7.6 Mechanisms of early detection and signposting of young people facing health risks
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In order to identify health risks to children and young people at as early a stage as possible, the federal government has adopted the Act to Strengthen the Active Protection of Children and Young People, Federal Child Protection Act (Gesetz zur Stärkung eines aktiven Schutzes von Kindern und Jugendlichen (Bundeskinderschutzgesetz, BKiSchG)) and the Act to Strengthen Health Promotion and Prevention, Prevention Act (Gesetz zur Stärkung der Gesundheitsförderung und der Prävention (Prevention Act, Präventionsgesetz, PrävG)).
Federal Child Protection Act (Bundeskinderschutzgesetz)
- Came into effect: 1 December 2012.
- Aims: Using findings from the Early Prevention in Childhood (Frühe Hilfen) programme and its many associated projects as the basis, the Act aims to improve child protection in Germany across the board, close gaps and strengthen the position of those who work in child welfare (such as parents, paediatricians, midwives, youth offices, family courts).
- Authorities responsible: Federal Ministry for Family Affairs, Senior Citizens, Women and Youth (Bundesministerium für Familie, Senioren, Frauen und Jugend, BMFSFJ).
- Selected measures: Make Early Prevention in Childhood programmes and strong networks available immediately from pregnancy, exclude ex-offenders (of relevant crimes) from working in child and youth services, prevent youth office hopping (Jugendamt-Hopping), implement standards for custodians of professional secrets with respect to providing information to the youth office, establish regulations on house visits, create binding standards in child and youth services.
- Evaluation: On 31 December 2015, the federal government filed a report evaluating the Federal Child Protection Act with the lower house of the German parliament (Bundestag).
Act to strengthen health promotion and prevention (Präventionsgesetz)
- Came into effect: 25 July 2015
- Aims: To strengthen the bases for closer collaboration between social security agencies, federal states (Bundesländer) and local communities in the fields of prevention and health promotion.
- Authorities responsible: Federal Ministry of Health (Bundesministerium für Gesundheit, BMG)
- Measures: Promote vaccination programmes, develop existing health screening for children, young people and adults, increase investments by health insurers and social care insurance providers in health promotion and prevention by more than 500 million euros in child day care centres, schools, communities, workplaces and care facilities.
- On the basis of a national prevention strategy (Nationale Präventionsstrategie), social security agencies – with the involvement of the Federal Employment Agency (Bundesagentur für Arbeit) and community umbrella associations – agree with the federal states (Bundesländer) on the specific type of cooperation on health promotion in local communities, child day care centres, schools, workplaces and care facilities in particular.
On the government side, the central stakeholders in health promotion and prevention work at a local level are the public health care service, the local authorities and their schools and youth centres. Health insurers and hospitals also get involved when the health of young people is at risk. In the private sector, youth work organisations, sports clubs, welfare organisations, education providers, self-help groups and counselling services also help with prevention.
For schools, school social work (Schulsozialarbeit) plays an important role in prevention. It provides largely low-threshold, preventive socio-educational assistance. This assistance compensates for social disadvantages or helps people to overcome personal limitations. A national school social work website is available with information and network details. The site presents examples and concepts from school social work in the individual federal states (Bundesländer) and local communities. School social work is governed by district and independent-city regulations, as well as the education laws, programmes, guidelines and edicts of the federal states relating to school social work.
Key stakeholders in school social work:
- German Association of Schools of Social Work (Fachbereichstag Soziale Arbeit, FBTS) The German Association of Schools of Social Work is the nationwide assembly of deans of departments/faculties of social work that offer study programmes in social work (formerly known as social education or pedagogy).
- Association of school social workers (Kooperationsbund Schulsozialarbeit) Its members are full-time employees of various federal associations (Workers' Welfare Association – Arbeiterwohlfahrt Bundesverband, AWO), the federal working committee for evangelical youth social work (Bundesarbeitsgemeinschaft Evangelische Jugendsozialarbeit, BAG EJSA), IN VIA Catholic association for social work for girls and women in Germany (IN VIA Katholischer Verband für Mädchen- und Frauensozialarbeit – Deutschland), the international association IB (Internationaler Bund), the social welfare organisation Der Paritätische Gesamtverband, the executive board of Education and Science Workers' Union (Gewerkschaft Erziehung und Wissenschaft, Hauptvorstand – GEW) and other individuals.
The education server provides an overview of stakeholders of school social work in the federal states.
