Consultation input to the plan for the prevention of neglect and behavioral difficulties

Løvemammaene Nord, led by Karoline Storelv Hansen, has written consultation input for Tromsø municipality's consultation regarding the prevention of neglect and behavioral difficulties. The plan that Tromsø municipality has out for consultation has been called "Safe upbringing". Løvemammaene Nord has placed great emphasis on the importance of systematic mapping of individual needs and early intervention as prevention. We have also put a lot of focus on children as relatives in the response to the consultation, as we believe it is absolutely essential that the municipality offers mapping, follow-up and early intervention to children as relatives in order to be able to achieve its goal of a safe upbringing.

Read the consultation input in its entirety below.

Consultation response – Tromsø Municipality – 24/02814 – Consultation input to the plan for the prevention of neglect and behavioral difficulties

Løvemammaene Nord is a regional team associated with the main organization Løvemammaene, which covers the counties of Nordland, Troms and Finnmark. We have 767 members in the North and great commitment among them. Løvemammaene is a diagnosis-independent organization that works to inform about and improve the rights of children and young people with illness and various support needs. We are passionate about support, freedom and equality for the whole family.

In the introduction point 1, the aims of the education reform are described. It states, among other things, that Tromsø municipality must strengthen work with early intervention and prevention, and that the help provided must be adapted to the needs of children and families in a better way.

Løvemammaene Nord agrees that Tromsø municipality has great improvement potential to achieve this goal. Today, there is no good system for early intervention and prevention for all children and young people with different support needs.

The title of the plan is "safe upbringing». Many children and young people in Tromsø municipality do not have a secure upbringing. Care, security, love and stability are mentioned as key words. Many of our members and member families who are faced with crises and stress over a long period of time with seriously ill children and children in need of help, do not know care, security and early intervention. Prevention and early intervention are therefore absolutely essential for our member families to recognize the key words.

It is particularly important that families with sick children and children who need help get early help, the right help and enough help. Only in this way can prevention, care and security be provided. This requires early intervention.

It is described that the help must be better adapted to the needs of the child and families. Løvemammaene Nord believes that in this work Tromsø municipality must be in close dialogue with children and young people, as well as their families, so that the needs can be mapped. Our member families constantly experience that the municipality introduces measures, sets up consultation services and the like, without it hitting the child or the family in the right way. We therefore believe that it is important that the need for what kind of help is needed is thoroughly assessed before measures are put in place. This applies to the entire aforementioned risk group, but also to children as relatives in order to be able to provide a good, comprehensive offer that embraces everyone. The municipality must in no way exclude anyone.

It also states that children and young people must be protected from physical, emotional or psychological harm in their upbringing environment, and that they must receive sufficient support to develop to their full potential. In what way should Tromsø municipality plan and achieve this goal and target group(s)? Unfortunately, children as relatives of siblings with illness/need for help do not seem to be valued in Tromsø municipality. These children are not surveyed, and do not receive any offers unless you are between 5-8 years old and can participate in the PIP club. We at Løvemammaene Nord think this is sad, and would strongly encourage the municipality to make room for siblings outside this age group as well.

1.1 "Safe upbringing" - Prevention of what and for whom?

Under this point, it is described what "safe upbringing" is based on knowledge. It is also described how the municipality is to strengthen children's protection and reduce risks linked to factors that particularly contribute to children being exposed to neglect or developing behavioral difficulties. What does Tromsø municipality consider neglect and behavioral difficulties? Many different terms are used which are not sufficiently explained or clearly described. This means that many children, young people and guardians may feel that one ends up "outside" the term and thus has no claim to help. On the basis of that, they also do not apply for help from the municipality and fall outside the scope. Tromsø municipality should be precise in its wording.

It is described that the following children are risk groups in this plan:

Risk factors

1) Children who are exposed to harmful forms of care (neglect, neglect and serious failure)
2) Children who are exposed to serious abuse (mental and physical violence, sexual abuse)
3) Children who are exposed to emotional unavailability/distance from guardians
- This point is very imprecise and should be described far more concretely. Are there children under this point to whom relatives of siblings belong? Parents with such large care tasks for their sick child/child in need of help, that the sibling experiences unavailability/distance from guardians? We in Løvemammaene Nord believe that this is a poorly described point and should be revised.
4) Children as relatives of guardians with drug problems or serious mental disorders
5) Children with developmental difficulties who are not understood and helped
6) Children who are exposed to a harmful psychosocial environment in daycare and school
7) Children living in families with living conditions challenges (children in low-income families)
8) Children as relatives of siblings with illness and/or need for assistance

Løvemammaene Nord believes there should be a separate point for children who are relatives of sick siblings, or siblings who need help. Children are described as relatives of guardians, but nothing about children as relatives of siblings. This means that they fall outside and receive per dd no mapping, prevention, early intervention, offers or help.

This is described in a separate section: "The municipality must have a particular focus on protecting and helping. Children and young people with mental illness are not set up as a separate risk factor, but mental illness will be a consequence of several of the risk factors. The municipality should therefore also have a particular focus on children with mental illness, and not just those diagnosed with anxiety or depression.'

