Substance abuse and mental health services in institutional child welfare services
The goal of the assessment
The main question of the assessment was whether mental health and substance abuse services for children and young people in care in institutional child welfare services are realised in accordance with the City’s objectives. This was assessed by examining whether access to mental health and substance abuse services for children and young people in institutional child welfare services has been promoted and whether the mental health and substance abuse service chain for children and young people has been developed in line with the objectives. The City of Helsinki is responsible for organising basic social and health services and certain specialised health care services. The Hospital District of Helsinki and Uusimaa (HUS) is responsible for specialised health care in Uusimaa. The assessment focused on the activities of the City.
Conclusions
The mental health and substance abuse services for children and young people in institutional child welfare services are partly realised in accordance with the City’s objectives. The City has child welfare units specialising in children with substance abuse and mental health problems. Medical services are outsourced for child welfare institutions and, if necessary, drug substitution therapy is provided to patients. Cooperation within the City and with HUS has been developed. The responsibilities and division of labour of actors in the mental health and substance abuse services chain for children and young people have been clarified in the Social Services, Healthcare and Rescue Services Division. However, those placed in child welfare institutions do not always receive adequate mental health and substance abuse services. The issues of those placed in institutional care are often serious, and the substance abuse and psychiatric services provided by the City are not sufficient for their needs. People placed in institutional care may not have access to HUS psychiatric services because child welfare institutions are already seen as providing care.
Recommendations of the Audit Committee
The Social Services, Health Care and Rescue Services Division must
- continue to develop preventive and early intervention substance abuse and mental health services to reduce the need for child welfare and specialist care services.
- continue to develop the mental health and substance abuse service chain for children and young people in institutional care.
- continue cooperation with HUS to find solutions to ensure access to mental health and substance abuse services for children and young people placed in care in child welfare institutions.