The main aim of this study is to evaluate the feasibility, preliminary effects and experiences of the Collaboration-Screening-Referral approach (in Swedish: Samverkan-Screening-Hänvisning - SSH) when used with parents referred to the Swedish child welfare services. The SSH is an approach to screen parents for symptoms of mental illness using structured questionnaires, establish intra-agency collaboration, and refer to mental health services. Additionally, to increase social workers\' competence in assessing and handling mental illness through receiving training in the SSH and administering the screening to parents.
The main questions the project aims to answer are:
* Are parents engaged with child welfare services willing to undergo screening for symptoms of depression and anxiety? * How have the implementation of the SSH proceeded and to what degree is it sustained? * How do parents and social workers experience the SSH? * Do social workers' behaviors, knowledge and competence relevant to supporting parents with mental illness increase when implementing the SSH?
Social workers answer questions before and after their training and after 6 and 12 months. Additionally, social workers and parents will be interviewed. Qualitative and quantitative within-group analyses will be conducted to examine experiences and preliminary effects of the SSH.
Working at the participating units.
None.
A parental role in relation to a child 0-17 years old (the participant does need not be a guardian or biological parent, can also be, for example, a partner to a parent).
A child welfare report has been filed for the child or the parent has reached out to the CWS themselves.
None.
Single group
The Collaboration-Screening-Referral (SSH) model
BehavioralThe SSH aims to identify parents in need of mental health support and to strengthen social workers' competence in addressing mental illness. The SSH includes three components: 1) Collaborating - establishing collaboration with local services offering support to adults with mental illness, 2) Screening - using screening instruments for depression (the Patient Health Questionnaire - PHQ-9) and anxiety (GAD-7) to identify symptoms of mental illness among parents, and 3) Referral - Discussing the results of the screening with parents and referring to appropriate services. Techniques from motivational interviewing are included. Social workers receive training and material to administer the screening and refer parents in need of support.
Social workers: Change from baseline in behaviors related to assessing and assisting parents with mental health challenges
Social workers will answer a questionnaire developed for the study, consisting of 12 questions about the methods they have used in the past months to assess and assist parents with mental health challenges. The questions are scored on a scale of 0 to 4, with a higher score indicating more frequent use of methods. Responses will be summarized to a total score of 0-48 or presented at the individual item level. Follow-up questions inquire about the specific instruments and interview guides used, the circumstances under which questionnaires are administered, and allow social workers to add additional methods in free-text.
The proportion of parents declining to complete the screening
Social workers will document the proportion of parents who choose not to complete the screening.
Social Workers: Change from baseline in perceived competence in supporting parents with mental health challenges
A 7-item questionnaire, designed for this study, will assess social workers' perceived competence in supporting parents with mental health challenges. Each item is scored on a scale of 0 to 3, with higher scores indicating greater perceived competence. The total score ranges from 0 to 21. The results may also be presented at the individual item level.
Social workers: Description (qualitatively) of reasons not to offer the screening
Social workers will provide reasons for why they have not offered the screening to parents.
Parents: Experiences of the SSH-model through individual qualitative interviews
Parents who have completed the screening will participate in interviews to evaluate their experiences, focusing on aspects such as acceptability and any discomfort or adverse encounters.
Social workers: Experiences of the SSH-model through interviews or focus groups
Social workers will participate in interviews or focus groups to evaluate their own and parents' experiences with the SSH model. The interviews will cover topics such as acceptability, the implementation process, perceived competency in assessing mental health, and the fit of the SSH with families' needs.
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