Recording: Are the kids alright?

VERITY FIRTH:  Hello, everyone.  We're just waiting for everyone to log on.  We'll probably start in about a minute, when a couple more people have logged on.  Thank you very much for joining us today.  I think it's going to be a very good and timely discussion.

 

All right, we might begin.  It's good to start on time and we can always have other people join us as we go along. 

 

So thank you, everybody, thank you for joining us for today's event.  Before we begin, I'd like of course to acknowledge that, well, all of us are meeting on different land of Indigenous people across Australia, so please pay respects to the land of the people that you are currently meeting on today.  In fact, one of the nice things we often do if you want to place the name of the people and their nation in the chat, it's a really nice way for us to all pay mutual respect to where you are today.  I'd like to pay respect to the Gadigal people of the Eora Nation.  I want to particularly pay respect to them as the traditional custodians of knowledge for the land upon which the university is built.  And I happen to live quite close to the university, so I'm still on Gadigal land even though I'm actually beaming in from home.

 

My name is Verity Firth.  I'm the Executive Director of Social Justice at UTS, where I lead up our Centre for Social Justice and Inclusion.  It's my extreme pleasure to be joined today by some very distinguished guests ‑  Professor Patrick McGorry, Georgie Harman and Josh Yasserie.  I will have the chance to introduce them all properly shortly.

 

There is a little bit of housekeeping before we get started.  Firstly, the event is being live captioned, so to view the captions, you need to click on the link that's in the chat panel.  You'll find it at the bottom of your screen in the Zoom control panel.  The captions will open up in a separate window. 

 

If you have any questions during today's event, please type them into the Q&A box, which you'll also find in your Zoom control panel.  Now, there will be an opportunity to ask questions, so that's really good, and there's also an opportunity to upvote questions, so if there's somebody else's question that you really think is a good one, upvote it, and on the whole we take the most popular questions, because often we run out of time.  If your question is popular, it's most likely to get asked.

 

It's an online event, which means it's not always perfect, there may be technical issues, but we'll work to resolve them quickly, so keep patient.

 

So today's event is the third and final in the Centre for Social Justice and Inclusion's 'The Future of Education ‑ Towards 2027' series.  What we've been doing in this series is imagining what universities can do to make access to education equitable as well as in a very difficult time really, so how do you continue to have a focus on access and essentially the liberating part that is education in a time where we're weighed down by financial unease, changing social conditions and political unrest.

 

October, as most people on this forum will know, is Mental Health Month.  As we approach the end of the year, it's a good time to consider the mental health impact that many have contended with over this year in the face of multiple overlapping crises.  It's also a perfect time to look forward and imagine how we can do things better and, particularly for universities, better support our students so that they do more than just survive at university, they actually thrive.

 

In early May, UTS staff rang students, specifically targeting students at risk of being impacted by COVID.  So we rang students who were already accessing our wellbeing services, experiencing disability, students from low socioeconomic status backgrounds, students with asylum status, Indigenous and international students and we rang them specifically to talk to them about the impacts of COVID‑19 on their wellbeing, on their living conditions, and on their financial security so that we could talk to them, check in with them, but also direct them to the emergency support available from UTS and external services.

 

Now, in that time we phoned thousands of numbers, but we managed to speak directly to more than 700 students and we heard some worrying statistics.  We found out that of these students, 39% of them were concerned about their finances; 22% of them, so 1 in 5, thought they might lose their housing or were very worried about their housing security; 25% of these students said they were concerned, or extremely concerned, about how they were going to stay mentally healthy; and 16% said they didn't have anyone to support them during isolation ‑ all concerning.  That was just a sample of 700 students at UTS.

 

So 2020 has thrown up disruption and challenges that many students have not experienced in their lifetime and it's not only a global pandemic that students are coming to grips with, it's a future of ongoing uncertainty and unrest, taking into account the climate crisis, the fight for equality against systemic racism and oppression, sweeping changes to the way universities teach and run, and the worst economic recession since the Great Depression.

 

At UTS, like many universities, we believe we are public‑purpose institutions.  We pride ourselves on placing social justice at the heart of our priorities and our purpose and this means we need to, particularly at this time, support our most vulnerable communities.  So as we plan, as we plan for the return to "normal" after COVID, how can we and other universities better support students' wellbeing and mental health, and particularly how can we do it for those underrepresented communities who are disproportionately affected by these changes and who already face greater barriers to access and success at university?

 

So to begin our discussion, it's my big pleasure to welcome Professor Patrick McGorry to deliver today's webinar ‑ our keynote talk, our keynote talk.  Professor Patrick McGorry is Executive Director of Orygen and Professor at the Centre for Youth Mental Health at the University of Melbourne.  He is also a Founding Director of headspace.  Professor McGorry is a world‑leading researcher in the area of early psychosis and youth mental health and his innovative research has played an integral role in the development of safe, effective treatments for young people with emerging mental disorders, notably the psychotic and severe mood disorders.  Professor McGorry has published over 800 journal articles and book chapters and edited nine books.  He is the current President of the International Association of Youth Mental Health and Past President of the Society for Mental Health Research and the Schizophrenia International Research Society.  He has been the recipient of numerous awards, including the Australian of the Year in 2010.  So welcome, Patrick.  I'm looking forward to hearing your thoughts.

 

PROF. PATRICK McGORRY AO:  Thank you, Verity.  Hi, everybody.  Thanks for that lovely introduction and for the privilege of being part of this great webinar today with colleagues as well.  I'm just going to talk for about 10 minutes. 

