another reason for inconsistency could be social bias, in which affiliation to one’s own professional group influences one’s conclusions when it comes to assessments. Considerable differences between professional groups have been found regarding which kinds of information they rely on when making decisions about out-of-home placements (Britner and Mossler 2002).

Hence there is a real challenge facing child-protection services in how to balance and improve decision-making. One important aspect of how to handle uncertainties seems to be who should be involved in the decision-making bodies.

Child protection in four Nordic countries

Child protection decision-making in the Nordic countries (in this study we address Sweden, Norway, Finland, and Denmark¹) emanate from a societal responsibility for children’s welfare and rights, something that might be in opposition to the will of the parents (Mattsson 2016). Interventions should first and foremost be made with consent from the guardians and, depending on age, the child (Hultman, Forkby, and Höjer 2017). This system is ideal-typically based on the idea of equal rights and that great attention should be paid to children’s participation and children’s perspectives. However, in all countries discussed here it is possible to decide on out-of-home placements, on both voluntary and coercive grounds (e.g. Gilbert, Parton, and Skivenes 2011; Burns, Pösö, and Skivenes 2016).

When child protection started to be organised as a societal responsibility during the early 20^th century, Sweden, Norway, Finland, and Denmark influenced each other. Norway was the first to begin organising such services, and the other countries followed (Grinde 1989). It was laypersons on child-protection boards in the municipalities who were appointed as the formal decision-makers in individual cases. As selected members of the boards, they were supposed to act as judicious representatives of the public (Betænkning 1212; Grinde 2004; Hietamäki 2012; NOU 1985:18: 18). Laypersons were also used within the legal system as lay assessors in both administrative and criminal cases.

There are several commonalities in Nordic countries’ child-protection services. These regard, for example, the overall structure of child protection, which is organised at the national, regional, and local levels. Basically, laws and overarching guidelines are formulated at the national level. The audit and control over the social work is organised at the regional level, while social workers, mostly at the local level, carry out the direct work with clients. The social workers are, for example, responsible for undertaking the investigation and for proposing a decision. Even though there are some differences in how central regulations for child protection are formulated, there are also great similarities in the main principles to protect children, especially when their health and development is at risk or is jeopardised due to shortcomings in their home or due to their own behaviour (Hultman, Forkby, and Höjer 2017).

Reforms of the decision-making systems

During the last 25 years, the organisations of the decision-making bodies and the actors involved have changed in Norway, Finland, and Denmark resulting in decreased influence from laypersons, while the Swedish child-protection practice has kept the traditional layperson model. These reforms were all to a greater or lesser degree answers to criticisms towards the child protection services. Two issues have been of major importance for the reforms – a) to ensure that decisions are in compliance with the rule of law and b) to support children’s rights to participate in these decisions. These issues have also affected policy discussions in Sweden, with the difference that it has not been considered necessary to change the layperson model of decision-making. The policy discussion in Sweden has mainly focused on social workers’ handling of cases, on how they involve the children in the investigations, and on what suggestions are being made in different cases – not on the decision-making system as such (Socialstyrelsen 2017a).

Rule of law and children’s rights

The critique of difficulties in upholding the rule of law in the old systems concerned mainly four aspects. 1) Making well-informed decisions and protecting the fair and equal treatment of the clients were deemed to be difficult within the highly decentralized organisation of child protection in local municipalities and with laypersons as the responsible actors. The local ownership was argued to lead to great variability in the decisions and in access to services. It could depend on where one lived, whether decisions were taken on voluntary or coercive grounds, and whether or not alternative support for out-of-home placements was offered (Aarum Hansen 2015; NOU 2000:12; RP 252/2006 rd). 2) There were also concerns about the knowledge base for the decisions, and this included both knowing too little and knowing too much. Social workers in smaller municipalities had few opportunities to build the competence required for more complicated cases and for decisions on coercive grounds because they were seldom confronted with such cases (Grinde 2004). The critique also considered the decision-making bodies that generally lacked the knowledge about children’s needs and development that is needed to make well-informed decisions (Graversenbetænkningen 1990:1212; Grinde 2004; Hietamäki 2012). Additionally, decisions in smaller communities could easily be negatively biased due to extrajudicial knowledge. Having preconceptions and being related in some way to the case being decided upon could make it more difficult to take a neutral standpoint in decisions, something that is especially important when it comes to coercive interventions (Grinde 2004). 3) There was a perceived risk that economics were prioritized over the interests of the child (Hietamäki 2012). 4) The dual role of child-protection agencies in being responsible for both the decision-making about coercive interventions as well as being the provider of care was considered a potential conflict of interest (Ot.prp. nr. 76 (2005–06)). By these arguments, the local knowledge and control, and thus the adjustment to local situations and needs that were important to the traditional system, were challenged, and especially the layperson’s role and influence were in many ways transformed into the source of the problem.

