MindMatters Panel: Module 4.8 Building support pathways 

Julia Zemiro:
Hello, I'm Julia. Welcome to the MindMatters panel. How do you make the best use of Mental Health services and resources? To answer that question we have: Brain and Mind Research Institute Executive Director and Professor of Psychiatry, Professor Ian Hickie; ReachOut.com CEO, Jono Nicholas; headspace School Support National Manager, Kristen Douglas; Deputy Principal Robert Blackley; and School Psychologist, Sarah Inness. But before we begin, again, let's go back and see how things are going with Phil and Madame Esmeralda.

Eagleton High clip:

PHILLIP
We treat our Health Providers as partners. Which means we work closely together and give each other feedback on how the relationship is working.

TRISHA
That’s right.

PHILLIP
And sometimes that feedback is positive, other times, well, it highlights issues that we need to work on.

TRISHA
That’s one way of putting it.

PHILLIP
Which brings us to the conversation we need to have with you, Madame Esmeralda...

[pause]

How’s it going?

MADAME ESMERLDA
I sense trouble in the fifth house of relationships.

PHILLIP
Now. It's funny you should say that because we do have some concerns about some of the advice you've been giving our students.

MADAME ESMERLDA
I don't give advice. I peer into the abyss, to the unyielding darkness I surrender and draw from the depths... a future as yet untold. What people do with it after that is their business. I don't know.

TRISHA
Okay, look. In the last week alone you've given Cindy Tan a fear of windows, you've convinced Asad Patil that he should drop physics because his destiny is with Cirque du Soleil. And Lee Oliver in grade nine says he won't be attending any class that doesn't prominently feature a cat.

MADAME ESMERLDA
Well, perhaps if your guidance officer did not refer every unhappy student to me. "Oh I'm in trouble for graffiti. I can't get a girlfriend." I help students confront their fate. I do not deal in trivia.

PHILLIP
It's true. There's a lot we can improve at our end.

TRISHA
Phillip!

PHILLIP
Even so, Madame Esmeralda, we think we need to look at winding back this relationship.

MADAME ESMERLDA
Very well. We will consult the oracle. The Tower reversed.

PHILLIP
Well that can't be good.

MADAME ESMERLDA
And the Fool!

Julia Zemiro:
I peer into the void and call upon the panel to connect with me on a range of Mental Health services. Kristen, Madame Esmeralda does make a good point about these relationships having to be a two-way street, how do we go about engaging with them? 

Kristen Douglas:
Julia, what I love about that video is that Philip the principal is trying to lead all of these improvement strategies. Completely stuffing it up, but he's the one leading them so I really like that. The two-way street is... I think it's about the fact that the school needs to be well-informed about services. They need to have processes in place internally to make sure that everyone knows their role within the school. And on the flip side, I think services need to understand that schools have kids six hours a day and if you are doing something therapeutically, supportively with a young person, you need to tell the people that have that young person six hours a day inclusive of the family but the school as well.

Julia Zemiro:
How do you build an effective relationship with local services and agencies? 

Sarah Inness:
I think it's... it's about contacting who you know around the place, inviting them in for a talk. We often have meetings at the start of the year. And our local youth services have meetings with people who provide support for young people either in schools or within face-to-face psychology support. So it's attending those, those... and outreaching to those people and just communicating and checking in with the students who have been referred there and asking how the service provider… how that went, and what more we could be doing, and over time that communication just builds and it develops the relationship that could... it’s a great working relationship.

Julia Zemiro:
How do you tell if a relationship is effective, Rob? 

Rob Blackley:
You can tell if it's effective if there's communication that's going on between both parties at being at the school and the outside organisation themselves if you're dealing with an outside organisation. Their willingness to come in to the school and to work with you. And lead you through with the issues that you might be dealing with. We worked closely with Orygen last year dealing with a particular issue. Now, that as I said, it was very reassuring for our staff, and that sort of reinforced the relationship.

Julia Zemiro:
It must be very empowering when you get someone like Orygen in and the teachers discover that they've actually been doing the right thing the whole way. I mean that's what this whole thing has been about, that sometimes you are instinctively going to be doing the right thing, tick, and now you can move on so...

Professor Ian Hickie:
But that's what's so good about the video. I mean, the fact the school has got three cases to take back to the provider and then go “Now look –  we're not sure what you’re telling us…”

[laughter]

…Really adds up to what we already know. I mean, there are real situations in which providers are saying things which may be counter-intuitive from the school's point of view. Or may be inconsistent with the way the school would normally manage a thing. There may be a really good reason 'cause you may be leading them to another level. The provider might say, "Hey, the last three kids you sent to me, all have major drug and alcohol problems." or "Do you know that part of the network is doing something else." I mean, so this sharing of information can take the whole relationship to another level. Which may have impacts on what the school needs to do and understand... The self-harm one's a good example. Some of the body image issues, some of the drug and alcohol issues. You know, the school might need to think about differently.

Well, my own interaction with school is, often say, kids come back to school for lunch time. They go, but what's the use of that? You know that's not gonna help with the academic thing, it might be a difference in what we're trying to achieve, developing common goals, because, really, mainly these referrals are just the start of the process. So being really clear about the culture in which the school is operating, the culture in which the health services are operating, and what's the agreed common outcome? Who does what? 

Johnathan Nicholas:
A big component of that is also the school can check in with the parents and the student themselves and say "Hey, we recommended that website, ReachOut.com. What did you think? Tell us what we could do better?" or "We suggested that service provider. Did you like them?" And the worst that's going to happen from the student's point of view or the family's point of view is they think "This school is proactively caring about me." And the school will get intelligence back, and will be able maybe to manage a slightly different referral process next time. So one of the challenges that we often have is, how do we repeat and follow-up and repeat and follow-up so that the experience for the next student is going to be slightly better than the experience for this student.

Julia Zemiro:
What are the benefits of actively managing your relationship with the service? 

Kristen Douglas:
Julia, I think it needs to be ongoing and regular conversations with the service, with the family, and also it's about the continuity of care. I think maybe decades ago we would take the young person to the front gate, we'd give them the number, we'd say "Good luck," and that was it, and that was us respecting the privacy around that young person. What we didn't probably fathom was that when that young person returns, we need to actually know what we can now put around them in terms of flexibly arranging timetables or care plans or that sort of stuff. So we need to hear back, so the information must go out, it must come back. That's about trusted relationships and information-sharing. I think that's the critical space.

Professor Ian Hickie:
And services change. You might have been referring to a service being great. Actually, certain people have left, that service has changed. But I must say on the other side of the fence, we can often find that schools have changed. They've changed principals, they've changed whatever, suddenly there's a different attitude. And if you haven't got a really proactive ongoing thing, you won't know that. If you've just got this referral and hope you take care of it kind of attitude.

Kristen Douglas:
I don't think there's any leadership or principal that would be oppositional to the argument say, invest a week of planning at the beginning of the year, and you'll save months of referrals and poor attendance, suspensions, expulsions, all that sort of stuff. Invest in that time early on to be well planned, and it flows through, but you've got to have commitment to that investment of time. Just like literacy and numeracy, it's like I said before.

Julia Zemiro:
And the final word goes to Kristen.

Kristen Douglas:
Again.

[chuckle]

Julia Zemiro:
What's your final advice for schools looking to strengthen the pathways between school and mental health services? 

Kristen Douglas:
I think it's simple. Know what's out there, privilege time, and understand that it may take time for that relationship to develop. But that investment is significant, and it's really worth it. Because when you've got thousands of kids in your care, the easiest and quickest way to get them into services, have that information that young person come back and get on with education. It's a much better investment.