 

As you said in your introduction, I think there's huge concern about mental health and the future of young people.  Absolutely they're one of the highest‑risk groups affected by the pandemic.  They were already struggling prior to the pandemic in many ways.  Just one piece of information ‑ they're the one group, emerging adults are the one group that have gone backwards financially in terms of security over the last decade.  Everyone else has been moving forward, especially people in my age group, greater security all the time, but young people are really the ones let down by society I think in many, many ways.  It's not surprising we're seeing a rise in mental ill health in young people generally.

 

If I can just maybe share the screen, I want to talk about university, the university, and I've got some information to share about that.

 

VERITY FIRTH:  I think Fiona will be able to give you access. 

 

PROF. PATRICK McGORRY AO:  This has been our mantra at Orygen and in youth mental health generally globally making the point that mental ill health broadly defines a number 1 threat to young lives and futures, the biggest threat to their lives, and obviously increasingly the biggest threat to their futures.  We talk about a broad concept of mental ill health here as well and the concept of mental wealth is talked about a lot.  It came from a British politician originally writing in Nature, I think the first politician ever to be published in Nature, talked about this idea that you build up social capital as you move from early life into the threshold of adult life and 22‑year‑old is probably the maximum value to society of anyone in society  and if you think about this concept of social capital because invested so much in supporting the young person getting to that stage of independent life when they can be not just having a fulling life, but producing and contributing to society. 

 

That was the slogan of the first National Mental Health Commission, "contributing life".  If you become mentally ill or underachieve in terms of your potential even in a more subtle way or if you end up on welfare or die from suicide, then clearly it's a massive waste of human potential, and university students are probably at the pinnacle there because they are the ones that have been ‑ they've reached that stage when they can achieve where their talents are actually being sort of built upon and they're ready to go and if they sort of fall by the wayside at that point or don't really flourish, then that's what this is all about anyway.

 

And why do universities play an important role here?  Because we did a project called Under the Radar.  Orygen has a policy badge, like a think tank, which produces reports for the Federal Government and then we basically ‑ we do these in partnership with various organisations and obviously all stakeholders contribute to this.  It was called Under the Radar, it was published I think about three years ago, maybe two years ago, and it led to a university framework project which was funded by the Federal Government which I'm going to say a little bit about.

 

Not all students are young, but in Australia in 2016 well over a quarter of the median students were under 25 and the access to tertiary education has increased greatly in recent years, so probably about ‑ you probably have a better idea than me, I think it's 40 or 50% able to access tertiary education, very different from say when I was in tertiary education.  It was a much smaller percentage in those days.

 

And this figure here ‑ Georgie will have seen this many times before ‑ it's the incidence curve of mental ill health across the lifespan.  You can see it's the mirror image of physical illness.  Basically physical illness strikes in little kids and in the over 50s in big numbers and between puberty and even middle age, but certainly across this emerging adults period, physical illness is not a big deal these days.  Even with COVID you're seeing this age group is relatively protected from COVID, whereas the other age groups, particularly the older age group, is more vulnerable.  So young people, physical health has never been better in human history, at least in high‑income countries, and their mental health has never been worse. 

 

There's lots of indicators ‑ I haven't got time to show them, but mental health in young people is getting a bit worse over the recent 10, 15 years.  Not all of that is due to social determinants I mentioned before, social forces of various kinds, but nevertheless we have to do something about it, preventive things, but we've got to actually respond to it.  Yes.

 

So this might be of interest to people.  There's a very good paper published last year in Lancet Psychiatry on this topic of student mental health care.  Maybe this is a bit undiplomatic, but it doesn't seem to have changed fundamentally from when I was a student really, but the way it's actually been delivered on campus, that's what our university framework program is about and trying to stimulate some reform and review of how we're going about this issue.

 

So this is the Under the Radar report which I mentioned, trying to get this issue on the agenda.  This is why we did it and it certainly succeeded in that respect, it's talked about a lot more.  Several conferences were held in the lead‑up to this about this topic, which I went to a couple of them, and it was a lot of engagement of the relevant people.

 

So what came out of this report was there's not enough data, there's not enough known about these issues actually.  There have been some surveys which were worrying.  This is pre‑COVID, showing quite high levels of psychological distress and that translates, as Georgie knows, into a certain level of caseness, need for care as well.  It's not a direct measure of that, but you can extrapolate from that.

 

The counselling services seem to be fairly oversubscribed and only access to a very small percentage of the people who actually needed access, so they're either at capacity or people are not seeking or a combination of the two.  And the relationship of those services to external mental health system such as it is, and obviously it's in crisis with royal commissions and productivity commissions anyway, it's really been ‑ this came out of our project actually almost like a finger pointing who's really responsible for the mental health of these students, is it the campuses, is it the universities, or is it the wider health system.  It's sort of like people taking a step backwards rather than a step forwards.

 

So I won't go through all this.  These are obvious things ‑ you mentioned some of them, Verity, I think in your introduction ‑ the stressors that were already in place, I think financial ones were very important.  In Australia students don't tend to move away from home to go to university as much as in, say, Europe or the US, but nevertheless that's one factor I guess, support networks. 