In Tromsø municipality, there are long waiting lists for offers of mental health care. The situation is the same in the specialist health service. It also means that more children and young people go an unnecessarily long time without a diagnosed anxiety or depression disorder, or other mental illness without receiving the necessary health care. Løvemammaene Nord thinks it is good that it is specified here that children and young people without a fixed diagnosis should also get help. However, we believe that it should be added to the list of risk factors.

2.1 Community part of the municipal plan

This point describes the community part of the municipal plan, where, among other things, the focus on 3 community goals is described. Social sustainability, Climate and environmental sustainability, and economic sustainability. It is described as "The societal goal of social sustainability where all residents are equal, treated equally and have good everyday lives."

Are all the inhabitants of Tromsø municipality equal and have good everyday lives? We in Løvemammaene Nord do not believe that, and that the municipality has a long way to go before reaching the finish line. If the citizens are to have equal lives, the right help and good enough help must first and foremost be in place for all citizens. In this way, equality can be ensured. There are not services for all age groups in the municipality, and especially not for all minorities. In addition, we find that Tromsø municipality has a tendency to train parents' need for help, by not granting the help parents apply for. For example, an application for relief or BPA. The parents receive a decision with a reduction in the number of hours applied for. We feel that the municipality does not understand and does not listen to the needs of the residents. It is a big step for parents to ask for help in the first place. Our member parents also tend to understate the extent of the need for help. This means that our member families are already applying for too little help when they apply.

It also says "The municipal plan's sub-goal 1.2 is particularly relevant in the preventive plan: Tromsø will give children and young people a good starting point for mastering everyday life and adult life. Giving children and young people a good starting point will, in this context, be an upbringing where they are safe, have their needs met, get the care, help and protection they need, both at home, in kindergarten, at school and in their free time."

Here, the municipality must first of all survey children and young people, as well as their needs and which help suits the individual. Not all offers in Tromsø municipality meet all age groups and all different needs. It is important to consider that a person is an individual and has different needs. After a thorough survey, you should create an offer that embraces everyone. Only in this way can Tromsø municipality achieve its goal.

3 Challenge image – Growing up in Tromsø municipality

According to this point, there are 15,148 children and young people under the age of 18 living in Tromsø municipality. In March 2024, a new Youth Data Survey was conducted in Tromsø. The numbers are reportedly not ready yet. Did this survey consider how many children and young people are relatives of siblings in Tromsø municipality? This would have been an excellent way to survey these children. Tromsø municipality has not as of dd a good system for. It is very worrying that Tromsø municipality stands out negatively in some areas compared to other municipalities in the country.

In Tromsø there is (compared to the national average):

• More people with psychological problems/symptoms/disorders
• More people who know loneliness
• More people with sleep problems
• More overweight and obese
• Fewer people are satisfied with meeting places
• Fewer people are involved in leisure organisations
• More people who have drunk alcohol/been intoxicated

This worries us in Løvemammaene Nord, and says something about the offer that Tromsø municipality provides its residents. It also says something about the municipality not detecting children and young people early enough, and that mapping and early intervention are not present in the municipality. If Tromsø municipality had caught up with these children and young people earlier, and given an offer, the figures could have been different.

It is also described that PPT is experiencing an increase in the number of referrals despite a decrease in the number of pupils, and that the development already started in 2020/2021. We wonder why Tromsø municipality has not previously started with a risk analysis of this. There is a high level of special education, which also tells us that the probability that all children with a decision on special education will not get the hours they are entitled to. This is against the background of the staffing crisis, which has been mentioned in the media a number of times.

It is also described that "the proportion of teacher hours given to special education is significantly higher at the secondary level than for the primary level, which is the opposite of what we want with early intervention". This worries us in Løvemammaene Nord. The figures are concrete examples that Tromsø municipality is unable to survey children and young people in an early phase and initiate measures. There are also parents who are neither believed nor heard in Tromsø municipality, and this may also be one of the reasons why children and young people wait longer for help and thus lose important training lessons and the like in school.

4.1 Basic knowledge and principles to achieve the overall goal

In order to achieve the overall goal and thereby meet the requirements set for the municipality through the reform of the upbringing and the changes in the welfare legislation, the following basic knowledge and principles are necessary for services and employees in Tromsø municipality:

Basic knowledge and principles:

