The National Audit Office's report on Sis's special youth homes

Martina Johansson (C)

Madam Speaker! Children and young people have the right to a secure upbringing. Children and young people have the right to support and care even if parental competence is lacking or if it is a behavior of their own that makes the child need support.

In the best of worlds, children and young people, if parental ability fails, receive help at an early stage at home in their own residence. In some cases, adult society fails, and in the worst cases, the child is placed outside the home. In those instances, Sis is one of the alternatives where children and young people with the greatest needs can receive care and support.

The government has received a lot of criticism in recent years, and the criticism is still being given.

Madam Speaker! The reasons why the criticism has persisted for many years are that for many years we have had a poor follow-up of the activities and the content of the care. The premises have been poorly maintained, and there has been a poor adaptation to societal changes. This is not new but has been ongoing for many years. Several governments have been responsible, and several Riksdags have not followed up on the activities in a sufficiently good way.

The report from the Swedish National Audit Office that is on the table today, a report from May 2024, shows further criticism regarding governance, mandate and content.

The government has responded by describing and reporting the measures that have been taken. Many of the measures are supported by the Center Party – they are good measures. But I still wonder if we get what we want. How do we follow up to ensure that there is quality for the individual child or young person? How do we know that a young person has changed their behavior after receiving care within Sis?

Madam Speaker! I feel that we are not quite getting answers to the questions. We are getting answers on certain parameters that are somewhat more of a fixed value. We are getting answers on how many deviations have occurred previously. The question then is whether the deviations have decreased because more doors have been locked or because the care and treatment methods have improved so that deviations are no longer interesting. I wish I knew that this is due to the improved care and attention, but I do not feel completely secure that it is so.

I miss a follow-up on the quality of care. I miss a collective effort in the Riksdag. Our children and young people are actually just as important as the work with defense or energy issues. We in Centerpartiet believe that we should carry out a collective parliamentary effort that follows up on the rights of children and young people.

Madam Speaker! Why is it so important? Yes, because the children are our future. We must ensure that our children receive the best care and support available. I am wondering why the government does not want to place greater emphasis on annual quality follow-ups. In the Center Party's follow-up motion, we put forward the request that the government should report the results of the measures to the Riksdag regarding the follow-up of the quality for the child. The response from the government parties in the committee is that some initiatives should not be taken. But no reasons are given. Why does the government not want to conduct a follow-up?

Today we had a visit from the Director General in the committee, and I asked how one goes about following up on whether the quality for the individual child has improved. I received the answer that interviews are conducted upon admission and discharge and that few respond - but those who do respond are satisfied.

But I still wonder how one follows up on whether the care and support for the individual actually becomes better. How do you measure the quality when children complain? How does the systematic work proceed to receive the complaints that come into the independent complaint management?

Madam Speaker! The Center Party's follow-up motion is about obtaining an annual follow-up of the quality, based on the individual child's or young person's reality. I move for approval of reservation 7.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Mona Olin (SD)

Madam Speaker! We are now debating the Swedish National Audit Office's report on Sis's special youth homes. I begin by moving to approve the committee's proposal in the report. The Sweden Democrats welcome the Swedish National Audit Office's review. We consider it an important contribution to the ongoing work being carried out with the aim of reforming state child and youth care.

They are responsible for the compulsory care of children and adolescents with psychosocial problems and substance abuse, but since the 1990s, they have also received young people who have been convicted of serious crimes. This creates a wide variation among those placed, which places great demands on the right personnel and competence.

That the Swedish National Audit Office's review shows that compulsory care at Sis's special youth homes often lacks effective care and treatment is no surprise. This problem has been repeatedly highlighted in reports and reviews for many years. Improvements are required both within and outside Sis. Compulsory detention is one of society's most intrusive measures, and without proper care and reintegration, the risk of recidivism in crime and substance abuse increases, which in turn leads to significant societal and individual costs.

Sis has a broad mandate and shall meet children and young people with varied needs. We also see that children and young people with increasingly heavy care needs and the group of young people with serious psychosocial and mental conditions are more frequently placed within Sis's activities today. It is testified that several of these young people should actually have been placed within child and adolescent psychiatry, but that the municipalities in their work do not get the young people into BUP and then, in the second instance, choose to place them at Sis. One of the recommendations given is that it needs to be clarified which target groups should be placed at Sis.

