cartoon of young people with mental health issues

Working with young people with mental health issues

Strategies

As stated earlier, young people who are seeking help will often turn to a trusted adult who they have developed a respectful relationship with.

There are many strategies that youth services can adopt to support young people with a mental health issue, whilst also linking them to health professionals for further treatment.

You can make your service more accessible by adopting the following strategies.

Be approachable

  • Make it as easy as possible to use your service. Consider the way that young people first make contact with your service and ensure that your environment is flexible, relaxed and welcoming. Talk to young people about what would make the service more inviting.

  • Participate in training on mental health issues and early warning signs

  • Provide training for staff on effective skills in engaging young people and talk about the importance of developing trustful, respectful and professional relationships with young people. Key skills for engaging young people include showing a genuine interest in their welfare and development, being reliable, listening with genuineness, respecting young people's knowledge about their own lives, being non-judgemental, and being accountable and transparent. 30

  • Develop a clear confidentiality policy that states when you may need to disclose personal information (eg. if the young person or someone else may be in serious danger). YAPA has a model privacy and confidentiality policy that you can adapt, at www.yapa.org.au/youthwork/modelpolicies . Advertise the fact that you provide confidentiality in your promotional material and at your service. When young people first contact your service take the time to explain your policy. 33

  • Provide training for staff and volunteers on managing challenging behaviours. The juvenile justice section of this manual contains practical tips on managing challenging behaviours.

  • Consider flexible ways that young people can access your service including scheduling appointments at suitable times and places, having some parts of your service available after normal business hours, increasing options for the ways you communicate such as email and SMS, conducting outreach and having flexible no-appointment based services. 5, 32

  • Sometimes young people may need to take medication while participating in your program, for example on an overnight camp. Be aware of the young person's privacy rights in regards to their medication. If you assist your clients to manage their medications, you should be aware of the guidelines in Guidelines for the Handling of Medication in Community-Based Health Services and Residential Facilities in NSW, from www.health.nsw.gov.au/policies/PD/2005/PD2005_105.html .

  • Be prepared to make a long term commitment to supporting young people. Follow-up, and ongoing consensual monitoring of a young person's situation can reduce the risk of the situation escalating.

  • Make an extra effort to stay in contact with young people.

Include the family

  • The support of family and friends can be very important to a young person who is experiencing a mental health issue. With the consent of the young person, include the family in the support process, inform them of resources, and engage them in providing further support of the young person.

Promote positive messages about mental health and help seeking

  • In partnership with your local health service, develop local education campaigns to raise an awareness of mental health and mental illness.

  • Promote positive messages about help seeking behaviour.

  • Talk openly about mental health issues. Many people are affected by mental illness, and may be too afraid to discuss it openly. By speaking openly and honestly about mental health issues you can reduce some of the stigma and negative stereotypes.

  • In partnership with your local health service, run preventative workshops on mental wellbeing such as self-esteem and coping behaviour.

  • Promote services such as Kids Help Line, the ReachOut website and local health services, through casual discussions with the young people you work with, brochures, stickers, posters or workshops run by these groups.

Network

  • Find out about local health services that are available for young people with mental health issues. For example, by inviting a guest speaker from the mental health service to your youth worker interagency or by making time to meet with health workers face to face.

  • Understand and develop appropriate referral pathways. There are different services available for mental illness and mental health problems and it is important to be aware of what services are available for each.

  • Network with local health services and talk about ways that your service can support young people with mental health issues. Your local health service may be able to provide you with further information, resources or training.

  • Explore opportunities for health services to provide outreach to your centre.

Responding to early warning signs

Early warning signs of mental illness often appear during adolescence. 15

In your work with young people you may notice some of these early warning signs. Diagnosis and treatment can only be carried out by a qualified health professional so it is important that you encourage the young person to see a doctor or mental health service as soon as possible. You should also talk to a mental health service for advice on how you can continue to work with and support the young person. 12

Early intervention in mental health issues is extremely important. Early intervention is likely to result in more effective treatments, less trauma on young people and a reduction in the severity of the mental health issue. 16

Common warning signs for depressive disorders:

  • persistent feelings of sadness
  • losing interest in activities previously enjoyed
  • losing appetite
  • difficulties sleeping or staying in bed for a long time
  • feeling tired, lacking energy or motivation, or alternatively feeling anxious
  • feeling bad, worthless or self critical
  • negative, pessimistic or gloomy thoughts. 21

Common warning signs for bi-polar disorder

People with bi-polar disorder experience extreme mood swings.

At the low end of the mood scale they may experience:

  • difficulty concentrating or making decisions
  • loss of interest in things they usually enjoy
  • sleep problems

At the high end they may:

  • talk very fast about ideas which they do not follow through
  • feel little need for sleep
  • have an inflated sense of power or confidence
  • behave in a reckless manner. 12

Common warning signs for schizophrenia

  • withdrawing from family and friends
  • not sleeping well
  • neglecting appearance or hygiene
  • deteriorating performance at school or work
  • difficulty concentrating, following conversations or remembering
  • talking or writing about things that don't make sense
  • being extremely anxious, panicky or depressed
  • reacting inappropriately
  • fearing - without reason - that others are monitoring or watching them or planning them harm. 12

Common warning signs for anxiety disorders

  • persistent worrying and fear, out of proportion with the situation
  • social isolation
  • poor sleep
  • inability to relax
  • avoidance of feared situations. 18

Common warning signs for eating disorders

  • preoccupation with body weight and control over weight and food.
  • for anorexia: preoccupation with controlling the amount of food eaten
  • for bulimia: feeling out of control with the amount of food eaten. 22

Common warning signs for self-harm

  • deliberately hurting body, eg, punching a brick wall
  • self-cutting, eg cutting upper arms or wrists
  • overdose of prescribed or illegal drugs
  • self-burning with cigarettes or lighters. 25

Common warning signs for suicide

People who are considering suicide may:

  • feel hopeless
  • write or talk about suicide
  • have an overwhelming sense of guilt, shame or reflection
  • lack interest in the future
  • give away their possessions or put their affairs in order
  • self-harm. 12

If you notice early warning signs or feel that something "is not quite right", speak to a qualified health professional for further advice.

For non-acute cases, youth workers can encourage the young person to seek help from a counsellor, doctor, community health centre, youth health centre or community mental health service. This may mean helping them to make an appointment and offering practical assistance in getting to the appointment.

For acute cases (emergencies) where a young person is acutely distressed or is at risk of harming themselves or other people phone the Mental Health Crisis Team in your local area (for Nepean area phone 1800 650 749).

Each Area Health Service has a memorandum of understanding between local police and health services as to who responds to an emergency situation, how a patient is transported and how a patient is transferred into acute care (if required). In some situations the local police will attend the scene and in other situations the mental health team will.