Additionally in the arguments for the reorganisations in Norway, Finland, and Denmark, the wish to make sure children’s right to participate is fulfilled was mentioned together with arguments for making decision more in compliance with the rule of law (de Godzinsky 2012; Betænkning 1212; Grinde 2004; Hietamäki 2012). Thus, even though children’s participation was mentioned as a reason for the reforms, it is not very clear how the new organisation of the decision-making was to make that change happen. Overall, the reforms aimed at making support and interventions more equal for individuals independent of which part of the country they lived.

This raises questions about how the different Nordic countries organise the decision-making and actors involved. Of interest is also if and how details in the organisation of the decision making might have consequences for the children and for the social workers.

Method

The analysis presented in this paper is based on policy documents and interviews with experts on child protection in their respective countries. The printed material included official reports, legislation, government bills, guidelines, and information about organisations and governmental and administrative authorities. The printed material was collected during the spring of 2016 via a search of organisations’ and the governments’ and administrative authorities’ websites in each country. This was complemented by a kind of snowball selection of documents (Lynggaard 2010) made from suggestions from the informants in the interviews. Because our aim was to capture accounts for each system, it was important to study documents that were considered to be strategic or topical in each country.

With the help of search tools such as Google Scholar and Social Services Abstracts, we also performed an overview of research linked to the research questions in order to provide context and background for the child protection organisations and the recent reforms in the four countries. Hence, the printed material included legally binding documents, government bills, and guidelines, as well as research articles and reports. We have treated all of the documents as texts with information about the questions we had in focus. Hence we have not tried to assess the function of the documents (Prior 2008).

We conducted 12 interviews during the spring of 2016 with key informants from Norway, Finland, and Denmark (we drew on our previous research when it came to Swedish child protection (Forkby and Höjer 2011; Forkby, Höjer and Liljegren 2015; Hultman, Forkby, and Höjer 2017; Liljegren, Höjer, and Forkby 2014). The informants were all persons with great knowledge of their own country’s policy development and/or the process and organisation for decision-making. Eight of them were researchers, and four of them had experiences from working in the administrative authorities dealing with these questions. The interviews followed a thematically structured interview guide with both open and more specific questions (Kvale and Brinkmann 2014). The interviews were held in an informal atmosphere. The number and the formulation of the questions differed somewhat from interview to interview in order to get a nuanced picture of each country. The purpose of the interviews was to deepen the knowledge about the organisation of the decision-making process. We were also interested in experiences from and discussions about the reorganisation of the decision-making bodies and the actors involved. The first participants were recruited through professional contacts, and subsequent participants were recruited through a snowball sampling process based on recommendations from the first participants (Bryman 2008; Kvale and Brinkmann 2014). Some interviews were conducted by email correspondence, and for some interviews we used Skype.

The documents and the transcripts of the interviews were thematically analysed to identify themes and subthemes that could help us answer the questions posed in this study. We took inspiration for the analysis from Bacchi’s (2009) policy analysis in which problems, actors, and solutions and their internal relations are identified. Subthemes as accounts for the current status of regulations and organisational structures were coupled to the model.

Like all research, this project has limitations. The intention was to identify important features of the organisation and the main actors involved in the decision-making process. This was realized through the focus on actors involved in the decision on some specific interventions, but at the same time there was an exclusion of decision-making bodies to which decisions can be appealed, and including such bodies might have given a fuller picture of the systems. Furthermore, the prerequisite the actors in decision-making bodies work under e.g legal and procedural regulations have not been illuminated in depth.

Moreover, the authors were not able to read any texts in Finnish. However, Finnish texts on legislation and policy are often translated into Swedish because Swedish is an authorized minority language in Finland.

