Help-seeking

1. Help-seeking Helen Cahill Australian Youth Research Centre The University of Melbourne h.cahill@unimelb.edu.au

2. Instrumental Felt sick Injured self Lost something Money problems Students more likely to seek this form of support except for $$ Social/emotional Felt sad Had friendship problem Being bullied Friend being bullied Family problems Help-seeking categories

3. Help seeking sources • Friends • Parents / caregivers • Teachers • In all categories Teachers are less likely to be asked for help than Parents and Friends • Cahill, Shaw and Wyn, 2004, Translating Caring into Action, Youth Research Centre

4. Help-seeking - key findings Gender differences - • boys less likely to seek help than girls, all sources, all categories Difficulties - • those who score highest in schoolyard difficulties and classroom difficulties are least willing to seek help, all sources

5. Gender and help-seeking • Gender difference in help-seeking is least marked on help-seeking from parents • Particularly marked in help-seeking from friends for social and emotional problems • Situations involving sadness, friendship problems or family problems are the most strongly gendered

6. Help-seeking grade 4 > 12 • Friends • Increases over time in most situations • Significant drop at year 7 • Senior SC students freer to ask peers for help on more personal questions eg bullying, money problems • Teachers • Seeking help from teachers falls consistently through PS and SC until year 11 when students turn back to teachers • Parents • Remains more constant over the years

7. Help-seeking - 3 sources compared for Years 5 - 12

8. Secondary students - seeking help from 3 different teachers Cahill, Shaw and Wyn, 2004, Translating Caring into Action, YRC

9. Primary students & help-seeking from teacher

10. What students say the teacher should do if he/she notices the student is down or upset: • Take them seriously • Ask them what is wrong • Listen • Follow up with a conversation • Respect the need for privacy

11. Strong predictors when my teacher: Smiles at me Says hello to me Talks to me Shows he/she is proud of me Takes an interest in what I do Moderate Predictors when my teacher: Organises fun activity Notices my effort Sets interesting work Encourages me to join in Helps me learn from my mistakes Teacher behaviors and Help-seeking(years 4-12)

12. When is it harder to ask for help? • Embarrassment and feeling shy • If you had a personal problem, people might tease you • What people might think of you • You can be embarrassed nearly all your life • Scared • If you’re scared it is hard to ask for help • It is scary to ask a stranger or someone you don’t know for help

13. When is it harder to ask for help • Autonomy • When you are older you can work the problem out by yourself • Pride and shame • When you don’t want people to know you need help

14. When is it harder to ask for help? • Access • If you don’t know their name • If you’re new you don’t know people to ask • When teachers on yard duty are talking to each other • Risk • When the kids say “I’ll do something if you tell” • Telling might make it worse • You might start crying if you talk about it

15. when is it harder to ask for help? • Privacy • When you can’t get to the teacher because other kids are around • They might talk about you and people find out • You don’t want other people talking about you • Relationship • When a teacher is angry or grumpy to other students • You have to like them and trust them • you have to think they like you • Reprimands • They might tell you off

16. Family relationships 17.1% Peer relationships 14.8% Partner relationships 9.6 Bullying 8.3% 37% experiencing frequent harassment 3 out of 4 calls made about bullying are in 10-14 years group Sexual orientation is the 9th most common reason for males to contact KHL (as opposed to 23rd most common reason for females) Calling kidshelpline about

17. Mental health/risk behaviours • Adolescents with more emotional problems are more likely to use substances • 54% with a high level of problems smoke vs 11% of those with low level problems • Similar patterns for alcohol and cannabis use • More likely to try to control weight, have physical health problems, have suicidal thoughts Sawyer et al (2000) Mental Health of Young People in Australia.

