Working with co-occurring mental health and substance use problems has been identified as particularly difficult and demanding for clinicians. This contributes to occupational stress, which can lead to increased rates of burnout, health problems, and even premature exit from the profession. The present study seeks to examine the potential mitigating effects of workplace support on departuruefroperceived interpersonal demands in clinical settings. A survey was administered to 82 clinicians, aged 27 to 66 years, across 16 outpatient clinics specializing in substance use treatment for youth. Demanding interpersonal situations, perceived organizational support (POS), professional experience and the perceived meaningfulness of clinical supervision were assessed and analyzed descriptively, as well as through correlation and multivariate regression analyses. POS, professional experience and meaningfulness with clinical supervision were used as predictors of the perceived difficulty of demanding situations. Findings revealed that higher levels of POS were associated with lower levels of difficulty in managing challenging situations encountered in everyday clinical work. Further research is however needed to identify the specific features of institutional support that contribute to these outcomes. This study highlights the critical need to create supportive organizational environments to enhance clinicians' ability to effectively navigate complex and emotionally charged situations in treatment settings.

This article explores how young children experience and create well-being in a multilingual preschool setting. Preschools are intended to promote children’s development, health, and well-being, yet they can also be understood as spaces of institutionalized adult control over children and childhood. Today, preschools are highlighted as particularly important for children with a mother tongue other than Swedish. Although interest in children’s well-being has grown, research on younger children’s well-being is dominated by adult perspectives, often overlooking how children themselves understand well-being. In light of the new Social Services Act’s strengthened responsibility for preventive work and the emphasized role of preschools for multilingual children, there is a need for nuanced knowledge about what well-being means for children in preschool. The aim of this article, grounded in a phenomenological approach, is to contribute to an understanding of how young children experience and create well-being in a multilingual preschool. The study was conducted through ethnographic and participatory fieldwork with fifteen children at the preschool “Katten.” The analysis shows that children’s understandings of well-being are framed by longing and waiting, and by everyday practices where well-being is created through seeking contact and being seen and acknowledged. Children actively participate in creating their own and others’ well-being by showing care, fostering togetherness, and engaging in reciprocal recognition. From the children’s perspectives, well-being emerges as a relational practice where small acts generate communities that can be understood as gestures of love. Finally, the article discusses the structural conditions of multilingual preschools for enabling recognition of children’s bodily expressions, connections to family, and life context. Implications for strengthening preschool and social services’ work with children’s well-being are presented.

Kapitlet behandlar unga omsorgsgivares (o)synlighet i svensk lagstiftning, de utmaningar de kan möta i sin uppväxtmiljö samt hur professionella inom socialtjänsten kan identifiera dem och deras behov. Med unga omsorgsgivare avses barn som regelbundet ger stöd eller hjälp till familjemedlemmar på ett sätt som går utöver vad jämnåriga barn vanligtvis förväntas göra. Trots socialtjänstens lagstadgade ansvar att tillgodose barns behov av skydd och stöd förbises ofta barns omsorgsansvar, vilket kan förstås utifrån brist på verktyg för att identifiera dessa barn. Problemet bottnar delvis i att barns omsorgsansvar inte är tydliggjort i svensklagstiftning i vilken barn betraktas som anhöriga i behov av skydd snarare än som aktiva omsorgsgivare. Denna osynlighet i lagstiftningen kan leda till att barns omsorgsansvar och dess påverkan på barnets välbefinnande förbises i socialtjänstens barnavårdsutredningar. Många av dessa barn lever i miljöer där förälderns behov eller problematik står i fokus, vilket kan leda till att barnets egna behov ignoreras. Barnets omsorgsansva rkan påverka hens fysiska, psykiska och sociala utveckling negativt. Vissa barn känner sig stressade och isolerade, även skolresultaten kan påverkas negativt med skolfrånvaro och bristande tid för läxor. Samtidigt kan vissa barn uppleva positiva effekter av omsorgsansvaret, exempelvis en känsla av att bidra till familjensvälmående, särskilt om ansvaret delas med föräldern eller andra vuxna i hushållet. Detta illustrerar vikten av att utveckla skyddsnät och strategier för att identifiera och stödja unga omsorgsgivare. I kapitlet presenteras även resultat från ett pågående forskningsprojekt som syftar till att utveckla och implementera ett bedömningsstöd för att identifiera unga omsorgsgivare i socialtjänstens barnavårdsutredningar. Preliminära resultat visar att barnens ansvar omfattar en bred variation av uppgifter, alltifrån praktiska hushållssysslor till mer känslomässiga uppgifter, samt att graden och arten av ansvar påverkar hur barnen upplever sin situation. Socialsekreterare beskriver hur verktyget har bidragit till en ökad kunskap om unga omsorgsgivares situation och mående i samband med barnavårdsutredningar. Det tonar fram en bild av unga omsorgsgivare som en utsatt och osynliggjord grupp som löper risk att mista sin rätt till en trygg och utvecklande barndom. För att säkerställa att dessa barns behov uppmärksammas krävs förbättrade verktyg, riktat stöd och en förstärkt lagstiftning. Vidare behöver vi se dessa barn som aktörer med unika behov av både skydd och stöd samt vikten av ett holistiskt angreppssätt för att synliggöra deras situation i välfärdssystemet

