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Youth Studies Australia v.21, n.2, 2002 43

Interest in depression and anxiety in,and the emotional well-being of,young people has grown as the

public health importance of mentalhealth problems has become clearer.The prevalence of depression isincreasing worldwide. As a result,depression is a significant health andeconomic burden compared to otherdiseases. Indeed, the World HealthOrganisation’s Global Burden ofDisease Study predicts that by 2020depression will be the second leadingcause of death and disease worldwide(Murray & Lopez 1997). Figurespublished by the Australian Instituteof Health and Welfare (Moon, Myer &Grau 1999) reveal that mental healthproblems and behavioural disordersaccount for over half the diseaseburden in youth in Australia.

Adolescent depressionDepression and anxiety are the mostfrequently reported mental healthproblems in young people. Depressionoften has its onset in adolescence withlifetime prevalence rates of MajorDepressive Disorder (MDD) in thecommunity ranging from 4% to 24%(National Health and MedicalResearch Council 1997). Parentalreports from the National Survey ofMental Health and Wellbeingindicate that less than one in threechildren and adolescents with depres-sion attend professional services toobtain help for their problems. Thisfigure is particularly concerning giventhat rates of depressive disorder, overa 12-month period, were 3.7% forboys and 2.1% for girls aged 6–12years, and 4.8% for boys and 4.9% for

girls aged 13–17 years (Sawyer et al.2000).

Adolescence is not “just a phase”, aroller-coaster ride that young peopletake on their journey towards adult-hood. Depression peaks in mid- to lateadolescence and young adulthood andshows continuities with depression inadult life (Rutter & Smith 1995). The

The Federal and Victoriangovernments have eachprovided $17.5 million

over five years to assist inthe establishment of

‘beyondblue: the nationaldepression initiative’.Therole of ‘beyondblue’ is toaddress the major healthburden of depression inAustralia.With depres-

sion and anxiety themost frequently

reported mental healthproblems in young

people, ‘beyondblue’ isdeveloping and imple-

menting a youth programthat features a multilevel,comprehensive, schools-

based research project whichwill include mental health

promotion, prevention andearly intervention.

Targetingdepressionin youngpeople

by Jane Burns and Karen Field

‘beyondblue’

44 Youth Studies Australia v.21, n.2, 2002

symptoms of depression includingwithdrawal, irritability and lethargycan impact directly on and severelyhamper the enjoyment of everydayactivities. This can have long-termconsequences, particularly withrespect to the quality of relationshipsyoung people develop with family andfriends, teachers and work colleagues(Sawyer et al. 2000). In the longer term,depression can reduce social and voca-tional opportunities for young peopleas a result of early school leaving infemales and discontinuity of employ-ment in males (Kessler et al. 1995).

As well as being a source of imme-diate distress for young people,

adolescent depression is strongly asso-ciated with a variety of other commonproblems and health-risk behaviours.Mood disorders have been shown to bea significant risk factor for suicide inboth older and younger adolescents(Brent et al. 1999). Depression isarguably the most important factorassociated with an increased risk ofrepetition of adolescent self-harm andsuicidal thinking (Patton et al. 1997).Depression is also associated withincreased levels of delinquency; lowerlevels of self esteem; and increasedlevels of alcohol, cigarette and tran-quilliser use. A longitudinal studyexamining the relationship betweendepression and substance use disor-ders in young women has shown thatco-morbidity is high during the devel-opmental transition to adulthood (Rao,Daley & Hammen 2000).

The public health approach tothe prevention of depressionin young peopleThe public health approach popu-larised by Geoffrey Rose (1992) aims toshift known, common and modifiablerisk and protective factors in afavourable direction, thereby reducingthe number of people at risk of devel-oping the targeted outcome. Forexample, to prevent cardiovasculardisease, one may focus on the promo-tion of good diet, increased exerciseand the prevention of smoking toreduce the risk of heart attack. Simi-larly, programs designed to preventdepression may focus on risk or

protective factors thatare modifiable in agiven environment.

The mental healthintervention spectrum,introduced in 1994 bythe Institute ofMedicine, defines“prevention” as thoseinterventions that occurbefore the initial onset

of a disorder (Institute of Medicine1994). However, the authors acknowl-edge that a classification system isnecessary that recognises the impor-tance of the whole spectrum ofinterventions for mental disordersfrom prevention, through treatment, tomaintenance. Under this system, treat-ment interventions, that are therapeuticin nature (such as psychotherapy,support groups, medication and hospi-talisation) are provided to individualswho meet or are close to meeting diag-nostic criteria for depression.

