 Good evening everyone and welcome to this evening's webinar. I'm Nicola Palfrey, a clinical psychologist and the National Clinical Manager for Headspace Schools. I'd like to welcome just over 400 participants who have joined us for tonight. We've got a fantastic group tonight joining us for the important topic of managing transitions for young people which we know is a really big issue always in life but it never more so than in the current circumstance. So first of all I would like to acknowledge on behalf of MHPN, the traditional custodians of the land, seas and waterways across Australia upon which our webinar presenters and participants are joining us tonight. We wish to pay our respect to the elder's past, present and future for the memories, traditions, culture and hopes of Aboriginal and Torres Strait Islander Australians. So we have a great panel tonight which no doubt you are somewhat familiar with. We have sent out the buyers so we won't go into a huge amount of detail because we're really interested to hear from them tonight rather than spend too much time in the upfront. So I'm going to throw straight to the panel to get them to introduce themselves. First of all we have Dr Michael Carr-Gregg. Welcome Michael. I've got a question for you Michael to start off with if that's okay. Sure. So Michael you recently ran a masterclass webinar on the grieving adolescent or adolescents going through grieving. Can you tell a little bit tell us a little bit about that session please? Oh well thanks very much yes it's a passion of mine. I don't think that we're very well prepared as a society to help anyone deal with their grief but particularly not young people and they grieve in a very distinctive way in little spurts when they think that the circumstances are ready for them and the most important thing I think when you're dealing with grieving adolescents is to listen really carefully and be directed by them and that was the main message. Thank you. Thank you Michael and I agree I think it's something that is good to come out of the shadows so we can talk about these things because then we can address them more clearly. So thank you and welcome. Thank you. The next panelist I'd like to introduce is Meg Cordary. Meg is a colleague of mine and I welcome her. She's joining us from Queensland and Meg is a social worker by trade. Meg as you know very well a lot of people think about Headspace they think about the centres and it as a kind of therapeutic service. There's a bit more to Headspace than that I was wondering if you can tell us a little bit a bit about what other services that Headspace offer. Yeah certainly thanks Nicola and hi everybody I hope you're having a good evening. So Headspace has a range of other services actually the centre network as we refer to it is only one part of Headspace national offerings. So we have the Headspace schools division which is actually the division that I work within and that has a different a bunch of different contracts and programs within it but also there's a really large online footprint of Headspace. So we have our Headspace service which operates staff sit in the national office in Melbourne and that service operates from 9 a.m. to 1 a.m. every day and you can engage with clinicians via email phone or web chat and that also includes family and friends they can access that service to which I think is pretty fantastic and that's free and there's some other things to Headspace has a digital work and study program and that's for anyone 15 to 25 years old they also have a career mentoring program that's for 18 to 25 years and it's really easy to register your interest for those programs you can do it online you can just go and fill in a form or give them a call at a Headspace and often there isn't a wait time for those services so they're really fantastic and there's a couple of other things as a group chat that you can access as well yeah a bit of variety. That's great thank you we might get into that a bit more as we go along tonight so thank you Meg and welcome and finally I'd like to welcome Anne Rubenstein. Anne we originally had you listed as a GP and we had a good discussion in the prep for this that you've left GP land and moved in to start your rights of passage business so be really interested to hear a little bit about that decision and prompted you to do that. Thank you thank you Nicola and good evening everybody so I had two medical careers first of all as a general practitioner for around 10 years and then I spent another 10 years as an emergency medicine doctor and one of the big things I noticed as a general practitioner was that I was treating a lot of older people and it seemed like a lot of their conditions came down to there was a lot of addiction involved and those addictions might have been drugs in our whole but could also be food or work or unhealthy relationships all sorts of different things and it appeared to me that a lot of the issues that they were dealing with actually started when they were teenagers and then when I started working as emergency medicine doctor I saw what I called the over representation of teenagers in the in the emergency department and I saw a procession of boys coming in who had had accidents you know that involved speed height wheels jumping anything that they could do to sort of test their mortality and unfortunately I saw also a lot of girls who were drinking or taking drugs or just getting into situations which were really completely wrong for them and often that they would regret for the rest of their lives and I couldn't find anything that was really addressing what I was seeing and when I started looking outside the box and I discovered that indigenous communities all over the world and traditional communities and many of the major religions would create a process to support their boys and girls at that stage where they were becoming adults and actually create a ceremony to celebrate and acknowledge the fact that they were transitioning from children to adults and to support them to find what was inside them what was their passion what was their gift what was their spirit that they were going to take into the world so from that we started running some contemporary rites of passage and basically just took over my life and so I left my medical career now we run programs all around Australia and we're set up programs in about 30 countries around the world. Fantastic thank you I look forward to hearing more about I think it's you know the lesson for all of us about as we move forward and things change there's also you know not the baby in the bathwater scenario what should we take with us what's worked really well for for generations so yeah that's great so welcome I hope everybody who's joining us can see that we're going to have a great triangulation of perspectives as we talk about this topic tonight so I'm going to go through now really quickly some of the housekeeping so we can get into the good stuff so first of all in terms of ground rules for tonight all of us joining we've got hundreds of people joining which is wonderful of course in any of these circumstances we ask you to be respectful of each other the participants and the panelists keep topics we want to hear from you in the chat box there's also questions and we'll go through where you can feed through that that through to us where you can chat with each other and where you can put questions through the panel in a little while we also have technical support available 1800 209 031 all that information should be in your email that you received to come into the session tonight you can click on their information icon on the lower right hand corner of your screen to get support as well try refreshing your browser go in go out those sorts of things we've also got a platform which we're excited about it's pretty familiar I think to a lot of us perhaps a year ago some of us had some notion of these platforms and now it's zoom teams all of those sorts of things you should be very familiar but the information icon is in the bottom right hand corner of your screen get that information there to ask the speakers a question click on the speech bubble icon in the lower right