Findings and analyses

Decision-making in child protection involves many challenges because it suggests an ambition to balance or to compromise between regulations, interests, and considerations from different stakeholders.

Actors involved in the decision-making bodies and their roles

The countries compared here have different solutions when it comes to actors included in the decision-making processes and differ as to whether laypersons or other actors are given the formal authority to make the final decisions about out-of-home placements. What unites the countries is that the decisions about out-of-home placements are preceded by an investigation from the child-protection agency. Even though there might be local differences within the countries because of the municipalities’ differing levels of self-governance, professional social workers have a core position in investigating and assessing the situation and proposing interventions for the children as well as compiling the main documentation for the final decision. Thus, the decision-making bodies are dependent on child-protection agencies and social workers. However, social workers work under country-specific conditions, and their role as decision-maker varies. In all of the countries except for Sweden, decisions about voluntary out-of-home placements are in most cases entrusted to officials at the managerial level (Hultman, Forkby, and Höjer 2017). Sweden differs in that the professionals lack the formal authority to make decisions, even though some specific decisions can be delegated from the laypersons to them (Socialtjänstlagen 2001:453 (SoL) 10:4). Table 1 shows which actors are given the formal authority to decide on removing a child from his or her home, both with and without consent from the parents and the child.

Table 1. Decision-making systems for child welfare. Actors given the formal authority to decide on out-of-home placements with and without consent and their organizational habitats.

Out-of-home placements	Sweden	Norway	Denmark	Finland
With consent	Laypersons at local Child Protection Boards^a	Head of child protection	Varies, often delegated to professionals Two judges and two laypersons in the appeals court^b	Head of child protection or appointed professional
Without consent	One judge, three laypersons in the administrative courts	One judge, one expert on children, one layperson on the county social welfare boards	One judge, two experts on children, two laypersons on municipal boards for child protection Two judges and two laypersons in the appeals court^b	Two judges, one expert on children in the administrative courts

^aDecisions about out-of-home placements are in some specific cases possible to delegate to professional social workers if the decisions are made with consent from the parents and children over the age of 15

^bThe vote of the chairman (one of the judges) decides at times of disagreement. The appeals court in Denmark has a special position in that it can change decisions made by professionals and municipal boards, but it is also given the authority to make decisions on its own in individual cases. For further information, see for example (Hultman, Forkby and Höjer, 20172017).

Laypersons’ dwindling influence

The changes regarding decision-making processes implemented in Norway, Finland, and Denmark have mainly influenced the role of laypersons who have traditionally played an important role in decision-making in individual cases. As shown in Table 1, they still appear in some parts of the process in Denmark and Norway, but they only hold a majority position in Sweden. In Norway, laypersons’ influence decreased significantly when local child welfare boards were replaced in 1993 by regional courts as formal decision-makers in cases of coercive out-of-home placements (Grinde 2004). In Denmark, it was decided to keep the authority to make decisions on coercive care at the local level, but in boards separated from the child-protection agencies. Through that reform in 1990, laypersons had to share the authority to make decisions with a judge and a psychologist or pedagogue (Betænkning 1212). In 2010, the laypersons’ roles were further weakened as the composition of these boards was changed. The number of laypersons decreased from three to two with the consequence that professionals (two experts on child welfare and one judge) are more in number than the laypersons, even though it takes at least four votes in favour to reach a decision on out-of-home placements. Additionally, an appeals court including two laypersons and two judges was given the formal authority to make decisions. The chairperson, a judge, has the decisive vote (Servicestyrelsen 2011). In Finland, the replacement of laypersons happened in 2007 when the administrative courts, with judges and one child-welfare expert, were expected to better handle the challenging out-of-home placements and took over the responsibilities for such decisions (de Godzinsky 2012; Hietamäki 2012). Finland is thus the only country in this study where laypersons no longer make any decisions in individual child-protection cases.

In Sweden, however, the decision-making body consists of only laypersons when it comes to most decisions about voluntary out-of-home placements, and they have the mandate to decide when to apply for coercive out-of-home placements. Laypersons also outnumber the judges in the administrative court where the decision-making about coercive care is carried out. The reasons for keeping laypersons as formal decision-makers have been that they ensure that citizens get an insight into the decisions, that there is some democratic control of the administration, and that they can influence the decision-making with judicious common sense. Additionally, it has been argued that they in their double roles as laypersons (in decision-making in individual cases) and politicians (on political boards and in their parties) can get crucial knowledge of the life situation of vulnerable groups, which is something they can transform into political reforms to help develop the local welfare (Forkby, Höjer, and Liljegren 2015; SOU 2015:71).

