7.6 Mechanisms of early detection and signposting of young people facing health risks
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The Child Protection Act defines early detection and prevention of risks as important areas. Prevention is specifically addressed in the act, which stipulates that:
- In order to ensure the rights and well-being of the child, the risks threatening the well-being and development of the child must be prevented. Prevention includes the detection of situations and events which threaten the child as early as possible and the reaction thereto, including the identification of the child’s development and behaviour problems, problems occurring in the family environment, identification of abuse and the increase of protective measures promoting the child’s well-being and development.
- State and local government agencies shall, according to their possibilities, develop measures in order to prevent the child’s need for assistance and to decrease existing problems. The measures must be based on the child’s needs, support the relationships between the child and the persons raising the child, support the social performance skills and they must be accessible, timely, effective and have a long-term positive effect.
The Ministry of Social Affairs is responsible for developing a legal and policy framework in the area of child protection, however, the implementation is ensured at the local level by local governments.
The Development Plan for Children and Families 2012–2020, approved by the Government in 2011 and renewed 24 October 2013, sets strategic objectives aimed at guaranteeing an improvement in the well-being of children and families and in their quality of life. This plan is the basis for improving the lives of children and families and achieving an increase in population. One of the five strategic objectives is “The rights of children are guaranteed and a functional child protection system is created in order to value each child and the kind of safe environment that supports the development and welfare of children”. Under this objective 3 policy measures were planned:
- Promotion of the rights of the child.
- Increasing the efficiency of early intervention and the child protection system.
- Provision and development of efficient interventions proceeding from the needs of people.
In the document, a line of action „Early intervention system for noticing the developmental needs of a child“ is planned including the following measures:
- Development of a system for evaluation of the developmental needs of a child and early intervention
- Analysis and development of a system of home visits by family nurses
- Development of guidelines and the provision of training for specialists who work with small children
- Organising the provision of information to a broader target group that helps identify the developmental needs of a child early
- Community-based development of a system for early noting of and intervention in the risk behaviour of children.
The Ministry of Social Affairs is responsible for ensuring the implementation of the plan, which ends in 2020. There is no information available whether there will be a new plan or not.
In 2014, the Ministry of Social Affairs also developed a Concept for Improving the Support System for Children and Youth at Risk, which states grounding principles and a need for improving the support system in Estonia. The document defines as the main goal of improving the support system achievement of a situation in which help for ensuring the well-being of children, youth and families are timely, appropriate, high-quality and sufficient, all over Estonia. In order to achieve this, the support system must be improved so that it guarantees (among other aims) „emphasis on prevention and effective intervention“.
The Social Insurance Board is responsible for providing support and training for local governments responsible for the implementation of the early detection and prevention work.
The Child Protection Act defines the functions of local governments and among them the obligation to “develop programmes and projects ensuring the rights and well-being of children and the application thereof in its administrative territory to prevent and decrease the risks that endanger children“. The local government can also establish a committee of children and families at local governments as an advisory body, if necessary.
However, in Estonia, local governments are autonomous by the constitution and may develop their own approach to providing services, networking and ensuring that their functions are fulfilled. Therefore, there is no standard model for early detection and prevention network, its members and stakeholders.
Please see chapters 7.4. and 7.5. for information on awareness-raising campaigns, specific websites, guidelines, handbooks and other material and tools supporting local stakeholders and raise their awareness about health risks faced by young people.
The training centre of the National Institute for Health Development offers professional development courses to specialists working to support health, such as kindergarten and school employees, youth workers, child adopters, foster care families, employees of social welfare services and rehabilitation centres, county and local municipality employees, counsellors, psychologists, health care workers and health promoters, social workers and NGOs. Main areas of training are:
- HIV/AIDS and substance abuse
- Health promotion and health counselling
- The network of Healthy Workplaces
- Health promotion for school and kindergarten staff
- Social work and pedagogics for residential home employees
- PRIDE-training courses for child adopters and foster families
- Courses for employees of social welfare services and rehabilitation centres
In addition, the centre also carries out an analysis of training needs and provides support to trainers in training methodology.
The Development Plan for Children and Families underlines the need to pay attention to “noticing and helping maltreated children“ as a specific target group under the policy goal „Increasing the efficiency of early intervention and the child protection system“.
In Estonia, there is in force a solidary health insurance system. Solidarity in health insurance means that someone's health insurance payments or contribution to the system or access to the necessary assistance do not depend on age, income or health risks. All medically insured people in Estonia are entitled to the same quality of health care, regardless of whether or not they pay the health insurance tax. According to the Health Insurance Act, persons for whom no social tax is paid are considered as having equal status to the insured person and all persons under 19 years of age have had equal status.
Local government is responsible for financing its functions from the local budget.