Laura Knight / 1
Review of Support in Tough Times- NSW Commission for Children and Young People, Mental Health Commission of NSW.
1 About the Research and Key Findings
Adolescence and early childhood is the peak time for onset of mental illness, but young people most turn to family and friends instead of seeking professional help.
This research focused primarily on schools and the barriers and supports for a young person seeking adult help for a friend experiencing mental health problems.The research shows the importance of school based actions and links to the reduction of social and emotional barriers that young people experience in seeking help.
Almost three quarters (71%) of students reported knowing someone who had experienced a mental health problem and 64% reported that they had known a friend or young person in that situation.
Most young people reported that they would help a friend experiencing mental health problems in a range of ways which could be helpful, including listening, taking their mind off things, advising them to talk to an adult, or advising them to talk to a professional.
Among students who had known someone experiencing a mental health problem, at least 94% had performed at least one helpful act and 86% had performed 3 or more helpful acts for their friend.
Almost one third (29%) reported that they did not know a suitable adult to get help from for a friend experiencing MH problems.
52% said that they would seek help from an adult for a friend with a mental health problem, while 27% they would seek adult help if they remained anonymous.
Barriers to seeking help were worrying about their friend being embarrassed (72%), feeling unsure about what to do (51%), thinking about involving and adult would make it worse (44%), thinking they were breaking their friend’s trust (40%), and if their friend said they didn’t want help, probably not seeking help (40%).
The aspects of a school environment which reduced the barrier for a friend seeking help were feeling that the adults were trustworthy, feeling comfortable to approach adults, the respect of confidentiality, knowing who to go to, and believing that the adults care about the mental health of students.
Young people were most likely to approach parents (74%), professionals (counsellor or doctor 49%) and adults at school (teachers, sports coach, and supportstaff 46%).
Conclusion
This research shows the barriers which young people face, brings to light the need to involve and educate parents, and the need to involve service providers within the school community. These will all help to create a successful environment in which young people can seek help for friends. If there is help given to young people by adults in a timely and appropriate manner, then this would help greatly both the young person seeking help, and the young person who needs help. The research also shows the need and value in including young people in the development of evidence based practices.
2 Intent to Seek Adult Help for a Friend
There is evidence that when encouraged to seek help from a friend young people are more inclined to do so. Also, because peers are often the first person someone turns to, they are more likely to notice when their friend is experiencing a mental illness.
In the study the majority of students expressed the intent to help their friend when faced with a mental health problem. Other students said they would help a friend if they could remain anonymous (25%). This may be due to some barriers faced by young people which are discussed later. Parents are the most likely people that young people turn to for seeking help, however just under half of those who had sought help for a friend from an adult in the past did not seek it from a parent, they sought it from school – which indicates just how important it is to have strong relationships between school staff and students.As parents are the most likely for young people to come to express concern, it is important parents know how to adequately deal with this if their child expresses concerns about a friend including who to contact at school about this and knowledge of community services.
3 Barriers to young people seeking adult help for friends
The major reason why young people did not seek adult help for a friend was that they were worried about embarrassing their friend (71%). Other reasons included that they were unsure about the best thing to do for their friend, it would break their friends trust (40%), they themselves would be too embarrassed to talk to, they were not comfortable enough to go to a professional, that they did not have a trusted adult to talk to, that involving an adult could make things worse (44%), that they did not know an appropriate adult to go to for help, and that they would not seek help if their friend did not want help. The least picked reason was that a young person did not think that the problem was serious enough to warrant help.
The biggest reason for young people not seeking help in the past was because they felt unsure about the best thing to do. One third of those who had not sought help in the past were because they had felt that their friends issue was not serious enough – when it fact it was – and draws attention to the fact that young people may have trouble recognising symptoms. Another barrier was confidentiality – students thinking that teachers gossip about what they have told them, that what they have said would somehow get out, or that teachers would treat them differently due to mental health. Negative experiences in the past with adults have also hindered young people approaching adults with concerns.
Young people had concerns in how adults would react to the problem, in that they would not understand the problems young people face, they would not take the problem seriously, or that they are simply not interested. Some young people were worried that adults might over catastrophize the situation or take action that the young person was not comfortable with, therefore making the situation worse. Others were worried that they would get into trouble if they approached an adult, especially if the problem involved illicit substances, or that they would discourage the young person from spending time with their friend.
4 School Effects on Student Intentions to Seek Adult Help for Friends
The strongest influences on intent for students to access help were their own social and emotional responses and barriers. Changes in the school environment both socially and in practice showed a reduction in the barriers facing young people. Factors such as relationships between the young people and their teachers were one of the key areas that showed a link between good relationships with teachers and intention to seek help. If a young person felt comfortable enough to approach an adult that they trusted whom respected and cared for them in return reduced the feeling that approaching an adult would make things worse, reduced embarrassment, and reduced reluctance to break a friends trust in seeking help for them. Learning about practical ways to deal with mental health problems also broke down barriers in young people seeking help. There are many factors in the school environment that have an effect on intent to get help and seeking help, therefore all of these factors needs to be addressed in helping to encourage young people to seek help.