hand corner I'll be monitoring that as we go through tonight and feed those through to the panelists at the end to chat there's two speech bubbles in the top right hand corner of your screen so that's where you can chat with each other share reflections as we go along as well you can change your slide and view video layout by clicking on the icon with two arrows inside a circle in the top right corner of the window this makes the video larger so you can see the panelists more clearly if that's what you prefer if you'd like to change your view to slide only or video only click on the square icon with an up and down arrow on the bottom right hand corner hopefully that is clear you can play around with it and hopefully get what you want so this evening we're going to have what is traditional for our panelists and for mhp and webinars each of our fantastic panel are going to give us about five minutes of their perspective from their professions and their point of view around the case study that you've all shared and hopefully are across and then we're going to open it up for questions so what we're trying to address tonight in terms of our learning outcomes is to look to identify the mental health indicators in the context of difficult life stage transitions for young adults so what are we looking out for and what can we do about them discuss tips and strategies that can help a young adult feel supported through these situations and discuss the importance of collaboration and appropriate referrals for young adults going through life stage transitions okay so let's get to it I'm really excited first of all to throw to Michael for his perspective on our case study so over to you Michael thank you very much Nicola well I always look at young people in terms of as I guess a child and adolescent psychologist would through a developmental lens and I'm actually a little bit worried about Chloe I think she's in a been in a really difficult space I think a lot of her key developmental tasks that I've listed on this slide have actually been significantly impacted upon by the COVID lockdown and her circumstances really most young people ultimately have three questions that they need to to answer who am I am I normal in their sense and where am I going and this identity formation really is greatly facilitated by Anna's rights of passage but also some healthy risk-taking behavior and clearly Chloe hasn't been able to engage terribly much in that in the last wee while and a really important predictor of well-being in young people is having a bunch of hopefully pro-social peers and clearly she hasn't been able to do very much of that either then I think about her capacity to emancipate psychologically from her adult carers Brenda and Pete and she hasn't really been able to do that either because the the family have been in lockdown and her capacity to hang out with her mates and take those healthy risks have been significantly compromised and what's worse and one of the reasons why I'd be very worried about Chloe is from an educational point of view remember she was a high achiever but year 12 has been an academic disaster for her she she and remote learning were not we're not friends remember the family had one computer a slow internet and all she really wanted was to go into nursing but unfortunately it would appear that she didn't get the ATAR that she needed so when I'm looking at young people I think about them in terms of these developmental tasks and this is clearly been problematic the the COVID experience has really stopped her from successfully I think tackling all of these tasks if we could have the next slide please the other way I like to look at young people is to see them in terms of their five worlds that a lot of them live in obviously what's going on inside them they're in a world their family their school their friends and of course their digital world what what we know is that there is a balance of risk and protective factors in all young people a lot of this stuff comes from the University of Washington and the social development model by Catalano Hawkins and Miller almost six decades of research which clearly shows that if you have the this perspective and you do a sort of forensic kind of formulation of what's been going on in the young person's world you can actually get to see where you go next which is obviously to minimize the risk factors and increase the protective factors now certainly from a family point of view this is a family that was hit hard both mum and dad lost their jobs the emotional temperature at home has been significantly elevated so we might be looking at some family work to help them in that respect with with her it says that she's the case study tells us she's sad and disappointed I wonder whether that's a little bit more than than sadness and whether in fact she may have developed a depressive illness certainly all of the the facts that I've actually seen many young people like this during the lockdown and many of them have in fact developed depression and a side order of anxiety and substance abuse as well so that wouldn't be at all surprising we don't really know very much about her digital world and not terribly much from the case study about her peer world but it's a fair bet that this is a young woman who really loved her basketball she hasn't been able to to to do that she couldn't emancipate she couldn't even complete her driving test and the only thing she really wanted to do is travel overseas and she's not going to be able to do that either so this is another different way of looking at young people next slide please so in order to get this information how would you do it well the answer comes from our wonderful friends at Headspace some years ago they took golden ring and Cohen's 1988 article in contemporary pediatrics which was known as the heads psychosocial biopsy was written for gps and just an idea of how you would have a conversation with a young person not read it as a list but certainly incorporated into your discussions your respectful hopefully discussions with the young person and I really love the the layout on on this you gently go through a home and education employment obviously eating exercise activities drugs and alcohol sexuality and gender and then the mental health components and of course the safety so look it's a pretty straightforward kind of method that I have with with young people single most important thing as far as Chloe is concerned is i'd want to get rapport hear her story and whack in a little bit of psycho education can we have the next slide please and I would use some psychometric tests because that's what psychologists do some of you are probably bored senses by psychometrics so I won't go that into any great detail other than I think it's really important as psychologists that we we measure what we can and I particularly enjoy using the the K10 with my general practice and social work colleagues because it's such a clear-cut indication of how young people are going and the next one please so the key interventions for Chloe hypothetically if as I suspect you might have depression or anxiety would be around psycho education using the wonderful resources at headspace beyond blue reach out probably do some CBT maybe IPT or ACT with her certainly the family therapy general well-being I don't think anyone on this panel is going to disagree with the benefits of a bit of exercise looking at the diet the sleep I would actually also recommend some e-therapy with her maybe some mood gym maybe use some of the smartphone apps and the most importantly of all thinking outside of the box maybe a little hypnosis and who knows she might love animals will do some equine therapy back to you Nicola thank you Michael incredibly efficient way through of that and I think that thorough assessment I think it gives us a really good grounding but one of the things that also I think can do for young people like Chloe is when they hear it out loud it gives them a bit of a grounding of oh and I wonder I feel a bit wobbly you know because there is a lot going on so I think there's something to be said for helping people articulate exactly what they're going through to feel