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Beginning Practice - Introduction to Youth Mental Health

Presentation to YJ Beginning Practice Workers
by

David Reid

on 12 May 2015

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Transcript of Beginning Practice - Introduction to Youth Mental Health

Understanding
Youth Mental Health

Youth Justice
Mental Health?
Young People
Youth Justice staff Beginning Practice
Your role?
in supporting a young person
Is this your 'Mental Health' experience...?
so important?
is important
David Reid
(Forensicare)

Why are
Mental health is a state of emotional and social wellbeing that allows an individual to cope with the normal stresses of life and achieve their potential
“A mental health problem is a broader term including both mental disorders and symptoms of mental disorders which may not be severe enough to warrant diagnosis”
What is a Mental Disorder?
Diagnosable illness

Causes major changes in
Thinking
Emotional state and
Behaviour

Disrupts the person’s ability to
Study
Work
Continue their usual personal relationships
What causes Mental Illness?
BIO
-logical predisposition (e.g. genetic predisposition)
PSYCHO
-logical view of the world which increases vulnerability (e.g. upbringing, emotional experiences, childhood trauma)
SOCIAL
situation which exposes individual to stress and other triggering events (e.g. culture, stress – school, r’ships)
Severity of symptoms
Duration of symptoms
Functional change
Difficulty in young people is that these problems are often:
emerging rather than overt
transient rather than static
multiple problems are coexisting and linked (don’t fit into box)
The Australian Institute of Health and Welfare has concluded that mental health problems rank as the biggest source of ‘disease burden’ in Australia for adolescents and young adults (aged 15-34 years)
Up to ONE in FOUR young people are likely to be experiencing mental health problems
Incidence of mental illness in young people is the highest of any age group


75 percent of people suffering from a mental disorder had an age of onset by 24 years
Only one out of every four young people with a mental health problem receives professional help
Of those with the most severe mental health problems only 50% receive professional help
Youth:
Adult:
* Experience barriers to appropriate care
“Juvenile offenders require a higher duty of care than adult offenders” (Australian Institute of Criminology, 2011)
Early recognition and access to help is associated with better long term outcomes.
Challenges…?
Lack of Trust in Service Providers
Drug & Alcohol Use
Poor literacy and numeracy
Intellectual Disability
Absent or strained family relationships
Limited social supports
Poverty, unemployment and unstable housing
* Get informed about the client’s history and make sure your team is informed
Things we can all do to support clients with
mental health problems…
* Try to understand what’s driving the behaviour
* Motivate by highlighting strengths and providing choices (PPB)
* Reinforce positive routines
* If you have any concerns about a young person, discuss
* Increase your knowledge of mental illness and promote awareness
* If you do have to break confidentiality, remind them you are not doing it to breach their trust, but because their safety is your main concern
* Model non-stigmatising and accepting behaviours
* Provide information to the young person about mental disorders
* Encourage the young person to engage with services (e.g. YHaRS, Children's Court Clinic)
Young People in Custody Health Survey - 2009
(242 young people)
POP QUIZ...
1. Mental health problems rank as the biggest source of ‘disease burden’ in Australia for adolescents and young adults aged 15-24 years (T or F).
Questions?
Being in custody can increase the likelihood of mental health problems
A lot of people find 'mental health' difficult
Where to go, what to say, what to expect
* Look out for warning signs of mental health problems
* Use clear language at all times, break tasks down into small steps
Offending over lifespan...
* More likely to suffer mental health problems
* Experience higher rates of social disadvantage
* Mental health problems may predate, emerge during or develop as a consequence
2. What is the peak age of general offending?
3. What percentage of people suffering from a mental disorder had an age of onset by 24 years? (a. 25% b. 50% c. 75%)
4. Three out of every four young people with a mental health problem receives professional help (T or F).
5. Being involved in the Youth Justice system can increase the likelihood of mental health problems (T or F).
What would you like to know?
Offences in Groups
Fare evasion
Graffiti/vandalism
Shoplifting
Homicide
Sexual offences
White collar
75% of all serious mental health conditions start before the age of 24, and preventatively focused interventions targeted to young people aged 12-25 have the potential to create significant personal, social and economic benefits.
The 2007 Australian National Survey of Mental Health and Wellbeing found that while young people (aged 16-24 years) had the highest prevalence of mental disorders, they also had the lowest rates of receiving services in the 12-month period prior to the survey. The rate of service use was especially low for young men, with only 13.2% accessing help and support services, in spite of a 12 month prevalence rate of 22.8%.
Social norms encourage young men to hide their vulnerabilities and to strive for independence. Consequently, perceptions around masculinity mean that many young men equate masculinity with self-reliance. Seeking help is perceived as the opposite to being independent and, by extension, masculine, resulting in young men being unlikely to seek help during their formative adult years.
Findings from a number of studies suggest that even when young men are able to identify sources of help, there is frequently a reluctance to use this help.
Both structural and individual factors provide barriers to men’s help-seeking, with young men’s reluctance influenced by a fear of stigma, embarrassment, an over-emphasis on being self-reliant and internalised gender norms.
In the NSW 2009 Inmate health survey of a random sample of 996 prisoners, a majority of participants were assessed as having a mental illness (commonly mild depression) and yet had not had any contact with a mental health service in the three months prior to their incarceration.
Custody is not a hospital, but you have a role to play in identification and support
When a young person comes into contact with the YJ system, it should be seen as an alarm and present an opportunity
If you have any concerns about a young person on remand, discuss it with team
Take Home Message...
New Internationalist
Young men don't receive help
Why not?
What we know about YJ clients...
Young men with mental illness also experience higher incarceration rates than young men without mental illness.
What can we do about impulsivity?
Who am I?
How does Victoria compare...?
AIHW, April 2014
So, what would you like to know?
The Youth Justice Mental Health Program
Complex cases...?
Personality disorders are associated with ways of thinking and feeling about oneself and others that significantly and adversely affect how an individual functions in many aspects of life.
Previously 10 distinct types of personality disorder, are now 6;
What is a Personality Disorder?
• Borderline
• Obsessive-Compulsive
• Avoidant
• Schizotypal
• Antisocial
• Narcissistic
Paranoid
Schizoid
Histrionic personality
Dependent
Psychosis...?
Stress-vulnerability model...
Full transcript