LIFE News: Issue 4

Welcome to LIFE News

youth sitting

Welcome to LIFE News - April 2009. In this edition LIFE focuses on youth and suicide prevention, taking a look at the latest youth-related research and National Suicide Prevention Strategy (NSPS) projects including the Sustainable Personal Development for Aboriginal Men Project, the Peer Support Project and many more. LIFE News contributors also report on youth programs from organisations such as Mental Health First Aid and the INSPIRE Foundation. LIFE warmly encourages feedback on LIFE News - please contact us with your comments and suggestions.

NSPS project updates

Sustainable Personal Development for Aboriginal Men Project

Sustainble Development for Aboriginal Men Project

Above: Aldren Mckenzie Snr

The Sustainable Personal Development for Aboriginal Men Project (SPDAMP) implements a broad range of community-based initiatives designed to develop and enhance culturally relevant life skills for Aboriginal males in the northern areas of South Australia. Based in Port Augusta, which is located 300 kilometres from Adelaide, the project works closely with schools and local communities in response to the suicide rate in 2005 - 2006.

Community and school workshops, group discussions, recreational activities and multimedia projects form core elements of the project's structure. Target groups vary from Aboriginal males in urbanised communities such as Port Augusta, to Aboriginal males in tribal and semi-tribal communities. SPDAMP assists Aboriginal males of all ages but has a strong emphasis on youth.

'The project focuses on helping Aboriginal men to feel a better sense of self-worth, especially those who have felt really low and have experienced possible issues relating to self-harm,' says CEO of Centacare Diocese of Port Pirie, Dr Peter Munn. 'We do this in a variety of ways that encourage people to talk about their issues and talk about ways to help improve their lives.'

SPDAMP has developed visual materials that have been integrated into presentations and workshops and, Munn says, have helped form particularly strong connections with young people.

'We have developed a presentation that is taken to communities and schools that uses paintings that show an Aboriginal person at different stages of how they might feel about themselves,' he says.

The paintings and visual materials have been developed by project coordinator Aaron Stuart, an elder of the Arrubanna, Lurigta and Adnymathner tribes. Stuart uses paintings of people, animals and plants to represent emotions and springboard discussions aimed to enhance resilience and coping skills. A painting of two kangaroos fighting, for example, represents anger. In one of his activities Stuart places three pictures on three chairs, each representing different emotions, and discusses the progression between them and the skills needed to keep away from the fourth chair, which has no picture on it and is representative of self-harm and suicide.

'This is my education method,' he says. 'If we use PowerPoint presentations and things like that it goes straight over people's heads. So we tell a story in their way, and we have to relate to them. We explain that everyone will face times in their life where they will feel down at some time or another. It's about how we make ourselves feel better.'

Stuart is currently developing a series of five short films called Yudum, the first of which is nearly completed. The films' scripts were written by Stuart in consultation with elders and community groups such as Males in Black, which consists of around 20 Aboriginal men who help young Aboriginal people adapt to cultural situations. Yudum is the name of the protagonist, a fictional character from before colonisation who is confronted with various issues and choices to make about his life.

Says Stuart: 'In the first movie we ask the question: was there suicide back then? Was there depression? How did Aboriginal people handle death in those days? The story is based around these questions. What mechanisms were in place? What resources were available? It is about the community structure and how they deal with it (suicide).'

Peter Munn believes the Yudum films will have far-reaching appeal and hopes many viewers will have access to the DVDs.

'They are intended for a wide audience and are culturally appropriate to Aboriginal people,' he says. 'We are hoping that we can get them produced and distribute them right across Australia.'

  • For more information about the Sustainable Personal Development for Aboriginal Men Project contact Dr Peter Munn via email or call 08 8645 8233.
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The Peer Support Program

Peer Support Program

Pictured above: Robyn Martin (left) and Jeanette Ishiguchi (right)

The Peer Support Program (PSP) provides peer-led training programs to teachers and students in primary and secondary schools, aiming to enhance the mental, social and physical wellbeing of young people across Australia. It is a good example of Action Area 3 from the LIFE Framework which emphasises improvement in community strength, resilience and capacity in suicide prevention.