validated by what they're experiencing but that's great we're going to throw to Meg now for her perspective so I'll pass it over to you thank you Meg great thank you hi everyone again I was thinking it might be useful to start with looking at a definition of a transition so that is the process or period of changing from one state or condition to another for me based on the case study and obviously this is the topic of our webinar tonight Chloe is undergoing a significant transition and that's from adolescence to young adulthood I think in terms of this transition she's experiencing lots of changes that would be of interest in terms of the social work lens so we'd be looking at a big change to her typical routine most young people have spent the first 18 or so years of their life in some form of care or schooling and Chloe is now 18 and she's thrust into the big wide world and what does that look like for her now in terms of her day to day I'd be thinking about the expectations both the internalised expectations for Chloe but also from others and also her sense of self her role her purpose so similar to what Michael has already touched on I guess in terms of that developmental focus I think a really really big one for me though is her support network what does that look like now during school young people are quite fortunate I guess that they have an inbuilt support network in their peers in teaching staff in guidance offices or in school psychs and school leadership of course not every young person has a positive experience of help seeking in school but for I guess a majority that support network does function to a degree for them so for Chloe leaving school what does that look like now so transition essentially I guess some keywords that jump out to me would be instability and uncertainty and when I look at the case study I also think about how this has been compounded by the global pandemic COVID-19 so not only is Chloe experiencing the state the states of instability or uncertainty a result of her transition from adolescence to young adulthood but also in living through something that I think not many of us would have ever expected this type of pandemic so Michael alluded to it before but really there's been major disruption to her schooling to meaning making activities for Chloe to her supports her peers and for me I think this combination has resulted in her presenting issues of low mood and lack of motivation and feeling you know a bit hopeless I guess what I wanted to really stress though is that Chloe is not alone and I've noted here a report that was released by Headspace in 2020 and it actually surveyed headspace center service users over 300 sorry 3,500 young people and you can see there some of the stats but essentially you know 75% of young people during 2020 of that group that survey group said that they definitely feel that their mental health has declined since the outbreak of COVID so I think I think that's really important in terms of normalizing and validating what Chloe's going through and I would certainly be seeking to do that in my work with her next slide please so naturally our journey would also start with a full psychosocial assessment as Michael noted and I used to work in the headspace center so I've used that heads assessment countless times know it back to front and it is really good and also I'd also want to be just establishing a baseline as well by using some you know K10 I'd be looking at SOFA in terms of daily functioning and I really value feedback informed treatment also so I'd be using that approach as well in my work with Chloe. I think for me a really key focus is on looking at what factors are exacerbating but also equally improving Chloe's presenting issues of low mood and lack of motivation. Again I'd pay particular focus to risk and protective factors so I can see a lot of crossover between what Michael spoke of and what I spoke of and that's not surprising considering that mental health social workers you know are part of that allied health obviously that group. I'd be thinking about a full risk assessment considering there some of the presenting issues can be symptoms of depression and just ensuring that safety is insured but really I just want to spend some time building rapport with Chloe I'd want to get to know her I'd ask questions about her present circumstances her part-time work her family her home environment her friends her aspirations she talked about nursing and just her goals for the future that would pretty much be my focus we know that access to education employment social participation and connectedness are all significant contributors to a young person's mental health and well-being and just their capacity to lead a flourishing life and actually research shows that these social determinants can be more important than health care or lifestyle choices in influencing health so that's a really big focus for me. Next slide please. Once I'd completed my assessment with Chloe I would just again spend time with her talking about the assessment and the outcome of that I really want to check my understanding of what's going on for her and especially considering the pandemic and Chloe's I guess lack of control an agency throughout what she has recently experienced I would want to ensure her agency throughout this process and also her self-determination I'd want her to feel in control and in that I understand her needs and the goals of treatment. I'd really validate as I said her experiences I'd normalize it I'd talk about you know that headspace report that actually you're not alone I'd highlight her strengths her resilience and her personal resources as a real priority. Next slide please. For me reading the case study I thought I probably would would be conscious not to over pathologize Chloe I think I'd be feeling that I'd be suspecting that maybe some brief intervention could fit for her and maybe an approach like solution focus therapy could work for me I think this could be really good it's focused it's goal oriented it's solution focused and it really assists clients to move in that future oriented direction rather than spending too much time I guess focusing on the problem or the past I'd be wanting to look to the future and what would be Chloe's ideal future and how would we know when she's there just one of the questions there that's highlighted exception questions so really illuminating when is the problem not present and I was wondering if Chloe's part-time work might be a good place to start to figure out you know how's that going for her it seems like that that's a real positive and a strength let's focus on that. In terms of practical supports of course be looking to re-establish a routine again that gives predictability and a sense of control for Chloe also like Michael just you know things like daily exercise sleep hygiene social activity all of those really basic self-care activities and a bit of a well-being plan I'd be thinking about particularly identifying early warning signs and stressors so that Chloe has a good understanding and good insight into what is it that could I guess result in a further decline in her mental state and of course we know that when stress increases so should our self-care because that's how we maintain our equilibrium so I guess depending on what Chloe feels comfortable with I would potentially suggest we could invite a family to be a part of a session for me the main purpose of that would be to create shared understanding between Chloe and her family but also to do some psychoeducation with family around I guess adolescence developmental stages what does that look like and her symptoms. Next slide please I guess to Chloe doesn't seem like she did talk a little bit about potentially getting income assistance but I'm wondering whether she might be eligible for that but also her parents I'm wondering whether they might be eligible for some kind of income assistance so I'd be assessing that and then in terms of her goal or desire to study nursing I think that the digital work and study service through headspace could be a great support for her and also her parents can access support through headspace too so yeah I'd really be