In both Norway and Denmark laypersons have been kept in decision-making bodies, but in reduced numbers. The reasons for this have been similar to those in Sweden (Grinde 2004). The rule of law is seen as strengthened by the involvement of ‘ordinary’ citizens (Ot.prp. nr. 29 (1990–91):136) because they can add a different perspective than experts, not least in decisions on coercive care (Betænkning 1212; NOU 2001:32). By that, laypersons are expected to contribute to a balance between different knowledge perspectives in the decision-making bodies. Additionally, the presence of laypersons is supposed to give legitimacy to the decisions, both in relation to clients and to the public (Betænkning 1212; NOU 1985:18: 18, 2001:32: 32, 2005:9).

Expanding influence from external experts

In all countries in this study, the influence from external experts, i.e. professionals not working within the child protection agencies but with knowledge that is seen as important in the decision-making, has expanded. It could for example, be actors with legal competence but also actors with knowledge about children’s needs and development. In all countries legal competence is required when deciding on coercive out-of-home placements. In Finland, judges outnumber other actors (de Godzinsky 2012). This could be understood as a solution to reducing differences in decision-making for individuals depending on which part of the countries they live by letting a legal logic characterise the child protection decision-making process (Grinde 2004) and thereby safeguarding that decision-making is done in accordance to the rule of law and due process (Betænkning 1212; Hietamäki 2012; Skivenes 2002).

Additionally, in all countries external experts with knowledge about children’s needs and development are expected to contribute with important knowledge to the investigation and to the decision-making processes. In both coercive and voluntary out-of-home placement processes, the potential need for external expertise is argued for in one way or another (Hultman, Forkby, and Höjer 2017).

In Sweden and Denmark, the social workers are expected to collect information from other professionals who have knowledge about the investigated child. In addition, a medical doctor or a psychologist should examine the child if it is deemed necessary (Serviceloven 50§; SoL 11:2). In Finland, social workers should consult a multidisciplinary team with special knowledge about children’s health and welfare before proposing an application of coercive out-of-home placement (Barnskyddslag 27§; Dickens et al. 2016). In Norway, external experts are involved in several steps during the investigative process. It is possible to use assessments from for example a psychologist in the application for out-of-home placements, but these assessments must first be reviewed by a special committee, including other experts with knowledge about children’s needs and development (Barnevernloven 4:3).

Hence, experts might influence the investigation process if their knowledge is asked for by the social worker. However, in three of the countries (Norway, Finland, and Denmark), external child welfare experts, mainly persons with psychological, pedagogical, and psychiatric competence, have also been given the authority to be involved in the decision-making bodies when deciding on coercive out-of-home placement.

The arguments for expanding the influence from experts as decision-makers have been the expectation that their specific knowledge will improve the overall quality of the board’s work and will increase the likelihood of decisions being in compliance with the rule of law (de Godzinsky 2012; Betænkning 1212; NOU 2005:9: 9; RP 252/2006rd). Sweden is again the deviant case, holding on to the traditional model in which experts, apart from a judge, are not present as decision-makers on the local child-protection boards or on the administrative courts (Leviner 2012).

One thing that might indicate different functions of the models studied here is whether they have produced different results with respect to the number of children in out-of-home placements. This does not seem to be the case, and the share varies between approximately 8 and 10 out of very 1,000 children (Table 2). The main difference regards whether the decision is made with consent from the parents and children or not. This difference might, however, be due to differences in how cases are categorized or calculated rather than the actors involved. In Norway, for example, all care orders made by the county welfare boards are categorized as coercive even though interventions could in fact be voluntary (Burns, Pösö, and Skivenes 2016).

Table 2. Children placed out of the home in the compared countries.