The workshops train teachers to implement the Peer Support Program in their schools, and they in turn train students to be Peer Leaders. Focusing on areas such as relationships, values, resilience, optimism and anti-bullying, PSP develops students' abilities in problem solving, communication, assertiveness, stress management, decision making, and other life and social skills. Peer leaders work with small groups of younger students. The program is based on the idea that the development of protective skills will help young people counter negative influences they might experience and enhance the skills required to get through everyday life.

The project commenced in New South Wales in the early 1970's, and in the last few years has expanded to Queensland and Tasmania. In 2009, Peer Support Australia expands its services to Western Australia and the Northern Territory.

'We use a very effective and highly leveraged method (of training) that enables an organisation of six people to impact on over 200,000 children each year,' says General Manager Sharon Austin.

'We obviously can't get out and have contact with every child so we use the schools to do that for us. We provide centralised workshops where we train teachers from different schools to implement the program in their school.'

The Peer Support Program began in the 1970s in response to a high school student who died as a result of drug overdose. The project founder, Elizabeth Campbell, was a health educator called to the school at the request of the principal. She provided counselling to students, family and school staff. Surprised that the students knew more about what was going on in the boys life's than any of the adults, Campbell created a program designed to address social issues the students were facing.

'It initially started as a preventative drug education program but over the years it has evolved into a universal mental health promotion program,' says Austin.

'The program is built on the premise that kids who are connected to their schools and peers will do better and are less likely to engage in risky behaviour than those who are disconnected. We don't promote it as a suicide prevention program or as a drug prevention program as such because we want to encourage schools to pick it up for a whole range of reasons.'

Maintaining contact with schools after training teachers is an ongoing challenge for the project. As it impossible to physically maintain contact with every participating school, Peer Support Australia is currently considering future web-based initiatives - such as webinars and chat forums - that could make ongoing contact more viable.

Explains Sharon Austin: 'What we are hoping to do in 2010 is look at ways we can use technology to help in that follow-up support. It will certainly not replace face-to-face training however we can use technology in ways to further support the workshops'.

  • For more information about the Peer Support Program contact General Manager Sharon Austin via email.

QPASTT

Above: QPASTT participant David Anei
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The Queensland Program of Assistance to Survivors of Torture and Trauma

The Queensland Program of Assistance to Survivors of Torture and Trauma (QPASTT) NEXUS program is a suicide and self-harm prevention project targeted at young people from refugee backgrounds between the ages of 12 and 24. Operating in Brisbane and Toowoomba, the program conducts activities including counselling, recreation, training, a holiday program and a school-based outreach program.

By engaging young people in diverse ways the project aims to cultivate social connections for young people, as well as supporting their ability to access community services and fostering self-advocacy skills.

A core aim of the QPASTT project is the development of 'locus of control' in refugees; a term used in psychology that refers to the extent to which individuals believe they can control significant events in their lives. Those with high internal locus of control are said to place more emphasis on their own actions; those with high external locus of control may place emphasis elsewhere - such as on chance, fate or other people. The project reflects the principle of Action Area 5 in the LIFE Framework which highlights targeted suicide prevention activities that build capacity for self-help and encourage people to express emotions.

'Sometimes young people from refugee backgrounds, due to a variety of reasons, have not had great experience in verbalising their wants and needs,' says youth team leader and NEXUS coordinator Kristen Price.

'Research indicates that young people with high internal locus of control have less self-harming behaviours, so a part of our counselling focus is on assisting young people to be able to advocate for themselves and increasing that locus of control.'

In January QPASTT held Digital Storytelling, an innovative holiday event designed to engage young people and develop their multimedia and computer skills. Participants chose to create a story using computer software and audiovisual equipment. A facilitated workshop, held over three days with participants from Togolese, Sudanese and Afghan backgrounds, provided hands-on experience with cameras, voice recorders, scanners and editing programs. The theme was 'connectedness' and at the completion of the workshop participants were given the opportunity to present their finished stories to the QPASTT staff.

