MindMatters Panel: Module 1.3 What is mental health? 

Julia Zemiro:
Hello, I’m Julia, Welcome to the MindMatters panel. When I was at school, every now and then the school had half days and the teachers spent the afternoon ‘in service’ which, when I think about it now must have been a group therapy session for having to deal with us. Joining me ‘in service’ to talk about mental health is Young and Well Cooperative Research Centre Managing Director, Dr Michael Carr-Gregg; Brain and Mind Research Institute Executive Director and Professor of psychiatry, Professor Ian Hickie; Deputy principal Rob Blackley; and school psychologist, Sarah Inness. But first, let’s look at how the staff at Eagleton High describe mental health.

Eagleton High clip:

PHILLIP
Our mental health strategy is all about boosting      protective factors. But sometimes it can be hard for staff and students to understand exactly what we mean by that. So we say that a protective factor is like a layer of bubble wrap.

Caring family is one layer, close friends is another layer, physical health, personal resilience... And all of these various factors add up to create a kind of force field that can protect you against anything that life throws at you.

Isn’t that right Daniel?

PHILLIP
It’s a simple activity but it makes the concept real for them. 

DANIEL
Mr Bird. I’m stuck!

PHILLIP
That is a problem with the metaphor.

DANIEL
Little help?

Julia Zemiro:
Oh – It’s just so hard to resist! But seriously, now look. What are the signs of a mentally healthy school?

Sarah Inness:
I think it’s really important to remember that it’s not utopia, not everyone’s problems are solved; I think that’s the first thing we need to remember. There are going to be some struggles with some people who are not coping – but it’s a way we respond to those struggles and how we try to prevent them. Mental health suggests that it’s not necessarily a focus on mental illness either, it’s an old school approach too it’s not just focusing on individual fires that we need to put out, but looking at ways we can help students across all areas with their lives.

Dr. Michael Carr-Gregg:
I like the idea of a mentally healthy school, being somewhere where kids feel safe and valued and listened to and actually have the skills and the knowledge and the strategies to manage their own wellbeing, so that’s like a priority.

Rob Blackley:
I think that when you walk into a school first up you can sense those things about being safe and welcoming – you can pick that up fairly quickly when you walk into a school for the first time.  

Julia Zemiro:
Yeah that kind of energy, there’s this sort of energy. 

Rob Blackley:
Yeah, that energy, that vibe about the place.

Professor Ian Hickie:
Well I think there are those schools, you know you walk you know people are connected, they know each other – there’s respect – and they’re the ones who cope with adversity, you’re still going to have problems in really healthy schools. But they cope with the whole situation and they support those who are in trouble but they also support everybody else to do the best they can.

Julia Zemiro:
What perceptions do people have about mental health in the community?

Sarah Inness:
There’s certainly a great awareness isn’t there? And I think there’s been a lot of work publicly where there’s a more public conversation about mental illness or mental health. I have young people who will come and see me and have already researched for instance – what they think they might be experiencing online – through some of the resourcing that are available to them and often they come with a diagnosis in their head – not that I diagnose in my office but they will often be right and so they’ve already accessed that information, felt comfortable accessing that information and comfortable accessing support within the school. Now that’s because we work really hard to make it ok to come and see the school psychologist, but I would imagine that our school can be unique in some ways because we’ve done a lot of work around that.

Professor Ian Hickie:
We do have to recognise how far the Australian community has come, we started a long way back. If you have a look at us compared to the rest of the world now – we’re way ahead. It’s interesting if you actually look in young people, people do actually raise the issue it’s just an issue of like – language – and what do we do with it.

Julia Zemiro:
That’s exciting, that Australia’s ahead.

Professor Ian Hickie:
Some things we win in. 

Julia Zemiro:
No but that’s great.

Professor Ian Hickie:
And something about the Australian community and attitude, we’ve seen this in HIV aids, we’ve seen this in a lot of drug and alcohol areas and other areas. When people are just fairly down to earth and fair dinkum about the situation and talk fairly openly, the problem we’ve is probably the language and just how we talk about these things – and then what we do. And it is an issue when you talk about mental health, if you say, let’s talk about physical health you start to talk about diabetes, cancer, asthma and everyone goes ”oh that’s a bit serious” but if you go “no actually we’re going to get fit, we’re going to feel better, we’re going to sleep better” that’s being healthy. We haven’t quite got there with mental health. With mental health, when you talk about mental health we need to talk about actually feeling well, feeling bright, enjoying things, pleasure – good mental health – being cognitive, being bright on the ball as distinct from also there are problems: anxiety, depression, substance issues. So we just haven’t got quite the rich language – and then the understanding – and that’s really the challenge, but we’re well on the way.

Julia Zemiro:
Is it possible to fix kids’ problems?

