There is extensive evidence on the social impact of many Finnish methods used in social and health services. On the other hand there is not so much evidence of the social impact of psychosocial services for children. Something should be done about this matter. To solve the problem, more resources are required to conduct an impact study, writes Marjo Kurki, a specialist researcher.
The premise of health and social care services is that there must be extensive evidence of their social impact. Otherwise, it is a waste of resources and money, and it makes no sense to organize services. There is extensive evidence on the social impact of many Finnish social and health care services. Healthcare relies on the national Current Care Guidelines based on research evidence for treatment and prevention of diseases.
The choice of psychosocial methods and psychological tests for children and families should also be based on the best possible evidence of the social impact of interventions and the reliability of the tests. What truly is the current de facto situation? Is there enough social impact?
International studies indicate low social impact
Psychosocial services use methods to promote mental health and wellbeing and to prevent problems. Psychological tests, on the other hand, refer to surveys or observations with prearranged ways to interpret measured results. Such is, for example, the GAD-7 form measuring common anxiety disorder.
In order to know if the psychosocial method is effective we need extensive research evidence of positive changes in children’s wellbeing. Similarly, the reliability of psychological tests should be based on extensive research evidence.
Very little is known about the social impact of many psychosocial methods and psychological tests in Finland. Sure, the aspiration is to do better, for example, by providing trainings for implementing effective methods. In addition, in October 2021, the Ministry of Social Affairs and Health opened a call for government grant applications in regards to the evaluation of psychosocial services for children and adolescents.
The funding provided by the Ministry is intended to support work on the development of welfare areas. Welfare areas should be able to provide effective services in particular. Whether there is sufficient knowledge and skill to do this is uncertain.
It is likely that welfare areas will end up adapting methods for which there is no strong evidence to be effective. However; one round of funding applications by the Ministry of Social Affairs and Health and the results it would bring, do not change the overall situation, that requires long-term work and understanding of research knowledge in decision-making processes.
Even a small amount of research indicates major problems with social impact. This became clear in the systematic review that we compiled. The review focuses on the social impact of psychosocial interventions and psychological tests used in all Nordic countries, including Finland, among children under 2 years of age as well as their families. The results of the review are thought-provoking.
Only three per cent of psychosocial interventions and just over ten per cent of psychological tests had strong evidence of social impact. In Finland, the Edinburgh Postnatal Depression Scale (EPDS) form used in maternity counselling, which is developed to identify maternal postnatal depression, is an example of a test with evidence of social impact.
In more than half of the psychosocial interventions, there were no evidence of social impact at all in the Nordic countries or internationally. So neither – strong or good evidence.
At least, three quarters of the psychological tests had good or excellent evidence of social impact. So the problem lies first and foremost in psychosocial interventions, not so much in the social impact of psychological tests.
Examination of social impact requires a lot of time
Strong research evidence means that the results of several high-quality methodical studies on social impact coincide. It is a question of cumulability, i.e. the cumulability of research data. Now cumulability is low in Finland in regards to psychosocial services for children. It is a matter of insufficient research resources.
Typically, social impact studies are based on analysis of causal relationship. A randomized comparison test is the most effective method for establishing the causal relationship between the given method and the effect. In the experiment, a group of subjects are randomly divided to receive one of several different therapies or methods.
It takes a lot of time to study causal relationships. Examination of social impact cannot be done without several years of follow-up data. This is precisely why impact studies require very specific resources and why funded research projects should be of sufficient length. This is not the case at the moment, at least with regard to the social impact study of psychosocial services.
As a result, psychosocial services for children and families are offered in Finland, with far too little known about their social impact. This is a waste of resources.