'The digital storytelling program came about because it is an innovative way to engage young people, who were not necessarily engaging in our holiday activities,' says Price.

'It was a really positive event and definitely something we will do again. One of the young women who participated was very shy at the beginning of the three-day workshop but at the end was so proud of what she had achieved.'

  • For more information about the Queensland Program of Assistance to Survivors of Torture and Trauma NEXUS program, email NEXUS coordinator Kristen Price.
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The Something Better Project

Something Better

Pictured above: Leaders and participants of the Something Better Project


The Something Better Project from the Queensland Citizens Police Youth Club provides a support network for youth in the Cape York communities of Hope Vale, Wujal Wujal, Napranum, Mapoon, Coen, NPA (Bamaga and surrounds), Lockhart River and Kowanyama. The project engages participants between 8 and 16 years of age, providing at-risk youth the opportunity to take part in structured activities including sport, outdoor and indoor recreation, and cultural events.

Liv Gray, development coordinator, says: 'We offer a range of different activities including diversionary activities, which are active supportive programs that provide youth the opportunity to do something new or to build on some skills they might have done previously. We also offer workshops not necessarily for kids that aim to increase awareness of suicide and things that people can do to help.'

Diversionary activities occupy roughly one half of Something Better's platform; the other consists of workshops that run cooperatively with the Dr Edward Koch Foundation. In April, May and June 2009 these workshops will be held in each of the eight Cape York communities and are intended to educate community members and service providers on subjects including risk factors and warning signs and triggers of suicide.

Recent diversionary activities undertaken by Something Better (held from October 2008 onwards) include mountain biking, bush walking, camping, painting, touch football, sea kayaking, raft building, camp cooking, orienteering, crafts, pancake making, abseiling and tree climbing. After experimenting with the introduction of role models last year, Something Better plans to develop their participation in coming events. Role models are members of the Cape York Family Violence Prevention Legal Unit and some traditional owners of the Cairns region.

'The kids can interact with these role models and get to know them during the time when they're out and about,' says Gray. 'They can be a familiar face, so if something does come up in relation to suicide or a challenging thing the kids are experiencing, they can actually think hang on a second, there is that person, and they are in my town or community and I can go and talk to them.'

  • For more information about the Something Better Project, contact development coordinator Liv Gray via email or call 07 4040 4928.
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headspace

headspace promoheadspace creates conversations with young people via popular online sites, tertiary institutes and music festivals. headspace's integrated and long-term strategy works to encourage young people to seek information and help for their mental health.

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Youth Mental Health First Aid

Youth Mental Health First Aid

By Claire Kelly
Coordinator, Youth Mental Health First Aid

In 2000, Betty Kitchener and Professor Tony Jorm launched the Mental Health First Aid program. It grew very quickly as organisations, workplaces and individuals recognised the value of having the skills to assist someone who was developing a mental health problem or experiencing a mental heath-related crisis. The program now exists in 13 countries.

From the time the course was first made available, a common request from participants was to adapt the program for youth. Teachers, youth workers and other adults who work with young people liked the program but wanted information tailored to a younger target group.

The Youth Mental Health First Aid (MHFA) program was launched in April 2007. The intended audience is adults who work with adolescents. School professionals have embraced the course, along with juvenile justice workers, youth workers, drug and alcohol counsellors and many allied health professionals. In the two years since it began, almost 200 people have been trained to deliver the Youth MHFA program.

Youth MHFA covers the same areas as the mainstream course: depression, suicidal thoughts and behaviours, anxiety disorders, psychotic disorders and substance use disorders. Two additional areas are covered: non-suicidal self-injury and eating disorders. While these problems can affect both adolescents and adults, they tend to have their onset in adolescence.