In the investigation "A review of the regulation of custodial sentences for young people," it is noted that crime has changed since the introduction of closed youth care. Fewer young people commit crimes, but those who do are more heavily involved in crime and commit more serious crimes. The use of firearms and explosives has increased, as has lethal violence linked to criminal networks.

If the sentence becomes longer as a result of this, support during the transition from institution to freedom becomes even more important to reduce the risk of recidivism. It is important that a custodial sentence for young people includes support in this transition. Society should also have the opportunity to monitor that the released person follows the set conditions and be able to intervene early in the event of negative developments.

If the correctional services take over the responsibility for convicted youths, Sis can focus more on care. Some of the places that are currently used for closed youth care could instead be utilized for care-based interventions. Such a change would create a clearer system where Sis is responsible for compulsory care while another authority handles the execution of sentences for youths convicted of serious crimes.

On 25 April, the Commission on a reform of the state child and youth care for a safe and high-quality care is to present its report. The Commission's mandate is to analyze whether the organization of the state child and youth care is purposeful and efficient, and to propose how the operations can be organized in a better way.

Furthermore, proposals shall be submitted on measures to strengthen the children's rights and legal certainty perspective, including interventions to prevent violence, and to ensure that coercive measures are only taken with legal support. The investigator shall also examine the need for more effective discharge and aftercare following placement within the state children and youth care and develop necessary legislative proposals.

The state child and youth care system faces several difficulties. But by following many of the proposals that these two investigations have presented and will hopefully present, we see a future where, through a clearer way of working, we ensure that the different problem areas existing among children and young people are met and treated in the right way, in the right place, and by the right staff. Then there will be opportunities and conditions to offer children and young people a safe and high-quality care.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Nils Seye Larsen (MP)

Madam Speaker! This is my first speech in the Committee on Social Affairs. I look forward to working here. I had thought that I could chill and take it a bit easy with coming here since I was so far down on the speaking list, but I am quite happy that I still came early.

Madam Speaker! I would like to begin by moving to approve the Miljöpartiets reservation 4 under point 4 on competence.

The Swedish National Audit Office's report on the National Board for Children and Young People, Sis, is an important audit that highlights serious deficiencies in the care and treatment of society's most vulnerable children and young people. It complements a long series of previous investigations and reports that have pointed out the same problems: that Sis is not functioning as it should.

The situation is deeply problematic. Deficiencies exist in area after area. A central factor that is highlighted is the staff's competence. It is absolutely crucial for the care and treatment provided. But according to the National Audit Office's report, there is even unsuitable staff at all the youth homes they visited. Far from all staff having undergone the mandatory training, even fewer have received further education in, for example, cognitive behavioral therapy or neuropsychiatric disabilities. The consequence is that the youth homes cannot offer the treatment and support that the children and young people actually need.

Madam Speaker! The care environment is another serious deficiency. Many of the visited youth homes are worn out and in poor condition.

Furthermore, the care is not sufficiently individualized to meet each individual's needs, which was one of the basic principles when Sis was formed.

This is unacceptable. The state has a special responsibility for the children and young people who are placed at Sis. When we as a society take children into care by force, we must be sure that we can provide them with the care they need.

Certainly, some efforts are being made to improve Sis. At today's meeting of the Social Affairs Committee, we received a good overview from the Director General regarding the improvement work they are carrying out. They have a tough situation to manage. We are beginning to see some positive results, but it is far from enough.

The National Audit Office proposes several measures to improve the quality of the operations. Even though the government has adopted some of these recommendations, it is not enough.

The lack of competent staff is a central part of the problem. Currently, training is offered within Sis, but not everyone takes part in it – not even those that are mandatory. A major competence boost is needed. The status of those who work with these young people must be raised. How can we attract staff with high competence? How do we create a healthy treatment culture in the Sis homes? We know that better-educated staff leads to fewer incidents and a safer care environment. Therefore, the initiatives that the government has taken so far are not enough. More is needed.

