7.6 Mechanisms of early detection and signposting of young people facing health risks
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Policy framework
Young people facing health risks (e.g. substance abuse, emotional and mental suffering) often have a complex life situation, with problems related to family, friends, school and work. Social services work to ensure that young people who are in a difficult position can get the help and support that they need. How the Social Services Act (SoL) controls the social services is described in section 4.6, Access to Quality Services.
The Social Services Act contains provisions on plans for individuals. When a person needs support from both the social services and the health services, the municipality together with the county council shall draw up an individual plan. The plan shall, when possible, be established together with the individual.
Stakeholders
When it comes to young people facing health risks, school health services, other municipal/county council health services, and social services are the key actors for cooperation.
Health care
If a child or an adolescent shows signs of a risky lifestyle, health services in schools should be able to offer well-planned efforts to combat an obvious risk development. The infrastructure for youth-specific health services is described in section 4.6, Access to Quality Services. The description there includes health services in schools (elevhälsan), Youth Guidance Centres (ungdomsmottagningar) and Psychiatry clinics for children and young people (Barn och ungdomspykiatri, BUP).
In 2015, the Swedish Schools Inspectorate (Skolinspektionen) inspected health services in upper compulsory schools (grundskolans årskurser 6-9). The purpose of the review was to find out if health services in schools manage to develop and maintain mental well-being among learners and prevent problems related to mental ill-health. The inspection report revealed that health services in the audited schools did not fully support learners with mental health issues. Access to student health was found to be insufficient in most of the reviewed schools. What more, the results showed that students lacked knowledge of the assignment and function of school health services, and that most of the schools did not have a clear strategy and did not systematically work to develop their services.
In 2020, the Swedish Schools Inspectorate inspected how 30 upper secondary schools promote students' health and well-being. The review focuses on three areas within students' health and physical, mental and psychosocial well-being. The first area concerns the upper secondary school's contribution to students' health and resilience to physical and mental illness through the school's teaching about healthy lifestyles and risk and health factors. The second area examines whether the education is designed from a health-promoting perspective. In this area, it is examined whether the school offers students opportunities for physical activity and access to a good and nutritious diet, and also promotion of good relations between students and between staff and students. In the third area, the school's conditions for promoting good health are examined. Questions that are asked are whether students' health situation is included in the systematic quality work and whether the competencies of school heath services are used strategically for the development of teaching and the learning environment. The final report reveiled that most schools that were reviewed need to develop their health promotion work. The systematic health perspective is lacking in the work of developing education and the schools do not give students equal opportunities to develop their knowledge of health.
Guidance to stakeholders
The National Board of Health and Welfare (Socialstyrelsen) has drawn up guidelines for how different actors at national, regional and local level can cooperate in order to better meet the needs of children and young people.
The National Board of Health and Welfare and the National Agency for Education (Skolverket) have drawn up guidelines for how to strengthen school health services and how to contribute to the development of equivalent school health services throughout the country.
Guidance to stakeholders is also described in section 4.4, Inclusive Programmes for Young People.
Target groups
The national mental health strategy (see section 7.5, Mental health, for more details) identifies several groups facing larger risks and who's situation therefore should be given special attention. Those identified are LGBT-persons, children and adolescents placed in social care, individuals with complex life situation (suffering of mental discords and having other problems at the same time), individuals with criminal behaviour, asylum seekers and immigrants, and persons belonging to national minority groups.
The Government strategy for young people who neither work nor study, for the period 2015-2018, identified young NEETs to be particularly at risk of developing health problems. Groups specifically targeted in the strategy (see section 4.3, Strategy for the Social Inclusion of Young People, for more details) were young people with disabilities, early school leavers and young immigrants.
Funding
School health services
In order to strengthen school health services, school providers can, since 2016, according to the Ordinance on interventions within School health services (Förordning om statsbidrag för personalförstärkning inom elevhälsan), apply for financial support. The Government has tasked the National Agency for Education (Skolverket) to allocate the grant. In 2021, the Government allocated a total of SEK 150 million (about 15 million euros) in state grants for improving school health services (2021 Appropriations Directive, National Agency for Education).