18. young people experience mental illness • over 20% of 12-16 year olds have a mental health problem • 23% of males • 18% of females • 27% 18-24 year olds have a mental health disorder • depression is one of the commonest conditions • 24 percent of young people will experience depression by age 18 years • Females more likely to experience depression & eating disorders • Males more likely to experience substance disorders Australia’s Young People - Their Health & Wellbeing 1999. Aust Institute of Health & Welfare

19. 1998 - suicide the second leading cause of death for 15-19 year olds • Second only to motor vehicle accidents • 116 males and 35 females in the 15-19 years age group died due to suicide • 11.5 per 100,000 persons • Males • 78 hanging, 10 guns, 9 gassing, 4 jumping, 4 poisoning, 1 drowning, 1 cutting, 9 other • Females • 23 hanging, 4 poisoning, 2 guns, 2 jumping, 1 drowning, 3 other • Attempts • Around 40 to 50 attempts for every death due to suicide

20. Attempts - 1997 • 15 - 19 years • 2,565 (1528 females and 673 males) are shown on hospital statistics for self-harm • Of 2565 attempts, 2260 used overdose • In this age group 40 – 50 suicide attempts are made for every completed suicide • 10-14 years • 364 (296 females and 68 males) admitted for self-harm

21. Self harm risk • 42% of adolescents with very high level of emotional problems had seriously considered suicide (vs 2 % of those with low problem levels) • 25% of those with high level problems had made an attempt during last year vs 1% of those with low level problems Sawyer et al (2000) Mental Health of Young People in Australia.

22. Promoting connectedness • Adolescents who feel cared for by people at their school and feel like part of their school are less likely to • Use substances • Engage in violence, • initiate sexual activity at an early age • Engage in suicidal thinking or behaviour • Increasing connectedness decreases health risk behaviours • Adolescents need increasing opportunities for autonomy, caring and support from adults, acceptance by peers, opportunities to demonstrate competence. McNeely, C.,A. , Nonnemaker, J.M., and Blum, R.W., 2002, “Promoting School Connectedness: Evidence from the National Longitudinal Study of Adolescent Health”, Journal of School Health, Vol.72, No.4, pp. 138-146.

23. School structures and practices associated with levels of student connectedness • Large school size • Difficult classroom management climate • Harsh discipline policies (eg. suspension for minor offences, expulsion for first offence) • Friendship patterns associated with race • Participation in extracurricular activities McNeely, C.,A. , Nonnemaker, J.M., and Blum, R.W., 2002, “Promoting School Connectedness: Evidence from the National Longitudinal Study of Adolescent Health”, Journal of School Health, Vol.72, No.4, pp. 138-146.

24. School connectedness, peer harassment and achievement • Students with least frequent peer harassment more likely to like school • students with high levels of peer harassment least likely to like school • “B” students report lowest levels of peer harassment • “A” and “C” level students report mid levels of harassment • Academically poor students report highest levels of harassment • Eisenberg, M.E., Neumark-Sztainer D., and Perry, C.L., 2003, Peer Harassment, School Connetedness, and Academic Achievement”, Journal of School Health, Vol. 73, No. 8, pp. 311-316.

25. Bullying around 1 in 6 children are bullied What impact does this have on their learning and wellbeing? • bullying affects learning outcomes • boys more often perpetrators & victims • bullies can appear to be popular (high status), but are often disliked • racist, sexist and homophobic remarks commonly ignored by teachers • Students who are bullied are more likely to experience depression and anxiety disorders

26. Bullier, victimised and the bullier+victimised • Bulliers - • have fewer adjustment problems than classmates • enjoy high social status • Victimised - • Suffer emotional distress • Are socially marginalised • Victimisation is predictive of later mental health problems • Bulliers + victimised • Are the most socially ostracized • Display the most conduct problems • Least engaged in school • Higher levels of depression and loneliness Juvonen, J., Graham, S. and Schuster,M., 2003, “Bullying among Young Adolescents: the Strong, the Weak, and the Troubled”, Pediatrics, Vol. 112, No. 6, p.1231-1237

27. HEALTH Depression Anxiety Low self-esteem Feeling lonely Suicidal ideation Substance use Sleep problems Headaches Bedwetting Fatigue Feeling sick EDUCATION Absenteeism Negative impact on academic achievement Decreased attachment or connectedness to school Dake, Price, Telljohan and Funk, 2003, “Teacher Perceptions and Practices Regarding School Bullying Prevention”, Journal of School Health, Vol 73, No 9, pp. 347-355 Bullying - effects