 

I suppose one of the challenges developmentally of becoming an adult in this transition period is sort of loosening ties with your family of origin and your scaffolding in a family sense and actually trying to develop new support structures, new peer networks, new structures.  I remember that when I was a student.  That's one of the key things and some of the friends you make at that stage of your life, they're friends for life.  Those sorts of things are obviously all happening at the same time, but I think particularly with this kind of remote learning, that's become a real casualty of that, to be honest, that ability to ‑ the social aspects of learning and education.

 

So it's obviously a very important issue for universities and for the community to address the kind of risk to failure, to educational failure.  We see this in high schools too.  50% of people who develop a serious mental illness will have dropped out of high school.  So there's incredible loss of value for the society through this wastage of human potential because we're not addressing the key undermining forces here.

 

I'll go more quickly because we'll run out of time.  Ben Veness, now Psychiatric Registrar of the Alfred, did I think it was one of those fellowships that allowed him to travel the world and look at what other countries were doing in relation to student mental health.  One problem was that the universities and institutions themselves were not taking it seriously, they didn't even see it as part of their duty of care really in many cases, and a bit like where high schools were 10 to 15 years ago, educators, we don't do that, we're not a health system, that's not our responsibility.  But I think one of the things we've tried to say with this massive shift to becoming a business and a market, universities have got a duty of care more than ever before.  They're making big profits ‑ or they were ‑ out of these students and they haven't put systems in place to actually address their needs properly, and it's particular the case with international students, which hopefully we can talk about.

 

Framework came out of this.  Greg Hunt basically gave us a grant to conduct a process, a collaborative process, across the whole sector which involved all the various stakeholders, including Universities Australia and lots of other lived experience inputs, other relevant organisations were involved in this process, and it was basically intended to come up with guidelines to create and to address mental health and wellbeing prevention strategies, but also trying to modernise and strengthen the whole service response, which was pretty inadequate really and obviously that's what I'm coming from in particular. 

 

My career has been about design and think about new models of care that provide much better access and much better holistic care for people compared to what we've been dealing and modernisation of these things is incredibly important, but respecting the need for skill and expertise which has been dumbed down a bit in recent years.  Everyone thinks mental health is commonsense these days and don't really understand the complexity and the skill sets that are really needed, so trying to get those different tiers or steps of care built in, and some great work in the UK to research research grants in the UK last week and there were several projects there, very sophisticated UK approaches to this issue, and there's an organisation called Student Minds set up in the UK which had a really positive effect in a peer sort of sense.

 

These are just the standard slides from this project, so I won't go through them.  There's no time.  But this is a serious process.  It's gone on for a year or two.  It's about to produce its final report, which has been approved by the various stakeholders.  It's very inclusive.  It was a student voice obviously.  Some of the emerging themes were ‑ this is on this slide here and I think, going back to Ben's comment, there's got to be leadership from the highest levels of universities as well as from the grassroots.

 

One thing I think, having grown up in the period of student activism in the 1970s, the student voice and the student power needs to be unlocked here I think so that they secure a better deal for themselves in this process.  That's another thing that I think these days probably needs more attention.  These are obviously all relevant sort of aspects of the problem, going through focus groups and so on.

 

So, in summary, all it really is is sort of a high‑level document.  It doesn't really come up, I don't think, with clear enough solutions and what we need now is a new phase of I suppose innovation and testing and trying to develop new approaches, new models, and trying to make universities more connected, and obviously with COVID ‑ I haven't got the slide here, but there's lots of data sources now showing that the level of distress and need for care in students, including some of our own modelling, has actually gone up dramatically since COVID, since the pandemic.  For example, a headspace survey showed 77% of young people felt their mental health had suffered as a result during the pandemic and we're certainly seeing surges of self‑harm.  I'm sure Georgie has lots of data on this too.  It's one of the very high‑risk groups. 

 

Students are particularly vulnerable, and particularly international students I'd say as well.  The disruption to education and employment in this age group is very, very significant, probably going to get worse, and a modelling group in Sydney showed it's a major driver of suicide risk in the coming years.  So far, fortunately, we don't seem to have seen that completed suicide rate rise yet, although there is a trend in young men that we've seen from the Victorian Coroner, so we've got time to act in a broad sense and students are incredibly important here.

 

At an international level, Universitas 21, one of the football leagues of university, has taken leadership on this and produced a declaration policy statement about student mental health.  So that's another vehicle of getting more high‑level action.  These are the universities involved in that process and Orygen and I'm sure others have been working with international students.  We've got funding to try to understand their needs a bit better and try to mobilise some better responses.

 

Another organisation relevant in this space, Batyr, they started off in high schools, now university campuses, it's a peer support model.  I think that's another great partnership, another great focus to actually involve there.

 

That was a bit of a slightly disorganised cook's tour of the area, but to flag we are very concerned about this group.  It's a very high priority for Orygen and I'm sure for headspace as well and the youth mental health sector generally.  We're looking for innovation, looking for partnerships and ways to reinvent this whole area in the coming years.  And it's obviously a perfect storm happening around universities right now, so whether that's a favourable environment, it's certainly an authorising environment for action.  I'll stop there.  Thanks, Verity.

 

VERITY FIRTH:  Thank you very much for that, Patrick.  That's a wonderful opening.  I've scribbled down a lot of issues I want to explore with you.  I'll move to other panellists now and then bring the conversation back.  I'm particularly interested in what you had to say about student voice.  I think that can be a really nice conversation with Josh as well, who's our student in the room, but also this moment and how we seize it as universities to actually bring something positive out of this disruptive moment.

