Response to interpellation 2023/24:280 on school and mental health
Translated from Swedish by AI; the translation may contain errors. The Swedish text is the original.
Summary AI, written in advance
L argues that children's mental health is deeply concerning and that the government is implementing initiatives for special education teachers and school social teams. L emphasizes that school health should be strengthened through a broad reform and a school health guarantee. L admits that curricula can cause stress and that the content on health can be too theoretical 1. L argues that curricula should function better based on children's brain development 2 and that mental health is already present in today's curricula 2. S considers that mental health should be present in the curricula from preschool to upper secondary school 3. S wants to investigate why children are feeling worse than in other countries 4 and wants to include gender norms in school 5. S wants the school to be warmer and more inclusive with gender pedagogy 6. S criticizes the government's fiscal policy as they argue that neither child and adolescent psychiatry nor school health are receiving increased resources 7. S considers that growing mental illness is an issue that a school minister must act upon.
Written by AI in advance and may contain errors. The numbers lead to the speech a statement builds on; check against the text below.
Statsrådet Lotta Edholm (L)
Mr. Speaker! Linus Sköld has asked me how I intend to act so that schools can better prevent mental ill-health among young people. He has also asked if I intend to take any initiatives to investigate whether teaching on mental ill-health should be introduced and, if so, with what content and in what structure.
I want to begin by emphasizing that the development of children's and young people's mental health is deeply concerning and something we need to take very seriously. Students are less content in school and are more stressed, and the relationship with teachers and classmates is deteriorating. Self-reported health problems, for example anxiety, headaches, and sleep difficulties, are increasing at the same time. Bullying is also increasing, and its consequences for the well-being of children and young people are naturally devastating. We know that good health is a prerequisite for succeeding in school and establishing oneself in the labor market and in social life.
Too many students do not get access to effective support measures in a timely manner. This applies, among others, to students with neuropsychiatric functional impairments, NPF. Schools need to be given better conditions to be able to meet the students' needs for support measures, and the support must be implemented earlier than it is today. The Government is therefore carrying out major investments to give schools better opportunities to employ more special education teachers and be able to establish more special education groups. To address the shortage of special education teachers, we are also ensuring that more people can train to become special education teachers.
We also know that ADHD can be a risk factor for long-term school absence if students do not receive the right support. Therefore, the government is improving the headmasters' opportunities to strengthen cooperation between school and social services and increase attendance for students through the investment in school social teams.
Measures to promote health and prevent ill health among children and young people are a good and important investment. School health services can, among other things, play an important role when it comes to conveying knowledge about good health and good lifestyle habits.
From the Tidö Agreement, it appears that a broad reform shall be made to improve student health and that the healthcare mandate of student health should be reinstated. A student health guarantee is introduced with the goal of increasing accessibility to student health. All school principals shall have cooperation agreements with healthcare and cooperation routines with social services to strengthen student health work. A review is made of the responsibility for student health. An important part of this is, naturally, to review how the school's work with mental health can be strengthened.
The government has thus implemented important measures to strengthen the schools' support and student health work, and this work will, of course, continue.
Linus Sköld (S)
Mr. Speaker! The increasing mental ill-health must be taken very seriously, says Lotta Edholm. Nothing could be more true. Every fourth child in Sweden has recurring mental health problems. Every other 15-year-old experiences mental health problems. Suicide is the most common cause of death among young people aged 15 to 24. The prescription of antidepressants to children and young people is increasing.
This has consequences for the economy and people's entire lives. Psychiatric conditions account for half of the sick leaves in Sweden. Every second person involved in organized crime has had contact with psychiatry. There are therefore good reasons to believe that mental ill-health should be prevented.
The Public Health Agency clearly stated in a report a few years ago that it is likely that deficiencies in the school's functioning have contributed to the increased mental ill-health among children and young people. This is the background to why I have submitted this interpellation to the Minister. The interpellation contains, as is known, two questions.
The first, regarding how the minister should act so that schools can better prevent mental ill-health, the minister has answered. She mentions, among other things, more resources for special education teachers and special teaching groups.
When it comes to the increased resources that are claimed here to be coming to the schools, I would like to object that the municipal sector forecasts a deficit of 7 billion next year; over 40 percent of the municipalities are expected to run a deficit next year as a direct consequence of this government's fiscal policy.
The Minister then says that cooperation must work better between different instances. For all parts, but cooperation in itself will not solve this problem.
Then comes a point from the Tidö Agreement, where the minister specifically says that they want to review the principalship. It seems to be an unusually bad idea. It is connected to what is stated in the Tidö Agreement but was not included in the minister's response, namely an increased care focus for school health. In that case, we are not talking about preventing mental ill-health, but about making remedial interventions. A care focus, as is known, does not mean promoting mental health, which is what would be needed.
