RECORDED Mon 15 Sep 2025
SUMMARY KEYWORDS mental health, suicide prevention, R U OK, young people, stigma, ALEC model, Ask, Listen, Encourage Action, Check in, school connections, complex health conditions, peer support, mental health challenges, support services
SPEAKERS: Hannah Brown, Megan Gilmour
Megan Gilmour 00:00
This episode is proudly brought to you by the TPG Telecom Foundation dedicated to creating opportunities to improve the health, wellbeing and education of Australian communities in need.
Hi, I’m Megan Gilmour, MissingSchool Co-founder and CEO, and this is Live & Learn. This is the podcast that unearths insights at the intersection of health and education, building a powerful alliance to keep kids with complex health conditions connected to school from anywhere. The podcast is recorded on Ngunnawal land, and we acknowledge and pay respect to the traditional owners of this land and the land on which you’re listening.
Megan Gilmour 00:43
Welcome to our weekly webcast, a place to zero in on the interplay between health and education and to amplify the voices of those supporting students to navigate their educational journeys despite complex health challenges. Today on Live & Learn we have with us Dr Hannah Brown.
Megan Gilmour 01:03
Dr Hannah Brown is the education and young people manager at R U OK?, Australia’s national suicide prevention charity dedicated to inspiring, meaningful conversations about mental health. Hannah leads strategies to boost awareness and engagement across schools, university and TAFEs, meeting young people where they are at.
She strives to provide them with the knowledge, skills and confidence to start, R U OK? conversations and to help break down the stigma surrounding mental health. Welcome to Live & Learn, Hannah, we’re so pleased to have you here.
Hannah Brown 01:39
Thanks so much for having me.
Megan Gilmour 01:42
Yes, so today we’re here to talk about supporting school connections for students with complex medical or mental health challenges. Let’s head to the first question.
Hannah, tell us how mental ill health impacts kids and why it’s something every Australian needs to know and care about
Hannah Brown 02:01
Yes. So currently in Australia, one in seven children and adolescents aged four to 17 years are currently experiencing a mental health illness.
We also know that half of all adult mental health challenges emerge before the age of 14, and more than 50% of children experiencing mental health challenges are not receiving professional help.
And we also know that seven out of 10 of the most common presentations to pediatricians are for mental health. So, it’s a huge problem, and I think those statistics just really reflect that
Megan Gilmour 02:44
Absolutely you’ve, you’ve taken us right there, right out of the gates, and it is an absolutely critical issue for every Australian to understand. And you know, we’re talking about young, young people here, but obviously it affects people across the whole spectrum of the population.
And also those startling facts about diagnosis and maybe not getting the help that people need. So that leads us into the next question.
Many people probably assume things about mental ill health. What’s the million dollar question you get from parents or loved ones, or kids themselves, when they’re in the context of the diagnosis, or even in a situation where we believe that there’s a mental ill health issue going on?
Hannah Brown 03:41
So, the number one question that I get from parents and from loved ones when I’m out the road, traveling as part of our conversation convoy, going to community events, is always how can I as a parent or a loved one support my child experiencing mental ill health?
And it’s obviously a huge question, but at R U OK? we have a really simple four step conversation model, and it’s called ALEC – A, L, E, C, to help guide through, to help guide people through this conversation. Did you want me to go through the steps of the ALEC model?
Megan Gilmour 04:20
Yes, yes. Well, I think that that kind of captures the next question, which is, what’s the most important thing you want them to know? Is it, ALEC? Okay, let’s do it!
Hannah Brown 04:32
Absolutely. Because, yes, as I said, that’s a question that I receive a lot while, while I’m working, and a lot of the times that I speak to parents and grandparents and aunties and uncles is that they always say, I’m not a health professional, I’m not a psychologist. I don’t feel qualified to have this conversation.
But the four step model, it is really simple, and it just really reinforces that anyone can have this conversation. You don’t have to have a qualification, and the first step is A for ask. And you know, as your child’s parent or loved one, you are absolutely fully qualified to ask them if they’re okay, and to encourage them to express their feelings.
It’s important in this step that you’re just there to support the child, encourage them to be honest in talking about their feelings and also not passing any judgment or feelings of your own that you might be having.
I think the most important thing to take away from the Ask step is to just ask in a genuine way, so you don’t have to use the words, are you okay? It’s whatever way that feels genuine for you and for the child. But it’s also important to make sure that you’re in the red right headspace to ask this question first, and that if you are, that you have adequate time to listen to them.
So that takes us into the second set, which is L for listen. And listening might seem like a really easy concept, but it’s actually extremely hard to be a good listener, especially when you are having this conversation with a loved one, with your child, because it’s human nature for us to kind of want to jump in and fix the problem, but that’s not actually helpful at this stage of the conversation.