 

I am now going to properly introduce Georgie and Josh and then ask them a few questions.  So Georgie Harman has significant and broad‑ranging leading policy and service delivery experience in the community, public and private sectors.  Georgie has been the CEO of Beyond Blue since 2014, where she's led a significant expansion of efforts and results in service innovation, suicide prevention and digital solutions.  Previously she helped set up and was Deputy CEO of the National Mental Health Commission, providing independent advice to government on reform. 

From 2006 to 2012, Georgie had national responsibility for mental health, suicide prevention, substance misuse, cancer and chronic disease policy and programs as Senior Executive at the Commonwealth Department of Health.  That all sounds very difficult work, Georgie.  She also led the development of a significant whole‑of‑government mental health budget package and the development of a legislation to introduce plain packaging of tobacco products in Australia.  Welcome, Georgie.

 

Josh Yasserie is a mature‑age student at UTS.  Hailing from Wiradjuri country, he is a proud father and Aboriginal artist following in the footsteps of his mother, Teresa Yasserie, also an Aboriginal artist, and uses his talent to tell stories from First Nations communities and perspectives.  During the COVID‑19 lockdown, Josh was initially looking forward to remote learning, but found himself trapped in Sydney and isolated from his family, Elders and country more than six hours drive away.  So welcome, Josh.  I'm looking forward to hearing your insights as well.

 

I neglected to say at the beginning if any of this content at any time is worrying to you, if you're feeling overwhelmed or it's making you feel anxious, please ‑ firstly, you can turn it off, you don't have to keep watching, or you can mute it for a little while, but also remember there are people you can talk to and of course you can always contact Lifeline on 13 11 14.  We will be posting those details in the chat box, which you'll be able to find in your Zoom control panel.  So please remember that.  Look after yourself.  Georgie ‑‑

 

GEORGIE HARMAN:  Hello.

 

VERITY FIRTH:  Tell us a bit about Beyond Blue.  It has a real focus on prevention and early intervention for all people, but particularly for young people.  So tell us a bit about what you do and what early intervention means.

 

GEORGIE HARMAN:  Yes, sure.  Can I go back to ‑ I think those data you started with, Verity, are really important because what COVID is showing us is the fractures and fault lines in the system that we have now and it's not just about the system, it's actually about our society, so income, age, gender, geography, culture, racism, discrimination, loneliness ‑ these are the things that we actually need to now really focus on because if we support those facing the greatest adversity, we'll all do better.  So I'm really, really passionate about that and I think that this crisis gives us greater momentum to do that than ever before because the data is unequivocal.

 

So what does Beyond Blue do?  We're I guess the best‑known and most visited mental health organisation in Australia.  About 13 million Aussies come to us in some way every year.  We focus on depression and anxiety, but increasingly suicide prevention as well.  We really believe you have to start early.  As Pat's numbers have shown, half of adult mental health conditions start by the age of 14 and three quarters by the age of 24.  So it's very different.  So we need to start early in life and also support parents and families.

 

Prevention is about making sure that we increase the protective factors ‑ things like eating well, getting enough sleep, exercising our body and mind, relationships, meaningful activities, connections, and also reducing the risk factors, those things like financial distress and poverty, racism, family violence, drinking too much, insecure housing.

 

Not all mental health conditions are preventable, but many common mental health conditions are and that's I really think where Beyond Blue operates in the space of.  We do a lot of prevention, schools, workplaces, communities, clubs, that sort of stuff, but early intervention is the next most important step and we think about that both in terms of early in life, so intervening early in life, again supporting healthy childhoods, supporting parents who are doing it tough. 

 

We talk about early intervention being early in illness, so if someone does start to become unwell, how do we actually put the supports around them so that their illness doesn't get worse.  And early in episode, so again, making sure that the deterioration when someone does ‑ especially when they live with cyclical mental illness, when we get in early where there's an episode of illness, we can actually do better for people.  So that's some of the stuff we do. 

 

In the Coronavirus period we were given money by the Feds to set up a national service.  We did that in eight days.  We've seen record numbers of people come to us.  We've taken a digital‑first approach to that, but also given a whole range of options to people.  Young people are predominantly ‑ are the biggest users of that service and the numbers of young people that have been coming to us in the last six months has actually increased quite dramatically.  They're coming to us with firstly anxiety, secondly depression ‑ this is in terms of the reasons for contacting us ‑ isolation, family and relationship problems and loss.  Those are the reasons that they're citing.

 

900,000 people have been to the digital site.  We're seeing 40 to 60% increases in contacts with our counselling service and that's both phone and web chat, but the most clicked through support option for people is peer support.  1.3 million people are going on to our online forums to actually support one another.

 

Sorry, quickly, Verity, the last point I wanted to make is this pandemic has forced us to work differently.  So we are forming really different partnerships.  We're working with Financial Counselling Australia.  The amount of financial stress that people are coming to us with and financial distress and mental distress are the two sides of the same coin.  So we've created really strong pathways to financial counsellors who can actually help people manage debt and money worries.

 

We're working with ReachOut and Lifeline so that the content on our service is actually being written for young people by young people, and if a young person is visiting pages on that site that indicate suicide or distress, they get a pop‑up intervention from Lifeline to say, "Hey, we've noticed you're looking at this content, we're a bit worried about you, do you want to speak by text to a Lifeline counsellor?"  So we're creating new pathways into services.

