7.6 Mechanisms of early detection and signposting of young people facing health risks
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Policy framework
The purpose of the Act on Pupil and Student Welfare is to promote pupils’ and students’ learning, health and well-being and inclusion, and the prevention of problems; to ensure support at an early stage for those who need it and to make sure that student welfare services are of equally good quality and available to everyone, and that the school community and environment are safe, healthy, and accessible. In this way, the whole Pupil and Student Welfare Act is based on the principles of ensuring early detection. There are several mechanisms, which promote this idea. As mentioned above, a young person is entitled to have school health-care, dental care, contraception and other sexual health counselling for young people. (For more information, visit: Youth Wiki/Finland: 7.5 Mental health) The Act on Pupil and Student Welfare regulates a single-structure basic education as well as upper secondary education and vocational upper secondary education. The implementation of student welfare may vary in educational institutions. However, education providers are always responsible for organising these welfare services for students.
School health care includes annual physical examinations for every pupil. Wide physical examinations are being carried out in the first, fifth and eighth grades. A wide physical examination includes parents’ interviews and a teacher’s evaluation of the pupils’ performance. One idea behind these meetings is to detect possible risks as early as possible (for more information in Finnish, visit here).
In addition, the national curriculum of single-structure basic education sets guidelines for early detection and signposting of young people facing health risks. According to the national curriculum, the teacher is responsible for promoting and following pupils’ well-being, supporting and guiding them, and identifying possible difficulties.
Stakeholders
In terms of everyday practices in school, teachers, school nurses and school psychologists are the most important stakeholders in the area of early detection and signposting of young people who face health risks. Their cooperation in this area is fundamental. As mentioned above, a teacher has an important role in promoting and following pupils’ well-being, supporting and guiding them and identifying possible difficulties in their everyday life. The teacher participates in wide physical examinations by giving an evaluation of pupil’s performances. According to legislation, a young person is entitled to have school health care, which includes also early detection. Therefore, school nurses, school psychologists and teachers have a key role in this task.
Secondly, education providers must follow and evaluate the realisation and impact of the Pupil and Student Welfare services in cooperation with the municipality’s social and health services and participate in the assessment, which is carried out by an external evaluator. The results must be made public.
Thirdly, the National Institute for Health and Welfare and the National Agency for Education must follow the realisation and impact of the Pupil and Student Welfare services at the national level.
Guidance to stakeholders
Since the most important documents regulating mechanisms of early detection are the Pupil and Student Welfare Act and the national curriculums (single-structure basic education, upper secondary education and vocational upper secondary education and training), these must be taken into consideration as the primary documents providing guidance for teachers and school health care professionals. The Finnish National Agency for Education organises training for stakeholders concerning the national curriculum, its goals and how to plan local curriculums are based on the national one.
Additionally, the National Institute for Health and Welfare has a list of published recommendations for school health care, school catering, mental health work, and family services on its websites (in Finnish). Also the NGOs produce handbooks and materials and offer training and education for stakeholders. For example, MIELI Mental Health Finland offers mental health work training for adults who are working with young people. (For more information, visit: Youth Wiki/Finland: 7.5 Mental health). The Mental Health Act covers the prevention of mental health problems, not only how to treat them.
In addition, the website called TEAviisari introduces how student welfare services have been carried out in vocational education institutions. The website is based on self-evaluations by education providers.
Target groups
If a young person does not participate in school health care’s physical examinations, their need for support will be assessed. The reason is that young people who do not participate in these examinations tend to be more often at risk of social exclusion than their peers. One way to assess a young person’s situation is to contact their parents or to organise meetings at home. Secondly, as mentioned above, the Youth Act obliges outreach youth work and education providers to collaborate in certain situations, in which there may be threats to a young person’s health and well-being. For more information, visit: Youth Wiki/Finland: 7.4 Healthy lifestyles and heathy nutrition.
Funding
School health care is currently funded by municipalities and the state. In the future Health and social services reform will affect the structure of funding. Student and school health care services will be put together under the responsibility of one organiser of the welfare area. The state finances and directs social and health services. In addition to other social security services, the welfare areas are responsible of organising the curatorial and psychology services of student welfare. Cooperation between education and social and health services is changing in municipalities from internal cooperation to cooperation between the municipality's education department and the welfare area's social and health department.