I have now arrived back in London after finishing up at the conference. Tomorrow we make our way for Scotland where I have an appointment to meet with Morag Kerr from the Glasgow Centre for Confidence and Wellbeing.
This truly has been the most incredible learning experience and, needless to say, I’m feeling so very blessed that this opportunity was offered to me.
The final day of the International Youth Mental Health Conference was really significant for many reasons – the most important being the official launch of the International Declaration on Youth Mental Health – a summary of which is located here. This composition of this Declaration has been involved collaboration and input from a wide variety of stakeholders – including many Australian researchers and organisations. The true significance of a Declaration is the power it has to take a diverse group of people and focus them into a common set of objectives. This particular Declaration calls us to imagine a world where “every young person has a meaningful life and can fulfil their hopes and dreams.” It has 5 key objectives and 12 ten-year targets – the first of which being a 50% (minimum) deduction in the rate of youth suicide. A document such as this has immense power to change attitudes, to put pressure on policy makers and to support the development of youth mental health services.
Following the launch of the Declaration, we were privileged to hear the first person accounts of a young person and a parent, who bravely shared their personal experiences of being touched by mental illness and the need for understanding, compassion and timely intervention by service providers. Both speakers relayed feelings not knowing where to turn and frustration in relation to stigma and discrimination. They both highlighted the need for sensitivity and empathy. It has become clear to me, from listening to the stories of so many young people at this conference, that the true difficulty of mental illness lies in two areas: the ‘invisibility’ and the ‘stigma’. Mental illness cannot be diagnosed with an x-ray or a blood test. In most cases it relies on the young person’s ability to articulate their symptoms and their experiences. In most cases, it takes quite a while for a young person to feel comfortable or ready to seek help because of the stigma that, unfortunately, still strongly pervades in this area.
The only way to counter stigma is through awareness and understanding. The latest figures from the World Health Organisation tell us that at any time up to one in four young people between the ages of 12 and 25 will be going through a period of mental ill-health. It is up to each and every one of us to ensure that we improve our own mental health literacy and do what we can to counter prejudice and stigma in our schools, workplaces and communities.
What was proven to us oldies (I was a little devastated that the term ‘young person’ applies to 12 – 25 year olds – tipping the scales at 31, sadly I’m not in the ball park of young any more!) is that the best way to improve outcomes for young people is to include young people in the discussion and to allow them to be part of the design of the solution. The young representatives at this conference communicated this loud and clear! They’re input emphasized time and time again that they are capable of finding a way forward and that the way forward must involve their input at a meaningful level – not just mere tokenism. It got me thinking about what more we can do in schools to allow our students to lead change. It also made me think that we need more information from the students regarding the design and implementation of our pastoral and wellbeing programs so that we are not delivering what we assume students need – but rather, giving them the opportunity to shape and guide us in what is most useful and relevant to them.
Never was this so clearly evident to me than in a workshop I attended where research was presented exploring the outcome of whether or not classroom based CBT is effective and cost effective in reducing symptoms of depression in ‘high risk’ adolescents aged 12 – 16. In this randomized, controlled study students across years 7 – 10 were presented a specific ‘pastoral’ type program which examined themes such as positive thinking, resilience, support networks etc. The program was presented by teachers across a range of schools and the young people involved were pre-tested and post-tested against a range of indicators identifying their levels of depression and overall wellbeing. This longitudinal study concluded that the program, in fact, had NO effect in improving the levels of depression in the students. This finding was quite disappointing for the researchers who then compared the findings to four other similar independent studies (Sawyer, Araya, Challen) – each of which produced the same findings – that generic well being programs communicated as part of the general curriculum to students actually do nothing to improve the overall wellbeing of the students. Now, there could be many factors behind this. I stayed behind and had a really good talk with the presenter, Professor Stallard. We both concluded that, ultimately, the improvement of wellbeing comes down to the leadership and culture of the school, whereby, the leadership, teachers and students all must see the importance of wellbeing as relevant and as part of the common language – in a setting such as this, an embedded pastoral program has the potential to make an impact. Although it feels a little like I’m stating the obvious here, this was a real light bulb moment – ultimately we need to have these discussions in our schools – what a powerful question to ask your staff: ‘what can we do to create a school culture where mental health and wellness is prioritised, discussed and valued by all members of the school community?’ I would be very curious about the flow of ideas that would stem from a question such as this.
The reality is, we live in a country with a fantastic health system – we are ahead of many other countries in what we are doing in the area of youth mental health. We are exceptionally lucky to have bi-partisan support regarding the importance of this issue but still the concern remains. Youth suicide is still the leading cause of death in young people aged 15 – 24 and although 1 in 4 young people in this age group are touched by mental ill-health only 10% ever present to hospital for help. When it comes to suicide prevention, we need to know the risk factors and we need to know our students. Among many risk factors is exposure – those young people who are exposed to suicide or self-harm are more likely to engage in these behaviors themselves later in life. Our focus needs to be equally divided amongst prevention, intervention and postvention. We all have a role to play in the achievement of the ambitious, but certainly realistic International Declaration on Youth Mental Health. Ultimately it needs to be a conversion of minds, from one person to the next. This is where real reform and revolution is born.
More to follow in the morrow, goodnight!