 

The other thing is because people are calling us with greater complexity of need, we're working with Mind Australia and when someone calls our counselling service and they need longer‑term support, they are provided with up to another five sessions with a Mind counsellor completely free of charge, no barriers to access.  So those are the kinds of things that we're doing to work differently to respond to the community's needs at this point.

 

VERITY FIRTH:  That use of the digital technology I think is fascinating in this space because presumably that's also about scale, isn't it?

 

GEORGIE HARMAN:  Yes, it's about ‑ we're not going to be able to get through this by treating one person at a time, as much as we'd like to, so we have to think about how do we bring together face‑to‑face services with technology, digital online, how do we actually achieve the scale that we need to do so that people have a whole range of tools to look after their mental health as well as to recover.  So those are the kinds of models I think we need to be really, really badgering governments and actually doing ourselves without waiting for governments.

 

VERITY FIRTH:  So Josh, first ‑ first, before you even get to speak in real life ‑ we are going to in fact share a short clip which is from an ABC segment that you spoke to in August about your experience of lockdown.  So we're just going to play a short clip before I ask Josh some questions.  (Video clip played):

 

The search has shown well‑designed online learning can be just as effective as face to face and actually even better if the two are combined.  The problem is there wasn't enough time for this to be well designed online learning.  It was a solution to a situation not seen out of wartime and the experience of students and teachers reflect that.  Josh initially thought it would be great.

 

JOSH YASSERIE:  It was great at the beginning.  Looking at it now, it's like you'd be able to stay in your pyjamas, go online, do your own thing and then switch off.  This is a crime against all Australians, especially white Australians, and that makes it heaps worse. 

 

But the talented Indigenous artist and proud father of one couldn't leave the big city.  He missed his traditional spiritual connection to the quieter land six hours drive away.  He'd never felt so alone.

 

JOSH YASSERIE:  When I see isolation, I'm looking at my family members that are isolated, my Elders, my country.  So for me to go back and be healed by my country, I can't do it.

 

VERITY FIRTH:  So expand a little bit on that for us, Josh.  How did you find the experience moving to remote learning and also I suppose ‑ both moving to remote learning but also the isolation of lockdown, and so forth, this year?

 

JOSH YASSERIE:  Like I said in that, I think it's ‑ I've had a very unique experience to it.  It was a good plan straight up at the beginning.  Then like, you know, things happened in the world, because this didn't just happen in a bubble, as we said.  This was at a time of George Floyd and everything else that was going on, COVID, switching to ‑ so I was sort of like I was getting affected from everything that was going on in the world, what was going on within inside myself with past traumas growing up in these spaces where they expect someone like me to be. 

 

I think, yeah, at the beginning it was nice, but as time went by and life hit these punches, you sort of ‑ you're locked in a room because of lockdown and then okay, Sydney is a hotspot, so how am I supposed to go back home and like that's a community there.  I can't ‑ maybe I did have COVID or something and then bring that to that community and decimate my whole community.  So I couldn't do that.  So I'm sitting in my room, I'm sort of in depression in myself being locked, isolated, and it's just ‑ yeah, I think I started rolling with the punches then. 

 

Because of COVID, it was blowing everything up, so everyone started to look at each other and looking at family, what's important in life and stuff like that and we've had that time to sit down and look at that.  So yeah, it's been a very mixed response to what's going on with the online, you know, education system.

 

VERITY FIRTH:  And with the benefit I suppose of hindsight in a way, even though unfortunately we're not quite through it yet, what would you like to see the university do differently?  What would have supported you better and would continue to support you better during all this turbulence?

 

JOSH YASSERIE:  Like I can understand that this is all new to everyone, but in saying that, it's like us as students, we're paying so much to have this university experience, but it's sort of like, you know, some of us don't have those computers, some of us don't have those equipment, and some of the stuff is not set up for people to have working at home online because you have to physically go in and do your work.

 

The university wasn't really sort of ready to go online and ready to do what we do.  So it was about accessibility, it's about the equipment, you know, access to that kind of stuff.  And if you can't do that, you can't go to your potential, you're sort of limited, and I think that's sort of like where it starts getting sort of hopeless for some of these students and stuff like that.

 

VERITY FIRTH:  Mmm, that's right.  I was interested ‑ because of one of the things that Patrick said in his speech about the role of student voice and student power, like this idea that ‑ you can see why that matters in terms of mental health too, because it's about having some sense of agency.  Did you find there was a sense of sort of support amongst students?

 

JOSH YASSERIE:  I guess for the younger ones they were bouncing off each other, and stuff like that, but because I am an Indigenous man, I am older, yeah, I've had my own kind of experience of university.  So it's sort of like that just referred back into the online world where it sort of maybe I have the one‑off kind of conversation to say, "Oh, are you all right" kind of thing.  I guess other students who are very social and have those kinds of networks ‑ I guess they were bouncing off each other.  But it's sort of the people that fall through these cracks that don't have that support.  That's the ones we've got to look after kind of thing.

 

So yeah, it's not just only students but, yeah, it's actually like trying to bring up a new community because like everyone has their own little community and social groups at university and they're all good like that, but when it starts to come into online and then you get into these breakout groups and you're with people that you don't really socialise with or want to talk to and stuff like that, so no‑one knows who's with who or what group is with what group and who's working together.  It's all like okay, we're just all numbers.  We'll throw you in there and throw you over there.  So it's like we're starting to lose that sociology, the community strength together, and it's like how do we form this digitally.