suggesting that that could be a good option for her if she if she was into that she had some really great role models in her aunts too so they could be supportive throughout that process yeah they're probably probably the main thing I guess just summarizing I'd really want to have a strength-based approach I'd want to be looking at some brief interventions and maximizing protective factors for Chloe. Wonderful thank you Meg that's fantastic I really like the notion of kind of getting to know her I think that can be underestimated or under discussed in working with young people get spend some time with her and understand her and and let her know that it you get it it really sucks like it really sucks what these young people are going through so it's understandable and we've had some questions coming through and you've picked up on some of them around over pathologizing versus validating and that balancing act so we might come back to that as well a couple of quick questions yes the slides are available yes the recordings available yes we'll hand out some resources so let's keep going I'm really keen to now hear from Arne and his perspective so over to you thank you and we need to unmute yourself Arne oh that's the number one error not quite of the year so so thank you Nicola thank you Michael thank you Meg it's such an interesting case and Meg I love that you talked about definition of a trans transition being moving from one stage in life to another and I actually I very supportive of what you have both said and I look at it also from a slightly different angle where I look at it that life is actually a series of transformations and from and if I could see my next slide please that we move from you know in the if for children preschool to primary school into high school we move from child to adolescent to young adult and into employment and adult life potentially become parents and one of the biggest and most significant transformations or transitions is in fact from adolescent to young adult and my my biggest concern with Chloe would be is if we felt she was actually in immediate danger of harm in any way and if that is our conclusion then we absolutely need to deal with that but moving back from that I actually think that what's happening with Chloe is a cultural issue and we're seeing and research that makes sure that a huge percentage of teenagers over half of them are struggling at the moment and part of it and if we you know we're used in Chloe as the case study and her movement from adolescent to young adult has basically been put on hold and she hasn't been able to complete school properly she hasn't been able to get into the course that she wants to get into she hasn't been able to get her driver's license all of these things that are so critical when as an adolescent these are the things that you're looking forward to these are the things that signify that you are now going to be an adult and and she's still had her birthdays so that still come around but she is still very much feeling and being treated like an adolescent when she is absolutely ready to move into the adult world and that in itself is going to create a big issue for her and the other thing is that this transition that she's going through I believe the transition from or any stage is actually a community responsibility and at the moment it's like it's Chloe's responsibility or Chloe has to find a way to move herself from adolescent to young adult whereas I believe the community should be coming around Chloe and together creating something to help her move from child or from adolescent to young adult and because we don't have the community doing that we're therefore having to bring all sorts of resources in and basically to pathologize to potentially support her in creating that transition and and if we only have one Chloe that's okay but if we have you know over 50 percent of the teenagers in our community struggling in a similar way and by the way I think a huge number of them were struggling before COVID anyway and and I think COVID has actually exaggerated the problem rather than created the problem and there's a lot of research which shows that the well-being of young people dips considerably around 14, 15, 16, 17 years of age and that these are in fact some of the highest risk ages and for me what I would like to see is actually a community process I would like to bring together all of Chloe's class and I would like to bring together with her class her parents and I would like to bring together also if we could get grandparents in there and I would like to see them sitting around and I would like to have Chloe listen to the stories of her parents and her grandparents and we are in a stage where the resilience of our children is at an all-time low because of the you know for many of them the privileges and opportunities and and probably you could say the lack of adversity that many of them have dealt with and so when COVID's come into it and all of a sudden some things have been cancelled and things can't happen and you know really in Australia relatively speaking we've done very well but it's been very difficult for a lot a lot of the teenagers however I would also love to have the teenagers listen to people like my father who's 91 years old and lived through the world World War II and lived through you know the Cold War and lived through some economic hardships and different things and I think when the young ones get to hear from the elders that not that not only you know that the young ones aren't the only ones who are struggling at this age it's actually a very normal thing and when they they learn that you know Chloe could well think she is the only one who's struggling but if we can create a scenario where Chloe can actually hear the stories of the other students her age and hear the stories of parents and grandparents and realise that to some level this period of life is difficult but hopefully it does pass and there are ways that we can get through it I think that would be very therapeutic and positive for Chloe and in our work in creating our programs around Australia and around the world we've recognised some of the things that it takes and some of the things for teenagers to thrive and I think this is similar to what Michael and Meg have said but in a different way so teenagers need a sense of belonging and it feels to me like Chloe is very much on her own teenagers need to create a vision and have a purpose it also seems to me that Chloe doesn't have much of a vision or a purpose teenagers need an awareness of their own gifts and their talents and their genius and spirit and once again it doesn't seem like Chloe has that going on and teenagers need an opportunity where they can sit with either other teenagers or adults or support people and be able to share what's actually going on for them to be able to share vulnerably about what's happening and not be shamed for it and not even be pathologised for it just have that opportunity to share and how beautiful to hear Meg say that she wanted to create rapport with Chloe and once again there's a lot of research coming out which shows that when a teenager has rapport with anyone who's older than them or anyone at all that that teenager will do better in all areas of their lives in their families in their educational outcomes and less likely to engage in deliberate behaviour so absolutely Chloe needs rapport Chloe needs a space where having heard stories and having shared her own story she can create a vision for the future she needs elders to tell her that even though she's struggling they see her and and the aunties that we're talking about you need a space to tell Chloe all the beautiful things they've seen about her growing up all the things that they love and admire about her and she needs a safe space to be able to work through this and she like many of the teenagers are struggling and yes I agree with the psychometric assessments and the and all the support that we're talking about but I'm also very interested in how as a community we can be normalising the process of creating ceremonies celebrations and support networks for our young ones as they're going through these stages