Madam Speaker! One proposal that should be highlighted is to introduce a new specialist education for social workers. Several experts have pointed out that today's social worker education is insufficient when it comes to meeting the challenges that exist. A specialist education at an advanced level with a focus on, for example, children, substance abuse, and youth would give social workers the tools they need to work at the Sis homes and in other important operations.

We must also review which children and young people are placed in Sis.

The National Audit Office recommends that the government review the target group. Many young people who are placed in Sis have great needs for psychiatric care or interventions according to LSS. But instead of receiving the right support, they end up in institutions that lack the competence and resources required. This must change. We must ensure that these children receive the care they actually need.

Madam Speaker! The group homes are often the final link in a long chain of interventions, placements, and care. Young people end up there after a long period of challenges and problems. It is also a symptom of the larger societal failures we have, when we cannot work to a sufficient extent, for example, with the preventive interventions and to reduce segregation and try to level the socioeconomic differences that exist.

One can, for example, see in one of the diagrams in the audit from Riksrevisionen how precisely those placed in Sis-homes differ very significantly from the rest of the population regarding factors that lie with the parents, such as the parents' income level and education level and a lot of other things.

When we fail our children and youth, it of course risks continuing in a devastating and destructive spiral. It must be broken, and it requires much more than just improving the situation at the Sis-homes. I think it is important to remember that.

We in Miljöpartiet have long emphasized the importance of preventive measures, the importance of the social services' work, and the importance of working together within school, health care, and elderly care. We have also highlighted civil society's role in helping children, so that they do not end up on the wrong track.

Miljöpartiet therefore considers that more must be invested in preventive measures. Early interventions can, as has been said, be decisive so that young people do not end up in crime or situations that lead to foster placements. Therefore, we propose 1 billion kronor for crime prevention work and 1 billion to the social services so that it can perform its work in the best possible way.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Johan Hultberg (M)

Madam Speaker! The Swedish Government Offices, the National Council for Children and Youth, the Swedish Work Environment Authority, the Health and Social Care Inspectorate, and the Swedish National Audit Office – all are actors that have audited the State Institution Board, Sis, and have directed serious and extensive criticism at the agency. The criticism and the alarms have also, for a long time, been heard from here, the rostrum of the Riksdag.

The Moderates and I personally have been among the sharpest critics of the authority, but above all of previous governments' inability and, unfortunately, also unwillingness to act based on the deficiencies and the criticism. A very heavy responsibility rests on previous red-green governments for the completely unacceptable deficiencies and pure conditions that have existed within Sis. Previous governments have shown direct omission. Previous governments have failed in their governance of Sis and have neglected the agency's crying need for better conditions to be able to shoulder its mandate in a good way.

Madam Speaker! Sis is also today, as the Swedish National Audit Office's report shows, an agency whose activities are plagued by serious deficiencies. An important difference from before is, however, that we now finally have a government that acts powerfully to increase the safety, security, and quality within Sis. Finally, we have a government that both urgently and in the long term addresses the many both serious problems and major challenges that Sis and the entire social child and youth care in general are plagued with.

The Moderates and the government, with Minister for Social Services Camilla Waltersson Grönvall at the helm, want to give the state child and youth care a real new start. Therefore, a special inquiry was appointed on February 1 last year with a mandate to review the state child and youth care's mission and organization.

Sis as of today will no longer exist. Tomorrow's state child and youth care shall have a strengthened care mandate with better opportunities to provide the affected youths with what they need: safe and high-quality care, school, and treatment. An important part of the reform work that has begun concerns moving the responsibility for youths convicted of serious crimes from Sis to Kriminalvården. Sis has therefore been tasked with preparing the phasing out of closed youth care. At the same time, Kriminalvården has been tasked with preparing the establishment of special youth departments for young people aged 15-17 who are convicted of serious crime.

Parallel to the long-term reform work, where the investigation on the future of state child and youth care is completely central, the government is working intensively here and now to address acute deficiencies and problems, to increase the number of places, to ensure safety and security at the youth homes, and to improve the quality of care. Specifically, the government has, among other things, increased the appropriations to Sis and strengthened the governance of the agency in various ways.