 

VERITY FIRTH:  Yes, which is big.  I'd be interested to toss this back now to Patrick and Georgie, you know, the creation of community and support and the sense of belonging when you're not actually physically in the same space as each other.  Patrick, do you have any thoughts about that?

 

PROF. PATRICK McGORRY AO:  Yes, one of our researchers,  Professor Mario Alvarez‑Jimenez, has developed a platform of care called Moderated Online Social Therapy, which the Victorian Government is rolling out across all youth mental health services, headspaces and state services in the pandemic and it addresses a lot of those issues.  It produces a community.  It's like a community that you are a member of.  So it might be a few hundred young people that have a particular type of mental health problem or a particular setting, like headspace, or could be done in schools as well.  It's a complementary thing to face to face. 

 

I think it's dangerous to sort of not respect the importance of the real face‑to‑face aspect as well.  These are not either/ors.  It's a matter of complementarity and balance.  That's what Mario's platform has been developed to do.  It's powerful because you get peer support built within it, you have peer moderators, you have clinical moderators, you have therapeutic things happening on it.  It's very, very powerful.  That's based on 10 years of NHMRC funded research now scaled up in the US and other places as well.  That's got great potential.

 

I think the other thing about the student voice I'd just like to say is one of the questions that I just responded to is why has this been allowed to be neglected by universities.  I said it's not just universities, it's the whole society neglecting mental health.  We've had heaps of awareness thanks to Beyond Blue over the last 20 years, but haven't had serious policy investment.  We've had oases of reform, especially from the Federal Government, I'd say over the last 20 years, but State Governments have allowed the whole thing to collapse. 

 

So I think why is that?  It's because the public have not had a voice.  The public have not had a voice.  The consumer voice in mental health has been weak and fragmented and we haven't had a grassroots movement, so we're setting up an organisation to address that and the students ‑ I don't say the students need to do that.  If the students were to do that, then you might see some action. 

 

You've got to use the word agency.  It's all very well to feel disempowered and miserable and so on, but the way out of that is actually developing and exercising your power and influence and that can be done at a grassroots level in a very powerful way.  Then they can form alliances with other leadership and other stakeholders that want to see the same thing. 

 

This is what ‑ Georgie said we have to do things differently, we've got to ‑ all the things she said at the beginning I totally agree with what it's exposed.  These are all political questions.  It's a political question why have the mental health needs of young people been allowed to be neglected because no‑one has forced people to address them.

 

VERITY FIRTH:  Political questions need political solutions.  Georgie, what would you like to add to that?

 

GEORGIE HARMAN:  I think back to your question, Verity, we're tribal.  As human beings, we're tribal and we're social creatures and all of that has been totally changed overnight, radically, unpredictably in ways we never imagined.  Loneliness actually is ‑ the way that loneliness affects our brain, it actually lights up the same part of our brain that lights up when we feel physical pain.  Actually loneliness is painful.

 

So there's some real science behind this done by much cleverer people than me.  But I love Josh's point.  It's the simple things that actually make the biggest difference and it's the end user, if you like, that actually often has the solutions and yet for some reason we forget to ask them what they need and what good looks like and what can we tweak so it feels better, it's a better experience, you'll get more out of it. 

 

There's a saying in mental health "nothing about us without us".  It's the rallying cry of the consumer movement.  As Pat said, there's lot of momentum here.  We're realising the real experts are the people who have the T‑shirt, people with lived experience, whether from a personal experience or a family experience or support person experience.

 

I think it's the simple things.  It's asking the question ‑ not just people like Josh holding truth to power.  It's about us people in power asking the right questions.

 

VERITY FIRTH:  And including students in the solutions, yes, I think that's so important.

 

PROF. PATRICK McGORRY AO:  Can I say one quick thing?  The success of the youth mental health reforms has been very dependent on what you just said, the young people actually having a key role in the whole co‑design and headspace and everything else, what Georgie said is right.  I think there's got to be respect on both sides for expertise, though.  Consumers need to respect professionals and researchers as well.  So it's got to be a two‑way street.

 

VERITY FIRTH:  Yes.  We talk about that a lot in engagement university, mutually beneficial transformative relationship.  It can be complicated.

 

I'm now going to ask some questions sitting in the chat because I want to give people an opportunity.  The first question, partly because it's a bit related to what we've just been talking about about consumer voice, student voice, is from Amy Cifuentes‑Platts and she asks, "Does anybody have advice on breaking down the stigma around mental health, especially for international students?"  You talked a bit about it, Patrick, I think it's better than it used to be, I'm a mother of a teenage daughter.  There is no doubt it's more openly discussed in schooling and amongst peer groups than it ever was in my day.  But what do we do about that and there is an issue in terms of international students who don't necessarily want to go to a counsellor and so forth and we have that issue at universities.  Patrick, do you have any views on that?

 

PROF. PATRICK McGORRY AO:  I totally agree.  I think it's definitely improved a lot with maybe you could say mainstream students and particularly common mental disorders like Georgie said too, but there are still areas where stigma is rampant.  We had the same stigma report card this week which showed for complex mental illnesses it's really very serious still stigma and certainly for different communities. 

 

It's not just the students from those communities.  It's actually their parents are more of a problem than the students because we've seen in headspace certainly parents trying to stop their kids seeking help because of stigma.  The kids are trying to seek help, but they're blocked.

 

But yes, it's a massive issue and not one size fits all.  As Georgie said, a lot of the divisions and differences have been exposed really by the whole crisis as well.