No, the one who wants to promote mental health could look at my second question in this interpellation. It concerns education in mental health. There are, in fact, a large number of organizations, including the minister's own agency, which advocate that young people should receive education in mental health. It promotes mental health to know how one's own and others' emotions work and what one can do if one feels unwell. Very many stand behind that idea, such as the World Health Organization, the European Union, and the Public Health Agency.
The Minister does not answer that question at all, but bypasses it entirely. I can only interpret this as that she does not intend to take any initiative to investigate whether education on mental health should be introduced. This follows an unfortunate pattern.
There is an ongoing campaign for the introduction of mental health on the schedule – a campaign that has gathered 19,000 signatures when we have this debate. So far, they have not been allowed to be handed over to the minister, but one has been referred to sending them by mail.
From my side, the question is: Is education in mental health something that the minister has already dismissed, or why is she avoiding that subject?
Fredrik Lundh Sammeli (S)
Mr. Speaker! Since 2006, the proportion of children and young people who have been diagnosed with depression or anxiety disorders has tripled in our country. Particularly noteworthy are the figures that prescriptions of antidepressants to children are three times more common in Sweden than in our Nordic neighboring countries.
This must be one of politics' most important issues. How do we break this development, and how do people get help early? When one sees the pattern regarding who is affected, it is also very clearly an issue of equality and equity that politics needs to focus on.
Regarding children's and young people's mental health, the most important measures are early detection as well as early intervention together with a well-functioning cooperation between actors and levels of care. There are deficiencies today in the form of too low a degree of detection, too long waiting times, and additionally deficiencies regarding the structured cooperation and follow-up.
Collaboration between the school, student health services, social services, and health and medical care must be developed, and the queues to child and adolescent psychiatry must be reduced. However, it is not just a matter of working from what we already know, where much is about resources and leadership, but this is an area where the need for knowledge needs to increase. Today, a consolidated and reliable knowledge base is lacking regarding the underlying causes and factors of mental ill-health, particularly among young people, and why it is increasing.
We Social Democrats have submitted a proposal to the Riksdag stating that we want to see an investigation into why children and young people are increasingly affected. Within the framework of such an investigation, many different conceivable causal relationships need to be analyzed, for example in relation to developments in other countries and to changes in the Swedish school system.
In addition to the interpellant's very clear question regarding the preventive work, my question in this debate is whether the Minister is prepared to take the initiative for an inquiry that contributes to increased knowledge on why children and young people in Sweden are far worse off than in other comparable countries.
Sofia Amloh (S)
Mr. Speaker! I want to start by thanking you that this debate is taking place in the chamber today, because there are many who are affected by mental ill-health or mental health. Above all, it is important that this debate is about children in school.
In addition to the children, who are directly affected when they do not feel well and have a life they do not enjoy and which makes them feel directly unwell during the day, I want to highlight those who are around the children, not least parents and siblings. To feel as inadequate as one does when a child is unwell and one has difficulty reaching them is unbearable.
Today we have a society with incredibly high demands on everyone. There are demands that we should perform, there are demands that we should be incredibly successful, and there are demands for strong ideals, in many places in this society. It is about how we should look and how we should be to be right - an ideal that is very narrow and that few people fit into. When one does not live up to this ideal - when one is not right - one also becomes wrong indirectly. This causes people, especially children who do not have the tools to handle this, to feel very bad.
This debate, Mr. Speaker, is about children being given the opportunity to learn to understand themselves and being given tools to manage their mental health. It is just like when we learn which diet is correct, which also plays a major role, or how important it is to move and that the school creates the conditions for this. Perhaps it should be done to a greater extent than today.
But even when it comes to mental health, it is incredibly important to get tools to understand one's own feelings – what should I do in this situation, why do I feel this way, and why do I feel this way?
Many times, the demands and feelings can manifest differently depending on whether it is girls or boys. We see that both girls and boys suffer very much, but that this can manifest in different ways. In that case, we need to meet girls and boys with awareness and great knowledge of which gender norms govern society, what it is like to be a boy and what ideals apply to that, and what ideals apply to girls.
In order to be able to meet the children in this, it is incredibly important that we have such knowledge and awareness of what the gender norms are, how they look and how they manifest themselves, but also that we continue to have perhaps an even more developed gender pedagogy, especially when it comes to this.
Girls and boys need to have the same right and opportunity to find these tools. How do you get through a sleepless night? What do you do when motivation fails? Then one needs to find relationships with each other and relate to social media.
I do not see that gender norms or gender or how it manifests in different ways for girls and boys are present in the Minister's response. My question to the Minister is: In what way is this supposed to matter in school when it comes to putting words to and managing mental ill-health in school?
Statsrådet Lotta Edholm (L)
Mr. Speaker! A number of different questions have been posed here.