The instructions to Sis have been changed and tightened in several parts. Among other things, it has been clarified in a new objective statement that Sis shall be responsible for ensuring that the children and young people they care for receive good, purposeful, and legally secure care that provides better conditions for a socially functioning life without substance abuse, crime, and other socially destructive behavior.

The authority has also received several concrete government assignments. I particularly want to highlight the assignments that have been given for the purpose of improving care. Among these, the assignment regarding an investment in high-quality care for girls deserves a special mention, as does the assignment to strengthen the possibilities for children to submit complaints to someone to whom they are not in a position of dependency.

Madam Speaker! This previous debate on Sis focuses on shortcomings and problems. That is perfectly in order. At the same time, it is important to emphasize that Sis's mission is incredibly difficult and complex, and that much of the activity within Sis actually works well. I have been around and visited many of Sis's youth homes and LVM homes, i.e., homes where adults are subject to compulsory care for serious substance abuse. During my visits, I have met incredibly many skilled and committed employees who truly do their utmost so that Sis can live up to its vision of creating space for change.

In order for Sis and its employees to succeed in their mission, it is required that we politically create the right conditions. Therefore, during the mandate period, the government has presented several propositions with important legislative changes which we here in the Riksdag have since made decisions on, and which have given Sis better conditions to maintain security and safety.

We have also in this chamber made decisions to provide Sis with better economic conditions. Last year, Sis received increased appropriations to improve the quality of care and safety at the special youth homes. Also this year and next year, the appropriations are being strengthened to enhance the quality of care. More concretely, it is about investments in competence and differentiated care. The youths cared for within Sis have very different challenges and needs. It therefore requires increased differentiation, which, it must be said, is challenging when the placements at Sis increase. The number of young people sentenced to closed youth care has increased significantly.

Madam Speaker! The shortage of places is also something that the government is working hard to solve. The appropriations to Sis have been increased to enable more places. The government has also appointed a coordinator who shall submit proposals on how more places in foster homes, HVB, sheltered housing, and special youth homes can be created.

But the solution to the shortage of places within Sis is not just to increase the number of places within the agency. Even more important is to work preventatively to reduce the need for placements within state youth care in the long term.

The new Social Services Act, for which the government has just submitted a bill, is a historically important reform to strengthen the social services' early and preventive work.

In the best of worlds, no child and no youth would need to be placed within Sis. Until then, the work must continue to address deficiencies and to improve the quality of care at Sis's special youth homes.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Madam Speaker! I can agree with much of what Member Johan Hultberg said. But there are things and matters where I feel that I am absolutely not quite on the same page.

The point is that the influx of children and young people is still increasing when it comes to recruitment. In that case, one might consider other measures than Sis.

A school and a preschool that hold together are needed. Functional child and adolescent psychiatry is needed. It is not functional now. So much more is needed that we cannot give to those families today due to a lack of resources. If one were to start very early, the influx to Sis would not have been as large as it has been.

Psychiatry is an issue that is truly under the ice. It has been so in itself for a long time and not just now. Completely different muscles were needed to pull it up.

The same applies to the school. Incredible efforts are needed. We understood that today after the presentation we received from the State Institution Board. It turns out that 95 percent of the children enrolled at Sis do not have a level that is okay. In normal cases, it is 5 percent. It is a crazy difference.

Then one wonders: Don't very reinforced resources in schools need to be provided in a completely different way to early detect the children who suffer very badly?

Just as the member said, there is also a need for another type of trained staff with proper education, proper method training, and so on. That is not how it looks today.

Does the Speaker see that it will be resolved during the next ten years?

The speech at riksdagen.se, in Swedish (opens in a new tab)

Johan Hultberg (M)

Madam Speaker! First and foremost, it can be stated that the enormous recruitment of young people into criminal gangs is a massive failure for society.

This applies in particular to previous governments that have failed to ensure that good preventive work is in place. They bear the responsibility for an integration policy that has been largely unsuccessful and for the fact that we have left far too many children without complete grades in school.

Now we have a government that is step by step trying to repair the serious holes and rectify the deficiencies and gaps in the Swedish welfare society. It is trying to establish a completely new Social Services Act that gives the social services the opportunity to step in and work preventatively at an early stage.