Sarah Inness:
I don’t think it’s a matter of us fixing – I think, that’s where I come at it from a psychologist – that I’m a team member – when someone comes and talks to me – and I always say to my students that I’m not the expert here in the room in your life. You are the expert in your life, I’m here to guide you through some possible solutions that you can try out and I’ve got some experience, I understand the theory behind it but I’m not going to fix those problems and I think that’s important for schools to understand – that there’s no quick fix, there’s no one magic bullet that’s going to solve a lot of this stuff.

Julia Zemiro:
But that’s a very challenging thing to hear because I think people think “you are the expert.”

Sarah Inness:
Yeah, but look I think so but they don’t want someone either to come into their world and take over, you have to be very respectful that they are emerging, especially the age group that we’re talking about today, they’re emerging their own individual identity and they need to try out things that aren’t going to work – we need to help them. Resilience is all about this, we need to help them try on their own solutions and possibly fail. That’s part of learning from that, that that safety net’s still there – with the adults in their world, the teachers and the parents that we hope they are connected with and supportive with their friendships, but it’s really important that we give them the opportunity to try their own solutions on and see their best fit.

Professor Ian Hickie:
But there isn’t a lot of clarification is there- about what’s the nature of a problem? I mean you run into a problem for the first time – you’re 13/14 and this could be another physical health problem –you have to sort out – is it something that’s easily fixed, learn a few skills, cope with that kind of anxiety, because face it – it’s fairly challenging and I can learn that and cope and use it again or is it more serious and requires a longer term kind of perspective so I’d argue some things are actually fairly fixable, fairly early, get the right skills, get the right advice, but people often don’t know that. They’re not being made aware of the stuff that can be done. They’re used to it in the physical health world – some easy things – pop down to the GP get it fixed – in this case, pop down to the psychologist, get it fixed, other stuff – pop online get it fixed. Teach yourself how to fix it. 

Julia Zemiro:
But what online services are available, Michael, that can help with seeking out that kind of directory?

Dr. Michael Carr-Gregg:
Well this is where we’re really fortunate in Australia because we’ve got wonderful websites like for example ReachOut, now you can as a young person, if you’re having relationship difficulties or if you’re starting at a new school, or if you think you might be same sex attracted, you can go to this website, you can get accurate up to date reliable information in a beautifully delivered fact sheet and you can get that kind of information. I’m very big on lamination and I go down to Officeworks. 

Julia Zemiro:
Back to the office. We’ll get the bubble wrap, and then we’ll laminate it. Michael I didn’t think that lamination would be a word we’d be hearing today. Do go on because I love office things. 

Dr. Michael Carr-Gregg:
I go down to Officeworks, I buy myself a laminator and what I do is I laminate these fact sheets, I know people mock me for this, I don’t care. 

Julia Zemiro:
I’m not mocking.

Dr. Michael Carr-Gregg:
I know, we’re sharing. I’m telling you that I’ve got a huge pile of stuff on depression and anxiety but it’s not just ReachOut. It’s beyondblue, it’s Orygen, it’s Blackdog Institute. There are just a plethora of some wonderful resources and quite often when I’m seeing parents, what I can do is send them links – really good links to beyondblue’s pamphlets on “Are you caring for someone with depression?” and here’s a discussion starter. So there’s a lot of wonderful material online. 

Professor Ian Hickie:
But we also, in a sense, have gone another step further, a lot of the apps that are out now, you can go from the information – to actually the program. Program about sleep rate cycle, program about managing anxiety, program about dealing with stress in your life and learn the skills and I think we teach this so much in physical health, here’s what you have to do to get fit, here’s what you have to do to lose weight, and actually make that – which we have as part of the school curriculum, learn this kind of stuff. We just haven’t got quite as far, we’ve started well down that path but actually going from information to skill acquisition to doing stuff. And then as you move along that path, sometimes you need help, sometimes you need other professionals to assist you along that path, and certainly to exist in a community, and I think this is where schools are really important, to exist in a community that promotes that idea. That that’s a perfectly reasonable thing to do with your mental health – just like with your physical health in order to succeed. 

Julia Zemiro:
It’s reasonable, perfectly fine. 

Professor Ian Hickie:
It’s perfectly normal, it’s a big part of yourself, your head, in fact it’s a really big part of yourself and actually in terms of success in school and in life it’s much more important than a load of the other bits. You know if you’re really going to enjoy and get pleasure out of life.

Sarah Inness:
I think school is a great influence for many different things. It’s one of the only places where you’re going to catch all adolescences at a certain point in their lives. It’s compulsory that they’re at school until they’re a certain age so we can influence in so many different ways in so many different aspects it’s in our relationships with our students, in our conversations that we have with them, it’s in assemblies in what we say to them, it’s in our classes it doesn’t have to be a specific class around mental health or wellbeing.

