7.6 Mechanisms of early detection and signposting of young people facing health risks
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Current situation in mechanisms of early detection and signposting of young people facing health risks as mental health issues would depend on the schools, teachers, school psychologists, primary health care centers (school health care) parents and family. Few upper secondary schools have school psychologists among their staff, but that is not common. The main treatment for mental illnesses in Iceland is medicine. According to the new mental health policy and action plan (2016) will be changes.
A mental health policy and action plan for four years (2016) (“Stefna og aðgerðaráætlun í geðheilbrigðismálum til fjögurra ára”). Funding is secured. The main object is; increased well-being and better mental health of the population and a more active social participation of people who suffer from short or long term mental disorders. The policy has three other goals or tasks:
- integrated and continuous service to people with mental disorders and their families, with nine actions tasks
- mental health promotion and prevention, with four action tasks
- prejudice and discrimination, with five action tasks
Two action tasks will be pointed out in part b) mental health promotion and prevention, according youth:
- Screening for anxiety, depression and the effects childhood shocks among youth in compulsory schools and appropriate support or treatment provided if they are at risk.
- To intervene early and to provide children who suffer, from anxiety or the consequences of shocking, support to reduce the risk of a situation developing in a worse way.
- Appropriate methods of screening for anxiety, depression and the effects of shocking among adolescents in compulsory schools. Children in need must be adequately supported or treated.
Examples of partners: Health institutions, The Directorate of Education and Local governments in Iceland.
- Increased number of children treated for anxiety or depression after implementation is complete and for the next five years after that.
- A plan for the introduction of data-based methods to reduce suicide youth
- Finding the best strategies for reducing suicide youths
- A workgroup will be established, they will provide evidence-based methods that reduce suicide and suicide attempts by young people. The group chooses methods to implement in Iceland for this purpose. At the same time, cost will be cost estimated and implementation plan made.
- The Directorate of Health
Examples of partners: The Ministry of Education, Science and Culture, Local governments in Iceland and specialists.
- Proposals for prevention of suicide youth together with the implementation plan will be available by the end of 2017.
One other thing worth mentioning from the action plan, psychiatric services will be available at 90% of primary health care centers in 2019. Further information (Icelandic): https://www.althingi.is/altext/145/s/1217.html
Mental health among youth in Iceland, report; Nordic Center for Welfare and Social Issues (Norden). Growing mental illness amongst young people is one of the most serious public health challenges facing our Nordic society. The project Youth in the Nordic Region focuses on young persons who suffer from or are at risk of suffering from mental illness, as well as their situation at school and their later transition to work and providing for themselves. A further important topic of the project is early retirement and retirement on mental health grounds amongst young adults. The report gives a quick, clear overview of who does what in Iceland in matters concerning young persons who suffer from or risk suffering from mental illness. Further information (English): https://www.diva-portal.org/smash/get/diva2:1071169/FULLTEXT01.pdf
Current situation in mechanisms of early detection and signposting of young people facing health risks according to alcohol, tobacco and substance use, Iceland is on the right track. Results from Icelandic national surveys (ICSRA) have been used to develop an effective prevention approach with a broad-scale and systematic assessment of the risk and the protective factors that predicted adolescent substance use in Iceland. The key components of this prevention approach included:
- Educating parents about the importance of emotional support, reasonable monitoring, and increasing the time they spend with their adolescent children.
- Encouraging youth to participate in organized recreational and extracurricular activities and sports.
- Working with local schools in order to strengthen the supportive network between relevant agencies in the local community.
According to The National Curriculum Guidefor upper secondary school smoking and other use of tobacco is forbidden on upper secondary school premises. The handling and use of alcohol and other intoxicants is strictly forbidden on school premises and at social activities under its auspices. If something happens in these matters, upper secondary schools are to contact the custodial parents/legal guardians if the student is younger than 18 years of age. Further information (English): http://eng.menntamalaraduneyti.is/publications/curriculum/
- Alcohol Act No. 75/1998. Further information (Icelandic): http://www.althingi.is/lagas/nuna/1998075.html
- Narcotic Act No. 65/1974. Further information (English): http://eng.innanrikisraduneyti.is/media/Log_og_reglugerdir/65_1974.pdf
Official public policy on tobacco control and action plan is currently in process. Iceland has though a strong legislation on tobacco control.
