"I am all the things" - Working Our Way Backward to a Place of Hope

Often in the challenging world of the NDIS Behaviour support practitioner, we can get swept away in a minefield of broken dreams and mitigating risk.

Knowing the fundamentals are important. the importance of data, how to replace functions in behavior's over time. However, there is truth in the edict that not one size training solution and strategy fits all.

By taking our young people on an identity journey, working through customized solutions and returning to the basics of - who we are now, what do we need, and how can participants where possible be agents of change themselves, how do we get there together, and how do we find the joys in the moment, we can find different ways of reimagining our futures as families, young people, and individuals.

In our practice, young people and their family write and review the strategies with us, go on the journey through functional change with us, and rewrite what they can in ways that make sense to them.

By paying attention to the needs of our families as well as our young people, we harness the powers of change differently (and this includes working alongside our service supplier communities in residential care)

By understanding the role and functional aspects of bodily responses and trauma, we can move towards a more integrated learning response, and live differently.

Kids Helpline is Australia’s only national 24/7 helpline for children and young people aged from five to 25 years. It is the safety net for Australia’s mental health system for children and young people. In the years of the Covid 19 pandemic, Kids Helpline has seen seismic shifts in trends and patterns of help seeking by children and young people unlike any seen before in its 30 year history. In 2021, we saw 2.76 million unique visitors to the Kids Helpline website and responded to over 177,000 children and young people who contacted Kids Helpline via phone, webchat or email. In particular, the complexity and severity of issues that children and young people are presenting with is changing. Some of these shifts can be attributed to changes at an individual level, but systemic changes, particularly in relation to mental health services, are also having a significant impact on Kids Helpline service demand. When there is pressure on the face-to-face mental health system for children and young people, Kids Helpline provides an early warning of potential system failure. This often places significant strain on our safety net and compromises our ability to catch children and young people before they fall into crisis.

Generations Z and Alpha, have their own unique preferences and expectations for help seeking, particularly in relation to their mental health and emotional wellbeing. Much can be learned from listening to their views and lived experience to create more responsive services.

This presentation will explore changes in young people’s help seeking behavior and what young people are telling us about their help seeking preferences and expectations of our services. It is timely to revisit our traditional models of mental health service delivery and assess the extent to which they are relevant to today’s children and young people.

Key messages:
Kids Helpline is the national mental health safety net for Australia’s children and young people.
Virtual mental health services for children and young people are a core part of the contemporary mental health service system.
There is a misalignment between what children and young people want in the mental health service system and what we are providing.
It is time to listen, learn and become more customer-centric to better service the needs of today’s children and young people.

Mental Health in the Community: A Wesley Kids Place-based Response in Eagleby

Eagleby has been identified as a priority suburb due to its complex low socioeconomic social fabric. At the end of 2020, five young people took their lives which highlighted the need for a place-based response. Wesley Kids partnered with the Eagleby Community Support Program to tailor a specific response in a manner that engaged the community. This involved several components (all co-delivered with Eagleby Community Support Program):
• School based psychoeducation sessions – multiple rounds have been delivered to Eagleby primary schools to build resilience and coping skills in young children.
• Eagleby All Stars – after school sports-based groups for children, supported by professional coaches with mental health content woven throughout.
• Eagleby Giants Football Club – inclusion of brief mental health psychoeducation for all participants at commencement of sessions.
• Specific community events such as Little Big Day Out for science week.

The success of the response has been evaluated through standardized metrics, and community feedback.

Eagleby All Stars has grown significantly in participant numbers, as a result of children encouraging their peers to attend. This peer-to-peer discussion led to the Eagleby Giants Football Club approaching Wesley Kids to deliver a similar program with their club members.

This multifaceted approach in Eagleby has seen community awareness of mental health increase; children’s mental health literacy improve; and has built strong community connections regarding mental health, including the establishment of the Wellbeing Consultant being a person that the community trusts to approach for mental health support. We have seen this through an increase in referrals, and discussions with parents regarding their own mental health issues and how they may best support their children.

The collaboration with Eagleby Community Support Program continues with upcoming programs including a school holidays Basketball program, Christmas fun day, suicide prevention talks to and much more.

Please see Emma Ashe

''We cannot grieve what we do not know”

Grief and loss underline so many experiences of change throughout our lives, yet so often we do not recognise that the experiences we live through warrant a grief response. This last year has thrown at us losses and change that we have witnessed on the national and international stage, yet the impact of these losses and change needs to be experienced through our individual and community expression of life. Grief and loss have been everywhere present, but often masked as something else. The changes and losses experienced by individuals, communities, and the country, have had a very real impact on us, but often expressed as a shapeless form.
Understanding the impact of natural disaster events through this lens affords us a deeper awareness of the process we experience, including the reality of what we are experiencing, the pain that it causes and our need to both adjust and find ways of living in the light of these extraordinary changes.