The “new” public health approachrecognises the need to influence thebroader social determinants of mentalhealth, specifically the environment orsetting in which people spend theirtime. Conventional health promotionat times overemphasises an individ-ual-focused approach and assumesthat education alone will increase

knowledge and aid a person to choosea healthy lifestyle. On its own, thisapproach can be inappropriate if itover-emphasises individual factorsand neglects the fact that the overallhealth of a community is the outcomeof an interplay between individualsand their community. A balancebetween health promotion, preven-tion, early intervention and treatmentmust be struck.

Depression and depressive disor-ders are common and are associatedwith impairment at all levels of func-tioning. Understanding the complexinterplay between predisposingbiological and psychosocial riskfactors and environmental andpersonal protective factors thatconverge and interact to determinethe onset of depression is critical.This knowledge should inform deci-sions that are made about the natureand targets of any preventive inter-vention strategy.

A developmental perspective isnecessary in the understanding of thecourse of depression and depressivedisorders across the life span. Inparticular, five risk factors in childrenand adolescents are associated withthe onset of depression: co-morbidanxiety, conduct disorder andsubstance use, a previous history ofclinical depression, being female,exposure to stressful life events, andhaving a parent or other close biolog-ical relative with depression. Theassociated mechanism may begenetic, psychosocial or both.Neuroticism or vulnerable personal-ity, parental divorce, early childhoodneglect or abuse, problematic parent-ing styles, living in a rural area, lowsocio-economic status, co-existingmedical conditions, ethnic origin andparental death are all probable riskfactors for depression in youngpeople (National Health and MedicalResearch Council 1997).

The initiative is seeking active participationfrom school communities, primary healthcare personnel, and educational and healthservices across Australia.

‘

’


‘beyondblue’s’ approach totargeting depression inyoung peopleThe identification of modifiable riskand protective factors is crucial to thesuccess of prevention efforts built onthe Institute of Medicine’s (1994)model. There is a strong theoreticalrationale supporting both an environ-mentally and individually focusedapproach working across the mentalhealth promotion spectrum; but toachieve a reduction in the prevalenceof depression in young people, and toreduce the burden associated withdepression, at least three types ofstrategies are needed:

• strategies that target risk andprotective factors amenable to inter-vention and which are capable ofreducing the onset of new cases offirst-onset depression;• strategies that better respond toand lessen the burden on youngpeople currently suffering depres-sion; and• strategies that assist individuals,and facilitate community participa-tion, to ensure control overhealth-related behaviours.

Specific examples of‘beyondblue’ programs‘beyondblue: national schools-basedinitiative’This initiative has adopted a nationalstrategy engaging health and education

across all States and Territories. The‘beyondblue’ initiative is utilising anevidence-based approach to developand implement a multi-level, compre-hensive, schools-based program, whichwill include mental health promotion,prevention and early intervention. Theinitiative is seeking active participationfrom school communities, primaryhealth care personnel, and educationaland health services across Australia. Itis anticipated that careful attention toengaging these groups will extend thelife of the project and provide a solidbasis for future programs that wish tobuild on the knowledge gained fromthis initiative.

‘beyondblue’s’ aim is to develop,implement and evaluate a nationalschool-based initiative for the preven-tion of depression in young people.(See box below for schools as anappropriate setting.) The initiative todate has involved national consulta-tion with existing research groups,education systems and the Common-wealth and State governments.

The initiative is designed to: • increase community awareness

and understanding of depression;• reduce the levels of depressive

symptoms for young people; • promote emotional well-being and

social connectedness in schoolcommunities; and

• increase the capacity of schoolcommunities to adapt, implement

and evaluate interventions relevantto the prevention of depression.

The ‘beyondblue’ initiative has twokey features. First, it will seek theactive participation of school commu-nities and education systems in allphases of its implementation. This isessential to ensure that all elements ofthe initiative become fully integratedwithin education systems and attractthe necessary capacity to maintaintheir existence in the longer term.Second, the initiative will becomprised of five elements, each ofwhich addresses a specific aspect ofthe risk and protective factors relevantto adolescent depression andemotional well-being. This multi-levelapproach has been adopted to achievegreater effectiveness than school-basedprograms, which rely on a single levelof intervention.

