Always has had to fight, describes the Helsinki resident Aino. Her firstborn was already demanding as a baby, and the symptoms worsened when she was a child. The child couldn’t find common games in the park with others of his age, on the other hand, he experienced wild tantrums at home. The child was violent.
The nurse at the clinic took the mother’s concern seriously and guided her forward. But since then, Aino has had to insist on demanding help for her child, who is not feeling well. Sometimes getting help has required that Aino has filed a child protection report for her family.
This year, hundreds of child protection reports have been made in Helsinki due to the child’s psychological symptoms. HS interviewed two mothers living in the capital region, for whom child protection has been the last means of getting help for their child. The interviewees do not speak about the subject by their own names, because the story deals with the sensitive health information of minors.
The only one the child has been a child psychiatry client of the Helsinki and Uusimaa hospital district (Hus) for almost ten years. Soon, due to his age, he will become a client of youth psychiatry. Many types of treatments have been tried with the child, and Aino’s mother is grateful for that. However, there has been no permanent help from the treatments so far.
“The offer has mainly been outpatient care, even if we need ward treatment or longer examination periods for the child. It seems to us that the child psychiatrist has raised his hands in our case”, says Aino.
So, together with the health care staff, Aino made a child protection report for her family. Now there is a third customership in progress. The customer relationship has already been terminated twice, when it has been determined that the family does not really need the help of child protection.
“Children’s welfare has also been told that their services do not help us. We don’t need a family worker, we need psychiatric care for the child”, sighs Aino.
He feels that a child with neuropsychiatric symptoms is an interloper.
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“Getting help has been made so difficult that child protection is needed.”
Such families end up as clients of child welfare services, a social worker Arja Ryynänen along more and more often. Ryynänen, who works in child protection in the city of Helsinki, has been in the field for over 20 years.
“The issue is that these parents are fully capable of taking care of their own children and their affairs, but getting help has been made so difficult that child protection is needed,” says Ryynänen.
According to Ryynänen, the clients of child protection are increasingly children and families who should only be covered by healthcare. According to Ryynänen, the situation is frustrating for all parties, because at the same time families who really need help and support from child protection are deprived of resources.
“It is a structural and societal problem that we in child protection have to prioritize families in this way,” says Ryynänen.
Huss about 15 percent of children and 20–30 percent of young people suffer from mental health disorders. The demand for mental health services in specialized medical care has also increased.
Husi’s child psychiatry and youth psychiatry for 13–17-year-olds treat approximately 8,000 patients each year. The number of patients treated in child psychiatry is six percent of the 0-12 age group. According to Hus, the growth has been considerable.
The number of child psychiatry referrals has increased by 140 percent between 2010 and 2020. In 2010, there were 1,790 referrals, ten years later 4,237. The most common mental health disorders in children are behavioral disorders, neuropsychological problems and anxiety.
Arja Ryynänen sees that the current school world in particular makes the situation worse.
“Open learning environments and increased self-direction are visible in our customer base. For example, ADHD children need a clear structure and adults to support their growth,” says Ryynänen.
According to Ryynänen, the burden of the daycare routine can also be seen in the children. Changing adults and noise exhausts children, who, after persevering through the kindergarten day, release all the bad feelings at home.
First the school doctor makes a referral to child or youth psychiatry, and it goes back to school health care. It is recorded in the answer that primary health care and social work provide care. According to Ryynänen, this is a classic example of how families of children with symptoms end up as clients of child welfare.
Either the school, primary health care or the parents themselves make a child protection report to make sure that the child really gets help.
According to Ryynänen, child welfare aims to support families through family work. Children’s protection also makes assessments and provides healthcare providers with additional information about the family. It is often the task of child protection to tell that the conditions at home are not the cause of the symptoms, but that it is something else.
During the waiting period, Ryynänen and his colleagues have to try to support the family.
“The children’s symptoms get worse, the parents become more and more distressed, and before long the family has the right grounds for a child protection client, when the parents get tired of the situation,” says Ryynänen.
At worst the exhaustion of the parents leads to the child having to be placed outside the home. Home nursing care is offered only to those suffering from somatic diseases. Children with strong psychological symptoms are always placed in institutions.
“Our foster care has grown enormously. It will be more expensive than early support, in which case help would already be given at school, counseling centers and in the child’s natural environment,” says Ryynänen.
More than 60 percent of children placed outside the home have been diagnosed with a psychiatric or neurodevelopmental disorder during childhood. In Helsinki, more than 2,000 minors are placed outside the home.
For Aino, placing a child in placement is not an option. That has also been suggested by child protection, when ward care has not been available for the child and the resources at home have been stretched to the limit.
“We don’t think financially here, let alone the interests of the child and the family. If the parents get tired, then it won’t save a penny of society’s funds,” says Aino.
Tiina’s middle school-aged daughter has an eating disorder. According to the mother, the daughter’s illness has dominated the family’s life for 1.5 years now. The daughter has been a client of Husi’s eating disorder unit for just under a year, but has been discharged whenever the body mass index has been high enough. Even in spite of the fact that the daughter has been in such poor condition that she has fainted.
“Treating a young person with an eating disorder is really difficult. My husband works part-time, and I myself have been on sick leave for a few weeks. The care of the child is round-the-clock”, Tiina describes.
The worst thing is that treatment has not always been received. According to Tiina, the problem is that the child has anxiety and suicidal thoughts in addition to an eating disorder. In the eating disorder unit, they help to get the young person to eat again, but they do not get help for psychological symptoms from the same place.
“As soon as the body mass index was over 18, the child was checked out of the eating disorder unit. He was sent home, even though his recovery is still in progress and youth psychiatry didn’t have clients yet,” says Tiina.
A child protection report was made about Tiina’s child by the hospital emergency doctor. The child was hospitalized due to cuts.
At first, Tiina was confused. He had always thought that child protection was for those families who are doing really badly.
“And suddenly we’re in a situation where child protection works at our house,” says Tiina.
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“Suddenly, help was also offered from the hospital side. I believe that child protection made it happen.”
When the family eventually ends up as a child welfare client due to the child’s illness, the parents are already very tired at that point.
“The parents may have visited dozens of employees telling them that help is needed now, and then eventually they end up in child welfare. Parents are frustrated and angry. Disappointment in society is big,” says Ryynänen.
Parents may have been bounced from one service to another, but no one has taken responsibility for helping the child.
“A child with symptoms has become society’s throwaway bag. No one is thrown out of child protection, but we are not able to offer healthcare help either,” says Ryynänen.
According to Ryynänen, the reception is usually positive in the end.
The initial shock Since then, Tiina’s family has also been replaced by gratitude. Tiina believes that the child welfare workers have speeded up the processing of referrals and also made the health care staff take the family’s distress more seriously. Tiina remembers particularly well the moment when the child protection worker told Tiina that now she doesn’t have to fight anymore.
“When the child couldn’t get to the eating disorder clinic due to psychological symptoms, child protection came and took responsibility. Suddenly, help was also offered from the side of the hospital. I believe that child protection made it happen.”
However, the fear that the child’s care will be stopped too early is constantly present. Tiina says that she was hopeful when her daughter became a client of the eating disorder clinic for the first time. The whole family believed that things would be alright now.
But in the peer support group, Tiina has heard many stories about how the family is stuck in a cycle where a half-healthy child is sent home and half a year later the child returns to treatment with the same symptoms.
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