It’s really important to just sit back and listen and give them the time to just sit with them. So, remove all distractions, give the child your full attention. Don’t be on your phone. Learn to sit in the silence and the possible discomfort that that brings, which, again, can be quite tricky to do, but it really gives time for the child to open up.
And you can also reflect back on what the child’s saying, repeat back to make sure that you’ve understood. And I often hear from parents that when they’re trying to talk to – especially their teenagers, the best thing that they do is they take them for a drive.
So, it just removes that awkwardness that can often be found when you know you’re having this conversation. Making that direct eye contact, it can be a bit awkward, so parents often say, Look, I’ll just take my teenager for a drive. We’re not looking at each other, but we’re still having that conversation.
And then that takes us into the third step, which is E for encourage action. And this will look different depending on the situation and depending on the conversation. But the main thing to keep in mind is that you ask your child how you can support them, rather than telling them what to do.
So, you can ask them, you know, what do you need from me right now, what can I do to support you? And if your child has been feeling really down or not in a good place for a couple of weeks, that’s when it might be time to bring in some professional support.
So, you know, calling Kids Helpline, calling lifeline or Beyond Blue, and I really encourage you to make that phone call together, so your child is included. It’s not something that’s happening to them. And same if you’re booking them a GP appointment, make that phone call with them.
And then the fourth and final step is check in. So, this might be, you know, the next day, or a few days later, and it’s just checking back in with your child and saying, you know, how have you been feeling since we last had that chat? Is there anything else I can do to support you?
And just making sure that check in is a regular thing. You know, it’s not, it’s not a one off. It’s a regular conversation.
Megan Gilmour 08:40
That’s such a great framework. And I’m sure we’ll get into some deeper parts of that. And I’ve had my own experience of this and making all the mistakes that, including wanting to solve, wanting to fix, and the ways that that just doesn’t work.
And I really recognise one of those points very strongly that you made, which is to actually listen and be with someone in that is an incredibly uncomfortable experience, and often where we’re offering solutions because we’re trying to solve our own discomfort about what that person’s expressing, where we want it to go away. We want it to stop.
So that’s where we start pulling out our checklist of how to fix it. And, yes, that really resonated with me – to listen and to be with, without trying to solve in that way of telling people what to do, or just get over it, yes, is so uncomfortable.
But in my own experience, when I understood that and came to know it, really, really created the actual empathy, because you’re with the feelings, you’re with them. You’re having to have them yourself. You’re not trying to just discharge it – you know?
Hannah Brown 10:15
Yes. There’s a saying that we need to listen, to understand, not to react. We’re not thinking about what we’re saying next. We’re just listening to understand what they said.
Megan Gilmour 10:27
Yes and what you find is sometimes you just really don’t know what to say when you’re not trying to fix it. Yes. So, such a great framework, and so helpful for people to have that, you know, just coming back to those four things.
And I loved the E, because I thought you were going to go to empathy, and then you went to an action-oriented step that involves both people. So that’s incredible.
Hannah, we’d love to know if you’re willing to share what brought you into the world of suicide prevention, mental health, supporting people with mental ill health.
Hannah Brown 11:19
Yes, so not many people grow up thinking that they’ll work in suicide prevention as their career, and I certainly didn’t. I actually studied nutrition and dietetics. I did my undergrad in that degree. I did my PhD in that degree. Was very much on track to work in academia in nutrition and dietetics.
But unfortunately, I lost a close friend to suicide towards the end of my PhD, and it was that loss that just as suicide does, it has a ripple effect on so many people, and it absolutely had a ripple effect on everyone who knew him, including myself.
And that was the reason that I pretty much decided that I’m leaving nutrition, dietetics behind. I need to get into mental health and suicide prevention, which was a bit of a challenge after doing a different path for almost eight years.
But I’m so grateful to be in this role. And my friend, when he passed away, he was only 25 so, you know, young people in mental health and suicide prevention is absolutely my passion. And, yes, I’m really grateful to be here at R U OK?
Megan Gilmour 12:48
Yes, thank you for sharing that, and sorry for your loss. To actually take that next step, and your lived experience into the future with you to make a difference for other people is profound and a gift.
So we’re really thankful and grateful to you for that, and the work that you’re doing in the community, which is, you know, based on the statistics, which tell the numbers story, but they don’t tell the qualitative story of the impact do they and just how profound that loss is for so many people. So just yes, our thanks to you for your work.
So, knowing all that you know, what’s your biggest hope for kids, for young people with or experience in mental ill health, their families and loved ones when navigating this, you know, really difficult circumstance?
Hannah Brown 13:53
I think there’s – I have a few, not just one. The first one is to know that they’re not alone. Because, especially as a young person, when they are struggling, it’s very easy to have the mindset that you know no one else feels this way.
There’s something wrong with me. Why does my brain work like this? So just letting them know that they’re not alone in what they’re going through, so many people are experiencing it, and to know that support is out there.