28. Bullying - impact • Victimised • Anxiety (3 -4 times more likely) • depression (4 times more likely ) • Bullier + victimised • Anxiety (6.4 times more likely) • Depression (6.3 - 8.8 times more likely) • Bulliers • more likely to fight, cheat, use drugs, vandalise, truant, carry a weapon, get in trouble with police, date earlier, be more aggressive to dating partners, Dake, Price, and Telljohan, 2003, “The nature and extent of bullying at school” Journal of School Health, vol 73, no. 5, pp. 173

29. Self-harmers don’t seek help • Gold Coast study of 14 schools, (3757 year 10/11 students) • 6.2% had self-harmed in last 12 months • Most self-harmers did not seek help before or after their most recent action • Help-seekers more likely to consult friend (61.4%) • Mother (18.5%), mental health worker (7.3%), GP (2.6%), • Digo de Leo and Travis S Heller, 2004, Who are the kids who self harm? An Australian self-report school survey. MJA, Vol. 181 (3) :140-144

30. factors significantly associated with self-harming • Exposure to self-harm in friends of family members • Sexual orientation worries • Low self-esteem • Distressing events • Digo de Leo and Travis S Heller, 2004, Who are the kids who self harm? An Australian self-report school survey. MJA, Vol. 181 (3) :140-144

31. Boys without dads and help-seeking Kidshelpline study: (Kidshelpline Newsletter Nov 2003) • 1/4 of boys of separated parents in the study said they never saw their father • Boys with separated parents more than twice as likely to say they never talked about their feelings or concerns than boys with parents together • Boys with parents together more than twice as likely to talk to someone if they are upset. • Boys rely more heavily on parents later into adolescence for support • Boys more likely than girls to experience depression and engage in externalising behaviours after parental separation

32. Boys and separated parents Boys with separated parents less likely to : • feel understood by their mothers • get along with their fathers • receive affection from either parent • talk to someone if upset More likely to : • Never talk about feelings and concerns • Have negative attitude to help-seeking (Kidshelpline Newsletter Nov 2003)

33. Internet help-seekers • Nearly one fifth had sough help for emotional problems on the internet in the last year • Seekers more likely to be suffering depression than non-seekers • 20% were dissatisfied with help they received • 14% said it helped significantly Gould, Harris et al, 2002, Seeking help from the Internet during adolescence, Journal of American Academy of Child and Adolescent Psychiatry, Vol. 41, Iss 10, pp1182

34. Those who most need help least likely to seek it • Uni students who are least skilled at managing their emotions have lowest intention of seeking help from family and friends • Adolescents (16-18) low in emotional awareness least likely to seek help from from fiends/family and have highest intention of refusing help from anyone • Low emotional competence not assoc. with intention to seek help from professionals • Ciarrochi, Deane et al, 2002, Adolescents who need help the most are the least likely to seek it: the relationship between low emotional competence and low intention to seek help, British Journal of Guidance and Counselling, Vol. 30, Iss. 2, p173

35. patterns • Females seek help more readily than males • Males more likely to seek help from parents than from other sources • Mothers frequently used as source of help by adolescents - this challenges assumptions about generation divide • Higher SES and education levels are associated with higher levels of help-seeking Kuhl, Horlick and Morrisey, 1997, Measuring Barriers to help-seeking behaviour in adolescents, Journal of Youth And Adolescence, Vol. 26, iss. 6, p 637-651

36. Is help-seeking useful? • Social support is beneficial but active help-seeking is shown in this study to be no more beneficial than not seeking help from the social network • studies show professional care can have a positive effect, no effect or a negative effect • Self-attention can have negative consequences for adolescents • Benefit from coping strategies that reduce their level of focus on self and problems and focus on other activities • Rickwood, D.J., 1995, The effectiveness of seeking help for coping with personal problems in late adolescence, Journal of Youth and Adolescence, Vol. 24, Iss. 6, pp. 685