Aim: This study aimed to investigate how professionals working with infants and preschoolers perceive the concept of early identification of children in need of support due to developmental, behavioral, or emotional concerns, which children should be identified and offered support or intervention, and why this should be done. Concerns can typically be associated to risk factors such as, parental mental health problems, relational challenges, or child abuse and neglect. The study was performed in municipalities implementing models inspired by the Getting It Right for Every Child (GIRFEC) framework with the aim of systematically identifying risk factors during the early years and offering preventive and indicated interventions to families. GIRFEC involves a broad collaborative approach including tools and a structure for meetings with both families and professionals.

Design: The study used an exploratory qualitative design with an inductive approach. Method: Data was collected via semi-structured interviews. Individual face-to-face interviews were conducted with 14 participants from three municipalities and seven organisations or workplaces. The interviews were analysed using thematic analysis.

Results: The analysis resulted in five main themes: 'It's about the parents', 'Focus on child behaviour and development', 'The impact of the relationship', 'Understanding young children is detective work', and 'Consequences of early identification'.

Conclusions: Our findings suggest that professionals are convinced of the meaningfulness of early identification and support, have a strong focus on the child-parent relationship, consider parents the primary road to identifying children at risk and in need of support, and believe that understanding young children calls for interprofessional collaboration.

The study explores the qualifications and competency needs of professionals working at Swedish Maria clinics, specialized in treating youth with co-occurring substance use and mental health problems. A web-based survey was conducted among 87 professionals working at the clinics to assess their qualifications, competence in managing co-occurring problems and perceived needs for further training. Most professionals had high educational qualifications, with backgrounds in social work, nursing and psychology. Although health care and social services professionals had generally similar competencies, there were some notable differences in their professionalism and competency needs. Healthcare professionals were more likely to report competence in managing severe psychiatric conditions. In contrast, social services professionals more often reported using a broader range of treatment methods. Both groups identified a need for further education in managing severe psychiatric conditions, such as trauma, psychosis and eating disorders. Social services professionals more frequently emphasized the need for family-oriented approaches, while healthcare professionals more often identified a need for more in-depth knowledge related to substance use. While professionals at the clinics generally possess strong qualifications, there are differences in their confidence and expertise relating to managing complex mental health conditions. Tailored training initiatives that address specific needs based on professionals' educational backgrounds and organizational affiliations could enhance inter-professional collaboration and improve treatment outcomes for youth with co-occurring substance use and mental health problems.

The Wellbeing Wheel is a tool used for early detection, assessment, and planning around children. This study examines how this artefact has been translated from Scotland to Sweden and what that process involved in relation to transformation from the original ideas when travelling from one specific context to another. The analysis was based on three graphic wheels and their supporting documentation, interviews, and field notes. The results reveal great similarity in the overall ‘spirit’ of the work performed to introduce the Wellbeing Wheel to the Swedish context, but on several points significant differences can also be noted, with some content being removed or relocated, and new content being added. These changes were conscious and intentional in some instances, while others arose spontaneously and ad hoc during the development processes.