5 Schools Supporting Students to Act
The findings show that young people who believed the mental health education they were receiving was useful and practical were more likely to intend to approach an adult for help for a friend. Young people who gained practical knowledge were more confident in using their knowledge and skills to help, and young people who had the chance to speak about mental health at school and felt they had someone to talk to were more likely to seek adult help for a friend.
Some ways to build confidence for young people to find help through the education system included:
-Practical mental health discussion which was also interesting
-Normalising mental health discussion, therefore lessening stigma
-Discussing the ethics of breaking a friends trust in order to gain help for them
Young people expressed the need for more engaging and interesting material about mental health, the need for information about how to recognise signs and symptoms of mental health in real life, and how to help themselves and other young people who need help with mental health problems. Young people also expressed the need to learn how to apply the theory in real life situations. Other ideas that were spoken about were the need to find help within their schools, and the need to know more about services that were available within their community. Young people were asked about their awareness of mental health services, almost 89% were aware that help for young people about mental health from a phone service, online services 88% and drop in centres 65%, however only 57% would consider using an online service and 42% would use a telephone service. Few could name a service besides the Kids Helpline (48%) but there was higher recognition from a list of services to look for advice for a friend. While some students acknowledge the fact that they would love to know more about services available, the students who had used online and telephone services expressed frustration of not knowing who was on the other end of the phone, waiting times, communication barriers, and cost.
Young people spoke about their own ideas for making mental health education more interesting, including making it fun, having doctors or other specialists come in and talk, or having young people who have lived experience tell their stories. They also reported the need for more open discussion for mental health in school, to normalise mental health problems. Not only would this help to reduce stigma, but it would also help to build a good relationship between young people and their teachers. Students would probably feel more inclined to approach these teachers if they had a good relationship with them, trust them, and know the adult will listen and take them seriously.
Schools in this survey developed an array of ways to build bridges between students and peers, their teachers, and counsellors. This included having teachers assigned to a year group who were responsible for monitoring them and helping with any problems these young people might have. Some teachers were also assigned to a smaller group of students for 15 minutes to speak to these students about any issues they were having. Other ways to build these supports were through peer support by assigning older students to a group of younger students that meet twice a week for 25 minutes. These systems were viewed very favourably by students who saw them as a positive source of support and guidance. Young people also expressed the need to know about the counsellors their school had, as many of them did not know who they were or how to access them. Some young people suggested the need for regular counsellor check-ups for everyone at school, because it would lessen the stigma of seeing the counsellor if everyone was going.
Students were more likely to approach adults for help if they had a respected relationship, like being treated as equals, having their confidentiality upheld, and feeling like they weren’t being judged. Students also felt they were more likely to approach an adult for help if adults recognised that the student was competent in being able to help their friend. They expressed the wish that if an adult did become involved, that they would like to remain as a stable source of support for their friend instead of the adult taking over. Students were also more likely to turn to adults for help if they felt that the adult cared about them – otherwise what was the point of turning to an adult if they did not care about the problem they were expressing? Students also noted how they would like to have adults such as parents and teachers check in on them to see how they are going, because sometimes it is hard for a young person to ask for help. They also expressed the need for adults to follow through with action – it showed the young people that they cared enough to take action, and therefore built trust between them.
As well as having a strong mental health program and policy within schools, there needs to be strong school-parent partnerships, and the ability for schools to access appropriate services for students when needed. Some parents don’t know what to do when faced with these issues, or schools find it really hard to engage parents in mental health discussions or school events which discussed mental health. Some schools rely on external services as they don’t have counsellors, but this was problematic for schools in rural or remote communities where services were very limited.
Summary/Conclusion
Mental health problems have affected the lives of many of the students in this study. 71% of the students reported knowing another person who had experienced a mental health problem and 64% had known another person who had a friend in that situation. Many young people turn to their friends in time of need before anyone else. This means that young people need to have the right skills to address these issues and also have barriers addressed in them reaching out to an adult for help. If these barriers were addressed in the school system then many would feel more comfortable in approaching an adult to get help for their friend. These barriers ranged from their concern for their friends feeling and breaking their trust, thinking involving an adult would make things worse, feeling unsure about what to do, or not getting help if their friend told them they did not want it.
Young people would feel more comfortable getting help from adults at school if they felt they were cared about, they felt comfortable enough to talk to them, they trusted the adult, they knew who to go to, and that the teachers respected confidentiality. Other factors which would affect this were also that young people wanted to be treated with respect by adults, recognise the young person as competent enough to help their friends, and being taught practical skills in order to help.
The findings also show that there needs to be an engagement of parents in the mental health and wellbeing of young people, so they have the skills and knowledge in order to help and to also have knowledge of services in the community. A partnership between schools and parents needs to be established so that schools can also turn to parents to let them know about mental health issues and what to do if a young person approaches them with concerns.
It is also factors which lie outside individual schools such as leadership within schools and the quality of it, the qualifications of staff, and recognising success in terms of student wellbeing – not solely on academic achievement. Schools also need to be working hand in hand with mental health services directed towards young people and to be able to connect young people to these services when they need it. Collaboration between young people, schools, parents and services would be the best way to address and reduce the barriers that young people face in seeking health regarding mental health issues for friends.