 

VERITY FIRTH:  Josh, is there issues of stigma in your community or have you felt that among the student body at UTS?

 

JOSH YASSERIE:  I think there is a real problem not doing anything with it.  Everyone can vent to someone, but there's nothing that they've been trained how to deal with this problem.  All it is is a big venting situation, where someone will come up and say, you know, "I'm dealing with this", blah, blah, blah, blah, blah, and then that's it, and they feel good just to have that venting.  But if they're sort of trained to understand what's going on with themselves and why they are feeling like this, maybe then they can have this information to go to.  So if they had training at the beginning to say okay, if you are having these kinds of problems ‑ and it should be a training session because they need to learn about cultural awareness ‑ you know, for even those Indigenous, international students that are coming through, no‑one has had training about cultural awareness, you know?  So what are we creating?  There's training about, you know, sexual assaults and stuff like that and they have questionnaires and stuff like that, so people are trained, but what happens in that space of these people that are vulnerable?

 

So I think if we sort of have either a little bit of training for people that are coming in ‑ maybe even the staff to actually, you know, identify these things within the classrooms.  I don't know if you do have that as is ‑‑

 

VERITY FIRTH:  A bit, yes.  It's interesting what you're saying about students, because we do mental health first aid training for our staff, but maybe we're not involving the student population as much.

 

JOSH YASSERIE:  That's the thing.  Like you said, it's a two‑way street, so we both need to work ‑ this is a together working situation.  It's not just a one side kind of thing.  This person has to seek the help, you know, to be helped.  So if they don't know, they're lost.

 

VERITY FIRTH:  And their first response, of course, the first response you get when you seek help is always very important.  Georgie, what do you think about stigma?

 

GEORGIE HARMAN:  Look, this is an area we do a lot of work in and, as Pat said, we've got a long way to go on more severe and complex conditions, but with depression and anxiety there's been a huge shift in stigma at a societal level and some degree at a structural level. 

 

But what stigma problem that we're concerned about is self‑stigma now, and if you think about what the definition of stigma is, stigmata is a stain on one's character and that's how people feel about themselves.  They feel that there's something wrong with them, they feel that they're weak, they feel that they're a burden to others, and they feel a great sense of self‑shame and that's a major barrier to help seeking, especially with international students.  I think that that's at the heart of Amy's question.  It's something we see a lot of.  The biggest antidote to stigma is putting people that look like you in front of others who look like them and them telling their story.

 

VERITY FIRTH:  Yes.

 

GEORGIE HARMAN:  That is the most powerful weapon we've got against self‑stigma.

 

VERITY FIRTH:  Yes.  That's really pertinent.  I'm mindful of the time.  The next question has got a lot of votes, so I want to ask it.  It's from Deborah Marsh:  "Do we need to be thinking differently for HDR" ‑ higher degree research, people doing things like PhDs ‑ "versus undergraduate students or are the issues, needs and solutions very similar?"  I might go again ‑ I know I keep going first to Patrick, mainly because I know he's done the report about university.  Was there recommendations in there about the particular stressors of HDR students?

 

PROF. PATRICK McGORRY AO:  I could take that on notice, Verity.  Sorry, I can't remember that ‑ actually, Penny Carson was the person leading that whole project.  I can't really answer that specifically.  I think obviously we have a lot of HDR students at Orygen and there are different stressors and different threats to their mental health absolutely, they've got different needs.  They're usually older, obviously, and so there are definitely different issues. 

 

It's a highly stressful thing doing a PhD, having done one.  It's probably one of the most stressful things you're actually going to do in your life, and especially in current conditions.  The kind of environment for higher education, it must be the worst period that I can remember actually that we're going through right now.  So there's that general effect, but there's more specific things too.

 

Also some of the career pathways that would have been open to people, they're very unstable, aren't they, and huge uncertainty, which is one of the big things about this stage of life, the increasing instability and uncertainty of it for young people.

 

VERITY FIRTH:  Yes.  I'm going to quickly make a comment because Helena talks about requiring academic staff to do mental health training.  We do it at UTS but don't require it, it's not mandatory, but that's interesting as an idea.  She also says she has had Batyr, the student run or student networking, come in and run sessions with her students and always highly received, so that's good.  Again, we're at 5 to 1, but I want to ask this final question from Paul Byron.  He's a UTS researcher and he's researching digital support amongst LGBTQI+ young people and still hearing stories of mainstream mental health services providing inadequate support to LGBTQ+ people, particularly trans and gender diverse folk.  Wondering if panellists might speak to how particular groups of young people face greater obstacles ‑ for example, common experiences of racism, homophobia, transphobia when accessing professional support and currently ... how this might be improved.  Georgie, do you have any views on that?

 

GEORGIE HARMAN:  I've got very strong views on this as a member of that community and as someone who's involved in the community.  Look, it's an interesting thing.  You're absolutely right, Paul, there are many mainstream organisations that need to really lift their game in terms of competency and an appropriateness of how they deliver services, especially to gender‑diverse and gender questioning and trans young people, and it's not about just putting a rainbow flag in the window.  There really are some important skills here. 

 

There's great organisations that actually teach those skills.  At Beyond Blue it's something we take very seriously.  All of our counsellors go through special training.  We know that there's actually quite a significant number of LGBTIQ community members that use our services.  We know generally that LGBTI communities want to use specialist and LGBTI endorsed services, but a great proportion actually are quite comfortable with mainstream services, as long as their experience feels respectful and is appropriate.  It's about lifting the bar for everyone. 