This presentation draws on a program evaluation activity by the Royal Flying Doctor Service’s Outback Mental Health team. It includes the voices of remote service workers providing mental health supports to Aboriginal teens struggling with a range of problems including suicidal ideation and histories of complex, inter-generational trauma.

The paper is structured using the ‘Web of Care’ model, developed collaboratively with Aboriginal communities, to assist in conceptualising and assessing networks of support around mental health clients in remote settings. This is an approach which helps with the visualisation and understanding of not only theoretical supports or connections but the actual impact of these ‘webs’ on the well-being of clients.

This presentation is based on six interviews with service providers I have worked in parallel with, providing support to Aboriginal youths experiencing suicidal crises along with other mental health difficulties. These are remote service workers keenly aware of the limited resources that exist on these margins, as well as the difficulties negotiating cultural boundaries, particularly where dominant, mainstream forces create even greater marginalisation of a people impacted by colonisation and inter-generational trauma. Highlighting this, narrative therapy methodology has been utilised to shift the conversation away from ‘apparent’ or ‘institutional’ care of clients towards the actual enhancements our service connections have been able to create – or not create - in the lives of these teens.

The presentation is supplemented by conversations with some key Aboriginal community members from the small remote communities I work with – I have asked them to comment and add their own thoughts about what could make even more of a difference for highly stressed teens in their communities. Through this process of dialogue, we hope to begin a journey of co-design; developing more robust, culturally appropriate and competent types of support.

Please see Gill Goodman

Objective: Smartphone interventions for suicidal thoughts have the potential to increase treatment access and reduce obstacles in help-seeking by providing accessible, anonymous, and timely support, which may reduce suicide risk. However, there are currently no apps available that attempt to reduce suicidal ideation. We developed a smartphone-based intervention -LifeBuoy- and investigated its efficacy compared to a control app in reducing the severity of suicidal thoughts in young adults. We also engaged young people with lived experience (LE) to co-design modifications to LifeBuoy in preparation for a larger 3-arm trial beginning in 2022.

Methods: Using a randomized controlled trial design, a community-based sample of young adults aged 18 to 25 years with current suicidal ideation (N=455) were recruited and allocated to receive one of two apps: LifeBuoy or an attention-matched control app. Suicidal ideation (primary outcome) was assessed at baseline, 6-week post-intervention, and 3-month follow-up. Mixed-effects modelling was used to examine baseline to post-intervention and baseline to 3-month follow-up changes in suicidal ideation for both conditions. We also collected data (n=90 surveys and n=16 interviews) from trial participants and partnered with a youth LE advisory panel (n=3) to iteratively refine the LifeBuoy app.

Results: LifeBuoy demonstrated efficacy in significantly reducing suicidal ideation in young people at post-intervention and after 3-months, relative to the control group. An attending co-author – one of our LE youth advisors – will present a summary of the feedback used to co-design modifications to LifeBuoy.

Conclusion: The present study is the first to show that suicidal ideation can be reduced among young people via a smartphone-based intervention, building evidence to address critical knowledge gaps relating to youth suicide prevention. Co-presenting these findings with a LE young person will model advocacy for a higher level of involvement with consumers, which is increasingly required in mental health research.

Little Wings: The Social Impact of Aeromedical Services for Children

Little Wings is a nonprofit organisation that provides free medical flights for seriously ill children and their families from rural areas to receive life saving medical treatment at city based hospitals. Over the course of a six month research project, Little Wings identified the impact of the transport service including the educational, medical, social/emotional and economic impact.
Population
Parents of seriously ill children along with services providers and the medical practitioners who care for them were involved in the study.
Method
A total of 67 interviews were conducted with families, staff and medical professionals. Semi-structured interviews were conducted to obtain qualitative data with key themes being identified in each area of social impact.
Results
A number of key themes were observed with significant impact in the area of medical, economic and social/emotional impact. Lowered travel fatigue and anxiety were significant along with significant economic and community implications for families.
Implications
The first implication is the impact of aeromedical transportation services on children and families who are experiencing a period in their lives of extreme trauma and stress. How does having access to a supportive transport service improve the quality and outcome of their lives.
The second implication is the process of social impact research allows us to examine our work in a child and family centred way to determine what is our impact so that we can choose to do more of what has a positive impact and do less of those things that do not enhance the lives of those we care for.

