1. Notice the Children Project 2003-2005 Project Workers: Veli-Matti Saarinen and Hilkka Räisänen

2. 18.5.2005 Project Workers Veli-Matti Saarinen and Hilkka Räisänen Notice the Children Project 2003-2005 According to many studies, parental mental illness burdens the whole family and is a risk to children´s mental health  The child's risk is estimated at 30 – 70% Ten years ago we become concerned about the children of mentally ill parents what to do, who to consult or whose responsibility it is to deal with the situation? In Child psychiatric care we noticed that sometimes the children's parents suffered from psychiatric disorders We suggested further measures to 56% of the children who were assessed during the earlier “Unnoticed Children Project” 1992 - 2002. The study showed us the importance of prevention while noticing the children's situation. Notice the Children project is focusing on that fact If we want to notice the children systematically we need education and consultation to the adult psychiatric staff and collaboration between adult and child psychiatry

3. Notice the Children Project 2003 - 2005 Own motivation Voluntary basis Referral Assessment of the child and family Interviews of parents /children YSR, CBCL, TRF -tools Home visits Multiprofessional negotiations Training, consultation,work supervision Beardslee family intervention 8 days Mini-intervention training 1day Beardslee’s family intervention 6 –8 sessions parents and children Concern about the children’s psychiatric health or family’s welfare Concern about the other parent Feedback meeting Informal support netw and multiprof team Immediately and 6 months later Negotiations on further examinations, care or support to the child/family Various therapies FCC, OM, CPC Child protection The other parent’s referral to care

4. 18.5.2005 Projectworkers: Hilkka Räisänen and Veli- Matti Saarinen Notice the Children Project 2003-2005 Methods: Assesment of the child´s and family´s situation - CBCL,YSR,TRF (Achenbach/Almqvist) - home visits, interviews of parents and children - observation of the family system Beardslee´s Family Intervention/Mini Intervention - supporting parenthood, promoting protective factors in the child’s life, supporting family interaction - psychoeducation Providing examinations, care and support services - multiprofessional collaboration, follow-up negotiations Training, consultation, work supervision Training and work supervision for project workers Collaboration between project workers, child and adult psychiatric units

5. 18.5.2005 Projectworkers: Hilkka Räisänen and Veli- Matti Saarinen Notice the Children Project 2003 -2005 Results: -The participants (1.9.2003 - 11.4.2005) were 48 families including 119 home-living children aged 0-21 - Further measures Child/adolescent psychiatric clinic8% Family counselling clinic 33% Child social welfare clinic 41% Other measures: primary health care, follow up etc13% - In 11 out of 48 families, the other parent was referred to care - 2 adult children were referred to psychiatric care

6. 18.5.2005 Project Workers Veli-Matti Saarinen and Hilkka Räisänen Notice the Children Project 2003 -2005 Conclusions: Both the families and the collaborating partners have experienced the project positively To ensure that the children of psychiatric patient are noticed, we need intensified multiprofessional collaboration, further training, a supervision and consultation system and a set of quality criteria and instructions to notice the children In clinical work, the families’ multiple problems and great child protection needs have been surprising Work with informal support networks and multiprofessional work have increased from the time of the earlier project, and a further increase is indicated Families appreciate the long term support; plans are made for follow- up negotiations even one year after ending the intervention The project revealed the lack of recourses in primary psychiatric and social services. Resources in primary services should be an essential part of prevention