To begin with, I think Fredrik Lundh Sammelis's questions are very interesting. This is not just a question for the school world, but it is about the whole and what kind of world we live in. We see that the question of mental ill-health among children and young people is not just a question that exists here in Sweden, but it exists in many countries, especially Western European ones.
Many governments, organizations and so on are struggling with this now and trying to find different types of answers, but my role in this as Minister of Education is, of course, the school and what it can do.
First and foremost, the school itself can be both health-promoting and health-detrimental, if one may use that term. One issue that has been raised many times, and where the government will now appoint an inquiry, concerns, for example, how the curricula are designed in Swedish schools. Many point out that they are not always designed according to how children's and young people's brains develop. Many children and young people experience stress caused by the fact that they simply cannot manage to meet the goals set in our curricula and educational plans. We must, of course, do something about this.
There are also problems with the fact that Swedish school is designed in such a way that it is often rowdy there, which is also not good for mental health. Some of the mental ill-health that exists has its root in that Swedish school is not always designed in the very best way.
When it comes to the question of what one should, so to speak, learn and what should be on the curriculum, it already includes subjects such as sports and health today, but obviously it is not enough. Perhaps it is too vaguely designed what one should do.
I personally believe that it may be the case that part of the design is not sufficiently instrumental, that is to say that it perhaps does not to a sufficient extent provide tools for students on how they should manage their mental ill-health, but rather occurs more on a theoretical level. This is something I am thinking about a lot now. I do not dare to say exactly how it should develop, but I am completely convinced that it must happen in one way or another in the future.
Then it is naturally also about better student health, and that is why I raise the question of cooperation. I am glad that Fredrik Lundh Sammeli thinks it is an important question, because it really is. If the school can cooperate to a greater extent with healthcare, for example, but also with social services, the opportunities to improve for the students increase.
Collaboration is really nothing that we should just push aside, but it is an important and major issue, just like that school health is developed in a good way because it has developed in a direction where it does not really function as a support for the students who need it the most.
Linus Sköld (S)
Mr. Speaker! Thank you, Lotta Edholm, for the answer! I have noted that just before this debate, a press release was sent from the Ministry of Education stating that tomorrow they will present investigation directives for a curriculum review.
This is gallant, but if Lotta Edholm is serious about what she just said – that she is thinking a lot about how education in mental health should look moving forward – it is in this curriculum review that it needs to be included. This is, so to speak, the window that Lotta Edholm has during this parliamentary term.
We have just now made a rather large revision of the curricula. They cannot be revised every year, so if it is to be done, it needs to be included in the investigation directive that Lotta Edholm will present tomorrow. Can she provide such a statement here today? Will the design of education in mental health be included as a task for the investigation that she appoints tomorrow? That would be appreciated.
I know that those who stand behind the campaign I mentioned, Mental Health on the Agenda, and who are otherwise following us both from the gallery and digitally today, would be very interested in such an announcement. Over 30 civil society organizations and, as mentioned, so far over 19,000 names as signatures stand behind giving such an investigation mandate.
As I mentioned earlier, the European Union also recommends in a council recommendation that member states include mental health on the agenda.
Social and emotional training, prevention of bullying, as well as mental and physical health should be included in the curricula, from preschool activities and childcare to upper secondary school, according to a council recommendation adopted by the Council of Ministers on November 28 last year. Lotta Edholm herself was included in this Council of Ministers. This means that Lotta Edholm has been involved in adopting a recommendation to the member states, and to herself, to ensure that these parts are included in the teaching.
This makes the question even more interesting. Will this be included in the curriculum investigation that Lotta Edholm presents tomorrow?
Fredrik Lundh Sammeli (S)
Mr. Speaker! Just as the Minister said, this is a reality that exists in several places on our globe. There is a growing problem in the Western world. But we stand out in a bad way.
School is so central in the lives and everyday lives of children and young people. Therefore, growing mental ill-health among children and young people is a natural issue for a school minister to act upon.
My question therefore remains: Will the Minister take the initiative for the government to appoint a comprehensive investigation where the school is part of the analysis that is conducted? And will the Minister work to introduce mental health into the curriculum? These two measures - mental health in the curriculum and a comprehensive investigation focusing on increased mental health among children and young people in our country - are two incredibly important components in the work that we must manage to accomplish.
Sofia Amloh (S)
Mr. Speaker! I want to mention what I said in my first speech, namely that we have an incredibly hard and tough society. It is a society where high demands are placed, where we are expected to perform, succeed, and live up to ideals. Here, there are very many who need to help each other so that we can have a society that is warmer and more inclusive, and where we see each other more as fellow human beings regardless of whether we are different. If someone chooses to be in one way and if someone else chooses to be in another way, we still need to see each other.
This needs to be in the school. If we cannot start with our children, it will be very difficult to see how we can change this in the rest of society. There must be an adult world that can meet this.