	Year	Children placed out of the home/1,000 children	Involuntary care of all children in care	Voluntary care of all children in care
Sweden^a	2012	8.2	26%	74%
Norway^a	2013	10.1	71%	29%
Finland^a	2012	9.6	19%	81%
Denmark	2011	9.3^b	15%^c	85%^c

^aBurns, Pösö, and Skivenes (2016)

^bSocialstyrelsen (2017b) Socialanalyse nr 2. Anbragte børn og unge Udvikling i antal og udgifter over tid. Odense: Socialstyrelsen. (0–22 år)

^cAnkestyrelsens statistikker. Anbringelsesstatistik. Årsstatistik (2011). (0–17 år)

Discussion

There is an almost omnipresent aspiration in child protection for improvement of decision-making systems as a way to reduce risks in children’s lives (Kemshall 2002). However, the complexity in child-protection decision-making means that there is not a simple answer for how to organise this process and whether laypersons or other actors should be involved.

Underlying incentives for the respective organisations in Sweden, Norway, Finland, and Denmark have been to ensure that decisions are in compliance with the rule of law and, more importantly, to secure children’s and parents’ right to participate.

Between-country variability in the organisation of decision-making might be inevitable due to country-specific prerequisites. The competence in the decision-making bodies is a formal way to make sure that the decision-making is in line with the intentions of the writers of the law (Svensson 2012). At times the Nordic countries are described as one entity, and there are definitely similarities. However, as this study indicates, there is also a number of significant differences.

Professionalized, hybrid, and layperson decision-making models

In none of the countries did one single actor have full power to decide on out-of-home placements. This means balancing between different knowledge perspectives in the decision-making bodies, and these balancing structures can be discussed in terms of three different decision-making models.

The system used in Finland can be labelled a professionalised decision-making model because the overall power in decisions about out-of-home placements is given to different kinds of external experts. The power is shared between experts with judicial knowledge and experts with knowledge about children and their well-being in coercive placements. When a child is placed out of the home with the consent from the parents and the child, it is then the head of the local child-protection agency who is given the power to decide.

Professionals are also part of the decision-making bodies in Denmark and Norway. In these countries, however, the power is shared with laypersons, and this could be seen as a hybrid model. The power to decide on voluntary out-of-home placement in Norway is given to the head of child protection agencies (Barnevernloven 2:1). In Denmark the decision making regarding voluntary out-of-home placements is usually organised in the same way, even though the municipalities’ self-governance means that there might be differences within the country (Servicestyrelsen 2011). The authority to decide on coercive out-of-home placements in these countries is shared between laypersons, child-welfare experts, and judges, which means a combination of knowledge perspectives (BEK 1127 af 24/09/2015; Skivenes and Tonheim 2017).

Sweden still has a layperson model in which laypersons are given the main power as formal decision makers in individual cases without the involvement of additional actors when deciding on both voluntary and coercive out-of-home placements (SoL 10:4).

Power, control, and discretion – consequences for social workers

The way the decision-making process is organised in Sweden, Norway, Finland, and Denmark gives social workers significant influence over the investigation that forms the foundation from which the decision is made. In Norway, Finland, and Denmark, the heads of municipal child protection agencies are also given the authority to decide on voluntary out-of-home placements in most cases. However, all three countries have special authorities to control and audit the social workers (Hultman, Forkby and Höjer 2017).

Overall, the increased involvement of external experts could be seen as a way to control,

complement, or compensate in areas where social workers lack the necessary knowledge, especially if social workers’ knowledge is not enough to fulfil the rule of law or their competence is insufficient to assess what is in the best interest of each individual child. For example, judicial processes have been seen as a way to introduce greater accountability and to bring child protection under control (Kemshall 2002). On the one hand, the professionalised and hybrid decision-making models show greater trust in social workers because they are given the authority to make decisions on voluntary out-of-home placements in most cases. Seen in this way, the confidence in social workers’ ability to assess what is best for children is lower in Sweden. On the other hand, Leviners study (2012) indicates that the courts in Sweden seldom critically examine social workers written investigation. Furthermore, in comparison with the other countries in this study, the Swedish layperson decision-making model relies more on social workers’ competence in that no experts other than judges are included in the decision-making bodies.

Does the decision-making model matter for the children?

The constellation of decision-making bodies and which actors are given the authority to make decisions might have consequences for social workers when it comes to discretion and power over their work. The question then is what the different models mean for the children involved.

