• NDT South Württemberg

• eSano Online-Trainings

• Soon-Systems GmbH

• Media HS Stuttgart

01.03.2021 - 31.08.2023

The project "Dazugehören BaWü: Individual support for disadvantaged young people in the corona-related difficult transition to adulthood" is a joint project funded by the Baden-Württemberg Ministry of Social Affairs and Integration as part of the Baden-Württemberg Health Location Forum. The project management as well as the project implementation and control are the responsibility of the working groups Youth Psychiatry/Psychotherapy Ulm (Prof. Dr Jörg Fegert) and Clinic for Child and Adolescent Psychiatry/Psychotherapy South Württemberg (Prof. Dr Isabel Böge), which have been cooperating closely for many years.

The aim of the project is to stabilise and strengthen young people who are in transition to adulthood and are affected by participation deficits due to mental disabilities or addiction with the help of digitalisation. Due to the restrictions imposed by the coronavirus pandemic, young people with mental disabilities or addictions have fewer opportunities to master their developmental tasks in the transition to adulthood. Baden-Württemberg as a healthcare location is responding with a modern, networked healthcare system and is preventing the emergence of a "lost generation" by improving the opportunities for young people with impairments to participate.

As an example, new approaches to digitally supported help planning and digital assistance for young people with mental impairments or addictions are being realised at four locations in the state. This will be achieved on the one hand via a participatory participation tool to be developed, and on the other via a web-based group training programme designed to help empower young people.

Sub-project 1: Participatory participation tool

To date, there has been no digitally supported transition planning between integration assistance in youth welfare and the framework conditions for young adults introduced in 2016 in the German Social Code (SGB IX). Digitally supported, networked case handovers in diagnostics and therapy as well as coordinated transitions from youth welfare to adult assistance or independence are intended to prevent lengthy assessment processes, in addition to the delays caused by the coronavirus.

The aim of this sub-project is to develop a tool that supports the process of needs assessment in a digitalised and standardised way and at the same time simplifies the transition to a further support system. The tool is structured as follows.

• Module 1: Needs assessment
• Module 2: Transition management
• Module 3: Communication platform

Not only is the transition process to be improved, the participation tool also includes newly created questionnaires for those involved as well as an adapted health professional statement in accordance with Section 35a SGB VIII. By following the International Classification of Functioning (ICF), while at the same time taking into account the previous practice of needs assessment in youth welfare in these documents, content-related barriers between the two assistance systems can be overcome.

Sub-project 2: Web-based group intervention

Necessary group events, including self-help events, have come to an almost complete standstill during the coronavirus pandemic. However, peer groups play a central role for adolescents. Therefore, as implemented in this project, not only personal encounters but also measures such as online group programmes must be provided in order to adequately support adolescents.

The central secondary prevention research aspect of the project lies in the avoidance of exclusion due to illness and impairment through prompt networking in a digitally organised network. The adolescents are to be empowered and strengthened in their participation. Group meetings and an accompanying app are intended to increase the young people's self-determination and ability to mentalise. The central goals are also to increase problem-solving and self-direction skills. After participating in the 7 sessions of the intervention, the adolescents should be strengthened in their ability to actively seek help and express what support they need. The target group of the intervention are adolescents and young adults between the ages of 15 and 27.

Model locations

The "Dazugehören BaWü" project is being implemented with and in the following model locations.

• Ostalbkreis
• Esslingen
• Sigmaringen / Mariaberg e.V.
• Biberach

Accompanying research

1. status quo survey

A status quo survey was carried out in order to be able to take the results into account in the creation of the two sub-projects. A written survey was conducted with the management levels in the youth welfare offices of the respective model locations, as well as interviews with case managers from youth welfare and integration assistance and with the young people concerned.

Written survey

The written structural survey of youth welfare office and integration assistance managers revealed that there are around 625 cases per year across all locations of young people aged between 16 and 27 in educational assistance/assistance for young adults and around 76 cases in assistance under Section 35a SGB VIII, which speaks in favour of the timeliness of (digital) transition planning. The model locations predominantly use standardised and open questionnaires as well as guidelines for case managers in both analogue and digital format to record participation impairments and participation needs.

Survey of case managers

In these interviews, mainly case managers, but also office managers from the youth welfare office and integration assistance were asked about their experiences during the transition. Among other things, the focus here was on interfaces and barriers in the transition process, the participation of young people and requirements for the instrument. 13 professionals were surveyed in 11 interviews. The following key statements from the qualitative interviews can be summarised:
An early approach by youth welfare services to integration assistance and the additional co-operation partners involved, as well as a close exchange between them, is fundamental to a successful transition. Furthermore, there is a desire for dedicated specialised services for the area of Section 35a SGB VIII. It is also emphasised that the young person concerned must be prepared sensitively and at an early stage for the transition phase.
Difficulties arise above all in the delimitation of responsibilities between the ages of 18 and 21 and the lack of standardised procedures. There is also a lack of knowledge about the services provided by other rehabilitation organisations. With regard to the participation of young people, this can best be realised through one-to-one discussions, but also through digital communication formats. Young people's skills such as self-efficacy and self-confidence, as well as fixed, self-organised daily structures, are also seen as conducive to a successful transition.
A clear guideline and a simple and appealing design for professionals and beneficiaries are required of the tool. In addition, the desire for an overview of all relevant assistance was expressed several times.

Survey of those affected

In the survey of those affected, the focus was on their own experiences with transition, obstacles and barriers in the transition process and helpful skills. For this purpose, two adolescents who were in the transition process at the time and one adolescent who had already left youth welfare were interviewed. Those affected described the transition process as non-transparent and not very participatory. They would also like more information about their options and rights.

2 Planned evaluation study

Both sub-projects will be evaluated. The use of the participation tool will be analysed exclusively in terms of feasibility, usefulness, satisfaction and suggestions for improvement. To this end, guided expert interviews will be conducted with case managers in relation to the needs assessment tool. On the other hand, the handover tool will be evaluated by means of focus groups involving both youth welfare and integration assistance professionals. The sessions and the app are also evaluated in the context of the group intervention. Participants are surveyed before and after the intervention using standardised questionnaires and specially created questionnaires on the benefits and quality of the intervention. Group leaders are surveyed using guided interviews.

Parallel to the general course of the project, a total of four publications were published across both sub-projects in a special issue of Nervenheilkunde on the topic of "Transition and participation - supporting young people when changing institutions":

• "The need is often not broken down in a differentiated way" Transition of young adults with mental impairment from youth welfare to integration assistance. An explorative qualitative study (Esch et al., 2022) Thieme E-Journals - Neurology / Abstract (thieme-connect.com)
• Individual support for mentally impaired adolescents between the help systems. Development of a digital tool for child and youth services (Gindele et al., 2022) Thieme E-Journals - Nervenheilkunde / Abstract (thieme-connect.com)
• Development of a group intervention to support adolescents in the corona-related difficult transition to adulthood (Neumerkel et al., 2022) Thieme E-Journals - Neurology / Abstract (thieme-connect.com)
• Requirements for the health professional statement according to §35a SGB VIII and suggestions for implementation (Hiller et al., 2022) Thieme E-Journals - Neurology / Abstract (thieme-connect.com)

Contact for questions:

Verena Gindele

Project email address:dazugehoeren.bawue@uniklinik-ulm.de

Project website:www.uniklinik-ulm.de/kinder-und-jugendpsychiatriepsychotherapie

Ministry of Social Affairs and Integration

As part of the Forum Gesundheitsstandort Baden-Württemberg under the coordination of BIOPRO Baden-Württemberg GmbH