So, we are lucky in Australia that we do have free support in the form of Lifeline, Beyond Blue, Kids Helpline. These 24/7 support lines that young people can access so for them to know about them.
And the really great thing with those, including Lifeline, is that they have text support services and web chat support services, because it’s really hard to make a phone call when you are feeling awful, especially for young people. So, to know that there’re other ways for them to receive support, and that can just be a text or a conversation with someone online through the Lifeline web chat.
Another hope that I have is for young people to be able to reach out when they are struggling. We know that young people in particular, find it’s particularly hard to do that, to put their hand up and say, you know, I’m having a hard time.
So that’s why checking in on each other is so important, because, you know, we just never know what people are going through. So that’s why we need to have this check in any time of the year, you know, not waiting until mental health month, or R U OK? day, but making it part of everyday conversations.
Megan Gilmour 15:47
Thank you and knowing that it was R U OK? day last week, which, you know, brings that to mind and makes that palpably, you know, clear to people or a reminder I should say. What would you say? How would we know to ask people are you okay? Or any other language, as you said earlier, that might suit you or feel more natural to you?
Is it that we notice, ‘Oh, they’re a bit different’? What are the things that we should use – in our busy worlds and lives with our own things, you know? How should we recognise the time to do that?
Hannah Brown 16:42
Yes, so you’re exactly right in that recognising when someone is acting not like themselves, so their behavior is a little bit different than normal. So, for young people in particular, they might not be returning each other’s texts, or they might not be turning up to sport practice.
Or someone who’s really, normally quite extroverted and outgoing has now become quite withdrawn. Or it could even be the other way that someone who’s normally, you know, keeps to themselves, is now very outgoing. Or they might be going out every night, or they might be drinking or posting things on social media that they wouldn’t normally post.
So how they’re acting is certainly one thing that we look at. We also look at what people are saying. So, this one’s a little bit harder to pick up on, because it’s not quite as common, I don’t think that people actually express how they’re feeling.
So, if they are just talking in a more negative way than normal, like they might be saying things like, ‘You know I feel like a burden. No one cares about me’, you know ‘what’s the point of planning things, there’s nothing to look forward to’. So just that really negative language.
And then the third thing that we look at is what’s going on in their life? So, we all have bad days. We all have ups and downs, but there are certain events that can be red flags. So, relationship breakdown is a huge one, especially for males. So, if there has been, you know, a breakup, or parents getting divorced, that’s a huge risk factor.
As well as there might be illness in the family, or they might be moving house, or there might be financial stress. So if you do know of someone who is going through a big life event, yes, again, that’s another time to just check in and say, ‘you know, I know that you’re having a really hard time at the moment with your parents or with your relationship, so I just wanted to check in’.
Megan Gilmour 18:54
Yes, and something else comes to mind for me now. It probably should just be something that we’re doing naturally with each other all day. Because, on top of all those things that you mentioned, which are just part of life and, you know, actually, all of the things that you can feel as a human in a single day, all of all of the things – joy, grief, despair, boredom, you know, whatever.
But we’re also facing a lot of existential crises. And particularly, you know, I noticed, but also obviously, it’s in the news, and it’s being talked about, is that’s having a particular effect on young people as it would, as the custodians of the future.
And it’s like, well, what kind of future are you making for us here that we’ve got to try and look after? And you know that, you know the democratic unrest, and the fake news, and there’s a lot. There’s so much, so much.
Hannah Brown 20:05
So much.
Megan Gilmour 20:06
Yes,
Hannah Brown 20:07
There’s so much. And young people can’t, they’re just constantly exposed to it. It’s on their phones, and that’s something that we never dealt with growing up. You know, if there was something happening at school. We went home and we might watch the news, but we didn’t have this 24/7, access to all of the awful things going on.
Megan Gilmour 20:33
That’s right, and which parts of them do you accept as truth as well? Or anything that’s in our feeds, and that includes everything from social media to news media to just whatever’s being transmitted in the day, messages between people as well.
So, there’s a lot going on there, and it just makes me think that, you know, even a hand on a shoulder at times might just be a moment of connection. And of course, we’ve got the loneliness epidemic as well. So, there’s, there’s just so much out there.
And I think this is, you know, this checking in is a real, a moment of connection apart from anything else, isn’t it? Just a micro connection.
Hannah Brown 21:26
Yes, as you said, we need it now more than ever before.
Megan Gilmour 21:29
Yes, absolutely. Coming back to our questions, so what are some of the common and perhaps frustrating public misconceptions about mental ill health, and how have you seen this impact families?
Hannah Brown 21:45
So unfortunately, with mental health in general, there are a lot of misconceptions and a lot of misinformation out there. With young people in particular, we know that while their awareness of mental health is quite high, so they know about things like depression and anxiety, the stigma of appearing weak and vulnerable is even higher.