Children's rights: Employees who work with children and young people must be familiar with the UN Convention on the Rights of the Child and children's rights
- and work according to this.
Best interests of the child: The best interests of the child must be a fundamental consideration in all actions concerning children. Children and young people must have their say and be listened to.
- The child's best judgment must always be made in all matters concerning the child, see legislation in section 104, subsection 2 of the Constitution. Here should too The UN Convention on the Rights of the Child Article 3, Section 1, and the UN Convention on the Rights of the Child Article 12, Section 1 be central.
Cooperation: All services are obliged to cooperate. The duty to cooperate applies both at individual and system level.
Better interdisciplinary efforts (BTI): BTI is to be used as a routine for early intervention and interdisciplinary collaboration around children and young people aged 0-23.
Risk factors: Employees must be aware of which children we should have a particular focus on, cf. the risk factors.
Children's perspective and children as relatives: Adult services that work with residents who have children must have a children's perspective and knowledge of children as relatives.
- Knowledge of children as relatives seems somewhat vague. Something specific should be said about how mapping, early intervention and services should be organized around children as relatives. Løvemammaene Nord believes that having "knowledge" of children as relatives is not sufficient. In terms of experience, our member families are left without offers for children as relatives, and this is often because the municipality has too little expertise and focus on this group. Such a formulation as "familiarity" will lead to training of this group once again.

4.2.2 Safe framework for families and a health-promoting upbringing

"Tromsø municipality must work for a safe environment for families and a health-promoting upbringing."

Once again we must repeat ourselves. Early mapping and measures are absolutely crucial for Tromsø municipality to achieve this goal. In addition, the help and need that families report must be acknowledged. It is not in all cases parental guidance that is right for a family, the child does not always want a leisure activity or a meeting place, it is not always conversation groups that are right for the child. Here, every need must be mapped, so that children and young people, as well as their families, get correct help that suits one's own situation. In far too many cases, we find that municipalities create offers that are not suitable. Only by mapping each and every individual need can you take targeted measures that will work best for the family and the child. It is largely about listening to the needs of families, children and relatives.

Strategic moves in focus area 2

Safe framework for families and a health-promoting upbringing:
a. Tromsø municipality shall strengthen the parents' skills by improving the parental guidance and parental support offered in the municipality.
- This information about offers must also reach all parents through health centres, doctor's offices, physiotherapists, occupational therapists, nurseries and schools, and other service providers in the municipality. Only in this way will parents who need an offer catch this. As it is per dd the flow of information about offers in the municipality is far too poor and is not picked up by those who need offers. Tromsø municipality should also revise its website, with updated information on offers.
b. Tromsø municipality shall focus on the needs of children and families and shall endeavor to offer help/have assistance measures for children in the risk groups.
c. Tromsø municipality must strengthen work with families exposed to living conditions and work to combat child poverty and break the social legacy.
d. Tromsø municipality must strengthen the offer for children as relatives, by ensuring families have sufficient information, support and help.
- We in Løvemammaene Nord believe that this is a very good point!

5.2.1 Coordination through a coordinating unit

Under this point, it is described that the Resource Center for Children and Families handles the task as a coordinating unit for children and young people aged 0-23. For us in Løvemammaene Nord, it appears as if the Resource Center has too many delegated tasks, not enough resources and not enough expertise to be able to coordinate, interact and attend to the needs of all residents of Tromsø municipality between the ages of 0-23. It is completely incomprehensible to us that the municipality's resource center should have expertise in children with behavioral difficulties, parents who are in crisis, parents with substance abuse problems, children with complex difficulties, and the like. It is necessary that the Resource Center has various suitable places to "solve" these issues when they receive an inquiry. It is not experienced this way today.

5.2.4 Interaction

"Meeting forums to discuss individual and system matters. Tromsø municipality must have meeting and collaboration forums where individual and system issues can be discussed across units and departments. External collaboration partners must be invited where it is natural (depending on the theme and age). The following meeting forums will be in place in 2024:

As a point mentioned under meeting forums for collaboration forums:

Collaboration forum for Tromsø municipality and voluntary organisations: A collaboration forum between the municipality and voluntary organizations that work with vulnerable children and young people, and their families. The purpose is to discuss challenges among children and young people from different perspectives and for the voluntary organizations and the municipality to increase awareness of each other's offers and services.

- Løvemammaene Nord wants to participate in this collaborative forum.

Strategic measures and proposed measures for the various investment areas in the plan "Safe upbringing"

Strategic measures in focus area 1: Inclusive kindergarten and school

Proposed measures focus area 1

Løvemammaene Nord believes there should also be a point stating that nurseries and schools should strengthen their competence for the theme "children as relatives". Kindergartens and schools should survey children as relatives and introduce measures for children as relatives at an early stage.
The remaining proposals are supported by Løvemammaene Nord.
Løvemammaene Nord supports the proposal.
Løvemammaene Nord supports the proposal.

Strategic measures in focus area 2: Safe framework for families and a health-promoting upbringing

Proposed measures focus area 2

Løvemammaene Nord supports the proposal.
Løvemammaene Nord supports the proposal.
Løvemammaene Nord supports the proposal.
Løvemammaene Nord supports the proposal.

Strategic measures in focus area 3: Safe meeting places and activities during free time

Proposed measures focus area 3

Løvemammaene Nord supports the proposal.
Løvemammaene Nord supports the proposal, but believes there should also be something about the universal design of offers so that everyone can participate.

Strategic measures to strengthen work across the three focus areas

Proposed measures across focus areas