because I I worry that our our networks like headspace are not you know that we're trying to replace what really as I said earlier should be a community responsibility with you know allied health professionals who just get stretched so thin trying to support all of the different teenagers and all what's going on with them so so that is the approach that I would take and really it comes down to what I discovered when I looked at communities around the world where they would create rights of passage when when the children reach that age as a community they create a celebration they would share stories create a vision acknowledge the gifts of each of the children and their their genius and their spirit whatever you want to call it create challenges for them to help them build up resilience and basically they would be creating a scenario that was mimicking what was going to happen for them as adults but doing it in a safe supportive way when they were younger so that when they got to the difficult times they had the coping mechanisms and the support networks to be able to get through them in a healthy way and my final slide if we can go to it because in my work I realise a lot of what we do now is we need to be building communities and so we have a model called a golden check-in and it's something that we encourage families to do and it's something that we encourage teenagers to do with each other and it's about when we check in with someone instead of saying how you're going or good or fine that we actually go a little bit deeper and in the golden check-in we use the letters of the word golden so g is how you're going overall o is what you what have you been occupied with and what have you been doing l what have you liked recently d has anything been difficult d is anything you're excited about or things that you're worried about and n what support do you need and we have found that just by creating and it's this this is the building rapport and it's something that we can do once a week the dinner table with our families it's something that I often do at my work at the beginning of meetings we just have a check-in that goes one level above just saying that I'm good or fine and actually genuinely gives us an insight into how the other person's going because if we know how someone's going then we can actually support them and give them what they need so that's my angle and perspective on it thank you very much thank you so much sorry sitting back listening to you I was really enjoying it and I love that scaffolded conversation I think you know we've done a great job in this country around encouraging people to check in with each other you know are you okay and all of those sorts of things I think what's become more apparent over the last little while is that a lot of people don't know how to respond you know if you get a an answer that is not I'm good thank you so I think also the the notion that people need sometimes a bit more they need to know that you're actually interested you know that it's not just a cursory tick box so I think that's a really lovely way to support that to have a conversation around you know what's going well and reflecting that we always have things that are going well and things that are challenging at any point in time I also love awareness of their genius and spirit I've written that one down I think one of my observations and bugbears in life is that the dominant narrative around adolescence is that they're awful that it's a terrible to point of life that your children are going to turn into these creatures and you know how would we expect them to thrive if all they ever hear about themselves is that they're awful critters when they're actually there they have genius and spirit so I really appreciate that personally so thank you okay you guys have done an amazing job of generating all of that in a really succinct amount of time which thankfully gives us time for questions because this is where we can get into the the nitty gritty a little bit we've had a number of questions coming through so as we go into it we can we've got the pictures of us that we all love our bio pictures you can actually change the view guys if you those of you watching at home so you can see all of us while we're chatting which might be more interesting than our pictures or it might be less flattering I don't know if you change the slide view by looking at that icon two arrows inside a circle in the top right hand side to change the view makes the video larger and the slides smaller so now I'm going to go and throw to our panel we've had some good questions coming through I am I wonder who might want to talk to the babe Michael I'll throw this to you to start off with if that's okay there's been a bit of a discussion about this but one of the first questions we got as we came through is from Megan or Megan I apologize my sister-in-law is a is definitely a Megan and she hates it when I get it wrong around is there a risk of medicalizing or I suppose pathologizing transition issues at the moment for somebody like Chloe and should we be normalizing versus pathologizing do you have a view on that I think we've got to be absolutely clear not to pathologize I just emphasize that this was a hypothetical and so I might have egged it up a bit for the for the sake of the the the case study it is absolutely possible that she's coping that she's going to cope really well with this next part of her life but I think we have to be alert to the possibility that she isn't you've heard the research that suggests that that there are significant links between certain risk factors and the development of some set problems set diagnoses and I'm very very happy to to tell people that that there's that that particularly their their parents who often are the ones that worry or schools that this young person is just going through a delightful academic adolescence and that it's it's really something that will develop over time so absolutely we should be aware of the danger of pathologizing great thank you Michael so any of the viewers that have been listening longitudinally please add your questions in we have got time to cover through a few of them we do have a number from registration as well so I won't get to all of them I'm trying to group then cluster them together so I apologize if your one isn't answered directly um and let's throw this open I'm sorry guys I have a prep due for this um well maybe I'll throw to you first Meg given you've worked a lot um in the school setting there's a question that's come through around gender specific do we see particularly different um challenges for um different genders as they in these life transitions that you've observed and feel free to say I don't know or know and throw to anybody else so it's a question without notice hmm great question oh it's got me thinking um I'd say the answer is yes we probably would see gender differences um with what they are I'm not sure I can on the spot does anyone else have any I don't know Michael I'm I'm happy to speak to that um so in my experience as a doctor there were overall gender differences if you took a thousand uh um young people it's really important is that just because someone is a girl who was born a girl doesn't mean that she would necessarily uh you know exhibit what the overall girls would typically exhibit or same as the boys however what I noticed was that for example in the risk taking behaviors that we see that the boys was very much more about going out and um you know looking in trouble and testing their mortality um and and that was why speed and and you know they would build a jump and they would jump over it with their motorbike and if they successfully landed it the first thing they would do is they'd go back and they'd make it higher uh and and they'd make it higher and you know it could only end in one way and and it was really about pushing it pushing it pushing it and pushing it out there facing fear pain and the possibility of death and what I saw an emergency and yes there were some girls who did that but very often I saw that the issues that the girls got into was when they would go inside and and internalize their problems and then from there