First, the inclusion of different competences might be beneficial for reducing groupthink that might hinder new perspectives on a case. Different professional groups can contribute with different perspectives, and a variety of perspectives could at its best reduce the likelihood of systematic biases (Britner and Mossler 2002). However, if this is to happen the collaboration between professionals must be highly organised (Ellet and Steib 2005).

Second, judicial regulation that is open for subjective interpretation always means a risk for unfair treatment (Svensson 2012). A way to counter this could be the inclusion of experts, supposedly drawing on their formal knowledge when judging on a case. Still, this has not been the silver bullet solution as hoped for, and the involvement of external experts has met with criticism. For example, in Norway actors involved in the county social welfare board have experienced that some external experts, mainly psychologist, are engaged too often and do not always follow the guidelines they are supposed to and thereby influence the rule of law in a negative way (Barne-, likestillings- og inkluderingsdepartementet 2015; Barnesakkyndig kommisjon 2014). Reports and research from Denmark and Sweden shows that medical or psychologist expertise is often given more weight than social worker expertise, even though the latter group is often the one closest to the child. This implies the risk that important aspects in the case might be ignored even when external experts are involved (Alexius 2011; Indenrigs- og Sundhedsministeriet et al. 2011; Socialstyrelsen 2015).

Prior to the reorganisations of the decision-making bodies in Norway, Finland, and Denmark, the layperson’s lack of knowledge about children’s needs and welfare in the decision-making bodies was stressed. The involvement of external experts with special knowledge about children’s welfare in the decision-making bodies was hoped to make it more likely that decisions would be taken in line with individual needs. Audit and control, possibilities to appeal a decision, and procedural regulations were introduced as ways to increase the probability of decisions being made in compliance with the intentions of the law (Betænkning 1212; NOU 2005:9: 9; RP 252/2006rd). However, the difficulties with legislation and regulations that must be translated into individual cases remain. Overall, the processes make decisions hard to compare, and thus it can be hard to say general things about the decisions’ fairness in how they accord to the rule of law (Svensson 2012).

How the decision-making body is organised might also have other consequences for the children. Previous studies have shown that processes needs to be ‘child friendly’ in order for children to participate effectively (Leeson 2007). Children tend to opt out if the decision-making process is too bureaucratic due to formal procedural regulations (Willumsen and Skivenes 2005). Even if experiences from county social welfare boards in Norway and the administrative court in Finland are positive when it comes to fulfilling the judicial procedural regulations and providing fair and equal treatment, concerns have been raised about how children are influenced by and understand the legal process. It has been noticed that there are shortcomings in ensuring children’s right to express their will, and both children and parents have had difficulties in understanding the legal processes. A possible result of the reforms could in fact be reduced rather than greater participation (Barne-, likestillings- og inkluderingsdepartementet 2015; de Godzinsky 2014). Mattsson (2016) underlines that one aspect of decisions being in compliance with the rule of law is the possibility to get insight into the decision-making process. If children themselves do not understand the process, the question is if the decision-making process could be seen as being in compliance with the rule of law.

In order to make it possible for children to claim their rights, they might need to have judicial support adjusted to them (Mattsson 2016), but appointed support without clear competence requirements or guidelines does not seem to be enough (Barne-, likestillings- og inkluderingsdepartementet 2015).

We have not found any evidence that a particular constellation of actors ensures that children are more involved than other constellations. It can be assumed that the establishment of experts with knowledge about children gives greater attention to children and their needs, especially if there is a mix of actors with different knowledge perspectives. However, this does not guarantee that children’s own perspectives will be given more attention. Though, before we can say something about potential consequences of the organisation of the decision-making bodies and the actors involved for children’s participation this need to be studied further.

Moreover, in order to improve child-protection decision-making we might need to know more about the involvement of layperson and other actors in the decision-making bodies, their specific roles, and how they influence the social workers’ arguments that are presented to them. All of the countries studied here aim for decisions to be made in compliance with the rule of law, but this is realized quite differently when it comes to which actors should be given the authority to make the final decisions. What we can see is that none of the studied models are a perfect fit free from potential difficulties and problems, but all models seem to be a balanced compromise.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by the Swedish Association of Local Authorities and Regions [2016].

Notes

1. Due to limitations of time and difficulties in understand the Icelandic language, Iceland was not included in the study.