So, it’s this stigma that unfortunately prevents a lot of young people from reaching out for support, because they don’t want to be seen as weak or vulnerable, especially among their peers. So again, that’s why it comes back to the importance of young people checking in on each other, because they’re not very likely to put their own hand up and ask for help.
Megan Gilmour 22:28
Yes. And also, as you said before, feeling like, ‘why is it me? I’m the only one, everyone else seems to be doing well,’ is also one of the greatest misconceptions ever, because basically, everyone’s having some form of personal, existential struggle.
I mean, that’s what it is to be human. But it’s harder to know that when you’re young and you haven’t made many laps around the sun.
Hannah Brown 22:54
Exactly. And what we see and what young people see on social media, it’s a very curated feed, and people only ever show the best of what’s happening in their lives. They don’t show all of the other stuff going on. So that also creates fiction, I think, because, we think it’s real life, but it’s not,
Megan Gilmour 23:17
Yes, absolutely, to be human is to experience all of the things. And I think for young people, it’s like just wait a little while, just wait it out. You know, the more you practice those things, those struggles, it never becomes any easier, but you realise that you got through it the last time. That’s just about all you know.
Hannah Brown 23:50
Exactly. And you do learn coping mechanisms and skills on how to get through things.
Megan Gilmour 23:56
Yes, and sometimes those are just wait it out because it’s going to feel uncomfortable, and that’s only – saying is so much different from the experience, right?
So, Hannah, how many you’ve told us before, but it’s worth repeating again here. How many Australian children and youth are living with mental ill health right now?
Hannah Brown 24:23
Yes, so it’s one in seven children and adolescents, and that’s those aged four to 17. And as I said before, I think something that’s really eye opening is that with more than half of all the adult mental health challenges – so things that we’re dealing now as adults – actually emerge before the age of 14.
So, it just shows, again, the importance of mental health in childhood. And these things that you know, we go through as children or as teenagers that we might not think matter, but then, 20 years down the track, it’s like, oh, okay, actually, that was quite important in in shaping my life and my mental health as an adult.
Megan Gilmour 25:11
So, yes, and it’s so true. I mean, there are some things that later in life seem inconsequential as things that happened, but that if you have ongoing conversations with yourself across life, you realise actually had a huge impact on you.
Hannah Brown 25:38
Absolutely
Megan Gilmour 25:38
Because it might because you were particularly vulnerable at that moment. It could just have been the moment in time where that thing felt just like everything, you know. And I just know this myself as I’ve traced back my life and certain experiences that I have as an adult, I’ve uncovered and mined through my life, and the memory pops up.
You realise it could have been in primary school; it could have been… yes, in the big picture, it looks inconsequential, but it was just profound. So, I really relate to what you’re saying there about, you know where things start, and if you might not even know that it needs to be addressed, but it can really carry through and grow internally.
Hannah Brown 26:28
Absolutely. There’s a reason why psychologists always ask about childhood. We might think, ‘Oh, why are they asking me about my childhood?’ But then they start going, and oh, okay, so maybe this thing that happened, or this thing when you’re a teenager, has actually had an impact on how you deal with things now, or how you regulate your emotions. So, huge impact.
Megan Gilmour 26:56
Yes, and how we frame things at that age, or how we frame things generally make such a difference to how we feel about it. That’s just how it is.
So that’s really something to pay attention to as well, because it means, I suppose, if we have more conversations with people at the time that things take place, if there’s things that stand out, then we might be able to nip those things in the bud before they take on a life of their own, and resolve them sooner rather than later.
Hannah Brown 27:39
Yes, absolutely. Deal with it in childhood before it then, as you said, into adulthood and the rest of your life.
Megan Gilmour 27:47
Yes, and an R U OK? moment, when we’ve had a disagreement with someone, or something’s not going so well, or to be able to check in then and come back to it, might just leave that door open a little bit.
Is there a risk of delayed diagnosis in cases of mental unwellness or ill health? Do you recognise that in your work?
Hannah Brown 28:15
So, there is definitely a risk, because there are not always physical signs that someone is struggling with their mental health. You know, it’s often not like our physical health. If we break our leg, it’s quite obvious that we have a broken leg, but mental health issues, they often can’t be seen.
And we know for younger children, they might not explicitly say that they’re feeling anxious ,or they’re feeling sad, because they don’t have that vocabulary yet, but they there might be other signs.
So, they might say something like, you know, their tummy hurts, or they feel sick. They might not want to go to school or hang out with their friends, which, you know, normally they love going to school and seeing their friends. So, it’s really picking up on, as I mentioned before, any behavior that’s outside of how they normally behave.
And yet it is hard, because, especially with younger children, they don’t have the words often to describe how they’re feeling. And then as teenagers, they might have the words, but there’s that stigma that’s preventing them from saying the words.