The five elements of the ‘beyond-blue’ initiative are:

Mental health literacy: Mental healtheducation will be provided tostudents, parents and school person-nel. Providing mental health educationto parents and school personnel willenhance awareness of mental healthissues among key adults living andworking with young people. Mentalhealth education for adolescents willprovide them with the informationthey need to identify problems, to seekhelp for themselves and to help peerswho may be experiencing depression.

Whole school approaches: “Wholeschool” interventions aim to improvethe quality of relationships betweenstudent peers, and between teachersand students, to promote protectivefactors at a social and individual level.This work takes place in classroomsand in extracurricular activities acrossthe whole school campus. A keyelement is “youth participation”whereby young people are encouraged

Why do schools provide an appropriate setting for the prevention of depression in young people?“An initiative such as ‘beyondblue’, which has a mandate to identify and describe effec-tive school community practice to prevent and minimise the harm associated withdepression, must encompass strategies that are uniquely available through schooling. Thisis not because schools provide a ‘captive audience’ for health interventions – rather itreflects the existing and acknowledged obligation of schools to provide structured oppor-tunities to learn, practice and apply in a safe and supportive environment the skills andunderstandings which contribute to mental health and well-being” (Ms Debra Kay,Manager, Interagency Health Care, Department of Education, Training and Employment, SA).

?


to develop a decision-making partner-ship with school staff and contributeto all areas of school life that affectthem (see model on pages 48 and 50).Other elements include the implemen-tation of mentorship and peer supportapproaches in school settings.Teachers will be provided with profes-sional development, relevantcurriculum materials, teaching strate-gies and approaches to developpositive classroom climates. Thesematerials will be designed to meet thecurriculum foci and learning outcomesin the Curriculum and StandardsFramework.

Sequential curriculum development:Teachers will present the curriculummaterials across Grades 8–10. Thecurriculum program will consist ofmultiple, developmentally appropriatecomponents and will introduce anddeliver important interpersonal life

skills (coping, communication,optimism, problem-solving). Schoolshave the capacity – and the mandate –to provide comprehensive curriculathat can be delivered and assessedacross the levels of schooling, encom-passing critical stages of developmentand transition. Comprehensive curric-ula can also anticipate and respond toissues that compromise the mentalhealth and well-being of students (forexample, at times of challenge andstress). The curriculum materials willbe developed in consultation withteachers and students.

Targeted intervention programs:Whole school and curriculumapproaches alone are insufficient toenable some young people to avoidmental health problems. For example,adolescents are at particular risk fordeveloping depression as the result ofserious life challenges, such asparental separation and/or divorce,death of a close family member, schoolfailure or having a parent with amental illness. Targeted interventionprograms provide an intensive inter-vention that focuses specifically uponthe needs of young people such asthese. The ‘beyondblue’ targetedapproach will consist of a two-termprogram for “at-risk” students whichwill be conducted in small groups bytrained therapists or counsellors.

Pathways for care: Young peoplesuffering from depression often findthe management of their illness partic-ularly distressing and difficult, withfew receiving help from professional

services. This element of the ‘beyond-blue’ initiative will facilitate betteraccess for young people to appropriateprofessional help. To do this, collabo-ration and coordination betweeneducation staff and health profession-als (especially general practitioners)across the school/community inter-face will be optimised. Young peoplewill be taught practical skills thatenhance their help-seeking behaviour,such as problem identification,arranging appointments with generalpractitioners and effective communi-cation with health professionals. Thiswill ensure that treatment and illnessmanagement is handled in the bestpossible way.

Specific benefits of the initiativeand expected outcomes for youngpeople attending schools participatingin the initiative included:• reduced levels of symptoms of

depression;• higher retention rates at school;• improved mental health literacy;• greater use of relevant health

services; and• increased school engagement.

The Australian Football League (AFL)and ‘beyondblue’ working in partner-ship: A3: Aspire, Achieve, Affect‘beyondblue’, the AFL, and AthleteDevelopment Australia (ADA) haveformed an exciting and unique partner-ship to develop a community-basedleadership program. The A3 programaims to encourage active participationin Australian communities to preventdepression in young people byconnecting them to their communitiesin meaningful ways. In addition, part-nering with a well-known sportingcode such as the AFL is core to‘beyondblue’s’ broader strategy toincrease community awareness andreduce the stigma attached to depres-sion and associated illnesses.

