Mental health condition is one of society‘s greatest health challenges, so preventive measures are essential and may contribute to equalising the social differences in health. Clinical practice and experience indicated that 70–80% of those who requested services had faced many challenges in their own childhood. Many of them were the third and fourth generation seeking help from the public health services due to mental health conditions or substance abuse problems.
The municipality unit’s vision is that Sarpsborg will become a pioneering municipality when it comes to public health services for those who suffer from both mental health conditions and substance abuse. From 2013 it was a priority for the unit to prevent intergenerational transmission and therefore the development and testing of the Sarpsborg Model has been ongoing. The objective of the model is to make a systematic effort to prevent intergenerational transmission, using both the individual and systemic perspective, as well as the socio-economic perspective. This implies a turn to the left of the services resulting in treatment and prevention simultaneously.
The goal is an early, systematic and enduring effort. Children are rarely better off than their parents – this is why we have to work through the parents to help the children. Moreover, children have to receive help not because they express symptoms, but because of the risk factors that are currently present.
Treatment is viewed in a perspective where the present, the past and the future are in coherence, and multiple factors concerning the individual, the next generation and forming a network are involved simultaneously.
Treatment and prevention have to involve the entire family to break the intergenerational transmission of substance abuse problems and mental health conditions. The intervention model consists of evaluating the dependent children in the unit and initiating the necessary measures. The current measures are as follows:
- Mothers who are pregnant or have infants and simultaneously suffer from substance abuse problems or have a mental health condition, enter a mother–child group.
- The mothers are interviewed about their own childhood and attachment to their parents.
- The mothers participate in a Circle of Security course for parents.
- They have individual therapeutic sessions.
- They receive systematic guidance.
The simultaneous measures, efforts, treatment and prevention both individually and in the groups, and the course, enable the individuals to help themselves as well as their children. Knowledge and competence provide more substance to the user’s perspective.
The unit has focused on systematic work, descriptions, the development of methods and testing the model. It has been a top-down and bottom-up process, in cooperation with other units in the municipality and the specialised health services for children and youth.