Lesbian and gay individuals' path into foster parenting in Norway—Barriers and facilitators at the person and system levels

Growing numbers of lesbian, gay, bisexual, transgender, questioning (LGBTQ) people are becoming foster parents in several western countries. The LGBTQ perspective on the child welfare system has received little attention in practice, research and policy. Despite their increased rights, LGBTQ foster parents continue to face challenges related to fostering. Knowledge is needed on LGBTQ individual perceptions of the process of becoming foster parents, including barriers and facilitating factors. This paper reports on the experiences of 13 gay or lesbian foster parents in Norway. The study shows a lack of knowledge about the possibility of becoming foster parents due to lack of information directed at them as a minority group. Participants felt vulnerable and experienced “minority stress” before encountering the child welfare system, while mainly experienced the encounter with the staff as good and respectful. Although several valued being treated “like everyone else” by the system, others questioned why LGBTQ-specific parenting issues were not raised and discussed. Apart from lack of information, the process towards foster parenting seemed mostly hampered by participants' own assumptions that sexual identity would be a barrier and to some extent biological parents' refusal. The study suggests that foster care and child welfare services would benefit from information in recruitment of foster parents, aiming at being more inclusive. Furthermore, we address gender and sexuality diversity related to foster care work and highlight the strengths and challenges it may offer.acceptedVersio

The importance of interdisciplinarity in accommodating patient needs among Norwegian nurses

What is known on the subject: Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors. Mental health nurses often describe role confusion in relation to other health professionals. Opportunities for interdisciplinary communication with other professionals may benefit health care. What the paper adds to existing knowledge: The current large-scale study is the first to investigate whether mental health and SUD nurses' perceptions of their opportunities to accommodate patients' needs are related to interdisciplinarity in the treatment unit and a nursing role with clearly defined responsibilities. Strong interdisciplinarity was associated with greater perceived opportunities to accommodate patients' psychosocial, somatic, and economic and legal needs, while strictly defined nursing roles/responsibilities were related to weaker opportunities to do so. What are the implications of practice: The findings highlight the need to address how mental health and SUD nurses organize practice to meet patients' diverse needs Interdisciplinary teamwork could strengthen nurses' ability to address patient needs Finding the best possible balance of providing service in teams or individually could improve resource utilization at the same time as strengthening patient care, and making sure that the patients' various needs are met. Abstract: INTRODUCTION: Nurses' roles in specialist mental health and substance use disorder (SUD) treatment services are multidimensional and complex. Their responsibility, autonomy and interdisciplinary collaboration may be of importance for their perceived opportunities to accommodate patients' health needs. Previous studies of interdisciplinarity and nursing responsibilities have mainly focused on outcomes such as patient safety, job satisfaction and organizational factors, and included relatively small samples. The studies have also mainly been conducted in other sectors than the mental health and SUD nursing sectors. Aim/question: The aim of this study is to examine the associations between nurses' roles, interdisciplinarity and their perceived opportunities to accommodate patients' psychosocial, somatic and economic/legal needs. Method: A cross-sectional web-based questionnaire survey was conducted in a nationwide sample of Norwegian nurses in the mental health, SUD treatment and combined mental health and SUD treatment sectors. Of 5,501 contactable nurses (74% of the population), 1918 (35%) responded. Results: The results revealed that interdisciplinarity was significantly associated with greater perceived opportunity to accommodate patient needs, whereas strictly defined nursing roles/responsibilities were associated with less opportunity to accommodate these needs. Discussion/implication for practice: Facilitation of interdisciplinary collaboration may improve quality of care for patients in mental health and SUD treatment services.publishedVersio

Polikliniske pasienter i psykisk helsevern for voksne 2013

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Når barnevernet overtar omsorgen – en forenklet kunnskapsoppsummering

Formålet med dette prosjektet har vært å utforme en forenklet systematisk kunnskapsoppsummering om tiltak i barnevern etter vedtak om omsorgsovertakelse. Systematiske søk ble gjennomført i utvalgte databaser for å identifisere publikasjoner som omhandler barnevern og tiltak i Norge. Det ble foretatt manuell filtrering, og det gjenværende utvalget (n=95) ble kodet. Tilsvarende ble gjort for grålitteratur (n=35). Den klart største andelen av forskningen omhandler fosterhjem, inkludert ulike sider ved det å være / ha vært i fosterhjem; noe forskning ble identifisert om ulike sider ved barnevernsinstitusjoner, mens svært få identifiserte studier omhandlet adopsjon. Noe forskning på biologiske foreldre fratatt omsorg, samt på barnevernstjenesten / systemet ble også identifisert. Effektforskning var nærmest fraværende blant de identifiserte studiene. ISBN: 978-82-14-07917-3publishedVersio