Megan Gilmour 29:28
Yes, and the differences that you have as a teenager too, in relation to adults, where you’re carving your own path. And so, you see this distinction between well, you as an adolescent, perhaps, and the boomers or whatever,
Hannah Brown 29:50
All the generations [laughter]
Megan Gilmour 29:55
Yes. And I think that’s really a good one with younger children. It’s, yes, the words aren’t there, perhaps. So that’s what we need to recognise. And the important point you made about invisible illness versus visible illness, and the perceived legitimacy between those two things, a broken leg is legitimate, cancer is legitimate. An injury is, is obvious and legitimate.
But are you really anxious? Are you really, oh, no, can we just talk you out of that, you know,
Hannah Brown 30:33
Just calm down, just take a breath.
Megan Gilmour 30:36
Yes, absolutely
Hannah Brown 30:37
And that’s where the stigma comes back into it. Because even, you know, adults and the Australia showing population in general, we’ve really only been having these conversations openly for the past maybe 20 years, if that.
So, there is still so much stigma, because you can’t see it. People think, oh, it’s not there. But we know that suicide is the leading cause of death for young people.
Megan Gilmour 31:07
Shocking. Just shocking.
Hannah Brown 31:08
It is. But so, yes, just because we can’t see something, it doesn’t mean that it’s not there and it’s not having a huge impact on the person.
Megan Gilmour 31:18
That’s right, and the number of cases that result in suicide are smaller than the number of cases of people living with it. So, you know, it’s a huge issue.
And what other kinds of complications? I think we’ve spoken about some of these already, but what are the complications kids with mental ill health face?
Hannah Brown 31:40
Yes, so children and young people with mental health issues are significantly more likely to miss school compared to their peers without mental ill health, and anxiety disorders are among the most frequent, but often under recognised mental health problems found in the students who refuse to attend school.
And then, obviously, this can be a vicious cycle: missing school, they fall behind academically, become more withdrawn from their peers, makes them more likely not to want to go to school. So yes
Megan Gilmour 32:14
Yes, you’re right in our wheelhouse now,
Hannah Brown 32:15
Yes
Megan Gilmour 32:17
Yes, absolutely. And we’ll come back to that, because we’re about to delve into the school bit. Can mental health issues also lead to physical health issues as well. Do you see that as a complication?
Hannah Brown 32:35
Yes, we definitely do, in many different ways. So, with anxiety, for example, some people who experience anxiety attacks or panic attacks, for them, they can be very physical, so they can have very physical symptoms of their body reacting.
We know our bodies react differently to stress, whether that’s being nauseous and vomiting, or even having skin rashes and things like that. So absolutely, mental health struggles can result in physical symptoms.
And we know that, as you mentioned before, loneliness, they’re now looking at the physical impact of loneliness on people and comparing it to –
Megan Gilmour 33:25
Worse than smoking
Hannah Brown 32:36
Yes, and to having a sedentary lifestyle. So absolutely, it has a huge impact on physical health.
Megan Gilmour 33:33
Yes, and the two go hand in glove really, given that they’re taking place in the same body.
And I don’t know if you saw this, but there’s just some recent study out of the UK, done on a large population to say that, unsurprisingly, but the data is there, that mental health worsens with school isolation. So missing school exacerbates or can cause mental ill health and vice versa. So, it’s a vicious cycle there, and that large scale study confirming that.
How are siblings and peers of kids who experience mental ill health impacted, and what should families be across?
Hannah Brown 34:28
So, for siblings or peers, it can be really frustrating, especially if they don’t understand what’s happening. So, you know, we were just talking about, if they can’t see it physically, it can be really hard for them to understand what’s going on.
So that’s why it’s really important that parents, families, talk to the children, the siblings and peers about what’s going on, and also recognise their feelings and that they might be feeling frustrated or upset. Because it can be really upsetting that you know their sibling or their friend is struggling, but they don’t know what to do to make them feel better.
So for parents and for teachers and for loved ones, just reinforcing that they just need to be there for them, checking in with them regularly, and also reinforcing that it’s not their job to fix anything, which is what we were talking about before, their support and their kindness is what’s really important, and that’s really all they need to do
Megan Gilmour 35:31
Yes, and would you recommend ALEC for siblings and peers as well?
Hannah Brown 35:38
Yes, absolutely. ALEC is great because it can be used by anyone. Doesn’t matter about age, education level. We talk about ALEC with young children in terms of being a good friend and being kind to each other and checking in on each other. So, yes, absolutely use ALEC.
Megan Gilmour 35:57
And do you just want to repeat what that framework is it’s Ask, Listen, Engage action.
Hannah Brown 36:04
Encourage action
Megan Gilmour 36:05
Encourage action.
Hannah Brown 36:05
Yes, perfect.
Megan Gilmour 36:07
And what was the last one?
Hannah Brown 36:08
And Check in
Megan Gilmour 36:09
And check in? Yes, virtuous cycle.