In general, the symptoms of mental illnesses are similar for adults and adolescents. However, the most common symptoms can be somewhat different. For example, one of the main symptoms of depression in adults is an unusually sad mood that does not go away, whereas in adolescents, moodiness or irritability may be more common than sadness. Another example is in the area of substance use disorders. It is uncommon for adolescents to meet the criteria of substance use disorders because they often have not been using substances for long enough to have developed a diagnosable disorder. In the Youth MHFA course, substance use is treated both as a potential indicator of an underlying mental health problem and as a risk factor for developing substance use problems (and other mental illnesses) later on.

There is also a focus on the particular challenges for young people who are in need of help, the barriers to help-seeking, and the paucity of evidence for many treatments.

Early intervention for mental disorder is important at any age. For young people it is even more important. Mental disorders in adolescents interfere with the important developmental tasks of adolescence, including the development of social skills and adoption of adult roles, and can prevent young people from completing education.

Adolescence is a time of rapid change. As a result, the symptoms of mental disorders can be dismissed as 'just a phase' or as normal adolescent behaviour. We encourage participants to try to distinguish normal adolescent changes from potentially serious problems. It helps to consider the tasks of normal adolescence when determining if there is a problem.

For example, a common symptom of many mental health problems is withdrawing from friends and family. A normal part of adolescence is withdrawing from family and spending more time with peers. This means that if a young person is spending less time with their family, and is not spending more time with peers, there may be a problem. Unusual behaviour which is transient is probably not a concern, but persistent behaviour changes may indicate a more serious problem. The course also encourages participants to trust their instincts. If a young person you know well appears not to be functioning as well as they were previously, and the behaviour changes appear to be problematic, there may be a difficulty which could benefit from professional help.

If you are interested in becoming a Youth Mental Health First Aid instructor, or in organising a course in your workplace, please visit the YMHFA website.

Claire Kelly
Co-ordinator, Youth Mental Health First Aid
Orygen Youth Health Research Centre
University of Melbourne

  • For more information contact Youth Mental Health First Aid co-ordinator Claire Kelly via email.
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Inspire Foundation

Kerry Graham

Above: Kerry Graham

By Kerry Graham
Former CEO, INSPIRE Foundation

Thankfully, over the last ten years the number of young people who have died by suicide has decreased by 56% (ABS, 2008a). However, as a nation, we should be concerned at the rising levels of youth depression, anxiety and intentional self-harm (ibid). Moreover, the 2007 National Survey of Mental Health and Wellbeing (ABS, 2008b) confirmed that there was little to no improvement in the number of young people seeking professional help. More than one in five (26.5%) young people aged 16 - 24 experience a mental health disorder. Only one in four (22%) of these young people engage with professional help (ABS, 2008b).

In the face of these statistics, we need to ask ourselves: 'What can we be doing differently?'

In my view, the answer lies clearly - to quote Inspire - in 'putting young people at the centre of everything we do'. As a system, as service providers and as practitioners, we must embrace person-centred practice and, in doing so, become more relevant and more accessible to young people.

One of the ways we can do this is through online programs such as www.reachout.com.au and www.actnow.com.au. Inspire is probably best known for its innovative use of technology to improve mental health outcomes for young people. While this is true, the focus on technology is a by-product of being a youth-centric organisation. We dedicate significant time and resources to understanding young people and how they use technology to learn, connect and seek help. We are highly accessible because we engage with young people in their preferred mediums of communication including internet-related areas such as online gaming, social networking and mobile technology. We are highly relevant because we involve young people in the development, and frequent redevelopment, of our programs.

Evaluations of Inspire's programs demonstrate the efficacy of the young-person centric model and the use of technology to improve mental health outcomes. Recent user profiling (Inspire & Leading Edge, 2008) showed that 30% of respondents are repeat users and, of these, 59% sought professional help - meaning Inspire almost triples the help-seeking capabilities of users compared with non-users.

But what happens when young people seek help? Do they receive a service as relevant and accessible as the one they experienced online? To help in this regard, in April Inspire launched a resource which helps health care professionals understand and use new technologies in their work with young people. Called Reach Out Pro, the site provides information on a range of online resources that can be used to enhance the effectiveness of the psychosocial support and mental health care provided to young people.