We will ensure that school policy is restructured so that we catch children and young people who do not learn sufficiently at an early stage. Everyone should, for example, be given access to holiday school and other such measures.

I really agree with Member Rågsjö that it is incredibly important that we strengthen psychiatry and make it more accessible. We must also ensure that we relieve the pressure on child and adolescent psychiatry. It is intended to be a specialist function but is to an all too great extent handling all forms of mental ill-health when it comes to children and young people.

That is why it is important that we, for example, strengthen student health. It is something that the government is working hard on right now. There is, for example, a specific student health guarantee in the Tidö Agreement.

I share the view that if we are to reduce the need for placements within Sis in the long term, it is required that we have a strong work line, that more children get to see their parents go to work, that we have a better functioning psychiatry and a better functioning school. It is required that we have a social service that can act early before the small problems have become large.

The government that I support unreservedly works every day. We will continue to do so until we have a completely different situation in Sweden.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Madam Speaker! It is noticeable that it is election season soon, I say somewhat cynically.

We have an unemployment rate of 10 percent. Which parents will not be affected by it? We have a school system that really does not work and will not work during this parliamentary term either. Completely different resources are required.

There is so much that is not working. There is also child poverty, and the number of evictions of children is increasing at an alarming rate. They are increasing enormously. These are also issues that must be addressed.

It is very good that we are getting a new Social Services Act. I believe everyone in this chamber agrees. But then it is also a matter of filling it in properly so that it becomes preventive work and that it becomes methodical.

Preventive work can be anything. It can be that you and I give lectures in school. Then we call it preventive work in our association or our company that we have formed.

There is evidence for preventive work. I want to see that there is real preventive work. There must be people out in the local community, such as field assistants and so on, as there were a very long time ago. It sounds like it was in ancient times. It requires resources for that.

It may be that one has to provide more resources to welfare than to tax cuts, what do I know, in order to reduce the number of children in Sis. It is a matter of ensuring that children in Sweden get what children in Sweden need in order to, for example, be able to leave school with grades. It is something that is absolutely basic in order not to end up on the wrong track.

We will speak more about this. But when it comes to Sis and the children who are there, I hope that they can get a better everyday life and that the care they receive there becomes real.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Johan Hultberg (M)

Madam Speaker! It is clear that the development within Sis is heading in the right direction. We had a briefing from the Director General in the committee today, and very much is heading in the right direction.

It does not mean that everything is good, really not. There is a great deal of work left to do to increase the quality, safety, and security at Sis.

As I mentioned in my speech, we Moderates believe that the entire state child and youth care needs a real fresh start. What exists today should not remain. We are to have something new and better. That is why the investigation that is currently underway and which will be presented later this year is so important.

When it comes to the new Social Services Act, I still want to emphasize something. Member Rågsjö said that preventive work can be anything. What is so important and good about the new Social Services Act is that we set requirements that one must actually work based on evidence and proven experience.

It is something that has not been clear in the current Social Services Act. Now, it will not be the case that the preventive work can be anything. There will be requirements that it must be based on evidence and proven experience. That is good and important. That is how we build a strong, well-functioning social service that can deliver results.

We are also filling the social services' toolbox with more and better tools. We will ensure that the new Social Services Act is linked to 10 billion so that we can carry out an initiative on strengthened staffing and competence, but also to be able to develop the crime prevention work in the years ahead.

We are also giving the social services new and other tools. The so-called intermediate coercion investigation is very important for us to close the large gap that exists within the social services between interventions that are based entirely on voluntariness and interventions with very far-reaching powers and restrictions. This applies, for example, when we place children in Sis or in another youth home.

In that gap, other tools are required. We are now giving those to the social services. We are also giving parents better conditions to receive help. One proposal in the investigation is that one should be able to have parental leave in order to be able to receive help and support. We are working on both supporting parents and supporting the social services.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Lina Nordquist (L)

Madam Speaker! Parents have a great responsibility, and they shall have a great responsibility. But if they do not suffice or manage, or if a young person has such great problems that compulsory care is necessary, society must step in. This happens first with support and help and, in the worst case, by the administrative court deciding that society shall take over the responsibility for the child.

