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Mental Health in Finnish Schools: So Close to Perfection []


By Cassandra Coburn, The Lancet, August 30, 2019

Finland's educational system is routinely praised as among the best in the world, achieving superb results through methods regarded by other scholastic systems as unorthodox. Among the differences that single it out for praise is the delayed start to education, with compulsory schooling beginning with a pre-primary education for children at 6 years old, and full-time schooling only starting at age 7. In contrast to the battery of tests faced by children elsewhere in the world, there is only one mandatory standardised test, taken at age 16. Commentators coo over the low amount of homework pupils are given, and the high regard in which teachers are held. But one of the most surprising—and important—aspects of schooling in Finland doesn't make it to the headlines: the provision of social and health care for students from within schools themselves. Nowhere is this more crucial than in increasing capacity to help children with mental health disorders.
The burden of poor mental health in children and adolescents is increasing around the world. According to a report by the UK National Health Service, around one in eight (13%) children and adolescents in England and Wales aged 5–19 years had at least one mental disorder when assessed in 2017. The same report found that, using comparable data that examined mental health disorders in those aged 5–15 years, the frequency of mental health disorders had risen from 9·7% in 1999 to 11·2% in 2017. Appropriate provision of mental health care for children and adolescents is vital: research has shown that young people who experience mental health problems are more likely to have disrupted schooling and issues with attaining and retaining future employment, as well as being more likely to become young offenders, have substance addiction, or otherwise be involved with problems with the law. However, appropriate provision of mental health care is harder to achieve for children than for adults because of children's lack of autonomy and inability to engage directly with the health-care system.

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Why do we not hear ideas about Primary Prevention rather than trying to deal with these very difficult and common problems after the fact?  My belief is that this would involve figuring out how to improve parenting skills across the population.  I wonder what readers' thoughts are about approaching this basic but generally untouched issue. 

Vincent J. Felitti, MD posted:

Why do we not hear ideas about Primary Prevention rather than trying to deal with these very difficult and common problems after the fact?  My belief is that this would involve figuring out how to improve parenting skills across the population.  I wonder what readers' thoughts are about approaching this basic but generally untouched issue. 

It would be wonderful if we can find a way to improve parenting skills. However, a couple of the obstacles that I have most encountered, (I am from a low-income Mexican migrant community in the Central Valley of California) include: ability to invest time in events which may not include some form of economic benefit and one of cultural stigma. That is not to say that these obstacles are not being addressed and have seen progress in overcoming them. My question would be a broad one, which cultural, economic, or social obstacles might have to be overcome to see significant success?


Vincent J. Felitti, MD posted:

My belief is that this would involve figuring out how to improve parenting skills across the population.  I wonder what readers' thoughts are about approaching this basic but generally untouched issue. 

Yes, parent-training is a necessary, key move, but implementation will be such a tough, tough challenge Dr. Felitti... 

I'm sure you know that some folks here in the West reject any concept of others' "involvement" (including 'training') in what they see as unassailable, "private",  family jurisdiction.  Some reject any intrusion into "sacred" personal  relationships (and outcomes).  Either way, ultimately, we would probably agree that "training" parents is not enough,  training  must result in change, for children to be safe. 

Who is accountable?   Ultimately a central question if not THE central question.

Acceptance of broad-scale, societal accountability for child-safety seems very limited:  For one, there is a strong politically-based (conservative) power center which objects to the concepts of parenting process-change and of parent-accountability to society.  So maybe the issues become a matter of degree.

Degrees of Family training and support and degrees of family accountability and degrees of family "surveillance"(as some  call it), seem to ultimately come down to the legal standing of children (versus parents and parental 'rights'). Children, even as a 'protected class', often lose.  They don't have money.  They don't vote.


Do children have a right to be safe? Should there be a "balance" between child rights and parental rights.  Is that even  a logical dichotomy ?  Should child-safety be the pinnacle, with no nod to "balance"?   

Are children "property" of their parents, without question, or does the Community have any accountability for training, for support, and for protection (and standards)?  If children will never have an equal power base,  without money, without voice, then maybe the answer is (adult) "Community" interests, Community standards, Community power?

Cultural norms were very different on this issue not long ago -- they are still different in some places around the globe. Of course a deep issue, meant to be rhetorical for now.


 "Community" used to be the clan or the tribe, in a supporting role for the two parents, all taking accountability for safety of all children (even here in the West). Children were understood to be the future of all. Bruce Perry has written on this.  

Fast forward --  USA, the largest capitalist country in the world is virtually the only country which has failed (for 30 years) to ratify the UN's "Declaration of Convention on the Rights of the Child”. At least one President described that failure as an international embarrassment. It is all a difficult conundrum and measured on a continuum. 

Still, I choose not to fault others, nor to stop pursuing children’s rights, but to keep working, even when solutions are not yet ‘perfect’.  For me, the safety-rights of abused children stand above the downside of inaction. Parent training must be part of improvement, part of change.  Other collateral concerns should also be addressed, yes, but not at the expense of holding child’s safety “hostage” in the interim.


This diatribe is certainly a round-about way of addressing the "parent-training"  / parent accountability morass, yes.  But looking a few moves down the chessboard,  I believe, sadly, that  the thorny issues will ultimately come down to child-rights vs parent-rights here in the West, given our history, philosophy and current statutes...


Parental training is required, but not sufficient to defend rights of the child.

There must be parental-accountability after the training.

The Community must move to help take some accountability for training, for support and ultimately for safety of children, even  at the expense of "sacred" parent rights. A dramatic, tectonic shift in our Western paradigm of accountability for child-safety.


All open for debate.  (No name-calling please)



"Do Children Have a Right to Be Safe ?" CLICK Link Here


Last edited by Daun Kauffman

Just a short observation...

I have long thought that the way in which we try to engage parents is sometimes what I call the 'bad enough' system.  Parents are often 'referred' (how would you like to be 'referred') for help, if they engage they have help and assistance often until the professional decides that they have achieved what they deem appropriate and then the support ends.  The parents are then left without the support of those who they have built relationships with until they are 'bad enough' again.  What an upside down model this is. I believe that we should be encouraging everyone to focus their efforts on prevention - asking the question 'How is what we do contributing to the prevention agenda or are we just continuing to pick up the pieces when it goes wrong?

We are part of a new not-for-profit, "Mountain Shadow," in Lodge Grass, MT interested in societal intervention in parenting.  We in Indian country theorize that destruction of parenting traditions happened primarily with the forced separation of so many children from their families in the boarding school era.  It also happened over a larger time span in the industrial revolution,  and even in the rise of civilization's empires and warlords of Mesopotamia, perhaps all humankind wherever populations concentrated in the last several thousand years and chaos with population decline ensued.

So we are seeking funding to organize semi-permanent school/parental learning circles across generations, each with an appropriate mix of children's ages so there is productive craft and gardening and meal preparation work, along with cleaning and keeping chaos at bay. The curriculum content would be transformed along the lines of some progressive initiatives such as Escuela Nueva Foundation, Indigenous Waldorf, and Montessori.

Each learning circle would be embedded along with others in a "supportive housing" neighborhood concept with buildings that fit needs for social and emotional safety and responsive human relationships connected with real life needs.  This housing concept is functioning currently in a number of states in the mountain west. See the Corporation for Supportive House. And see Douglas Cardinal Foundation for Indigenous Waldorf.

Would love to have input on a design to let learning again be founded on family relationships as a foundation instead of an unnecessary sweetener for disciplined learning.




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