The Healthy Cities Network(Gesunde Städte-Netzwerk) in Germany is part of the World Health Organization's Healthy Cities project. It is a voluntary network of local communities. The main goal is to act as a campaign and learning tool to support local work under the Healthy Cities initiative. The Healthy Cities Network gives professional and specialist assistance to health authorities, social security offices, housing departments, environment agencies and urban development planning employees as well as representatives of health initiatives and self-help groups. The German branch has a general meeting once a year, and Healthy City symposia are held every two years.
The German Society for Prevention of Child Abuse and Neglect (Deutsche Gesellschaft für Prävention und Intervention bei Kindesmisshandlung, -vernachlässigung und sexualisierter Gewalt, DGfPI) is a collective of around 750 experts and expert organisations from across Germany and neighbouring countries who work actively to improve child protection. The DGfPI offers a platform for professionals working in any field in positions of responsibility who are confronted with the various forms of child abuse and neglect and who work with victims and their families. They include experts working in social work, education, the justice system, the court and probation system, healthcare, therapy and counselling, and academia and research.
Local stakeholders in prevention work will find support and information on the website of the Federal Centre for Health Education (Bundeszentrale für gesundheitliche Aufklärung, BZgA). Information, educational, school and training services and resources for individuals affected and communication multipliers can be found by following the Internet links under 7.4 Healthy lifestyles and healthy nutrition. BZgA also has an overview of national counselling services in the following areas:
- Addiction counselling
- Eating disorders
- Pregnancy advice
- Sexuality, partnerships and contraception
BZgA has produced a handout called 'Stay healthy – communities' (Gut Drauf-Kommune) to promote the health of children and young people in local communities.
The surveys carried out by BZgA on drug use and other dependencies (computer games, internet) among young people support efforts to prevent young people from becoming addicted.
The Addiction Yearbook (Jahrbuch Sucht) by the German Centre for Addiction Issues (Deutsche Hauptstelle für Suchtfragen e.V.) contains the latest statistics on the use of alcohol, tobacco and pharmaceuticals, and on gambling and the use of addictive substances behind the wheel in Germany. It also provides information on the treatment of addicts in Germany and statistics on addiction treatment and rehabilitation.
Surveys are also carried out in the individual federal states (Bundesländer) on the use of addictive substances, and the results are used for prevention work and other activities. The Saxony centre for addiction issues (Sächsische Landesstelle gegen die Suchtgefahren e.V., SLS) publishes a report on addiction treatment 2020 (PDF, 975 KB).
http://www.bundesgesundheitsministerium.de/themen/praevention.html – Website of the Federal Ministry of Health (Bundesministerium für Gesundheit) with information on prevention and child health
https://www.kindergesundheit-info.de/themen/risiken-vorbeugen/ – Website of the Federal Centre for Health Education (Bundeszentrale für gesundheitliche Aufklärung, BZgA) with information on risks and prevention, along with work materials and practical background information for professionals
Specific target groups for prevention work and health promotion activities are small children (Early Prevention in Childhood [Frühe Hilfen] programmes) and their families, children of nursery school and school age, children whose welfare may be at risk, and children and young people from disadvantaged backgrounds (poverty, migrant background, dysfunctional family background, children who have dropped out of school, disability, etc.).
The federal government does not specifically fund health promotion measures and prevention work at a local or community level.
Financial support for projects to promote health in local communities is, for example, offered by some health insurers.
On the basis of Sections 20 and 20a of Book V of the Social Code (Fünftes Sozialgesetzbuch, SGB V), Bavarian health insurer AOK Bayern supports community projects to promote health in the Free State of Bavaria by providing project funding. The funding framework is explained by the National Association of Statutory Health Insurance Funds (Spitzenverband der gesetzlichen Kranken- und Pflegekassen, GKV) in its prevention guideline (Leitfaden Prävention). The guideline specifies action areas and quality criteria for health insurance services in connection with primary prevention and the promotion of health in the workplace and which apply bindingly to the provision of local services. The guideline helps policy holders to avert health risks at an early stage, reach their full health potential and improve their resources to do so. Assistance could be, for example, steps to assess need, training in prevention and health promotion for communication multipliers, documentation, evaluations or public relations.
The health insurer Techniker Krankenkasse supports community projects to promote health that focus both on individual measures and on creating healthy communities as part of a general Healthy communities (Gesunde Kommune) concept.