These special youth homes differ from other HVB homes in that they have special powers regarding coercive measures. The form of care was originally created with a focus primarily on older teenagers with substance abuse, addiction, and criminality, but over the years it has also been used for significantly younger persons. It concerns 12- and 13-year-olds, and at times children as young as 8 who harm others or themselves so seriously that they sometimes risk not even surviving.

This makes it incredibly important that the care is correct and that we take care of society's most vulnerable children in a wise and caring way and with knowledge. A year ago, the government decided on a reform of the state child and youth care. Something new and better is needed. The investigation is ongoing now; the reform has been launched. This is very important.

One might think that it should have happened a long time ago, and I think that too. But now it is finally on its way. Now the youth care's care mandate is to be strengthened. Every young person shall have safe and high-quality care and school. They shall receive the treatment they need. The mandate will be reported later this spring.

Madam Speaker! Furthermore, a special investigator has been tasked with proposing measures to strengthen the child's perspective in care according to LVU. The investigator has also been tasked with identifying ways to increase expertise in cases of care according to LVU. Everyone knows that our investigations were needed. The major reforms were needed.

But children are cared for at Sis here and now, and while waiting for the reform that these young people truly need, the government has decided on several changes to the instructions for the State Institutional Board. This includes, among other things, a new clarity, Madam Speaker, regarding the fact that the authority shall ensure that the children and young people in care receive good, purposeful, and legally secure care so that they have a chance to have a functioning life - without suffering, without harming others, and without harming themselves.

Furthermore, the government has secured methodological support to ensure a legally secure application of Sis's special powers. Every child placed at Sis shall be able to submit complaints to someone to whom they are not in a position of dependency. You hear it - this should have been obvious a long time ago!

Young girls have historically been most affected by Sis, and the government has made specific investments in the care of girls.

It is sad that this has not been in place earlier. But now it is happening. The children shall be safe and secure. This applies to both the children who are currently in the state youth homes and the children who will need the support of the state and society in the future.

Placed children and young people shall have access to good health care and dental care and an uninterrupted schooling. Their school results shall be monitored. We know that a completed schooling is a vaccine against the vast majority of suffering later in life.

Madam Speaker! It is simply a matter of every child having a bright future - both those who are cared for today and those who will need support in the future.

I vote in favor of the committee's proposal, and I am very pleased with the work that is now being carried out.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Karin Rågsjö (V)

Madam Speaker! The National Board of Institutions has to take care of what society has failed at. Today we have heard that 95 percent of the children and young people who are at the National Board of Institutions have deficient schooling, compared to 5 percent of the rest of the population. We know how much school matters. Presumably, it has been this way for a very long time, and one can wonder why so little has happened.

Society waits far too long to catch these children. They don't just appear as 15-year-olds; they have been in preschool, school, and child psychiatry. The parents needed support, and so on. We can all state that society has waited too long and continues to wait too long. If you dismantle the welfare state, you eventually stop seeing the children. The preventive work is set aside in a welfare state that becomes more anorexic.

The Riksrevisionen's overall conclusion is that Sis does not reach the goals of the operations at the special youth homes and that children and young people placed in the special youth homes do not receive effective care and treatment. It is very bad, especially when one also considers that these children cost money. Now I sound like the worst right-wing ghost, but it costs quite a lot to have children and young people placed in Sis homes. Therefore, one can expect that they should also receive something.

But it is not only the State's Institutional Board that should be blamed, but we must also blame the municipalities that – excuse the sloppy expression – dump children and then have no plan for what should be done thereafter. This is completely devastating, and it has been going on for quite a long time. I have seen it from close quarters.

The National Audit Office considers that Sis's mandate is unclearly formulated both in instructions and in legislation. A lot is underway now, and that is very good. It is also about which target groups Sis should receive. When we listened to the Director General for Sis today, we heard about girls who are mentally very unwell. It is obvious that these girls, who have an extreme self-harming behavior, should be closer to psychiatry and not end up at the State Institutional Board.

The National Audit Office has noted in its review that there are no guidelines or equivalent where it clearly states when a child or a youth should be cared for in a special youth home, receive psychiatric compulsory care, and so on.