the issues would happen and when you threw the potential for drugs or alcohol in the mix then it would just get a lot worse and they would and we had things like schoolies which you know by the way we call a rite of passage which I have a major issue with and I saw many many girls who did things on schoolies that were um or had things done to them on schoolies that were were really quite tragic but the interesting thing was when I would say to the girls who I would be looking after in emergency did you know beforehand was there some voice saying in your head saying that is not a good idea and very often they knew very often they knew that what they were doing was was not going to work well but they did it anyway and when I would say to the boys did you know before you did this did you know that it was going to not work out well and the boys would say no didn't even think about it so that was a gender difference that I saw and you know it's very interesting that in the in the in the rites of passage that were created for boys and girls very often traditionally the boys would have to do something that involved them being able to deal with pain fear or the potential of death and the girls would have to do something would they would often put them on an internal journey where they would learn to trust in a voice now in the rites of passage that we create now we don't you know we don't just say well the boys have to do that and the girls have to do this we want the boys to learn to trust and find their inner voice as well and we want the girls to also get in touch with their inner warrior and their strength and their their power in that way so that's how we sort of work with it and part of how I look at it that thank you that's great I think it's nothing is absolute right and certainly gender we know is not but I think that's really interesting I really like the notion of the stance of curiosity you're coming from you know and and sitting with a young person and and being curious about what that journey is such a terrible word but you know that what that experience was like and at what point were they trusting themselves or listening to that themselves and not and I think that reflective modelling that reflective questioning is is a really great place and we don't do it enough I think you know we jump to lecture or correct really quickly a lot of the time versus letting people come to their own conclusions so thank you got some really other interesting questions coming through I wonder Michael maybe this one for you and I'll come back to you Megan I'll throw you one that maybe I don't feel like I'm throwing you quite so much under the bus I apologize for that Michael there's a question here from Belinda about young adults appearing to get stuck post school the lack of confidence in society in themselves and a comfort living at home and in the digital world but not a deep satisfaction any thoughts on that observations or you know how you might work with that it's kind of and the stuckness that we might see in some young people and on we about what we're doing next yeah I mean I think the two interesting things about that one is there's a sort of identity diffusion amongst some young people not all when they leave school they're not entirely sure about what's next and I think Anna's absolutely right about the fact that there were problems pre-COVID but I think there are now more young people who seem both stuck in your words but also there seems to be amongst some of my clients a you only live once type philosophy where nothing matters now they can't do the things that they want to do I've had young people tell me you know all the economies are stuffed and our politicians are useless and the world's burning up and and we'll all die of global warming so I think there is a pessimism there which has always made me feel a little bit sad because I've always associated young people as you do with hope and optimism and curiosity so it worries me that some of my clients might be so pessimistic so what do we do about that I think that our major job is to provide hope and different ways of thinking I think one of the key messages if I had sort of one minute on on national YouTube where every young person was listening I think the message that I'd want to send two messages would be if in life you can't change something you can always change the way you think about it and see life as it is but for goodness sake focus on the good bits thank you um yeah just picking up I think that they link in really nicely um with some of the stuff that the other panelists have been saying and it reminds me my dad is 85 and I asked him the other day about um you know his reflections on what we're going through given he lived through world war two in the UK and he said it was interesting it's his um he's been thinking more about that than he has for many many decades and I think those the sharing of stories and hope and that notion that you know that say world war two that a lot of these kids grandparents lived through um you know six years of time and um what that meant for them and what that meant for them and their life and and uh and hope and and changes and transitions and things there's a lot to be said for stories and sharing of stories of of resilience I think that's um there's yeah it's really important how it how we do that and how we give um validate what your people are going through but also give them hope about where where too from here um Meg I want to throw to you if that's okay I had a number of questions in the registrations but also this evening around the role um that schools can play um obviously we've got Chloe who's leading year um 12 and I think we all hope that that would be that cohort that we're impacted but clearly we've still got COVID we still have lockdown we um I've got two nieces in the UK who are just about to finish their degree who have done two years out of their three-year degree pretty much in lockdown um and they're looking to see you know maybe come to the southern hemisphere for the next stage um so I'm wondering about you know schools and other institutions what they can do with the current cohorts or how we can maybe support them as they're looking forward to their transitions um yeah perhaps into this uncertainty and instability that you mentioned yeah certainly um in my experience so as I mentioned earlier headspace schools the division of headspace national um one of the biggest contracts of the schools division is BU um and so we support schools around whole school well-being um in terms of frameworks for that um building mental health literacy of educators and also building their capacity to support our young people and their school community in general so I talk a lot with schools about I guess the risks of transitions um a poor transition but how do we also put strategies in place to enhance um and maximise protective and healthy transitions and schools have been doing this for years and years and years they're really good at um supporting transitions you know not only from say uh kidney to prep um but then year 60 years seven and I know that's new in Queensland I'm from New South Wales that's normal to me um and then from year 12 to year 13 as we call it um and so in my role I've supported a number of schools increasingly who are looking at that year 13 as I guess a pretty big um it's a pretty big risk time in young people's lives and I was thinking just before when Anna was talking about that you know males are far less likely to help seek um and yeah definitely that you touched on as well Anna around you know in terms of their behaviours they're they're much more I guess destructive um so thinking about how can schools be mindful of that and what can they put in place to maximise protective factors during their senior schooling years so that um you get you have more likely to have that healthy transition and I think I'll touch on just a couple of them um you know a big one for me is early support so what's in place to make sure that there are support pathways that young people know how to help seek um that parents and families are aware of local services know about referral pathways you know all these