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- Bortes, Cristian, 1984-
(författare)
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Growing up with poor health and managing school : Studies on ill health and young people's educational achievements
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim and objectives: The overall aim of this thesis was to empirically investigate consequences of poor health for children’s educational outcomes in Sweden. A central tenet is that health problems impact not only the afflicted individual but also people in their social and emotional proximity, in particular immediate family members. More specific objectives were to study: 1. The relationship between multiple clinically diagnosed mental disorders and children’s educational achievements in Sweden. 2. The bidirectional relationship between mental health problems and academic performance among Swedish adolescents, as well as heterogeneous patterns associated with gender and socioeconomic groups. 3. The effects of parental somatic and psychiatric health problems on the probability of youths leaving upper secondary education before completion in Sweden and potential gender differences in these effects. 4. The relationship between having a sibling with health problems and a healthy sibling’s school grades in the final year of compulsory education in Sweden and how socioeconomic background modifies this relationship.Theoretical framework: Key concepts applied in the thesis are health and illness. The ability to perform things in life, the ability to act, determines whether a person is healthy or ill. Illness (or poor health, treated as a synonymous term) entails a reduced ability to act in relation to one’s life situation and its demands. Family is viewed from a systems theory perspective. Poor health of a parent reduces his or her ability to maintain regular roles, which may require reorganisation of the family system. Siblings’ health problems can affect other children in the family by inducing concerns and occupying and diverting parents’ time and attention. All of this could be psychosocially stressful in many ways, not least for children in the family and their ability in relation to schooling.Data and methods: The research objectives were addressed by utilising social and medical microdata from Swedish administrative registers covering the entire population in Sweden. Data pertaining to different populations, collectively covering the period from 1987 to 2017, were used in four studies designated Studies I–IV. Educational achievement was measured in terms of teacher-assigned school grades awarded by the end of compulsory school and in upper secondary school, as well as completion (or non-completion) of an upper secondary education. Poor health was measured through data on outpatient visits to specialist healthcare facilities, psychotropic drug prescriptions and admissions/discharges from Swedish hospitals. Socioeconomic background was measured by parental level of education. The data were analysed by fitting linear and logistic regression models as well as cross-lagged path models.Results and conclusions: Empirical results of Study I showed that specific diagnosed mental disorders have varying, largely disadvantageous, associations with educational achievements of students that differ between boys and girls. Documentation of this in Sweden adds to evidence that mental disorders have a negative overall association with educational achievement, despite substantial variation in support and educational systems across countries. The results of Study II provided no support for a bidirectional relationship between mental health and academic performance of students aged 15-16 to 18-19 years. However, they support a unidirectional relationship, as a negative relationship was found between school grades at graduation from compulsory school and rates of subsequent psychotropic medication use in upper secondary school. The relationship was equal in size for both boys and girls but mainly among adolescents with the highest educated parents.Study III showed that having a mother or a father with psychiatric, but not somatic, illness that necessitated hospitalisation after completing compulsory schooling was associated with an increased probability of leaving upper secondary school before completion. No significant gender-based differences in this were found. Results presented in Study IV showed that having one or more siblings with health problems that necessitated recurrent hospitalisations was associated with lower grades. Children with ill siblings were also less likely to be eligible for an upper secondary education compared to children whose siblings did not have poor health. Socioeconomic background did not affect this educational disadvantage.Results presented in this thesis clearly corroborate the importance of health for children’s education. Children’s educational achievements at the end of compulsory school are inversely related to mental health problems in their adolescence. Thus, academic competence may have positive effects on certain aspects of young people’s mental health, which underscores the importance of promoting opportunities for youth to do as well as they can in school. The reciprocal aspect of the relationship between mental health and academic performance among school-aged children remains an important issue that requires further investigation. However, health is not just an individual issue; parents’ and siblings’ health problems can affect children and have negative ‘spillover’ effects on their schooling and educational achievements. This underlines the importance of a psychosocial perspective when identifying children’s difficulties in school. Taken together, health, and thus the school’s student health task, is highly associated with academic achievement and schools’ pedagogical responsibilities.
