Sweden has been gathering data on the mood of its youth for over thirty years, and the results have not been encouraging. The nation’s Health Behaviour in School-aged Children study has shown a consistent increase in teenage mental health complaints since the early 1990s, including stress, sleep issues, and chronic depression. By 2014, schoolchildren in Sweden were reporting multiple health complaints at a rate that was almost twice as high as it was in 1986. That is a big change in a nation that, by most international standards, makes substantial investments in social welfare and education. It brought up a clear and difficult question: what is wrong and where does it begin?
Researchers have been drawn simultaneously in multiple directions by the quest for answers. One thread focused on preschool attendance, specifically examining whether the age at which Swedish children enter group care and the amount of time they spend there are related to adolescent mental health outcomes. This was followed by a 2026 cohort study that used data from the KUPOL longitudinal project. The researchers were cautious not to overstate what the data could support, and the results were modest and somewhat inconclusive: children enrolled before the age of sixteen months showed slightly higher odds of certain behavioral difficulties compared to those who started at twenty months or later. However, the associations were weak and the population attributable fractions were small. This type of research poses as many questions as it provides answers.
Here, context is important. Sweden’s childcare system differs from many other nations’ haphazard arrangements. Preschool is nearly universal, heavily subsidized, and subject to national regulation. Approximately 83% of children between the ages of one and five attend, and by the age of three, that number rises to about 95%. The child-to-caregiver ratios and staff qualifications are among the best in the world. Sweden may have been among the first to recognize the obvious negative effects of early group care. The fact that it is not simple is a significant discovery in and of itself.
The formal research apparatus is not the focal point of Swedish OMEP’s involvement in this larger discussion, but the organization’s work with municipalities and regions has been a part of Sweden’s broader cross-sectoral response to the mental health trend. The recognition that early childhood wellbeing cannot be addressed by a single institution is reflected in that response, which included the appointment of a national coordinator by the government to coordinate the efforts of agencies, local authorities, regions, and nongovernmental organizations. Many children between the ages of one and six spend most of their waking hours in preschool settings. Whatever influences those hours has a significant impact.
Observing this develop in research papers and policy documents gives the impression that Sweden is actually struggling with a conflict inherent in its own achievements. At ages when, according to some researchers, long-term one-on-one relationships with caregivers are crucial, the very infrastructure that enabled Swedish women to enter the workforce and promoted gender equality on a large scale also placed very young children in group care. That tension is not resolved by the KUPOL data. It might give it some depth. It does, however, provide a better understanding of which early factors require ongoing attention and which, based on available data, are less significant than previously thought.
The extent to which Swedish OMEP’s specific work within municipal partnerships has changed practice in specific preschool settings is still unknown. Instead of using dramatic interventions, groups like OMEP typically have a gradual impact on systems through advocacy, training, and curriculum development. However, the more comprehensive approach—bringing together early childhood specialists, educators, health authorities, and municipalities to consider the preschool years as a critical time for mental health, not just cognitive development—is a reasonable one. Sweden was the first nation to engage in this dialogue. The solutions, if any, are still being developed.