Other issues on the government's agenda concern the fact that we have a large number of violent crimes that are largely directed at women. I know that the Minister for Equality is working on this.
Here one can see exactly what efforts need to be made for children and young people so that they find the right path regarding the relationships they have with one another.
My question therefore remains. The entire society needs to work with precisely those gender norms that we are forced into. How will the Minister ensure that these issues are included in the work even in schools, and above all when it comes to gender pedagogy and other pedagogy where we need to talk about these issues? Will this be on the agenda? When it comes to precisely gender pedagogy, it is something that the Sverigedemokraterna actually do not want to keep. They do not want to talk about gender norms. It is therefore time for the Minister to answer the question: Will it be included, and will it be developed?
Statsrådet Lotta Edholm (L)
Mr. Speaker! The Government is taking measures in a number of different areas. I have mentioned that we will, for example, review course plans and curricula to ensure that they function better based on how children's and young people's brains develop. There are today major problems regarding stress related to the fact that some children and young people actually cannot achieve the goals for the teaching. It is simply impossible because the goals are set up in such a way that they are rather aimed at adult brains than at young people's brains. We must rectify this.
We have just appointed an inquiry into safety and study environment. It is clear that when there is peace and quiet in the classrooms, it benefits all students. But it benefits above all those students who have a difficult time in the classroom. It is incredibly important that this inquiry presents proposals on how one can promote safety and study environment.
We will also soon appoint an inquiry into how student health services are functioning. Many testify that student health services today function worse, especially for those students who really need them.
We are now investing large sums of money to reduce the queues to child and adolescent psychiatry. But we are also adding resources so that the school can cooperate in a more effective way with, for example, social services.
When it comes to the investigation directives for the investigation that I will present tomorrow, no specific topics will be mentioned. This is a large and broad investigation that will be tasked with reviewing everything in the curricula and in the course plans, not just this.
But I still want to emphasize that these questions are already included in the curriculum today. I guess that is also a reason why the Social Democrats, during eight years in government, did not introduce this on the schedule – it has previously been demanded that it should be a separate subject – without them having considered exactly how this can be built up in the best way. It is, after all, not an entirely easy question to answer.
This is included in many different subjects today, but still, it is perceived as, for example, not being sufficiently concrete and not providing sufficient tools for students who experience that they need this. That question is something I truly take with me further in my work. It is a large and important issue. And the school has an important responsibility when it comes to this. But exactly how this should be done, I actually do not dare to answer today.
Linus Sköld (S)
Mr. Speaker! To begin with, I want to interject that the government's fiscal policy means that neither child and adolescent psychiatry nor school health will be met with increased resources - on the contrary. All regions will have deficits next year, and over 40 percent of the municipalities will have deficits next year.
I think we need to build a school that promotes health, a school that children and young people feel good about attending. In that case, it may be necessary to review the knowledge content and the design of the curricula, just as Lotta Edholm indicates.
It may also happen that it is necessary to strengthen student health. I am the first to stand behind that. What I do not believe one will gain from is a reorganization of student health. Very little will be gained, or rather, great things will be lost, by moving the head of student health to the regions instead of to the schools. It will not strengthen the school's health promotion and preventive work.
To further promote mental health, there are plenty of organizations suggesting that we should have mental health as a knowledge area, not necessarily as a separate subject. This is something that, among others, the Minister has recommended. The point is that children and young people continuously need to learn about how their own emotional lives and their emotional selves function.
I think the minister is drifting a bit off target when she says that there will be a broad review. One does not write an investigation directive without providing certain input values to the investigator who is to carry out the investigation. I therefore think she should use her closing remarks to answer whether she will say at the press conference tomorrow that it is included as part of the investigator's mandate to investigate whether mental health should be included on the agenda or not.
Statsrådet Lotta Edholm (L)
Mr. Speaker! I am very concerned that so many children and young people in Sweden are experiencing increased mental ill-health. It is deeply alarming that bullying is increasing in our schools, that more and more young people experience an insecurity in school, and that many experience that the adult world turns a blind eye when it sees what is happening among young people.
I believe that what we as school politicians can do most of—what we are best at—is to ensure that we get a well-functioning school. It benefits all students, but it benefits least of all those students who need school the most. I have tried to say today that I do not dare to say how this part of the school's mission could be developed. I note that this already exists today within curricula in primary school and upper secondary school. That is good, but it is obvious that this does not quite meet the needs that actually exist just because it, so to speak, exists in writing. I am truly ready to take that in and look at this.
The investigation for which directives will be presented tomorrow will cover all areas. It will be very broad, and no individual subjects will be mentioned in that way in the directives. Instead, it will be in general terms - in the sense of achieving a curriculum and course plans that are better adapted to how children's development actually looks.
Source: The Swedish Parliament. The speeches come from the open data of the Riksdag, translated into English by AI, which may contain errors.