Comprehending socio-relational factors of mental wellbeing in the oldest old within Nordic and Mediterranean countries

Socio-relational aspects are essential for mental wellbeing (MWB), especially in the oldest old age. Our study aims to explore the socio-relational aspects related to MWB in accord ance with the experiences of the oldest old of four European countries; and to examine how these differ between Mediterranean and Nordic people. A total of 117 participants aged 80+ years old were recruited, and 23 focus groups were performed. Qualitative con tent analysis identified five main themes. Family seemed to be the most important driver of the MWB of the oldest old, followed by relationships with close friends. Participants felt better when they had a sense of being needed, cared for, and connected. Loneliness and isolation negatively affected MWB, although solitude was appreciated. Differences appeared between Mediterranean and Nordic regions. Initiatives to promote positive interactions with family and friends, as well as social activities within the community, may contribute to strengthening MWB in the oldest ol

Obstacles to continuity of care in young mental health service users’ pathways - an explorative study

Background: Users of mental health services often move between different primary and specialised health and care services, depending on their current condition, and this often leads to fragmentation of care. The aim of this study was to map care pathways in the case of young adult mental health service users and to identify key obstacles to continuity of care.Method: Quarterly semi-structured interviews were performed with nine young adults with mental health difficulties, following their pathways in and out of different services in the course of a year.Results: Key obstacles to continuity of care included the mental health system's lack of access to treatment, lack of integration between different specialist services, lack of progress in care and inadequate coordination tools such as ‘Individual Plan’ and case conferences that did not prevent fragmented care pathways.Conclusions: Continuity of care should be more explicitly linked to aspirations for development and progress in the users' care pathways, and how service providers can cooperate with users to actually develop and make progress. Coordination tools such as case conferences and ‘individual plans’ should be upgraded to this end and utilised to the utmost. This may be the most effective way to counteract the system obstacles

Interagency collaboration for early identification and follow-up of mental health problems in residential youth care: evaluation of a collaboration model

Despite high levels of mental disorders among young people living in residential youth care (RYC) institutions, only a small percentage of these children receive help from mental health services. The aim of the present study is to explore the usefulness of an inter-agency collaboration model from the perspective of service providers, and to investigate factors that promote and hinder effective inter-agency collaboration around early identification and follow up of mental problems and disorders among youth in residential care. A purposive sample of 16 professionals in three RYC institutions and related child and adolescent mental health services and child welfare services that were involved in piloting the collaboration model was recruited. Semi-structured individual and group interviews were conducted, and a thematic analysis was conducted to identify key themes. The results suggest that the collaboration model promoted increased awareness on mental health issues and a greater systematic inter-agency collaborative effort in assessing and following up the mental health of children and adolescents in RYC institutions. However, there were major challenges related to central elements of the collaboration model; the conduction of the multidisciplinary meeting within the deadline of three weeks, and participation of child welfare services-providers at the multidisciplinary meeting. Further dissemination of the collaboration model merits further consideration of the choice of screening assessment battery due to the lack of participation from teachers and parents, the time limit of three weeks and measures to increase participation from the municipal child welfare services.publishedVersio

Obstacles to continuity of care in young mental health service users’ pathways - an explorative study

<span style="font-size: x-small;"><strong>Background</strong>: Users of mental health services often move between different primary and specialised health and care services, depending on their current condition, and this often leads to fragmentation of care. The aim of this study was to map care pathways in the case of </span><span style="font-size: x-small;">young adult mental health service users and to identify key obstacles to continuity of care.</span> <span style="font-size: x-small;"><strong>Method</strong>: Quarterly semi-structured interviews were performed with nine young adults with mental health difficulties, following their pathways in and out of different services in the course of a year.</span> <span style="font-size: x-small;"><strong>Results</strong>: Key obstacles to continuity of care included the mental health system's lack of access to treatment, lack of integration between different specialist services, lack of progress in care and inadequate coordination tools such as ‘Individual Plan’ and case conferences that </span><span style="font-size: x-small;">did not prevent fragmented care pathways.</span> <span style="font-size: x-small;"><strong>Conclusions</strong>: Continuity of care should be more explicitly linked to aspirations for development and progress in the users' care pathways, and how service providers can cooperate with users to actually develop and make progress. Coordination tools such as case conferences and ‘individual plans’ should be upgraded to this end and utilised to the utmost. This may be the most effective way to counteract the system obstacles.</span