What’s the current population of school aged children experiencing mental ill health. And how accurate is this data? Is it tracked for example? Can we trust the numbers?
Hannah Brown 36:29
Yes, so we look to the Australian Institute of Health and Welfare for all of this data. And yes, it’s basically what I was saying before. With the one in seven children
Megan Gilmour 36:45
Between four and 17?
Hannah Brown 36:46
Between four and 17, yes,
Megan Gilmour 36:48
Yes. So, with a 4 million student population in Australia, I put that at 571,000 kids.
Hannah Brown 36:57
My gosh,
Megan Gilmour 36:59
Its half a million, yes.
Hannah Brown 37:04
Yes. And we often hear people saying things like, ‘Oh, you know, back in my day’ – especially older people saying – ‘back in my day, there was no such thing as anxiety and depression, and all the kids were fine.’
Megan Gilmour 37:19
They weren’t!
Hannah Brown 37:20
But we know that that’s not the case – issues have always been around. It’s just that now we’re talking about them and we’re recognising them and helping people get support, whereas before, it wasn’t spoken about.
Megan Gilmour 37:36
That’s right, and life is so much more complex now in other ways as well. So, as we talked about, the kind of the existential threats are more than just war. There’s a lot going on there. And so, yes, the 21st Century pressures bringing their own effects and impacts as well.
Hannah Brown 38:04
Absolutely
Megan Gilmour 38:07
So now that we know that we’re talking about 570,000 school kids, do they miss a lot of school and why? So, you did say that that that school attendance is affected. Would you like to make further comment on that one?
Hannah Brown 38:30
Yes, so children with an anxiety disorder miss more than twice the number of school days than other children, and then that difference becomes greater in high school.
So, you asked, you know, why is this the case? There’re quite a few different reasons. The first is that symptoms themselves can make school attendance hard. So, anxiety can make mornings really overwhelming. There’re panic attacks, there could be stomach aches, refusal to get out of bed or leave the house. Depression, we know can cause fatigue, low motivation.
But then there’s also physical complaints that we’re talking about before that are tied to mental health. So, these could be headaches, nausea, feeling sick. So again, more reasons why they’re staying home.
And then finally, school can be a stress trigger for a lot of these kids, especially if there is bullying. We know stigma is a huge issue. And then also looking around academic pressure or fear of failure, particularly when we’re looking at really high stress times like exams. So yes, lots of reasons,
Megan Gilmour 39:47
Yes, the expectations and the whole rhythm of school could be quite challenging for a lot of young people, which is what we’re seeing as well.
And I suppose another one, which is in your wheelhouse too, is eating disorders, or, you know, changes in eating, enjoyment of food, or relationship to food when you’re feeling anxious or depressed.
Hannah Brown 40:17
Yes, and then having to be monitored while they’re eating, they might be hospitalised. So obviously, kind of terrible then.
Megan Gilmour 40:25
Yes. So, affecting all of those, you know, primary bodily functions.
This being the case. What are the critical times in the school life of a kid who’s facing mental health issues?
Hannah Brown 40:41
So critical times are really any time of transition or change. So, we know going from primary school to high school is huge stress for all young people, not just those experiencing mental ill health.
Finishing high school and then deciding, you know, do they go to uni or TAFE or have a gap year or work, is obviously a very stressful time.
For young people, if they have to change schools, that can lead to quite a lot of stress as well. And as I mentioned before, times of high stress. So, exams, the HSC, for example, very stressful time. I still have nightmares about my HSC, and I did mine a very long time ago.
Megan Gilmour 41:28
That’s a lot. Yes, the psychological impact of it, the pressure,
Hannah Brown 41:32
Huge, absolutely huge. So yes, those times of transition and change, or times of high stress.
Megan Gilmour 41:39
And of course, again, with lower or fewer experiences in life, the experiences you are having, like, you know, changing a school year or a school or whatever, they’re monumental in terms of the amount of time you’ve lived. You know what I mean? It’s like these things are happening, you know, and you’re a seven-year-old, that’s a large proportion of the child’s life to go through that transition and feel that experience.
And thank you for mentioning those. It’s always such an interesting answer to that one across medical conditions and mental health issues.
The transitions are the thing that comes up the most. I mean, puberty is another, but you could say that’s a transition, isn’t it, a kind of biological transition that a human’s making. And yes, these times of change just create a greater burden or disruption to business as usual, which creates additional stresses.
What should families and schools be prepared for then at different times?
Hannah Brown 42:56
So, supporting kids or adolescents with mental health issues isn’t just about one moment in time, like it is for anyone experiencing mental ill health. And so, families and schools often need to anticipate different challenges at different stages of a child’s journey.
So, any of those examples that we were just talking about, if there’s exams coming up, if they’re moving into a high school from primary school.
And this is why checking in regularly is so important, listening without judgment, again, is so important, keeping any negative emotions like frustration and our own frustration out of the conversation.
