08 SES 11, School Climate and Collaboration for Youth Health Promotion
While Nordic adolescents’ overall health is better than ever (OECD, 2016), the polarisation of health remains a topical issue that needs to be addressed (Elgar et al., 2015). Polarisation can lead to inequalities and social exclusion, which expose adolescents to a high risk of unhealthy, antisocial and criminal behaviour and even violent radicalisation and extremism (Bhui, Warfa, & Jones, 2014; Elbogen & Johnson, 2009; Wilner & Dubouloz, 2010). It has been proposed that violent radicalisation and extremism have roots in adolescence (Pels & de Ruyter, 2012).
Adolescents may face complex, multi-faceted problems due to different individual, social and contextual factors (Bhui et al., 2014; Wilner & Dubouloz, 2010). These factors include, for example, mental illness and substance abuse (Elbogen & Johnson, 2009), social inequality (Elbogen & Johnson, 2009; Howe, 2008), lack of the school engagement (Carter, McGee, Taylor, & Williams, 2007) and education (Pels & de Ruyter, 2012).
Adolescents’ situations and support needs must be addressed with the collaboration of a number of professionals (EUCPN, 2012; Sugimoto-Matsuda & Braun, 2014), where schools are involved as a partner among others to tackle adolescents’ health promotion and crime prevention. Education has been identified as one of the factors that could play a crucial role in promoting adolescents’ health and preventing complex problems that could lead to violent radicalisation and extremism by guiding adolescents to respect others’ rights and tolerate different perspectives (Pels & de Ruyter, 2012; Ramboll, 2017). Schools can also offer support and education to parents to guide them towards a tolerant and open upbringing of their child (Pels & de Ruyter, 2012). In addition, schools and teachers are in a position to detect adolescents that may require support from other agencies. This makes them important actors in multi-agency collaboration with a focus on adolescents’ health promotion and crime prevention.
Early crime prevention is prioritised in all European countries (EU, 2014; EUCPN, 2012). The focus needs to be on preventive services provided in a meaningful way to adolescents in a context relevant to their everyday life (Howe, 2008; Sugimoto-Matsuda & Braun, 2014). Support that is provided early can have a critical impact on adolescents’ future health and prevent criminal behaviour from turning into a criminal lifestyle (Wainwright & Nee, 2014). Multi-agency working models offer an opportunity for early intervention and coordination of comprehensive services that are meaningful to adolescents. However, little attention has been paid to the evidence-basis of these models; therefore, the critical analysis of multi-agency models in the Nordic context would be needed to identify and share the best practices. The adolescents in the Nordic countries face similar challenges and risks in relation to their health, which is why lessons learned in one of the countries can be easily applied to the others (Ramboll, 2017). Additionally, the experiences obtained in the Nordic countries have global value, and can be utilised in the development of multi-agency collaboration and preventive efforts aimed at adolescents.
The purpose of this study was to benchmark and describe the Nordic multi-agency working models that focus on adolescents’ health promotion and crime prevention. We had three research questions: i) what are the targets and structures of the working models, ii) what kind of multi-agency collaboration is implemented and how is this conducted and iii) how does the multi-agency process promote adolescents’ health and prevent future crimes?
We used the benchmarking framework to systematically compare working models and their best practices (Francis & Holloway, 2007; Moriarty & Smallman, 2009). We identified the benchmarking collaborators using the snowball method. We located contact people from the Nordic countries and they provided us with information about the multi-agency working models used in their countries. Working models were also searched using internet queries. The inclusion criteria for the working models were focused on adolescents or young adults, the promotion of health and prevention of criminal behaviour, basis on multi-agency collaboration where at least one agent represented the police, and having the working model financed at least partly by public funds. We identified five multi-agency models, two from Sweden (SSPF and SIG) and one each from Finland (Anchor), Denmark (SSP) and Norway (SLT). The data collection included two interlinked phases using documents and complementary Skype interviews. The documents were found through our contact people, from selected models and from the internet. A guide for supplementary Skype interviews was constructed based on the documented data. We recruited two voluntary participants from each country, each with knowledge to complement the documented data. We interviewed three police officers, three coordinators, one model consultant and one social service manager (n=8). The data analysis began by reading through the documents (n=53) several times. The data were then extracted into the observation matrix, which included background information, focus and stakeholders, process and implementation, management, and evaluation, resulting in a total of 196 pages of text (single-spaced, Calibri, 11-point). The data were then analysed by inductive content analysis (Graneheim & Lundman, 2004). We identified meaningful units and sub-categorised them based on their similarities and differences. The interview data were transcribed verbatim, resulting in 89 pages of text. This data were analysed using deductive content analysis (Graneheim & Lundman, 2004), following the categories produced based on document analysis. The whole data were further abstracted into three main categories.