sorts of things schools can do a lot in that space um and then family partnerships so thinking about um getting groups of parents together to share their concerns around their young person graduating um normalise it validate it again but then use that as a resource and I guess that's what Anna was talking about too is that using our communities our organic communities to maximise protection and and reduce risk so I think yeah there's a lot that schools can do I could probably go on for a long time um a really key thing too is some schools call it like a life skills program um but essentially it's part of their curriculum and so it's um common deed time maybe once a week where young people learn life skills so what does it mean to help seek what does it mean to support a friend or identify that a friend isn't going so well um how do I talk to my mum or my dad or my grandparents if I'm struggling you know what does that actually look like and and practicing those skills and also maybe looking at developing a well-being plan this can all be done in school so that when that young person doesn't have that um natural support network they've got some strategies they've got some skills they've got a bit of a plan and hopefully um we'll be able to catch them early and one final thing I'll say is a strategy that I've seen used and this is a little bit resource heavy so it's not possible for all schools but is looking at um young people within year 12 who might be showing some I guess indicators that they might not transition well um so at risk of poor transition I guess so and then wrap around some supports around them whilst they're in year 12 um upskill their parents so that they can be that support network for them when once they've graduated and then if they can keep in touch with the student or the family for the first 90 days of their graduation um check in and that's a really great opportunity to course correct early if things are going wrong yeah that's great thank you thank you big um just picking up on some of the points there I know there's um the challenges with services right services are full across the country now more so than ever um I certainly know across the the work that we're doing um networks often uh and rural and remote regions there is um online services uh telehealth terrible word um web facilitated chaplain so forth I wonder Michael I know this is an area that you're interested in um you could talk a bit about that it's an area that I think when we have conversations around it there is mixed messaging about people like it people don't like it I think it's um yeah it's what interested in your view about what's what people's views are about this and how they might be useful for for young people transitioning well I think the um uh mental health services are dramatically underfunded you'd expect me to say that and I I think it's true um and therefore I think we are increasingly reliant on e-therapies um and I think that Australia probably leads the world in the development of um things like mood gym um I'm thinking about the wonderful apps that reach out have put out in terms of reach out breathe reach out worry time um I'm thinking about an organization I used to be on the board of smiling mind and their uh incredible work uh promoting mindfulness um and look I think we have to be really um proactive in this and I think that it is not um everybody's cup of tea but I also think a lot of this is the way in which we as clinicians introduce young people to uh these apps and uh websites and uh I would always do so in a way that was immensely respectful of the young people I wonder if you would like to trial this for me is a much better um kind of attitude than here's an app go use it which I fear some people do I think it's a really good point um I think sometimes we want to have conversations the people who are telling me that young people won't use them at my age I'm like have you asked a young fee for person because I have two teenagers at home and they have no problem whatsoever connecting um and uh with their friends constantly um via xbox or snapchat or you know that's their social connection so yeah I think we have to be cautious about our own view of what is and isn't and certainly some of the young people I've dealt with prefer it you know there's a preference for that versus face to face the um privacy is an issue you know is mum listening at the door you know versus in the therapy room we might be able to keep her further away so there's I think it yeah it's really good I love that idea of asking them to try it and um you know do a critique for us look at these different ones and tell us yeah that agency and bringing people into the conversation is a great one um and I am keen to come to you we've got um a number of questions around rights apparent passage in different cultures and the use of ceremony and so forth um it's got a question from Linda rights of passage in different cultures also teaches teenagers the responsibilities of becoming an adult and trains them in living skills before they celebrate their transition into adulthood can we work with teenagers on issues around finance time management etc to help them become independent is that something you see is helpful in this space absolutely I think one of the things I found from the rights of passage that I studied was that they all did it in the same using the same uh elements but it would it would modify according to which community was in and where the community was at so I look at it with schools you know our children when our children go into school they are young children they're almost babies and my hope would be that by the time they leave school they're actually young adults and they're equipped and they have an understanding of what it means to be a young adult and they have some of the the key 21st century skills which is what we're calling these days of resilience and adaptability and curiosity and emotion intelligence and and various other skills that we can be teaching and and uh I think what happens in year 13 and when they first leave school is a very strong indicator there's something we're really not doing well because we see legions of kids going to Byron Bay the Gold Coast Bali Fiji as soon as they leave school the next day they're on a plane and they're out there and they're drinking as much as they could and they're looking for drugs and they're and they're having inappropriate sex and you know unfortunately too many of them not all of them obviously but too many of them are getting in trouble and and I think that the role of schools has to be not just to give our children an academic result it absolutely has to also be to educate and to support our kids so that the transition into young adulthood has happened as much as possible before they leave school and also I think we can't just leave that up to the schools and we can't just leave it up to the allied health services to support the kids who are struggling once again it has to be a community responsibility within the schools and like me I'm now doing most if not 90% of my work in schools and it's about rebuilding communities within the schools getting the parents involved getting the parents actually involved with each other so that they're not only supporting their own children but all the parents are supporting all the children and we for example say to the parents get to know your children's friends and in fact you may well be able to have a better conversation with one of your children's friends and you can with your own child at certain times and we want all the children to know that if they have a problem and they for whatever reason are not comfortable speak to their own parent that there are other parents or aunties or people that they can go to so all sorts of community building activities that we can do starting in kindergarten and going all the way through and then at key times like for example the year nine camp and transforming year nine camps from activities where they go abseiling and bush walking and kayaking to actually at least a part of that camp is an opportunity for them to talk about okay how do I want to be as an adult what's my vision what sort