In this episode, GP Bianca Forrester and Child and Adolescent Psychiatrist A/Prof Sandra Radovini tackle the tricky topic of self-harming and suicidal behaviours. Sandra describes the key elements of assessment and management for self-harming behaviours themselves and the presence of self-harm as a red flag for suicidal behaviours. They discuss the importance of formal training and support when working with young people who might be experiencing these behaviours. Sandra describes how we might better understand what we can work with and when we need to refer. Sandra also reinforces the the importance of working with supports. Patient information about Self Harm https://headtohealth.gov.au/mental-health-difficulties/self-harm Safety Planning resources For an explanation of safety planning https://au.reachout.com/articles/how-to-make-a-safety-plan or directly link to the app: https://www.beyondblue.org.au/get-support/beyondnow-suicide-safety-planning/getting-started Training and education resources Asist training http://www.livingworks.com.au Orygen training https://www.orygen.org.au/Training/Training-areas/Self-harm-and-suicide-prevention Headspace training for GPs https://headspace.org.au/health-professionals/gps-and-general-practice-at-headspace/ Phone Counselling and Support Where people are in crisis and need to talk to someone about their distress or trauma, there are a range of organisations listed below that can assist them. beyondblue www.beyondblue.org.au 1300 22 4636 beyondblue is a national organisation that has a range of information and resources associated with depression and anxiety. Useful resources and further information about beyondblue programmes are available on its website at www.beyondblue.org.au or by contacting its Support Service on 1300 22 4636 (toll free). The Support Service runs 24 hours a day, seven days a week. All calls are one-on-one with a trained mental health professional, and completely confidential. Lifeline Australia www.lifeline.org.au 13 11 14 Lifeline Australia provides a free, confidential and anonymous, 24-hour telephone counselling service for adults needing emotional support. Lifeline Australia also has a range of information and resources available from their website, about providing care in times of crisis. Kids Help Line www.kidshelp.com.au 1800 55 1800 A number of children and youth may also need emotional. Kids Help Line is a free and confidential, telephone counselling service for 5 to 25 year olds in Australia. Black Dog Institute www.mycompass.org.au The Black Dog Institute provides a 24 hour free mobile phone/computer...

In this episode, GP Bianca Forrester and Child and Adolescent Psychiatrist A/Prof Sandra Radovini have a conversation about disruptive behaviour in school aged teens. Bianca asks Sandra to help her to organise her thinking about this group of presentations. Sandra frames up this common presentation by describing how "all behaviour has meaning". So, how do we begin to understand the feelings behind the behaviours? How do we understand these teen's needs? How do we engage the young person in a collaborative relationship? And how can we as GPs and practice nurses help? Sandra refers to the AMAZE website for information for health professionals, including links to online training. https://www.amaze.org.au/i-am-a-professional/ This Podcast was recorded at the PodHub on the 4th of June, 2019 Presented by: Bianca Forrester Produced by: Bianca Forrester Audio Engineering: Chris Hatzis Post-Production: Arch Cuthbertson Music: Space Cadet Lullabies Graphics: Gaal Creative The Maze Phase is a production of the University of Melbourne, Australia. The Maze Phase is licenced under Creative Commons, Copyright 2017, the University of Melbourne.

Professor Susan Sawyer, Paediatrician and expert in Adolescent Health, describes contemporary understandings about the beginnings and endpoints of "Adolescence". She relates her viewpoint piece, published in The Lancet journal in 2018 titled "The Age of Adolescence" which describes how advances in brain imaging and neurobiology have furthered our understandings of biological beginnings and endpoints, how these discoveries might add to our understanding of this time of life. She discusses rights, the law and contemporary social influences and how all of these elements frame our understandings of this time of life and how we might work better with (and for) teens both in clinical practice and in research. We discuss her article The Age of Adoelscence. To check out the article head to: https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(18)30022-1/fulltext Timing of normal puberty For more information about growth disorders in teens: https://www.racgp.org.au/afp/2017/december/growth-disorders-in-adolescents/ Susan refers to HEADS screening. For more information check out episode 1 of the Maze phase or head to the RCH guidelines: https://www.rch.org.au/clinicalguide/guideline_index/Engaging_with_and_assessing_the_adolescent_patient/ This Podcast was recorded at the PodHub on the 5th September, 2019 Presented by: Bianca Forrester Produced by: Bianca Forrester Audio Engineering: Chris Hatzis Post-Production: Arch Cuthbertson Music: Space Cadet Lullabies Graphics: Gaal Creative The Maze Phase is a production of the University of Melbourne, Australia. The Maze Phase is licenced under Creative Commons, Copyright 2017, the University of Melbourne.

