Promotion of children's mental health (MH) plays an important role in preventing further MH problems. In Finland, the wellbeing of children is supported in early childhood education and care (ECEC), basic education, maternity clinics, and child health clinics. Providing these services for children and families requires multiprofessional collaboration. The aim of this study was to investigate the current practice of children's MH promotion, more specifically children's MH services and multiprofessional collaboration between social and health care services and ECEC/ basic education. The study focused on MH questions regarding children in 18 municipalities of Finland from the approach of socio-ecological model of health promotion. The participants of this cross-sectional study were ECEC professionals in municipal day care, basic education professionals, and primary health care professionals who work with children younger than 14. The data collected via questionnaires were analyzed using descriptive statistics, chi-squared analysis, principal component analysis (PCA), the Brown-Forsythe robust test, and Tukey HSD post hoc comparisons. A total of 482 professionals participated in this study. Overall, respondents indicated relatively poor satisfaction toward most aspects of current MH promotion. Professionals from municipalities that provided primary health care and social services independently evaluated MH promotion most positively. However, deficiencies in multiprofessional collaboration between organizations were reported. The work experience influenced professionals' perceptions of the challenges of collaboration; respondents with the least work experience were most critically concerned. These results imply that the promotion of children's MH and MH services needs to be further developed.
Findings on children’s mental health promotion at the policy level are scarce, and the perceptions of the municipal administration on factors affecting children’s mental health have not been reported. This study describes the perspectives of policymakers and leading officeholders on promotive and risk factors for children’s mental health in a socioecological context. The perspectives of Finnish policymakers (n = 15) and officeholders (n = 10) in municipalities were examined using semi-structured interviews. The data were analyzed using inductive content analysis and were categorized according to the five levels of a socioecological model of health promotion: public policy, community, organizational, interpersonal and individual levels. The public policy level emerged strongly in the findings, specifically strategic planning and implementation challenges related to the promotion of children’s mental health in the municipality and state administration. At the community level, environmental factors promoting children’s mental health as well as risk factors were described. The organizational level consisted of support, requirements and development needs in children’s services. The importance of family and close networks at the interpersonal level, as well as the individual basis of mental health, were also evident. The integration and better collaboration of child and family services, the use of child rights impact assessment in political decision-making, and financial support from the state could contribute to improving strategic planning to support children’s mental health at the municipal level.
Aims: Little is known about how municipal strategies, programmes and plans pay attention to the promotion of children’s mental health and whether it is discussed and reported in the municipal councils, boards and committees. The purpose of this study was to examine how municipalities in one Finnish region promote mental health, with a focus on the promotion of children’s mental health. Methods: Document analysis was used as a research method. Documents were selected for a one-year period (2018) from three municipalities of the North Savo region. Analysed documents ( n=269) were municipal strategies, programmes and plans, as well as meeting minutes of municipal councils, boards and committees. Eight domains of the structural indicators of mental health were used as an analysis frame. Results: In total, 1169 mentions related to the structural indicators of mental health were found in the documents. In strategies, programmes and plans, parenting-related mentions were found most often. Regarding the minutes, the issues discussed and reported about the wellbeing of children focused on practical issues, such as the construction of day care buildings. Conclusions: Document analysis indicated that mental health promotion involved mostly the society and environment and not as much the age and setting. There was a lack of mentions regarding preschool experiences and family support/childcare and the promotion of mental health through schools and education, especially in the meeting minutes of municipal councils, boards and committees.
Aim To describe promotive and risk factors for children's mental health at the individual, interpersonal, organizational, community and public policy levels of the socioecological environment. Design A descriptive qualitative interview study. Methods Data were collected in Finland during autumn 2019 via semi‐structured interviews. Participants (n = 23) comprised public health nurses who worked in child health clinics and school healthcare. Data were analyzed using inductive content analysis. Results Several promotive and risk factors were identified to have affected children's mental health. Intra‐family factors were the most important in the opinion of public health nurses, and they were most concerned about family related risk factors. In addition, the descriptions of nurses revealed that children are in a socially unequal position in terms of their place of residence. It was also uncovered that there were fewer social and healthcare and leisure services in small municipalities, the distances to services were longer, which was perceived to complicate the use of services, and the fear of stigma was greater. Conclusion According to public health nurses, factors at the individual, interpersonal, organizational, community and public policy levels of the socioecological environment affect children's mental health and overall well‐being. Consequently, the promotion of children's mental health should be emphasized at every level of the society, considering the whole family. Impact This study indicated the importance of considering factors that affect children's mental health at all levels of the socioecological environment. The results can be reflected in the relation of the socioecological model of health promotion and used in planning the work of nurses in primary healthcare and other relevant nursing settings to emphasize promotive and preventive work.
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