Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Professor Anders Hjern, Karolinska Institutet, Sweden
- Second opponent: Professor Gunn Astrid Baugerud, Oslo Metropolitan University, Norway
- Third member and chair of the evaluation committee: Senior Researcher Anne Bukten, University of Oslo
Chair of the Defence
Professor Emeritus Reidar Tyssen, University of Oslo
Principal Supervisor
Professor Einar R. Heiervang, Innlandet Hospital Trust
Summary
Children in out-of-home care often have complex physical and mental health needs, many of which remain undetected upon entering care. This PhD thesis, conducted at the Unit for Child and Adolescent Psychiatry, evaluated a multi-disciplinary health assessment in Norway. examining needs, subsequent service use, and user experiences.
The assessment included 196 children aged 0-17 years. The thesis combines quantitative data on mental health and service needs, a 12-month follow-up survey of 103 children, and qualitative interviews with 9 adolescents and 12 foster carers.
Findings revealed extensive and multifaceted needs. Mental disorders were highly prevalent (50% of children 0-6 years; 70% of children 7-17 years). Overall, 92% were recommended support from services beyond child welfare, and 39% of younger and 71% of older children required help from three or more services. Yet, follow-up data showed substantial gaps in service provision. Only one third of children needing specialized somatic or mental health services had been in contact with these services one year later.
User experience indicated high trust in the assessment team. The children emphasized the importance of being seen and heard in a safe environment, while foster carers valued being involved and having the opportunity to provide and receive information. Both groups expressed concern that recommendations might not be followed – a concern largely confirmed by follow-up findings.
The discrepancy between identified needs and actual service provision highlights challenges in referral practices and interagency collaboration. Without systematic follow-up of recommendations, the potential benefits of health assessments may be lost. Strengthening referral routines and monitoring adherence to recommendations is essential to ensure that identifying needs translate into support. The findings are important for enhancing health assessment practices and informing service development for children in out-of-home care.
Additional information
Contact the research support staff.