The A3 program is delivered byAFL players, who serve as positive

The highs and lows [of afootball career] are similar tofeelings associated with the upsand downs of adolescence.

‘

’

Stud

ent

art:

Cla

ire S

pier

s


role models. Selected players undergoextensive experiential training,providing them with skills to helpfacilitate leadership training for youngpeople. Opportunities to participate inthe program are made available to asmany young people as possible withcommunities identifying, planningand implementing sustainable projectsthat promote community connected-ness and foster emotional health andresilience. The players subsequentlyreturn periodically to the communityto provide ongoing assistance to theyoung leaders.

Importantly, the program alsoprovides opportunities for AFL playersto develop and use new skills, worktogether to create “team” cohesion andcontribute to the community in ameaningful way.

Are AFL footballers appropriatecommunity role models?

• Many AFL players have the poten-tial to be role models – in theirfootball careers they face extremehighs and lows, pressure to succeed,high expectations, isolation fromfamily and friends, and no guaranteeof success. The feelings associatedwith these highs and lows aresimilar to feelings associated withthe ups and downs of adolescenceand, therefore, football players canbe useful role models as they canrelate to the experiences youngpeople face.• Many young Australians bothadmire and revere AFL football andAFL footballers.• The involvement of high-profilesportspeople assists with localcommunity recruitment andprovides access to young peoplewho would not ordinarily engagewith services or who find it difficultto access services, for examplesocially disadvantaged youngpeople, young men and those inrural and regional areas.

What are the objectives of A3?• To decrease the reported numberof cases of depression, particularlyamong adolescents, by providingleadership training.• To promote resilience, self-esteemand connectedness in young peopleby providing them with leadershipopportunities.• To increase community awarenessregarding the impact of depressionand the importance of communityconnectedness as a preventativemeasure.• To destigmatise depression by util-ising AFL players as spokespersonsand positive role models in thedelivery of the A3 project.• To encourage young Australians tostrive for excellence through partici-pation.• To provide opportunities foryoung people to contribute to areasof their lives that directly affect themand to have increased social respon-sibility.

What are the achievements of A3to date?

• ADA and ‘beyondblue’ have nomi-nated and trained 74 AFL players.• The A3 program was successfullylaunched on 23 August 2001 atColonial Stadium in Melbourne. Theprogram was positively received.• Players are now working indiverse communities acrossAustralia. • The program has been or iscurrently being delivered in 18government schools, eight non-government schools, three at-riskday programs and three juvenilejustice youth training centres.

Reach Out! and the InspireFoundationReach Out! (www.reachout.com.au) isa national initiative that uses theInternet to help young people getthrough tough times. Reach Out! was

developed by The Inspire Foundationin response to the unique challengesthat young people in rural areas oftenface. Issues such as isolation, higherunemployment and reduced access toservices may all contribute toincreased levels of depression andsuicide in some rural communities.

Reach Out! is a unique initiative,which was launched in March 1998with support from the CommonwealthDepartment of Health and FamilyServices. The Reach Out! Rural andRegional Tour (RORRT) began in April1999, just one year after the launch ofthe Reach Out! service, with the aim ofworking with communities to promotepositive mental health for youngpeople living in rural and regionalAustralia.

I am really pleased to have beenpart of it … and I would highlyrecommend the RORRT to anyother community that was consid-ering doing it. Really worthwhilefor young people (Rural HealthWorker, QLD Health).

Reach Out! provides much-neededinformation, assistance and referrals ina format that appeals to young people.The service offers an anonymous andstigma-free way to get help, exploreissues and discover how other youngpeople have coped through difficulttimes. Reach Out! aims to inspireyoung people to help themselves byproviding them with access to impor-tant information, stories, contacts andsuggestions on a whole range of issuesfacing young people today, in an envi-ronment that is fun, interactive andengaging.

The RORRT travels to rural andregional Australia taking a message ofhope and inspiration to young people,linking up young people with thosewho can support them in their localcommunities, demonstrating the socialbenefits that can flow from use of theInternet, and building web sites that


Research tells us that young people’s feelings

of connectedness to school and family, and

prosocial relationships within the commu-

nity, are protective factors against negative

health outcomes including depression.