We believe that the government should review the issue of skills upgrading. We think, just like the Green Party, that it is important. Much is being done, but more must be done. The National Audit Office suggests that Sis should ensure that the staff receive the right competence to provide care and treatment in an efficient way based on the needs of children and young people. This will, of course, also cost from a budgetary perspective.

We believe, however, that the government should take further initiatives for a substantial competence boost in the area. A competence increase is completely necessary regardless of how the operations will look in the future and how we will organize the State's institutional board and housing for children of this type.

I therefore move for approval of reservation 4.

The speech at riksdagen.se, in Swedish (opens in a new tab)

Gustaf Lantz (S)

Madam Speaker! A good way to measure how well a society functions is to look at how it treats its most vulnerable individuals. That is why it is sad to read the Swedish National Audit Office's sharp criticism that Sis is not reaching the goals of the operations at the special youth homes. The Swedish National Audit Office states bluntly that children and young people placed in special youth homes do not receive effective care and treatment.

It takes a great deal before society does something as intrusive as taking a child into care. It takes even more before society locks up a child. Before that happens, much has failed. The care and support that should be around a child has not been there. Not infrequently, the children come from families or environments with sexual abuse, violence, or substance abuse.

It is an extremely vulnerable situation to be placed at home in a locked environment. When this occurs, a heavy responsibility rests on society to provide children and young people with a care and treatment that can make the future brighter for the child.

Madam Speaker! There must be a clear mandate for such an important task. There is not, according to the National Audit Office. There is an ambiguity in the instructions to the agency, but also in the law.

Questions that, according to the Swedish National Audit Office, remain hanging in the air are which target groups Sis shall receive and what care and treatment shall be offered. There are therefore uncertainties regarding who shall live in a Sis home and what shall happen to them there. The core of the operation is, after all, that one has a mandate. The current situation is unacceptable.

The Swedish National Audit Office notes that there are no guidelines or equivalent where it clearly states when a child or a young person should be cared for at a special youth home, receive psychiatric compulsory care, or receive interventions according to LSS in situations where all these interventions could be relevant.

Many girls and boys with very severe self-harm behaviors are today locked up in Sis-homes. Some of them take every opportunity to try to take their own lives. These children and young people should receive care within psychiatry. They need very intensive care with high staffing levels rather than a locked environment. Children should not just survive but also live.

If the government nevertheless judges that this group shall remain at Sis-hem, the specialized healthcare must be arranged within Sis in a completely different way than today. This is also stated by the Swedish National Audit Office in its review.

Madam Speaker! The Government has appointed inquiries concerning Swedish youth care, and they will soon report on their assignments.

I really hope that the criticism directed by the Swedish National Audit Office is addressed in the proposals that are pending. Not least the lack of expertise in cases and goals regarding care according to LVU is an issue that risks hitting individual children hard. It is therefore important that a regulation is introduced that ensures this competence as soon as possible.

I and my party will follow the government's work very closely and return with proposals if there are grounds for it.

(Applause)

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Christian Carlsson (KD)

Madam Speaker! The Swedish National Audit Office considers that Sis's mandate is unclearly formulated regarding both which target groups Sis should receive and what care and treatment Sis should offer. Let me first say that this is relevant criticism.

To Sis's special youth homes, children with very complex problems come today. It concerns young girls with mental illness and serious self-harming behavior, young drug users and persons heavily burdened by crime.

For many of the children, it is absolutely crucial that they are handled in the right way so that they do not pose a danger to themselves or others. It is therefore problematic that Sis has not been equipped to handle its many different target groups. One has been particularly ill-equipped given the dramatic increase in children who are clearly criminally involved or serving their sentences at Sis. When it comes to the latter, it is a fourfold increase over two years.

Reports have also been made about completely different types of irregularities at Sis homes. Young girls have been subjected to violence and sexual abuse by both staff and other residents. Not least, it concerns that children and young people within Sis who have mental health issues have also not been given access to the support, care, or treatment they need and are entitled to, largely because the cooperation between Sis, the regions, and child and adolescent psychiatry has functioned all too poorly.

An important work of change has now begun within Sis, and it seems to be yielding good results. For example, we see that the number of deviations from residences has decreased by 50 percent over the last five years. But the poor conditions at Sis homes have been serious for a long time, and we must be able to ensure the safety of the thousands of children and young people who are within the state's child and youth care.