And for both families and the schools to ask the child what they can do to support them, which goes back to the ALEC model before that, trying not to tell them what to do, but rather include them in the conversation and ask how they can be supported.
Megan Gilmour 43:53
Yes. Amazing. This is a tricky one, and it’d be a difficult one for people to hear. Is there anything different that we should do for somebody who we believe to have suicidal ideation, or who’s disclosed to us that they’re having suicidal feelings and thoughts?
Hannah Brown 44:13
Yes, it is a tricky one. But if we suspect that someone is feeling suicidal or having those thoughts, the main thing to do is to ask them directly.
So, for a long time, people avoided doing this because there was this myth that asking about suicide would increase the person’s risk of dying by suicide. But we know now that’s not the case. There is plenty of research and evidence to show that it doesn’t increase the risk, because most people know that it’s an option; you’re not putting the idea in someone’s head.
So, we do need to ask directly, we need to use the word suicide, because otherwise, if we say things like, oh, you know you’re not doing you’re not thinking of doing something stupid, are you? Or you’re not thinking of hurting yourself?
Well, for one, both of those statements have a lot of judgment to them and negative judgment, but they’re also too broad, so hurting yourself, you know that could mean anything. We do need to ask directly about suicide.
If they say yes, ask them if they have a plan, you know, okay, what are you thinking of doing and try and remember that information, because you’ll need to pass it on to a health professional, to a crisis support person.
And I think its awkward, you know, obviously people would feel very awkward asking that question, but I think it’s important to keep in mind that it’s actually really helping the other person.
Because it’s extremely hard for someone to put their hand up and say, ‘Hey, I’m thinking of suicide,’ but it’s so much easier if all they have to answer is ‘Yes’, if someone comes up to them and ask them directly, and all they have to say is, ‘Yes’, that’s a huge burden taken off their shoulders.
And then as I said, if they do have a plan taking down the detail, but then bringing someone else in, whether that’s, you know, a crisis support line or a GP or, you know, you can always call triple zero if you do think their life is an immediate danger as well.
Megan Gilmour 46:28
Yes, and continuing to keep those communication lines open.
Hannah Brown 46:34
Yes, yes. Checking in if they say ‘No’, but you don’t believe them, maybe asking again a little bit later, because at least the fact that you’ve asked, they know that they can go to you as a support person and you won’t judge them.
Megan Gilmour 46:52
And perhaps it gives them the message that you’re paying attention to how you’re viewing them; they’re seen. They’re seen, and their struggle is seen in its extremity, could save a life
Hannah Brown 47:11
Yes, absolutely. It shows that someone cares about them, someone supports them, yes, and that you’re someone they can go to.
Megan Gilmour 47:20
Yes. Thank you for sharing that, and I know that would be difficult for people to hear and talk about, but this is precisely why we need to talk about it and not stigmatise it. Because it’s lifesaving. It’s a life-saving conversation, potentially.
And the stigma, as you keep saying and reminding us, is part of the problem here is, and making people feel ashamed of where they’re at, or giving them the impression that their life’s good and they shouldn’t be. Do you know what I mean?
That’s some of the thing that goes on, which is, ‘But you’ve got a great life. How could you?’ It’s like we don’t understand someone’s inner world. Yes, very, very important. So, thanks for taking us into your knowledge and experience with that.
We’re up to the part about what are the biggest challenges or vulnerabilities facing kids with mental ill health at school, and what’s happening now to address that through our school systems. Is it enough?
You might have covered some of these things. Please feel free to expand or reiterate what you’ve said to do with current vulnerabilities, and whether you think there’s more that we could do in our school systems?
Hannah Brown 48:49
Yes, so I’ll say stigma again, because it is truly such a huge challenge for young people. That’s that stigma and misunderstanding. They don’t want to be seen as weak or vulnerable. There’s fear of being judged, as you said before, with that example, ‘you know you have a great life, what are you upset about or being teased or bullied?’
Because, again, it comes down to that misunderstanding of what mental ill health looks like.
Academic pressures, which we touched on before. So, it can be really hard to concentrate on schoolwork and exams when your brain is foggy, and your brain isn’t allowing you to focus on those things, which then, as we spoke about, can lead to students falling behind academically. And then it’s that vicious cycle.
And then loneliness, which we which we’ve touched on. But you did ask the question, what’s happening now to address these challenges? And I think it’s been great to see that many mental health organisations in Australia, including R U OK? are now focusing on stigma and how it can be decreased with young people.
One of the best ways to decrease stigma is to share real stories of lived experience. So, on the R U OK website, we have our chit chat channel, and this is so that young people can see and hear that they’re not alone in what they’re struggling with, because they can see – ‘Oh that person has a similar life to me, or that person reminds me of myself, and they’re going through similar things to what I am.’