Conversely, it makes sense that feeling

isolated and disconnected from one’s

community has emerged as a risk factor for

young people (Resnick, Harris & Blum 1993).

Fuller wrote that “the less able a community

is to monitor the behaviour of young people

and to provide them with a meaningful

sense of belonging and connectedness, the

higher the likelihood of a wide range of

problem behaviours” (Fuller 1998).

Therefore, responsibly handled opportu-

nities for youth participation (i.e. effectively

facilitated, resourced and supported opportu-

nities) in schools and communities have

emerged in the literature as a positive factor in

individual young people’s lives. They go

beyond “youth voice and agency” to involv-

ing young people in relevant, concrete

activities that have valued outcomes. They act

as an effective intervention, not by targeting

problem behaviours directly but by promot-

ing what the International Youth Foundation

refers to as “youth development”. This

includes the healthy development of self

worth, mastery and future, responsibility,

autonomy, accountability, self-awareness,

emotional competencies, membership and

belonging, and civic and social competence.

The key aspects incorporated within

“positive youth development” approaches

include:

• building resilience through participation;

• developing life skills; and

• enhancing the acquisition of critical

developmental tasks and milestones.

From the outset, it is important to note

that “youth participation”, as depicted and

defined in this model, is based on the belief

that a collaborative partnership between

adults and young people is mutually benefi-

cial and has positive outcomes for society as a

whole. Often youth participation literature

implies exclusively youth directed and

conducted activities and structures, e.g.

minimising adult input. It is for this reason

that youth participation in this sense is often

either unsuccessful or unsupported. This is not

to say that youth participation does not

include activities which are youth directed

and run. For these activities to be successful,

however, we need to ensure that the young

people are supported and resourced and have

the skills necessary to participate actively.

This model of youth participation is based

on the right and need for all members in

society to participate in areas of their lives that

directly affect them or affect the community

in which they live. This, however, implies a

level playing field (i.e. we all have the same

skills, resources etc.) in order to participate

fully. This model has been developed based

on two assumptions:

• that many young people lack the

resources (opportunities and access) and

skills required to participate and thus will

need adult and organisational support in

order for this to occur; and

• that adults and organisations are often

either unwilling, unaware or do not know

how to empower young people and ensure

full participation within the structure and

function of their setting, be it school, organ-

isation or wider community.

In line with this collaborative approach,

the model places equal emphasis on both

the youth participation methods and activities

and the adult and organisational require-

ments or responsibilities.

Figure 1 on page 50, depicts the entire

model, emphasising the two core elements

and the outcomes. The element on the left-

hand side of the model, “requirements”,

refers to the general commitment of the

organisation as a whole and its adult workers

to the philosophy and implementation of

youth participation. This must mean more

than just a verbal or written commitment, it

refers to a number of concrete actions, behav-

iours and resources that are required to ensure

implemented youth participation is successful.

These include such factors as commitment,

opportunities, resources, support and positive

regard, and safety and security.

The element on the right-hand side of the

model refers to a range of youth participation

“methods” and activities. These include:

inclusion and shared decision-making; youth-

run organisations, projects and activities;

young people helping young people (includ-

ing an emphasis on peer work); hearing and

learning from young people; young people

informing service, program and policy devel-

opment; and young people developing

internal and external resources.

The final element of the model refers to

the potential outcomes of youth participa-

tion in terms of positive youth development.

This includes benefits such as awareness of

the inner self, building relationships that

connect, and achieving competence and

mastery.

A model of youth participation andpositive youth development

by Karen Field (beyondblue), Helen Rimington (Centre for Adolescent Health,Melb., Vic), Susanne Prosser (Hume City Council), Elly Robinson (Consultant)


provide a positive profile of youngpeople in their local communities.

What are the objectives ofReach Out!?The RORRT had an overall aim ofreducing mental health difficultiesamong young at-risk people bypromoting help-seeking behaviour.

The tour had four key objectives:• to increase young people’s connec-tion with the community bypromoting a positive profile ofyoung people living in rural andregional Australia;• to help alleviate depression byencouraging help-seeking behaviourand coping skills among youngpeople living in rural and regionalAustralia;• to assist and enhance existingcommunity agencies to bettersupport young people at risk; and• to promote “net social benefits” –the use of the Internet as a valuabletool in social service delivery.