"What is the impact of depression on school aged teens?" GP, Dr Bianca Forrester, continues the conversation with Child and Adolescent Psychiatrist A/Prof Sandra Radovini about mental health problems in teens. In this episode Bianca and Sandra explore the role of the GP in assessing and managing depression in practice. "What predisposes adolescents to depression"? In seeking to understand the young persons experiences in context, for anxiety she poses the question "What are the pressures"? With depression as a presenting problem she poses a different question....tune in to find out.... This Podcast was recorded at the PodHub on the 30th May, 2019 Presented by: Bianca Forrester Produced by: Bianca Forrester Audio Engineering: Chris Hatzis Post-Production: Arch Cuthbertson Music: Space Cadet Lullabies Graphics: Gaal Creative SSRIs- We discuss the indications, effects, benefits associated with SSRIs. Check out these resources for more information. About SSRIs in GP: https://www.racgp.org.au/afp/2013/september/ssris-and-adolescents/ About SSRIs in adolescents https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4791100/ About optimal doses https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(19)30217-2/fulltext For more information about Assessment and management of Depression check out these reources. Orygen -National Centre of Excellence in Youth Mental Health Treating Depression in young people. https://www.orygen.org.au/Training/Training-areas/Depression/Clinical-practice-points/Treating-depression-in-yp Other recommended Guidelines https://www.nice.org.uk Simply input: Depression in Children and Young People Great interactive guidelines by NICE Guidance Exerpt from NICE guidelines regarding Brief Psychological Intervetions (BPI); This intervention is based on the brief psychosocial intervention (BPI) carried out in the IMPACT trial (Goodyer et al. 2017)1. Core components of BPI include: · psychoeducation about depression and action-oriented, goal-focused, interpersonal activities as therapeutic strategies · building health habits, · planning and scheduling valued activities · advice on maintaining and improving mental and physical hygiene including sleep, diet and exercise · promoting engagement with and maintaining school work and peer relations, and diminishing solitariness. BPI does not involve cognitive or reflective analytic techniques. 1 Goodyer IM, Reynolds S, Barrett B et al. (2017) Cognitive-behavioural therapy and short-term psychoanalytic psychotherapy versus brief psychosocial intervention in adolescents with unipolar major depression (IMPACT): a multicentre, pragmatic, observer-blind, randomised controlled trial. Health technology assessment 21(12), 1-94. Finally, for patient resources and education: https://headtohealth.gov.au provides good patient information, advice and digital health options.

How can we help teens who are struggling with intense or uncomfortable feelings? In this episode, GP Bianca Forrester speaks with Child and Adolescent Psychiatrist A/Professor Sandra Radovini about best practice approaches to understanding anxiety in school aged teens. They discuss important aspects of assessment and how to understand the adolescent's problems in context. Sandra asks the key question: What are the pressures? And describes how to explore key areas of the young person's life. Sandra also provides useful insights into creating an individualised management plan and how to work with the young person's key supports, where possible and formal networks. This Podcast was recorded at the PodHub on the 30th May, 2019 Presented by: Bianca Forrester Produced by: Bianca Forrester Audio Engineering: Chris Hatzis Post-Production: Arch Cuthbertson Music: Space Cadet Lullabies Graphics: Gaal Creative In this episode, Sandra describes the role of e-mental health tools for underserviced groups such as young people and those living in rural areas. Check out some of these resources. e-Mental Health tools Head to Health supports users to navigate digital mental health services from some of Australia's most trusted mental health organisations. Provided by the Australian Department of Health, Head to Health brings together apps, online programs, online forums, and phone services, as well as a range of digital information resources. https://headtohealth.gov.au/?utm_source=mindhealthconnect&utm_medium=301 Apps and iCBT courses https://thiswayup.org.au/how-we-can-help/apps/ https://thiswayup.org.au/how-we-can-help/courses/mixed-depression-and-anxiety/ https://thiswayup.org.au/how-we-can-help/courses/social-phobia/ https://thiswayup.org.au/how-we-can-help/courses/teenstrong/ https://moodgym.com.au https://mindspot.org.au/anxiety Webchat support Teens can get online to chat with professionals https://kidshelpline.com.au https://headspace.org.au/eheadspace/ https://www.beyondblue.org.au/get-support/get-immediate-support A piece from The Conversation about the role of e-mental Health https://theconversation.com/online-therapies-can-improve-mental-health-and-there-are-no-barriers-to-accessing-them-111357 A meta-Analysis of RCTs for online CBT in youth demonstrates that outcomes of online CBT are comparable to face-to-face interventions for anxiety. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0119895 Rural...

What is Youth Friendly Heath care? We hear a lot about the mental health problems in Australian young people. However, as a group, teens present to primary care less than any other age group and the problems that they present with are often unrelated to their mental health. In this episode, GP Bianca Forrester asks Prof Lena Sanci (Academic Expert in Adolescent Primary care) about the barriers that teens face in accessing the health care services they need, and how we, as health professionals, can help them to overcome some of these barriers. Working with Adolescents- How can the GP help? This Podcast was recorded at the PodHub on the 30th July, 2019 Presented by: Bianca Forrester Produced by: Bianca Forrester Audio Engineering: Chris Hatzis Post-Production: Arch Cuthbertson Music: Space Cadet Lullabies Graphics: Gaal Creative Lena describes the WHO framework on Adolescent Friendly Health care. Head here for more information: https://www.who.int/maternal_child_adolescent/topics/adolescence/health_services/en/ This Podcast was recorded at the PodHub on the 14th June, 2019 Presented by: Bianca Forrester Produced by: Bianca Forrester Audio Engineering: Chris Hatzis Post-Production: Arch Cuthbertson Music: Space Cadet Lullabies Graphics: Gaal Creative

A 5 minute listen- Introduction to the Maze Phase. A season recorded in 2019 with the aim of providing an overview of common mental health disorders and the assessment and management in primary care. Principles of Youth Friendly care and theories of adolescent development woven into the series. Due to the Bushfires in Australia and now the COVID 19 pandemic, release of the series was delayed. While the series does not specifically deal with the impact of these events on Australian teens, the principles principles put forward in this series remain relevant in practice.