I encourage all health care professionals to logon to Reach Out Pro at www.reachoutpro.com.au and take some easy steps to becoming more relevant and accessible to the young people in your care.

Kerry Graham
Inspire Foundation's CEO

  • For more information visit the INSPIRE Foundation website or email INSPIRE CEO Kerry Graham.
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LIFE Youth page

Youth are considered an at-risk demographic and a range of factors are associated with an increased risk of suicide in young people. The LIFE youth webpage provides important information on youth and suicide prevention in Australia. It includes information on statistics, trends, key organisations and policies. This page is a portal through which readers can access succinct facts and visit recommended websites for more information.

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Kids Helpline: integrating new technology in youth suicide prevention

Kids Helpline

By Dan Mobbs
Clinical practice supervisor, Boystown

Kids Helpline (KHL) is a free professional counselling service for children and young people aged between 5 and 25. It has been operating its phone service since 1991 and commenced delivery of web and email services in 1996. Kids Helpline is one of a broader network of services operated by BoysTown, whose overall mission is to 'enable young people who are marginalised and without a voice to improve their quality of life.'

KHL is giving a voice to marginalised young people across Australia. KHL now provides higher levels of ongoing services to its clients than ever before. In 2008, 4000 counselling sessions identified suicide as an issue. This equates to approximately eleven counselling sessions each day from children and young people with current thoughts of suicide, and represents a 45% increase on 2006 figures. This finding is particularly important as, whilst it is concerning that it appears young people are increasingly likely to have thoughts of suicide, it also suggests that they are more likely to contact KHL in times of extreme emotional stress. KHL also experiences a significantly higher proportion of children and young people accessing web and email services to discuss issues relating to mental health and suicide (KHL Overview, 2008).

Online forms of therapy removes the stigma associated with accessing traditional mental health services and appears to reduce a client's anxiety when compared with face-to-face services (Derrig-Pallumbo, 2006). As part of Kids Helpline's commitment to professional counselling for children and young people we offer access to a range of modalities (phone, web, and email), the combined benefits of which can be utilised wherever necessary and appropriate.

Web and email appear to be providing highly marginalised young people with access to counselling. Many clients initially access the service by sending an email to a counsellor due to the increased emotional distance they feel writing emails. Through the emails, counsellors begin to build a therapeutic relationship and assess risk. As this relationship develops young people often take the next step in accessing the same counsellor through online chat services where they experience real time communication with a counsellor. This then further reduces the client's anxiety about help seeking. The next step is to work with clients on the phone. Often clients may continue to share many of their issues through email when they do not feel that they can discuss their issues with a counsellor on the phone. Some clients also use email as an emotional outlet during times of distress between phone counselling sessions.

Once KHL establishes a relationship with a client, we often work with the young person to seek face-to-face supports in their local community and continue to liaise with workers to provide a collaborative and coordinated response, particularly to clients with complex needs. Work is undertaken in collaboration with the client and with their permission, with the exception of cases that require an emergency response to ensure a client's physical safety.

KHL continues to review all ongoing cases with a team of clinical practice supervisors and counsellors are supported during their shift by experienced shift supervisors. As a team, KHL strives to continue to deliver a high quality service to children and young people.

References:

Derigg-Palumbo K.,(2006) On-line Therapy: Issues and Ethics Psychotherapy in Australia Vol. 13 No.1 November pp. 24 - 29.

(2008) Kids Helpline 2007 Overview: Issues facing children and young people.

  • For more information contact Kids Helpline on 1800 55 1800 or visit their website.
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Australian research update

Secondary school teachers' ability to identify suicide risk of students

A recent Australian study (Crawford & Caltabiano, 2009) explored secondary school teachers' knowledge of youth suicide and their ability to identify a student who might be at risk of attempting suicide.