What has Reach Out! achievednationally?Since its launch, Reach Out! has:

• had direct contact with over23,000 young people across NewSouth Wales, Queensland andWestern Australia;• had its web site visited by over560,000 people and currentlyreceives approximately 25,000visitors per month, each of whomstays on average for 12–15 minutes;• developed 263 town web sitesprofiling young people and thetowns they live in with interviews,stories, artwork, poetry and images.These town web sites can be foundat www.rorrt.reachout.com.au andcan also be accessed from the ReachOut! home page;• won numerous awards; and, moreimportantly, • helped a number of young peopleget support when feeling depressed.

The ‘beyondblue’–Reach Out!partnership: what was achieved?‘beyondblue’ proudly supported TheVictorian Reach Out! Rural andRegional Tour, an initiative of theInspire Foundation (www.inspire.org.au). The basis for this partnership wasthe parallelling of the RORRT goalswith ‘beyondblue’s’ community aware-ness and consumer advocacy strategy.

In partnership with ‘beyondblue’,Reach Out! completed a Victorian tour,which involved:

• visiting 84 communities andmaking presentations to 13,100young people in schools, TAFEs, andtraining and employment groups;• presenting to 13,000 serviceproviders; and• adding 94 Victorian individualsub-sites to the RORRT web site(www.rorrt.reachout.com.au) featur-ing young people’s artwork, storiesand opinions, interviews andphotographs.

A consultative tour commenced on6 August 2001. The RORRT teamvisited a number of regional centresaround the State, meeting with localyouth service providers to gaugeinterest in the RORRT. People whoworked with young people – teachers,GPs, community health centreworkers, church youth group leadersetc. were invited to attend regionalmeetings to determine whether theywanted the RORRT to visit their area.

Commencing on 27 August 2001,the RORRT team embarked on a 12-week “formal” tour of more than 70communities across rural and regionalVictoria. Cathy Freeman and theHonourable Jeff Kennett officiallylaunched the “formal” tour. TheRORRT itinerary included presenta-tions to young people in 25 rural andregional towns and cities.

Presentations included a demon-stration on how the Reach Out! servicecould help young people through a

tough time and provide informationabout other help services in their localarea. At the end of each presentation,young peoples’ images, interviews,stories, songs and artwork werecaptured on a digital camera andsound recorder and formed the contentfor their town web site.

The Centre for Adolescent Healthhas been appointed to conduct aformal evaluation of the tour. The part-nership inclusive of a formalevaluation will be the first step for‘beyondblue’ in its exploration of theInternet as an innovative and excitingavenue of access to care for youngpeople who are not engaged with tradi-tional health services. Information thatwill inform further research in the areawill be collected around five coreoutcome areas.

Youth participation andpositive youth developmentYouth participation is about develop-ing partnerships between youngpeople and adults in all areas of life sothat young people can take a valuedposition in our society and thecommunity as a whole can benefitfrom their contribution, ideas andenergies.

It is clear from the ‘beyondblue’initiatives discussed above that thenotion of “participation” is a keyingredient of all our youth-targetedintervention. Youth participation isoften denoted only in terms of “aright” and less acknowledged withinthe prevention and treatment literaturein terms of its value as an intervention.Researchers and practitioners acrosssectors recognise its virtues in terms ofempowerment and self-determination,but fail to acknowledge its potential inpreventing and treating a range ofhealth-risk behaviours. The modelshown on pages 48 and 50, developedat the Centre for Adolescent Healthpresents a framework for youth participation and positive youth


development that introduces strategieswhich help to strengthen protectivefactors and increase communityconnectedness.

AcknowledgmentWe would like to acknowledge contri-butions to this paper from thefollowing: The National Schools BasedInitiative executive; Michael Sawyer,Deb Kay, Sara Glover, George Pattonand Sue Spence; Athlete DevelopmentAustralia and the Australian FootballAssociation; the Inspire Foundationand Reachout crew; Jack Heath,Jonathon Nicholas and Kylie Lee.

ReferencesBrent, D.A., Baugher, M., Bridge, J., Chen, T.

& Chiappetta, L. 1999, ‘Age- and sex-related risk factors for adolescentsuicide’, Journal of the AmericanAcademy of Child and AdolescentPsychiatry, n.38, pp.1497-505.

Fuller, A. 1998, From Surviving to Thriving:Promoting mental health in youngpeople, ACER Press, Vic., p.86.