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| 2. |
- Kjellgren, Maria, 1973-
(författare)
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Skolkuratorns samtalspraktik : en studie om individuella samtal med barn i den svenska grundskolan
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis fills part of the existing knowledge gap regarding school social workers (SSW) individual counselling practice. The overall aim is to investigate the individual SSW counselling in Swedish elementary schools, as part of the pupil health team (PHT). This will be achieved by exploring the following three basic research questions: What characterizes school social work regarding structure, process and interventions in individual counselling sessions held by SSWs with children? How do SSWs describe the difficulties and opportunities in school social work, interventions and performance, and collaboration with other actors in pupil health teams? What characterises SSWs’ individual counselling according to the adolescents’ experiences and expressed needsThis thesis consisted of four research studies. The first one concentrated on SSWs personal experiences of counselling children, in which focus group studies were conducted with 22 SSWs (four groups). In the second study, the SSWs described their experiences of being a part of a multi-disciplinary team, the PHT, during the focus group interviews. These two studies were analysed by content analysis. The third study consisted of a quantitative protocol study regarding child characteristics, counselling strategies and interventions analysed by descriptive statistics. The purpose on the fourth study was to increase knowledge about the individual counselling from the adolescents’ perspective. Individual interviews were conducted and analysed through content analysis.This thesis highlighted the necessity for children to express themselves, in regards to their life situation, concerns and problems. SSWs could be one prominent actor in the children’s lives by providing individual counselling sessions. SSWs are described as the PHT psychosocial expert with specialised knowledge regarding the impact of negative psychosocial factors on children.In addition, this thesis concluded that available regulations and guidelines meant insure that children are listened and able to express their narrative in a safe and trustful school counselling environment are limited.
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| 3. |
- Näslund, Hilda, 1989-
(författare)
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Personalising service user engagement : entrepreneurs and membership organisations in the mental health sector
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- New modes of social mobilisation are emerging in the mental health sector. Member-based mental health service user organisations (MHSUOs), targeting people with lived experience of mental ill-health and occasionally their relatives, have been active in Sweden since the 1960s. Today, broader developments towards personalisation of politics are visible in the area, exemplified by the phenomenon ‘service user entrepreneurs’ (SUEs). These are individuals with lived experience of mental ill-health, channelling their engagement through businesses they have established and typically using social media to build networks around their causes.The overall aim of this thesis is to contribute to the understanding of service user engagement in the mental health sector, as it is expressed through collective and personalised forms of mobilisation. More specifically, I will examine the expressions of and the dynamic between member-based MHSUOs and network-based SUEs.The thesis consists of four sub-studies: Study I is an international narrative literature review that analyses the role of and challenges facing MHSUOs. Study II is a document study focused on mapping Swedish MHSUOs in relation to their activities and relationships. Through case study methodology, study III examines the communication of SUEs, specifically attending to how they establish authority. Based on interviews with SUEs and representatives of MHSUOs, study IV explores how these groups regard the role of experiential knowledge for their endeavours.In the thesis I discuss how professionalisation and hybridisation processes are seen in Swedish MHSUOs. These organisations engage in advocacy but also educational activities, and provide experiential knowledge as a service to external actors. MHSUOs typically have close collaborations with public authorities. Such collaborations have political potential, by giving service user groups the ability to contribute to policy development. However, there are also associated risks of tokenism and co-optation. Maintaining and investing in more autonomous spaces to meet and develop alternative perspectives, would be a strategy for MHSUOs to protect their independence. I further discuss how the emergence of SUEs is typical of broader trends in social mobilisation towards the use of social media and a focus on personal narratives. The phenomenon SUE distinctively illustrates a broader social surge for publicised accounts of vulnerability that can be capitalised on. The analysis identifies personal narratives, mobilisation of collectives and institutional perspectives as sources of authority drawn upon in the SUEs’ communication.Furthermore, the results show that SUEs and MHSUOs have witnessed increased demand for their experiential knowledge. Experiential knowledge can be articulated through personal narratives of individual experience, but also as a form of knowledge that originates in collectively deliberated experiences. These different articulations have distinct political potential. However, it is important to clarify what kind of experiential knowledge and representativeness that is required in different arenas.
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