of relationships do I want to have how am I going to treat the people who I'm in relationships with what are the things that I need to let go of if I'm going to become that person and also somewhere in there like I mentioned before either the teachers or if we can get their parents involved or their peers actually speaking to each of them and recognize and naming what are the gifts and genius and talents and spirit that we see in them so that you know a couple of years before they're leaving school they've already started this concept of creating a vision that they're comfortable to share with their peers and in fact with their teachers there's there's as I meant earlier there's research coming out that if there's a mentoring relationship between teachers and students the students do better on every level yeah and what we're often finding is that mentoring relationship happens in the primary school but once they get up into the high school the teachers are often coming in delivering their information and leaving and and the students are not getting that mentoring relationship to the degree that they potentially could so it's by bringing these things back in and using things like school camps that I think we can be doing a lot of preventative and positive work with the students thank you I love that my brain's pinging all over the place it just as you're saying that I was remembering in primary school um when my kids were in primary school they would come home with a poster and everybody had written on a post-it note something they noticed or admired about them yeah we do that with little kids why aren't we doing it we're the year nines you know the who are so desperate for it they are so desperate for someone to tell them that they see them that they love them that they admire them you know a lot of these kids who are really acting out are also hugely talented of course they are yeah and they just need someone to tell them that they see them that's one of the things they need yeah that's great thank you um I have to have to wrap it up I don't want to I do um I'm going to throw to each of you um now and I'll return to the the natural order just for for a couple of minutes and we've we've talked around I really like the fact that we've had a good amount of time for Q&A it also always means we get into the the nitty gritty a bit but um Michael you mentioned before if you had a minute of of YouTube time um that I was wanting to use anything you wanted to add you've got a couple of minutes now to to wrap it up key messages around what we've been talking about tonight that you'd like people to take away yeah I'm really worried about young people in 2021 um I really don't like the media uh narrative at the moment and um as a person who works in the media um trying to to counter that is uh a very high priority for me um I think that we need to celebrate uh the uh I think someone used the word genius um and I'd actually add the curiosity around young people I think they're uh they need to see and hear some positive um reflections of themselves uh and uh we really need to call out the negativity when it when it happens and uh I just wanted to to thank you for your superb um facilitation of this evening and say thank you very much to my fellow presenters I think you're all brilliant thank you Michael it's been a great conversation Meg um how about from you a couple of key takeaways that you'd like people to think about yeah um latest echo what Michael said first that yeah really great to be on the panel with you all tonight um I think for me I challenge that young people aren't resilient I think they're especially resilient um I think they are critical thinkers and they think outside the box and they're not willing to accept maybe what generations before them did um and I really admire that um so I think yeah I think they are resilient and I think they have an abundance of skills and inherent resources and it's our job to help them uncover those that's that's what I would say and I think the earlier we do that the better so I love that I work with schools I love that I work with educators um and really building their capacity to do that work um I'd say family partnerships are essential um yeah yeah perfect thank you Arnie over to you thank you um I I I'm both worried and optimistic I think over has created some incredible opportunities it's brought a lot of families home and it's brought you know so many families I've spoken to the kids that left home recently and then they got them back for another year again and some families really struck that but other families have told me it's been astonishing you know just having that time again and and and the things that they've been doing together and and I think also I've really noticed the shift in schools with this genuine realization that well-being is not just a you know a box at the bottom of a spreadsheet that it is actually a critical part of the the education of our children and more and more schools are looking for genuinely positive impactful well-being programs and I love that and and you know in terms of our work which I've been doing for 25 years more and more schools are going you know what what do we need to be doing that least asking the questions what do we need to be doing to genuinely equip our children with the skills they need for when they leave school and when they get to year 13 so I'm seeing a really big shift and I'm a big fan of young people in our work it's all about you know finding what is special and wonderful about them so we're lucky that we get to see the extraordinary side of these young people and I think if we can bring that out more and more you know that actually gives me a hope for the future it's a great note to finish on um I just want to double down on one of your other messages I think in a lot of the work I've done and some of it's around following community trauma events and other things is talking to young people about who they can talk to young people are incredibly conscious of the burden on parents and not wanting to talk out of turn or not wanting to worry parents when they're particularly stressed in Chloe's circumstance it's a good example so actually letting kids know who they can talk to and they won't kind of be talking out of school or betraying the confidence of their families I think is a really good message to A let them know that it's okay to talk B to encourage them to do it but see to so they know what their options are I think that's a really good message anyway we have to wrap it up I can talk underwater so I'll stop I want to thank you all so much I think it's been a fantastic conversation for everybody I've really enjoyed it and I hope the participants have no doubt they have you can let us know that that's what we really need to do we take it really seriously we get really comprehensive feedback and it helps us shape what else we do so please click on the pie chart icon in the lower right hand corner of your screen beside the speech bubble to fill out the survey or you'll get a pop-up at the end of the webinar you will get some follow-up communication from MHPN with the recording so you will get the recording all of the webinars that MHPN do are available I encourage you to have a look at them there's some fantastic historical ones there I often go in there myself to have a look at topics we've got upcoming webinars please have a look for MHPN emails about things that are coming up in June we're having a webinar on adjustment disorders actually a question about that in the pre-question so that will be relevance we also have a podcast series or MHPN do I feel like I belong to the family trauma and resilience series their podcast is available Apple Spotify or from the MHPN website there's also local networks check them out there's over 373 networks across the country and finally before I close I'd like to acknowledge the lived experience of people and carers who have lived with mental illness in the past and those who continue to live with mental illness in the present thank you everybody for your participation for the questions for the panelists and all of you for your interest farewell and good evening thanks very much