It was against this background that we, at the government's press conference in February last year, announced that an investigation would be appointed to create the conditions for a fundamental reform of state youth care. The investigator shall particularly consider whether there is a need for further differentiation and how the care and the caring mandate can be strengthened.

Madam Speaker! My assessment is that the government's historical and far-reaching work in this area, in combination with already ongoing investigation work and announced investigation work, for example a central intake and placement function for the special youth homes, meets the Swedish National Audit Office's criticism in a very good way.

Against this background, I move for approval of the committee's proposal.

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Martina Johansson (C)

Madam Speaker! Thank you, Christian Carlsson, for the speech!

As I said in my speech, the Center Party agrees with the government regarding many of the measures it has taken to improve the situation within Sis, for we all know that the operations there need to be improved.

What I and the Center Party lack, however, is how we are to know that it will actually get better. We all have the same ambition: that the care of and the attention to our most vulnerable people shall become better, but how do we know that it will be so?

The starting point for the Center Party's follow-up motion regarding the report was that we wanted the government to return on the fact that the quality for the individual shall be followed up annually. Even though I stand behind the measures that have been taken, I do not know if they actually provide what we are looking for.

In the response regarding the follow-up motion, it states that the committee is not prepared to take any initiative on the issue, but it says nothing about why. Why, Member Christian Carlsson, does the government not want to conduct a quality follow-up based on the measures that have been taken and which we see actually making a difference for the individual child?

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Christian Carlsson (KD)

Madam Speaker! Let me first note the positive aspect that we are, despite everything, a united committee. We value these issues highly and truly want to work and strive to improve the situation for the children and young people at the special youth homes.

It is a work that has been carried out for a long time, and it is pleasing with the positive change we see within Sis today and with all the initiatives that concern developing a new type of youth care moving forward.

Of course, one needs to follow up on reforms and what results different types of authorities and operations can deliver. There, I would say, is a major deficiency within the social sector as a whole.

We have a new Social Services Act in the works where we are talking precisely about the importance of it being evidence-based and that it can be followed up. We are in the process of developing a social services data register so that cases can be followed and the effect evaluated. It is an under-researched area, so there is much to be done there.

I have no other opinion than that the government will need to follow up on the outcomes and effects of even Sis's work, but we see no need for any announcement from the Riksdag. We feel completely secure that the government intends to follow up on its reforms and Sis's work.

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Martina Johansson (C)

Madam Speaker! I can confirm the good work forward that we are all doing. During the previous parliamentary term, we Christian Democrats and Center Party members worked together on the then government regarding this work.

I have also always spoken a lot about evidence-based and how we follow up and so on, so there we agree. But again: We take different measures, but we do not evaluate what effect they actually have for the individual child before we take more. The risk exists that with good intentions we create different measures that in the end do not give us what we actually want.

I think it is a deficiency that we did not receive an answer to a question to the Director General on how the quality around the individual child is followed up, other than that it is based on an admission interview and a discharge interview. So much happens in between. I truly hope that other quality work and other follow-up takes place than what we were presented with.

We can measure the number of escapes, i.e., how many choose to escape from our institutions. It has decreased. When it comes to persons who are convicted and serving sentences at Sis, there have been no escapes at all in recent years. That is very good, but – as I said in my speech – is it because the doors are locked in a better way or because the care and support have become better? I think there is quite a big difference. I want to feel secure that it is because the care and support have become so much better that fewer people want to escape.

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Christian Carlsson (KD)

Madam Speaker! I see no reason to extend the debate but will note that the government must, of course, follow Sis's quality work and how their change process proceeds. Sis needs to have a quality work that also involves follow-up of the results of the placements and the treatments and interventions that are implemented. That is what we agree on. Let us ensure that it happens! We shall continue to work in that direction.

For me, it is obvious that follow-up work must be carried out, but I do not see that we need to make a motion regarding it today. That is the difference. But we agree that follow-up shall be done, because these vulnerable children deserve it. They need security and also have a right to care and treatment that can improve their lives. That is what we work for together moving forward.

The deliberation was hereby concluded.

(A decision was to be taken on 19 February.)

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