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Project: Children as next of kin at school (CANOK)

The "CANOK at school" project is about the empowerment and training of school nurses to identify those students (7-17 years old) who are experiencing mental health problems due to their role as children as next of kin (CANOK). These are children whose parent or parents (or other co-habiting family members) suffers from serious health issues (mental disorder or disability, serious physical illness or injury, addiction to alcohol or other agents) or have died unexpectedly. The project promotes awareness of CANOK and provides new tools for school nurses to understand, manage and support CANOK and their mental health in school environments, in line with the Swedish Health Care Act.

Project information

CANOK at school: Empowering and training school nurses to identify and support children as next of kin with mental ill-health: a training intervention for professionals
Project manager
Elizabeth Hanson
Other project members
Lennart Magnusson, Francesco Barbabella, Samantha Sinclair, Pauline Johansson, Ellinor Vasko, Linnaeus University; Eva Nordqvist, Swedish Family Care Competence Centre (Nka)
Participating organizations
Linnaeus University
Swedish Family Care Competence Centre (Nka)
Municipalities of Borås, Jönköping, Mullsjö, Oskarshamn, Uddevalla and Uppsala
Swedish Red Cross Trauma Centres in Skövde
Church of Sweden (Borås)
National Board of Health and Welfare Sweden
The Region of Kalmar County (Region Kalmar län)
Advisory and Ethics Board (AEB): a Board with eight international experts (from various European countries)
Eurocarers: European federation of non-profit and research organisations workingon/for informal carers.
The Kamprad Family Foundation for Entrepreneurship, Research & Charity Research and education
1 Jan 2023–31 Dec 2025
Health and Caring Sciences (Department of Health and Caring Sciences, Faculty of Health and Life Sciences)
Research group
The Informal Carers, Care and Caring research group – a research arm of the Nka

More about the project

The project is about an important and complex societal challenge. In general, international research has demonstrated that being a CANOK constitutes a risk factor for mental health and well-being, with around 50 percent experiencing care-related stress and 40 percent mental health problems. Further, this situation exacerbates health inequalities during the life-course.

CANOK often also experience the consequences of social exclusion.

According to Swedish law – the Health Care Act (SFS 2017:30) and Patient Safety Act (2010:659), CANOK are children whose parent or parents (or other co-habiting family members) have serious health issues (mental disorder or disability, serious physical illness or injury, addiction to alcohol or other agents) or die unexpectedly. CANOK are protected by the national welfare system, in line with the Council Recommendation (EU) 2021/2014 establishing a European Child Guarantee and the related incorporation into Swedish law.

Recent Swedish research reveals that: 24 percent of all children 15 to 17 years of age are CANOK, of these 27 percent have mental health issues; 13 percent have physical health problems; 13 percent have deteriorated school results; 11 percent have thoughts about harming themselves; 10 percent are bullied, teased, or ridiculed. It is estimated that over 70 percent of CANOK are actually young carers, defined as children and young persons under 18 years of age providing significant or substantial care, assistance or support to family members.

The project develops an educational intervention for school nurses, aiming at:

  1. Increase their awareness regarding the living situation and mental health problems that CANOK often experience.
  2. Offering tools and materials that school nurses can use to identify and support CANOK.
  3. Follow up and monitoring CANOKs’ progress during their schooling.


The CANOK at school project’s specific objectives are:

  • To co-design and evaluate a training intervention for school nurses which empowers them to manage primary and secondary prevention of mental health issues among CANOK.

  • To initiate and maintain a constant dialogue with end-users (school nurses) and stakeholders (CANOK, schoolteachers, school social worker, managers, school physicians, National Board of Health and Welfare) to promote awareness of CANOK, their needs and effective ways to co-operate for their wellbeing in the school environment.


The CANOK at school project will be organised in five interdependent scientific work packages:

Work package 1: Theoretical and conceptual model for supporting CANOK.

Work package 2: Training intervention design, implementation and evaluation.

Work package 3: User and stakeholder engagement via a Blended Learning Network and Advisory and Ethics Board (EAB).

Work package 4: Raising awareness and reaching societal impact.