Of the 201 teachers, 80 (40%) of these teachers had had a student either attempt or complete suicide. The respondents were also asked about the existence of a school policy on suicide and the results indicated that:

  • 34 (16.9%) had a policy;
  • 87 (43.3%) did not have a policy; and
  • 77 (39.3%) were uncertain about the existence of such policy

Additionally, the majority (148 or 73.6%) had not participated in suicide prevention training.

The knowledge of teachers was assessed by asking them to rate 40 statements relating to youth suicide, which were divided into five categories: 'warning signs', 'precipitating factors', 'prevention and treatment', 'demographics and statistics' and 'risk factors'. Responses indicated that teachers had stronger knowledge of the items in demographics and statistics, and prevention and treatment categories. Meanwhile the knowledge areas of precipitating factors, warning signs and risk factors were considerably weaker.

In conclusion to this article, the authors recommend that suicide prevention training be included in both university and in-service training programs, and that all schools ensure that suicide prevention policies are developed and implemented.

References:
Crawford, S, and Caltabiano, NJ (2009). The school professionals' role in identification of youth at risk of suicide. Australian Journal of Teacher Education 34, 28-39.

  • Visit the LIFE Library record for 'Secondary school teachers' ability to identify suicide risk of students'.
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International research update

Development of posttraumatic stress disorder and risk of suicide attempt in American youth


Recent research (Wilcox, Storr, & Breslau, 2009) has assessed the relationship between elevated suicide risk and exposure to traumatic events within young people.

A sample of approximately 1,700 young people aged between 21 and 23 years were asked whether they had experienced one or more traumatic events, and if so what age they were at the time. These traumatic events were allocated into two broad categories: 'assaultive' and 'nonassaultive'.

Assaultive included any experience during which the respondent had been violently assaulted. Nonassaultive included:

  • being involved in a serious car accident or other serious types of accident;
  • experiencing a life-threatening injury or illness;
  • having a child experiencing life-threatening injury or illness;
  • witnessing a killing or a serious injury;
  • discovering a dead body; and
  • learning that a close friend or relative died unexpectedly or had been either assaulted or seriously injured.

The respondents were also assessed for symptoms of a number of mental health disorders including posttraumatic disorder (PTSD). Eighty-one percent (or 1,173) of the sample reported being exposed to a traumatic event, 8% of whom went on to develop symptoms of PTSD. Ten percent of people with PTSD had attempted suicide, a higher rate than those without PTSD.

The paper concludes that experiencing a traumatic event will not necessarily lead to a suicide attempt; rather it is people who develop symptoms of PTSD in response to the traumatic event(s) that are far more likely to attempt suicide.

References:
Wilcox, HC, Storr, CL, and Breslau, N (2009). Posttraumatic stress disorder and suicide attempts in a community sample of urban American young adults. Archives of General Psychiatry 66, 305-311.

  • Visit the LIFE library record for 'Development of posttraumatic stress disorder and risk of suicide attempt in American youth.'
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What's new

Improved features on the LIFE website

LIFE Communications is pleased to announce new and improved features on the livingisforeveryone.com.au website. These features include our extensively revamped LIFE discussion forums accessible to members of LIFE Professional Development Network (PDN).

For people who work to prevent suicide, the LIFE PDN is an invaluable resource. It is an online community designed to assist professionals to engage with each other, share expertise and stay up to date with the sector. The LIFE discussion forums are one tool through which these objectives can be achieved. Register today if you haven't already signed up for PDN membership.

The new LIFE discussion forums were trialled in March and present new innovations in online community building for suicide prevention in Australia. The forums have been revised to allow extra functions such as increased ability for users to create and edit discussion threads; increased ability to locate other users and relevant information; and other functions available in a redesigned and user-friendly structure.

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Next edition of LIFE News

LIFE News focuses on drug and alcohol and suicide prevention


The fifth edition of LIFE News will feature projects, people and comment focusing on drug and alcohol and suicide prevention. LIFE Communications encourages input and contributions. If you would like to contribute to this edition, please contact us with your idea.

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What would you like to see in LIFE News? What are your thoughts about this current edition? We warmly encourage your feedback - please contact us with any comments or suggestions.

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