Julia Zemiro:
I agree Sarah, the thing that I used to love so much when you go to class is when you had this teacher so engaged in what they were doing, you forgot all the other stuff and you were thinking “you’ve taken me somewhere else” and that becomes an interest that you then might look up yourself. It’s the wonderful things that happen when that teacher is doing their job which I know that half the time we’re giving teachers so much more to do all the time. 

Professor Ian Hickie:
It’s not just the teachers though, I mean you know, schools are communities and so the students are students. 

Julia Zemiro:
I haven’t been to one for a long time though.

Professor Ian Hickie:
But I think that one of the problems, the dangers in this area, is that the teachers feel “oh my god, I’ve got to be the teacher, the educator, the social worker, the psychologist, you know, what else? Physical health person?” You know, and that I think does become a sort of burdensome thing but what teachers do normally, is a key part of that but involvement of parents with schools, the promotion of the connection between students. I mean lots of schools have very good social hierarchies built in, student to student and across classes etc. to build that community thing, I mean as parents of teenagers, I want to make kids go to school more, not less, they are much happier there, they are much more normal people then when they’re at home and you know it’s true and it’s true of the adolescent brain – it’s much more focused on ‘What are my friends doing?’ than ‘What do my parents think?’ in a way that’s biologically normal and socially normal so we really need those places to function as communities and to see it just as core business to promote that community connection because it’s the connectedness, we’re a little lost in some ways, in individual psychology these days in what goes on in your head as distinct from we need to be connected with people to stay well.

Rob Blackley:
For a number of our kids it’s a safe place for them. 

Julia Zemiro:
Maybe even the safest?

Rob Blackley:
In a number of cases it’s their safe haven where there’s structure, there’s organisation there’s procedures and there’s a general concern about that their welfare.

Julia Zemiro:
Can you build utopia?

Rob Blackley:
I can’t know if you can build utopia.

Professor Ian Hickie:
Close! Close! 

Julia Zemiro:
Oh Ian, always striving for the best. 

Professor Ian Hickie:
They are model communities, in fact, one of the previous problems we had with young people is when they leave school, they drop out of the social scaffolding that exists, and the role models I mean seriously you know there are much better parent models for many of my children then me. You can see diversity.

Julia Zemiro:
But why is that Ian? What are you doing wrong?

Professor Ian Hickie:
If you ask my daughters – lots. There are other models, there are other ways of being in the world, however good individual parents are that’s just one way of being in the world, you can see other ways of being in the world with one of my teenage daughters, her male geography teacher, best person she’s even met in her whole life, he’s in the world differently. For a lot of young women, the way they see other women cope in the world with the issues that they’ve had to deal with, in terms of body image or self-esteem that is different, and it gives them a model, a mentor, a way of being in the world, so we don’t just talk about psychology, they see people coping differently and that opportunity is fabulous so it is an issue, a really major social investment. So it’s capitalising on what schools do but then promoting the really key bits of that, the modelling, the mentoring, the connection, because that’s what really builds mental health. 

Dr. Michael Carr-Gregg:
I think kids learn teachers, not subjects. And when I’m doing my interviews with kids, what I actually always look for is some charismatic adult in their life that is going to make a difference and looking at my own kid there was just one or two teachers who were just absolutely inspirational who really made a difference for them and improved their wellbeing. I went to a school for emotionally disturbed teachers and I didn’t have any at all but let’s not go there. It’s not about me.

Julia Zemiro:
But honestly, you can have a great teacher for one term, and it can turn your head around. Not your life, because you’ve still got to do that when you leave and all that, but it can turn your head around about how you think about something. Full disclosure, my mother was a teacher so I’m a big fan. You can see it, we’ve all had one, we all had the teacher we didn’t like but we’ve certainly had at least one or two teachers that got us through.

Professor Ian Hickie:
Well that’s just the teaching aspect there’s also the school friends because it’s not just the teachers are very charismatic and very important role models but promoting the connections, many people have friendships they made at school, particularly later in school that they continue throughout life, the stability in that and the representation of you know respect and emotional warmth and the interaction at key ages really matter, so you know, how peers behave in schools which is then moderated by schools in many ways and the way in which the school interacts with the peer interactions is critical.

Dr. Michael Carr-Gregg:
Surprisingly, I’m agreeing with Ian.

Julia Zemiro:
Exciting.

Dr. Michael Carr-Gregg:
I reckon one of the greatest predictors of wellbeing for young people, is in fact having a rich repertoire of friends and I think where schools can really contribute to that is teaching kids how to obtain, maintain and retain those friendships not just at school but as Ian says way beyond and I think that will sustain them, builds resilience, that capacity to phase, overcome and be transformed by adversity.

Julia Zemiro:
If you think mental health is constant happiness well remember this quote from Edith Wharton, “If only we’d stop trying to be happy, we could have a pretty good time.”