The Nordic multi-agency working models implemented health promotion and crime prevention aimed at adolescents diversely and at different levels. All models involved multi-agency collaboration using regular meetings and, in Finland, the participating professionals worked regularly in shared premises. The models were organised based on steering groups, management and operational levels. With the exception of the Finnish model, the analysed models applied coordinators or consults to strengthen collaboration between stakeholders and organisations, and support the coordination and implementation of preventive efforts. The main stakeholders at the operational level were the police and representatives of social services. Depending on the model and country, they were supported by professionals from schools and/or health care. In addition, youth workers served as main stakeholders or close partners depending on the model. The role of the participating professionals involved acting as specialists in their own field. The target groups of the analysed models were adolescents suspected, committing or at risk of committing crimes or requiring multi-agency support. Individual processes were planned with adolescents and their parents based on the adolescents’ needs. The school’s role in the multi-agency collaboration was to promote adolescents’ health and to detect adolescents needing support from a multi-agency team. In addition, schools were supposed to share information with other professionals concerning ongoing actions and topical issues of pupils’ health and risks related to issues such as crimes, substance abuse and potential violent radicalisation and extremism. Adolescents’ teachers could be involved in the multi-agency team and support ending the criminal lifestyle or preventing future crimes. Multi-agency collaboration was described as a meaningful and effective way to promote adolescents’ overall health. However, there was variation in the local organisation, stakeholders and their roles, and the practical implementation of the models. Further attention must be paid on evidence basis and effectiveness of these models.
Bhui, K., Warfa, N., & Jones, E. (2014). Is violent radicalisation associated with poverty, migration, poor self-reported health and common mental disorders? PLoS ONE, 9, 1–10. Carter, M., McGee, R., Taylor, B., & Williams, S. (2007). Health outcomes in adolescence: Associations with family, friends and school engagement. Journal of Adolescence, 30, 51–62. Elbogen, E. B., & Johnson, S. C. (2009). The Intricate Link Between Violence and Mental Disorder. Archives of General Psychiatry, 66, 152–161. Elgar, F. J., Pförtner, T.-K., Moor, I., De Clercq, B., J M Stevens, G. W., & Currie, C. (2015). Socioeconomic inequalities in adolescent health 2002–2010: a time-series analysis of 34 countries participating in the Health Behaviour in School-aged Children study. The Lancet, 385, 2088–296. EU. (2014). Preventing and Countering Youth Radixalisation in the EU. Brussels. EUCPN. (2012). The prevention of youth crime through local cooperation with the involvement of the police – A pilot study The prevention of youth crime through local cooperation with the involvement of the police – A pilot study. Brussels. Francis, G., & Holloway, J. (2007). What have we learned? Themes from the literature on best-practice benchmarking. International Journal of Management Reviews, 9, 171–189. Graneheim, U. ., & Lundman, B. (2004). Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurse Education Today, 24, 105–112. Howe, R. B. (2008). Children ’ s Rights as Crime Prevention. International Journal, 16, 457–474. Moriarty, J. P., & Smallman, C. (2009). En route to a theory of benchmarking. Benchmarking: An International Journal, 16, 484–503. OECD. (2016). OECD Health Statistics 2016. Pels, T., & de Ruyter, D. J. (2012). The influence of education and socialization on radicalization: An exploration of theoretical presumptions and empirical research. Child and Youth Care Forum, 41, 311–325. Ramboll. (2017). Efforts to prevent extremism in the Nordic countries. Copenhagen: Ramboll. Sugimoto-Matsuda, J., & Braun, K. (2014). The Role of Collaboration in Facilitating Policy Change in Youth Violence Prevention: a Review of the Literature. Prev Sci, 15, 194–204. Wainwright, L., & Nee, C. (2014). The Good Lives Model - New directions for preventative practice with children? Psychology, Crime & Law, 20, 166–182. Wilner, A. S., & Dubouloz, C.-J. (2010). Homegrown terrorism and transformative learning: an interdisciplinary approach to understanding radicalization. Global Change, Peace & Security, 22, 33–51.
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