Institute of Medicine 1994, Reducing Risksfor Mental Disorders: Frontiers forpreventive intervention research,National Academy Press, Washington,DC.

Kessler, R.C., Foster, J., Saunders, W.B. &Stand, P.E. 1995, ‘Social consequences ofpsychiatric disorders: Educational

attainment’, American Journal of Psychi-atry, n.152, pp.1026-32.

Moon, L., Meyer, P. & Grau, J. 1999,Australia’s Young People: Their healthand wellbeing, Australian Institute ofHealth and Welfare, Canberra.

Murray, C.J. & Lopez, A.D. 1997, ‘Globalmortality, disability, and the contribu-tion of risk factors: Global Burden ofDisease Study’, The Lancet, n.349,pp.1436-42.

National Health and Medical ResearchCouncil 1997, Depression in YoungPeople: Clinical practice guidelines,AGPS, Canberra.

Patton, G.C., Harris, R., Carlin, J.B., Hibbert,M.E., Coffey, C. & Schwarz, M. et al.1997, ‘Adolescent suicidal behaviours:

• Inclusion and sh

ared

decision makin

g

•Youth-run orga

nisa-

tions, project

s and

activitie

s

•Hearing a

nd learning

from young p

eople

•Young people h

elping

young people;

informing servic

e,

program an

d policy

development; d

evel-

oping intern

al and

extern

al reso

urces

•Commitment

•Opportunities

•Resources•Support andpositive regard

•Safety andsecurity

Negotiation skills

ListeningGroup skills

Accessing information

Developing self-esteem

Problem-solving

Dealing withauthority

Interpersonalrelationship skills

Outcomes = Positive Youth Development

Inner selfRelationships that connectCompetence and mastery

Methods

Figure 1. A model for youth participation and positive youth development

Requ

irem

ents


Australian Infant, Child, Adolescent & Family

Mental Health Association Ltd(AICAFMHA)

ABN 87 093 479 022

AICAFMHA provides:

• Email facilities for discussion of topics: the AICAFMHA Discussion List

• Information about Mental Health News and Resources: the AICAFMHA News List

• A comprehensive website at http://www.aicafmha.net.au/

• Support for national child & adolescent mental health conferences

• A location for people with an interest in mental health for Australia’s youth to network

Join AICAFMHA and support the organisation that promotes positive mentalhealth for infants, children, young people and their families/carers.

See membership details on the website or call 08 8132 0786 for further information.

A population based study of risk’,Psychological Medicine, n.27, pp.715-24.

Rao, U., Daley, S.E. & Hammen, C. 2000,‘Relationship between depression andsubstance use disorders in adolescentwomen during the transition to adult-hood’, Journal of the AmericanAcademy of Child and AdolescentPsychiatry, n.39, pp.215-22.

Resnick, M.D., Harris, L.J. & Blum, R.W.1993, ‘The impact of caring and connect-edness on adolescent health andwell-being’, Journal of Pediatrics andChild Health, n.29, (Supp.1), pp.S3-S9.

Rose, G. 1992, The Strategy of PreventiveMedicine, Oxford University Press,Oxford.

Rutter, M. & Smith, D.J. 1995, PsychosocialDisorders in Young People, Wiley,Chichester.

Sawyer, M.G., Arney, F.M., Baghurst, P.A.,Clark, J.J., Graetz, B.W. & Kosky, R.J. et al.2000, The Mental Health of YoungPeople in Australia: The child andadolescent component of the nationalsurvey of mental health and well-being,AGPS, Canberra.

Jane Burns is Deputy ExecutiveOfficer of the ‘beyondblue: thenational depression initiative’ andHonorary Fellow, MurdochChildren’s Research Institute.Karen Field is Senior ProgramManager of ‘beyondblue: thenational depression initiative’.Email contact:[email protected]

• Some web sites of relevance to this articleinclude:

• beyondblue:www.beyondblue.org.au/site/

• Reach Out!:www.reachout.asn.au/home.jsp

• The Inspire Foundation:www.inspire.org.au/

• Other youth mental health programsinclude:

• MindMatters – a mental health promo-tion program for secondary schools:http://online.curriculum.edu.au/mindmatters/

• Friends: Prevention of anxiety anddepression – an anxiety prevention andlife-skills enhancement programpromoting psychological resilience forchildren aged 7–11 and youth aged12–16: www.australianacademicpress.com.au/friends/friendshome.html

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