The ReSPECT Project is currently underway within NSW. This research contributes the perspectives of young people to the debate on service reform. It employs a participatory and co-design methodology, engaging young people in the re-envisioning of the service system, and in the development and trial of youth-led service initiatives. It also explores organisational barriers to including young people in policy debate and service decision-making. The ReSPECT Project is being conducted in partnership with Uniting, Carers NSW and Winangay. It is one of the first research projects in Australia to follow the development of youth-led service ideas from development through to implementation and evaluation.

In 2019-2020 we worked with five groups of young people to understand their experiences of services, and to scaffold each group in the development of one service initiative that they would like to see taken forward within their local area. These ideas were presented to local service providers at a ‘Pitch Day’. Our workshop will give particular focus to one ‘pitch’ that was directly related to the provision of mental health services. The idea developed by the young people has been taken up and will be implemented by Uniting, under a governance structure that includes young people.

Our workshop will present the ReSPECT model of engagement with young people and with service organisations, outlining the steps used in the project to meaningfully engage with young people in service design. It explores how participatory and co-design principles (as opposed to consultation), were applied to support the engagement of young people in decision making and governance structures, and how to understand and address the organisational barriers that stand in the way of meaningful child and youth engagement. Our workshop will be delivered in partnership with Uniting, and co-presented with a representative from the ReSPECT Change Makers group (youth participant).

Wesley Kids Mental Health Partnerships: Engaging Children and Families in Collaborative Focus Groups

At Wesley Kids we believe that children and their close supporters have invaluable lived experience, insight and ideas. We are committed to building genuine partnerships with children and their families, incorporating their voices into our service delivery to ensure we are meeting their needs in the most effective way. This guiding principle was embedded from the design stage of Wesley Kids, as we sought meaningful feedback on child and family mental health service provision through focus group discussions with parents and children in the local community. Three major groups of participants were recruited through existing connections within client, professional and personal networks of WMQ staff, including representatives from key demographic populations such as ATSI, CALD, single parents, low-income earners and out-of-home carers:

1. Parents/Carers
2. Children aged 0-5 (with parents in attendance)
3. Children aged 6-13

Conducting focus groups with children presented unique challenges and considerations that we addressed by ensuring a child-centred environment, age-appropriate discussions, small group sizes, incentives and skilled facilitators with experience connecting with children. We clearly communicated our purpose, encouraged honest feedback and gained informed consent from children and their parents.

Focus group responses have informed the growth and development of Wesley Kids, from the redesign of therapy rooms, to the choice and implementation of programs. We have used child and family feedback to reflect and respond to needs as a team, ensuring that our clients feel welcome and safe in our centre. Responses have additionally been utilized to inform local politicians of the mental health needs of children 0-12 on the Gold Coast.

Ongoing partnerships were created from these focus groups, with the invitation and subsequent commitment from a group of parents/carers and children to be involved in our F.R.I.E.N.D.S of Wesley Kids Advisory group, which will continue to advise and inform our service.

At Wesley Kids we believe that children and their close supporters have invaluable lived experience, insight and ideas. We are committed to building genuine partnerships with children and their families, incorporating their voices into our service delivery to ensure we are meeting their needs in the most effective way. This guiding principle was embedded from the design stage of Wesley Kids, as we sought meaningful feedback on child and family mental health service provision through focus group discussions with parents and children in the local community. Three major groups of participants were recruited through existing connections within client, professional and personal networks of WMQ staff, including representatives from key demographic populations such as ATSI, CALD, single parents, low-income earners and out-of-home carers:

1. Parents/Carers
2. Children aged 0-5 (with parents in attendance)
3. Children aged 6-13

Conducting focus groups with children presented unique challenges and considerations that we addressed by ensuring a child-centred environment, age-appropriate discussions, small group sizes, incentives and skilled facilitators with experience connecting with children. We clearly communicated our purpose, encouraged honest feedback and gained informed consent from children and their parents.

Focus group responses have informed the growth and development of Wesley Kids, from the redesign of therapy rooms, to the choice and implementation of programs. We have used child and family feedback to reflect and respond to needs as a team, ensuring that our clients feel welcome and safe in our centre. Responses have additionally been utilized to inform local politicians of the mental health needs of children 0-12 on the Gold Coast.

Ongoing partnerships were created from these focus groups, with the invitation and subsequent commitment from a group of parents/carers and children to be involved in our F.R.I.E.N.D.S of Wesley Kids Advisory group, which will continue to advise and inform our service.