Background Adolescents with substance use problems (SUP) constitute a group expected to face increased mental health problems (MHP). SUP can exacerbate mental health issues while also serving as a coping mechanism. Understanding the interplay between psychological, substance-related, and social factors is crucial for shaping effective interventions for this demographic. This article presents a three-year follow-up study with adolescents who had outpatient treatment for SUP, focusing on MHP and psychiatric conditions.Objective This study aims to determine the prevalence of ongoing SUP and MHP in adolescents who received outpatient treatment at a specialized substance use clinic three years post-treatment initiation. Additionally, it seeks to explore psychosocial risk factors distinguishing adolescents with solely MHP from those with both MHP and persistent SUP (co-occurring problems) three years post-treatment initiation.Method The study utilizes a longitudinal design, combining structured interview data at intervention onset with national register data at one- and three-years post-treatment initiation. A total of 451 adolescents participated, with 29% females and a median age of 17 years. Descriptive statistics and gender distribution of outcome groups are presented, alongside logistic regressions to assess the predictive value of risk factors for psychiatric conditions, substance use, and co-occurring conditions.Results Nearly three-quarters of enrolled youth show no ongoing SUP, and one-third exhibit indications of MHP three years after treatment initiation. Risk factors diverge when distinguishing adolescents with MHP from those with co-occurring problems at the three-year mark post-treatment. School problems, depression, female gender, and low primary drug use increase the likelihood of solely exhibiting MHP.Conclusions Integrated outpatient clinics like Maria clinics could play a crucial role in early detection and management of both SUP and MHP. The findings offer hope, suggesting positive outcomes regarding substance use even for individuals with heavy risk loads or severe SUP.

I Region Kronoberg pågår en länsövergripande förändringsprocess som syftar till att stärka barns och ungdomars välbefinnande. Processen kallas Barnens bästa gäller! i Kronobergs län (BBGiK) och kan beskrivas som ett nytt arbetssätt som syftar till att skapa länsövergripande strukturer där olika aktörer kan arbeta tillsammans för att stärka barns och ungdomars välbefinnande.

Inom ramen för Region Kronobergs verksamhet genomförs sedan år 2003 enkätstudien Barns och ungdomars hälsa och levn adsvanor i Kronobergs län. Den omfattar länets alla barn i årskurs 5 samt ungdomar i årskurs åtta och gymnasieskolans andra läsår och genomförs vart tredje år. Vid den senaste enkätundersökningen år 2021 medverkade totalt 5502 barn och ungdomar (Hiltunen & Johansson 2021). Genom att använda befintliga data av god kvalitet minskar behovet av att tillskapa särskilda resurser och former för uppföljning av BBGiK, samtidigt som en utökad användning också ökar värdet av det arbete som lagts ned för att skapa databasen. Genom att använda statistik som kunskapsunderlagökar möjligheten för beslutsfattare och andra relevanta aktörer i länet att styra och utveckla verksamhet samt arbeta med resursfördelning som kan gynna särskilt utsatta grupper eller områden, något som torde ligga i linje med ambitionen för BBGiK. Med hjälp av statistiska analyser av större populationer av barn och ungdomar kan insatser som stärker barn och ungdomars välbefinnande utökas från de indikerade individorienterade till att gälla även större grupper genom selektiva insatser eller unga i allmänhet genom universella insatser (Forkby & Löfström, 2010).

Även om den aktuella enkäten inte utformats för det nya arbetssättet inom ramen för BBGiK finns dock en rad frågor som kan fungera som indikatorer för dimensionerna i barnens bäs ta-hjulet. Följaktligen finns goda möjlighet att kartlägga dimensioner av välbefinnande bland unga i Kronobergs län på en mer aggregerad nivå.

Syfte och frågeställningar

Syftet med denna rapport är att utifrån befintlig verksamhetsstatistik presentera ett förslag på hur en lokal uppföljningsmodell kan se ut inom ramen för BBGiK. Ytterligare en målsättning är att presentera ett kunskapsunderlag för lokalt preventionsarbete för länets samtliga kommuner.

I denna rapport beskrivs livsvillkoren för de ungdomar som påbörjade behandling vid Mariamottagningarna i Stockholm, Göteborg och Malmö under år 2022 avseende användning av alkohol och narkotika, uppväxtförhållanden samt hur de har det med skola och arbete, kriminalitet och psykisk hälsa. Dessa uppgifter jämförs med tidigare års data (2013-2020) för att belysa generella trender i de tre städerna. Rapporten sammanställs årligen och utgör ett underlag för kunskaps- och metodutveckling vid verksamheterna. Rapporten är framtagen av Institutet för kunskaps- och metodutveckling inom ungdoms- och missbruksvård (IKM), Linnéuniversitetet på uppdrag av Stockholms stad, Göteborgs stad, Malmö stad, Västra Götalandsregionen och Region Skåne. Författare till rapporten är Mats Anderberg och Mikael Dahlberg som är forskare och lärare vid Linnéuniversitetet.