The Finnish educational system emphasizes the child’s right to go to school close to home and to get appropriate support measures according to his/her special needs in own school. At the same time, outpatient care is becoming mainstream in child psychiatry instead of inpatient care, earmarking the rare beds in wards for the most severely ill children. Together, these trends result in more learning problems as well as emotional and conduct problems being present in classrooms of ordinary Finnish primary schools. In Finland such problems can be dealt with by the so-called multi-professional student welfare group, school healthcare, teacher and family, but still many teachers feel they are left alone with the challenge of managing a child with mental health problems in the classroom together with the rest of the group. New ways to support the teachers and other adults working in schools in their demanding job are needed.

Alava School of the City of Kuopio is a hospital school providing education for children receiving (in-patient) treatment in the Kuopio University Hospital. In addition to that, the consulting special needs teachers of the Alava School have provided face-to-face or telephone consultations for school teachers in the City of Kuopio since 2012 in order to help the children and adolescents in their school work, but also support teachers and other adults working in classrooms.  Consultations have proven needed as the knowledge base of class and subject teachers about special needs education varies a lot, and experts in the field are not always available due to scarce resources in schools.

Consulting the special needs teacher of Alava School gives class and subject teachers a possibility to feel supported and not left alone with challenging children, learn about best practices and the consultant’s experience, benefit from networks, get supervision and counseling when needed, and access a link to the Department of Child Psychiatry at Kuopio University Hospital.  Thus, consultation contributes to preventive and promotative work, as the natural, daily developmental environments are the places where the main part of support, treatment and rehabilitation of children should take place. Furthermore, the consulting special needs teacher is not a part of the actual working community in the school and can therefore provide an objective viewpoint from outside.

The region Pohjois-Savo in Finland comprises of 18 municipalities with a total population of 247 800, of which 15 % aged 0-14 years, on a total area of 20 366 km² (Pohjois-Savo in a Nutshell, 2017). Kuopio is the biggest city with nearly half of the population and school-aged children in the region, while the other municipalities are significantly smaller and scattered with lower population density affecting the provision of public services including special needs education. As a part of the eHealth Services for Child and Adolescent Psychiatry (eCAP) project implemented in the region by the University of Eastern Finland, Kuopio University Hospital and the city of Kuopio, the expertise of the consulting special needs teacher of the Alava School has been made available also to schools in other municipalities  via video conference (VC). According to our understanding, such an approach has not been utilized in special needs education earlier, despite the technology is widely available and video conferencing provides a great opportunity to flexibly overcome the geographical distances, save time, money, environment and other resources as well as utilize the expertise and peer support easily and with low threshold.

In our small pilot study we want to find out whether classroom and subject teachers in these municipalities perceive video consultation service by the special needs teacher from the hospital school as comfortable, useful and feasible.

The possibility to consult the special needs teacher of Alava School by video was offered to six municipalities in the region Pohjois-Savo, namely, Iisalmi (with 3369 children aged 0-14 years), Kiuruvesi (1256 children), Siilinjärvi (4 394 children) Sonkajärvi (559 children), Varkaus (2 748 children) and Vieremä (566 children), as these municipalities had proven receptive to adopting child psychiatric video consultations launched earlier in the course of the project. In autumn 2017, the educational authorities of these municipalities were contacted for inquiring about their interest to take part in the pilot study and all agreed. The schools were visited in November 2017 – January 2018 in person by the special needs teacher and the project manager for introducing the service and providing training and materials for the potential “clients”, mainly class teachers and special needs teachers working locally. The service was launched in January 2018 and the piloting phase will go on for five months, throughout the Spring term 2018 until the end of May. The consulting remedial teacher will make approximately 7 hours a week available for consultations in an electronic booking system, which can be found on the website of the Alava School (https://peda.net/kuopio/p/alava/hankkeet/ecap-hanke/vl) or directly in the address vello.fi/ecap. The consultations can last 30 minutes for smaller, practically oriented questions or 60 minutes for more detailed and comprehensive discussions, depending on the need of the client, who can also decide upon the day and time of the consultation. After submitting the booking form the client receives a confirmation email with a link where he/she can edit or delete the appointment if needed. Later the remedial teacher will send by email a separate invitation to the Skype for Business meeting at the settled time. During piloting the service will be free of charge for the municipalities. In the course of and after the pilot, data will be collected for evaluating the usefulness and feasibility of the service. The booking form will provide information about the client, his/her geographical location (postcode) and the duration and desired topic for the consultation. After the VC the clients will be asked to fill in an online questionnaire with questions related to the perceived quality and feasibility of the VC, ideas for further development, and the client’s experience in teaching. Later in the Spring 2018 some clients will also be interviewed by phone.

The preliminary results of this small five-month pilot project will be available in early June 2018. As the service has aroused a big interest among the target groups, we hope it to be also utilized very actively. The study will reveal from which professions and geographical locations the consultation requests come from, and what kind of challenges related to pupils’ learning difficulties or emotional and conduct problems generate the most consultations requests, thus demonstrating the need for further support and, perhaps, training among the school teachers and other school staff. Based on this pilot study we hope to be able to conclude whether it would be worthwhile for the Alava Hospital School to continue further implementing and developing this work method in order to support teachers and other adults in schools in Pohjois-Savo region to manage the diverse challenges and problems of their pupils.

Pohjois-Savo in a Nutshell, 2017, https://www.pohjois-savo.fi/tietopalvelut/tietoa-pohjois-savosta/tilastot.html. Accessed 30 January 2018.