 

But there are some great organisations out there, the LGBTI Health Alliance, Switchboard here in Victoria that are really pushing this as an issue at the moment.  It is still one from a policy perspective that keeps getting overlooked, but this is a group of ‑ this is part of our community that is at higher risk of suicide, apart from Indigenous Australians, than any other group in the community, especially trans people.

 

VERITY FIRTH:  Yes, yes.  So the final question that I'm going to let you all have words on.  It's from Janelle Spate.  She's seeing the urgency.  So I suppose her question is fundamentally I see it in my family and see it in my volunteer work.  How do we get government to take urgent action and how do we make the message clear this is an illness that can be cured, this is a way we can help people?  I suppose if you've got any last‑minute thoughts about the call to action and how we do that or anything else you want to say.  We'll start with you, Josh.  Any last‑minute thoughts?

 

JOSH YASSERIE:  I wouldn't know how to answer that question.  To me I think it's got to do more with people knowing more where they can go.  Like for Indigenous people we're not looking at government to save us.  That's how we see it.  So it's sort of how do we strengthen ourselves, you know, because at the end of the day we can only save ourselves really.  So for that question I don't know how to answer that with like government and politics and stuff like that.  I'll leave that to the experts.

 

VERITY FIRTH:  Yes.  But what you're saying is your community bands together.

 

JOSH YASSERIE:  That's it.  We are community people, so it's like not only do we have one mother, you know, our kinships ‑ this is all community‑based of Indigenous people.  Like with the question from before, like I tell you, for Indigenous people if it wasn't for Jumbunna, I wouldn't have went to UTS because of the support that they have, the spaces that they have for Indigenous people, that's the support that maybe that community needs with LGB.  So they could use that as a framework of what Indigenous people do, yeah, to create those spaces because without that support I don't think I could do what I do, be who I am, you know, without it.

 

VERITY FIRTH:  That's wonderful, Josh.  I hope there's Jumbunna people on the line.  That was great.  Georgie, what's your carry and call for action?

 

GEORGIE HARMAN:  We're waiting on the Productivity Commission report.  It's about the 20th report we've had into mental health in the last like I don't know how many years.  There has to be something that's done and I think generally governments know that.  It's how they go about making the changes and actually working together. 

 

The most important thing is that ‑ yes, we want the Commonwealth to do stuff.  We actually need the states and territories to be working with the Commonwealth to do a lot more and it's that working together and the redesigning a system so it actually works for people.  People don't care who funds which bit.  They just want to get a service that works for them.  So for me the biggest piece is about yes, of course we want more money, but the more important bit for me right now is actually governments redesigning a system together with us, with community, with people and families. 

 

And I think Josh made a beautiful point, it's not just governments that actually hold the solutions, it's us, it's the communities that we work, live and play in and that find nourishment in.  So I think governments have absolutely got to step up and do their part, but we've also all got to do our part too.

 

VERITY FIRTH:  And universities have to do their part with or without government support.

 

GEORGIE HARMAN:  Absolutely, yes.

 

VERITY FIRTH:  Patrick, you get the last word.

 

PROF. PATRICK McGORRY AO:  I agree 110% with what Josh and Georgie said.  I think there's a link between the two.  If the community organisers understand what it means and you can definitely do a lot of those things and every community is like that.  I'm from an Irish family.  Community and family and all of those structures are incredibly important.  We've lost them from most cultures, they've been degraded in many cultures, so reviving that would be really good,  but then mobilising that in a political sense, because I think we have leadership at the moment.  The current Prime Minister, the current Premier in Victoria, I've been involved with the Royal Commission, there's huge effort going into what Georgie just described redesigning the system so it actually works for people in a very different way from the way it has been operating. 

 

So I think we've got a huge opportunity.  But the sympathetic politicians only move as fast as the community creates the expectation and pressure for and the community has kind of failed.  It's the wider Australian community have actually failed I think so far.  We're all responsible for that because we actually have been bought off with, you know, soft solutions and just patted on the head and said, well, you're more understanding and more aware, but we're not going to provide the services because currently the services are only provided for a minority of people who need them and the quality of services provided are substandard. 

 

We wouldn't tolerate that if that was happening in asthma or diabetes, but we've tolerated it in mental health.  We have to take responsibility and not always blame the politicians.  They're only able to be empowered to act as much as we kind of expect.  So we've got to wake up and students have a role to play, students are always the activists, young people are the ones who fight the battles.  We can see that with climate change.  Why aren't we as students, you know, fighting this battle?  It's our own self‑interest as well as the altruistic part.

 

VERITY FIRTH:  On that call, that's a bit of a call to all of us to up our game.  So thank you very much for that, Patrick.  Thank you, Georgie.  Thank you, Josh.  Thank you for being a part of this panel today, and thank you to all of the audience who joined.  There is still a multitude of questions in the Q&A, so I apologise we haven't got to those questions, but it was a really stimulating discussion and it's definitely given me a lot to think about, particularly in relation to the university and how we support our young people. 

 

So thank you, all, for attending today.  As usual, this will be recorded and the recording will be made available.  I notice somebody else has also requested a copy of Patrick's slides.  I don't know whether they're available, Patrick.

 

PROF. PATRICK McGORRY AO:  Yes, of course.

 

VERITY FIRTH:  We will organise also providing a copy of Patrick's slides to anyone interested.  Thank you very much, everyone.  Thanks again for your time, panellists, and see you all soon.