- Tobacco Control Act, No. 6/2002 (English): http://eng.velferdarraduneyti.is/acts-of-Parliament/nr/19484
Policy on alcohol and drug prevention 2020. The object is to prevent young people from using alcohol or other substance abuse. Evidence-based actions including marketing of alcohol for young people, checking that age limits for buying alcoholic beverages are respected and further enhance the school system's role in the welfare of children, e.g. through participation in health promoting schools, increased involvement of parents and NGO´s in prevention. No action plan is avalble and that includes no timframe, measures or funding. According to the policy, action plan shall be written in 2014 and measures to be taken will address prevention, treatment, post-treatment, monitoring and rehabilitation. The action plan is to be evaluated every second year. This is currently still in process. Further information (Icelandic): https://www.stjornarradid.is/media/velferdarraduneyti-media/media/rit-og-skyrslur-2014/Stefna-i-afengis--og-vimuvornum-desember-2013.pdf
Addiction report (2015-2016) (“Fíkniskýrsla”). The Parliament intention was to review narcotic policies, based on humanity solution. This report is a result of work done by a group of specialists appointed by the Minister of Health in 2014. The group should consider policy formulation based on actions to reduce harmful effects and side effects of substance/drug abuse. Further information (Icelandic): https://www.stjornarradid.is/media/velferdarraduneyti-media/media/frettir2016/Fykniskyrsla_30082016.pdf
Young people at the age of 18 become legally indented or “adults” in the Icelandic legal and welfare system. Upper secondary schools have a role in signposting their students that are at risk, especially age 16-18. All schools have education or social counsellor and some of them have a part time psychologist. Further information is provided in the Upper Secondary Education Act 2008 No 92 12 June (English): https://eng.menntamalaraduneyti.is/media/frettatengt2016/Thyding-log-um-framhaldsskola-juli-2016.pdf
The general practitioner or other health specialists at the Primary Health Care should be responsible signposting young people at risk, according to the Regulation on primary health care No. 787/2007. Further information (Icelandic): http://stjornartidindi.is/Advert.aspx?ID=2aa87f27-5da4-4494-95ca-fbed296b443e
Health behavior website, the Directorate of Health and Primary health care are currently in working process, developing website with material intended for people who want to change their health behavior, according nutrition, physical activity, mental health and well-being, alcohol, tobacco and drug prevention. Guidelines etc. for children, youth and adults. Further information (Icelandic): https://www.heilsuvera.is/
The Directorate of Health website, determinants of health and well-being. Guidelines, videos, articles, brochures etc. on e.g. nutrition, physical activity, mental health and well-being, violent and injury prevention, alcohol, tobacco and drug prevention, dental prevention, sex health promotion, health promotion etc. Further information (Icelandic): https://www.landlaeknir.is/heilsa-og-lidan/
Primary health care website. Further information (Icelandic): https://www.heilsugaeslan.is/
Doktor.is – website with questions and answers from medical doctors. Further information (Icelandic): http://doktor.is/
Red Cross – helpline. Further information (Icelandic): https://www.raudikrossinn.is/hvad-gerum-vid/hjalparsiminn-1717/hvad-gerum-vid-3
- with mental health problems
- without work
- living in poverty
- vulnerable groups
A large part of the policy actions, which are mentioned in this chapter about Health and well-being, are funded by state budget. Some of the activities carried out by NGO´s, are funded by the state budget but also by public funding. Public funding available:
- The Public Health Fund (“Lýðheilsusjóður”). This fund is financed with 1% of the taxes on alcohol and 0, 9% of the taxes on the wholesale of tobacco, which is “earmarked” for prevention and health promotion. According to The Medical Director of Health and Public Health Act, the role of the fund is to support public health work that is in accord with the objectives of the Act, whether within the Directorate of Health or outside it. Further information (Icelandic): http://www.landlaeknir.is/um-embaettid/lydheilsusjodur/
- The Icelandic Sport Fund (Íþróttasjóður). The objectives of the fund are to improve sport facilities all over Iceland, to support research and innovation in the field of sport and to gather information for policymaking. Further information (English): http://en.rannis.is/funding/youth-sport/the-icelandic-sportfund/
- The Icelandic Youth Fund (Æskulýðssjóður). The main objective of the fund is to help youth clubs and organisations in Iceland improve and expand their activities. Further information (English): http://en.rannis.is/funding/youth-sport/youth-fund/
- The Lottery (“Íslensk getspá”), is owned by The Organization of the National Olympic and Sports Association of Iceland, The Icelandic Youth Association and The Organization of Disabled in Iceland. A part of all sales is allocated to the work of these NGO´s. Further information (Icelandic): https://games.lotto.is/
- The Icelandic Centre for Research (RANNIS). RANNIS administers the main public competitive funds in the fields of research, innovation, education and culture in Iceland. Further information is available English: http://en.rannis.is/funding/
The City of Reykjavik Prevention Fund (Forvarnarsjóður Reykjavíkurborgar). The fund's aim is to strengthen preventive activities in line with the city’s Prevention Policy, both within the neighborhoods and citywide.