Sharing stories of hope is really important, and just really reinforcing the important role that peers play in checking in on each other and making sure that we’re asking the question genuinely. It’s not a joke. It’s not something to be laughed at.
Because you know, if you are a young person struggling and you see someone in the playground making a joke about, R U OK? or about mental health in general? Obviously, that can really negatively impact that person.
Megan Gilmour 51:15
Or people watching exactly who are admitting you never know. You never know who’s watching.
Megan Gilmour 51:20
One in seven, right? One in seven. Just keep that number in mind.
Hannah Brown 51:26
Yes
Megan Gilmour 51:28
I also just want to add to this too, as an older person, is just to acknowledge the power differential between adults and young people and the role that that plays in mental wellbeing or not, and the kinds of things that can happen to young people, or have happened to young people across their life by older people.
And just the power infrastructure and the power difference, the difference in agency, meaning the challenges for a young person to get the resources, the energy, the agency, to even actually know the steps, because you’ve never done them before, towards like, how do you go about getting help?
And then you’ve got potentially financial issues rolled up in there too, and family situations and struggles that are underpinning all of this, or overarching all of this, and any number of things that are going on.
And I think what you said at the beginning stood out for me, strikes me as well, is any human experiencing this is not broken. You’re not the problem. It’s something all humans navigate and at different times and moments in the day and across life that can be more severe than other times as well.
Which means the checking in is always, you know, that’s what we’ve got to do. We’ve got to not make assumptions. I’ve really taken that away from what you’ve said today as well.
Hannah Brown 53:19
Yes, and, and what you just mentioned about the power difference between adults and young people. I think that’s why we know that the peer-to-peer check in is important, because even from our own research at R U OK?, we know that young people, they will talk to a peer before they talk to a parent, a health professional, anyone else, they will go to a peer first.
Megan Gilmour 53:51
Yes.
Hannah Brown 53:52
So, it’s making sure that young people feel comfortable in having these conversations. And again, the ALEC framework, it’s so simple, anyone can do it. You don’t have to have any qualifications to have the conversation, and that’s why we do really need to encourage and keep encouraging young people to keep checking in on their peers.
Megan Gilmour 54:16
Yes, kids stick together honestly. Just, there’s power in numbers. It’s just, you know, stick together. Do you want to just call out, like, spell out ALEC again for us at this at this juncture?
Hannah Brown 54:33
Yes, Ask, Listen, Encourage action and Check in.
Megan Gilmour 54:37
Yes, beautiful. So that really brings us to the last point, and that is, well, is there anything else that you’d like to say about school quality of life for kids with mental health issues?
Hannah Brown 54:56
I think just making sure that there is a school culture that supports and encourages those regular check ins. So, this includes teachers role modeling, genuinely checking in on each other, making sure that these conversations aren’t just happening in World Mental Health Month or on R U OK? day, it’s a year-round conversation.
Because, as we’ve been saying, the more normalised these conversations become, the less stigma there is, and then the more people that will reach out for help when they need it.
Megan Gilmour 55:33
Yes, every day, every moment of every day, there’s an opportunity. Yes, that’s my takeaway, and I’m definitely going to be more encouraged to practice that more obviously, because sometimes you also don’t, you know, you stand back a little bit and don’t necessarily want to disrupt someone’s privacy or something like that. But I think there’s a lot of ways to do it. And you’ve helped us see that.
So, what’s your call to action? Hannah, for mental health, in seven words or less.
Hannah Brown 56:15
So, I might be cheating, because I’m going to use letters. It might be over, technically, over seven words. It’s to ask, R U OK? any day of the year?
Megan Gilmour 56:28
Boom, that’s perfect. And yes. And thank you so much for the work that you do. I really mean it when I said earlier that you’ve used your lived experience, and I suppose every moment of every day that you do this work, you’re honoring your friend, and that’s the legacy that you’re providing. They’ll never be forgotten. So, yes, I know they’d be proud of you.
Hannah Brown 57:01
Thank you.
Megan Gilmour 57:03
So, a big shout out to R U OK?. You can find them over at www.RUOK.org.au [https://www.RUOK.org.au]. Go there. Give generously, practice ALEC, support the work in any way that you can. And let’s get more aware and more active about our checking in with the people around us. Even if it’s someone at the bus stop, it doesn’t have to be someone you know well, it could be anyone really.
Well, thank you for joining me on Live & Learn today. Hannah, it’s been wonderful to chat with you today and your generosity of knowledge and experience that you’ve shared with us, I’m sure, will make huge difference to the audience that gets to hear this webcast.
Hannah Brown 57:55
Thank you. Thanks so much for having me on.
Megan Gilmour 57:59
Thanks everyone for tuning in, help us turn up the volume so all kids are seen and heard. Follow along, like, share, comment, or leave us a review, because we love hearing from you. And if you want to donate, head to MissingSchool.org.au [https://www.missingschool.org.au] because every dollar makes a difference.
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