3. Australian statistics - 2015
-Population: children & young people aged 4-17 yrs
- 1 in 7 had experienced mental disorder
- 1 in 10 teenagers had engaged in SH
- 1 in 13 had contemplated suicide
- significant distress symptoms
The Mental Health of Children & Adolescents
2nd Aust Survey of Mental Health & Wellbeing. 2015: iii
4. Contemporary profile of young Australians
Main mental health disorders:
- ADHD (7.4%) - est 298 000
- Anxiety (6.9%) - 278 000
- Major Depressive disorder (2.8%) - 112 000
- Conduct Disorder (2.1%) - 834 600
Almost ⅓ presented with comorbidity
The Mental Health of Children & Adolescents 2015: 4
5. Help seeking increased
Despite an increase in the number of children
& adolescents seeking help
33% 2008
95 % in 2015
Suicide - biggest killer
6. Kids + School
What does it mean for us?
- Need to better identify
- Respond more rapidly
- Engage in effective practice
- Develop standardised care
- Collaborate
7. Young people with mental health issues
Decrease in level of functioning across 4 domains
8. Schools
Staff can play an important role in supporting a young person
Focus prevention, harm minimisation - < prevalence + impact
9. Schools + Duty of Care
NSW 2009
- Legislation introduced which increased school’s legal obligation to actively
manage student violent behaviour which includes self-harm.
- Part 5 A - NSW Education Act (1990)
- Emphasis to promote safety
- Supportive environment
- Improve educational outcomes for vulnerable students
- NSSF/ Melbourne Declaration for Young People ‘articulates nationally
consistent future direction, strengthening accountability’.
10. Part 5A
Introduces the obligation for schools to “assess, manage and eliminate” any
risks posed by a violent students behaviour to the health & safety of all members
of the school community.
11. Self Harm
- By definition falls within the Act
Particularly when a young person
- Broadcasts injuries
- Engages in self-harming behaviour on school premises
- Engages in self-harming behaviour in presence of staff/peers
- Where they are known to self-harm & threaten to engage in such behaviour >
unreasonable distress in others.
Ministerial Guidelines Part 5A: 3. 3-6
13. Part 5A
- Not restricted to physical acts includes psychological injury
14. School staff -
What does it mean for us?
What are the implications in
Regards to students who
Seriously Self harm?
15. Violence under the Act
“any behaviour that seriously interferes with the
physical or psychological
health, safety and wellbeing
of staff, students and/or others who may visit the
school site.”
Does not have to be intentional
Ministerial Guidelines Part 5A: 3.1(a)
16. What is self-harm?
- Any deliberate behaviour designed to inflict damage to one’s own body
- Without suicidal intent
- Cutting, scratching, picking
- Swallowing inedible objects, hazardous materials
- Overdosing drugs
- Burning, scalding
- Hair-pulling
- Banging or hitting parts of body
22. Identifying the risk
Identify and document :
● behaviour of concern
● function of the behaviour
● Related safety issues
● Who?
● When?
● Identifiable triggers?
23. Current situation
● Describe current incident
● Situation?
● Why is it an issue now?
● Timeframes
● Admissions
● disclosures
24. Background information
Personal
● Family
● Interpersonal
● Mental health
Contextual - “climate”
● Students history at school
● Previous incidents/absenteeism
● Educational
25. Personal
● Situation prompting current concern
● Past hospital admissions
● Relevant history + SH or suicide attempts
● Known mental health issues
● Potential or actual diagnosis
● Expected level of psychosocial functioning upon re-entry/ &/or at time of
incident
28. “Teach your children well!”
“Their father’s hell
Will slowly go by….”
“..you must have a
Code that you can
Live by..”
29. What is the inherent risk?
Without supports put in place:
● what is the likelihood of injury?
● what would be impact?
● How serious is the risk?
30. Planning & Design
● What do we need to do?
● Who is doing it?
● How?
● When?
● What do they need?
● TIMPERLEY CYCLE OF ENQUIRY
● Nominate CASE Managers >
● Internal
● external
31. Timperley & Hatti
Cycle of enquiry
What do we
know?
What do we
need to
know?
Hatti
Know thy
influence
34. Role of mental health clinician
● Conduct risk assessment
● Mental health assessment
● Proposed treatment plan
● Medication (what? who administers? when?
● Ongoing counselling
● Frequency, nature of intervention
● Prognosis
35. Role of the school
● Conduct risk assessment
● Understand mental health needs
● Understand proposed treatment plan
● School based management
● plan
● Determine available support
● Determine roles & responsibilities
● Negotiate the re-entry
● Ongoing monitoring
36. Role of parent
● Provide support
● Facilitate students care
● Engage in necessary therapy
● Keep the school informed
● Agree to the conditions of re-entry
● Agee to attend school upon request
●
37. Role of School Counsellor
You are the only mental health expert in the school!
● Consultation
● Advice
● Recommendations
● Part of the team
● Not treating clinician
● What is your role?
38. Prior to actual re-entry
Meet with the student to determine
● how well do you think they are?
● How do they present?
● insight?
● How do they feel about coming back?
● Wishes upon returning to school
● contact/support persons
● Soothing strategies?
● What to tell friends?Staff?
39. Understand the risk + the DOC?
● Can we reduce the risk?
● With all controls in place what is residual risk?
-----------------------
● Care
● Safety
● Breach
● negligence
40. School’s expectations
● Clear
● Explicit
● Clearly communicated
● Consequences?
● Who follows things up?
● Can we execute our duty of care?
Principal carries the duty!
41. NSW 2009
- Legislation introduced which increased school’s legal obligation to actively
manage student violent behaviour which includes self-harm.
- Part 5 A - NSW Education Act (1990)
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