Knowing mental health: Anxiety

Posted on October 4, 2014November 13, 2014 by Aaron Garth

Don’t empty today of its strength

We kick off mental health week with the most prevalent of disorders, Anxiety. Anxiety robs people of their ability to cope with the turmoil of everyday situations. It robs them of the ability to reach their potential. Most of all it robs them of life. When we speak of anxiety as a brain disorder we are not speaking of the everyday anxieties we feel when we have to do something like driving in heavy traffic or speaking in front of a group. We are speaking of the crippling anxieties that some of us feel that stop us from living life to the full.

When our thinking becomes so disordered by anxiety we cannot do even the most basic tasks. We cannot get out of bed, leave the house or even hold a conversation. Our ability to think clearly and rationally is basically gone. Your limbic system takes control and your primal fight or flight instincts kick in. your frontal lobe, the part of the brain that orders rational thought, has been overridden. All the fears and failures you can imagine are now in control of your thought and actions. You are now in a state of complete primal anxiety.

Add to all of this the fact that adolescence is already a time of storm and stress and we have a setting that is ready to ignite. Our young people are already experiencing changes in their brains which they are struggling to deal with and on top of that anxiety is nipping at their heals. Any strength that they had to face the daily challenges of being an adolescent is torn away to deal with their anxieties. Grades, relationships, groups, fears, all of these and more conspire against our young people. They set them up for worry and dread.

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As youth workers we often provide a first point of contact for young people to address their anxieties. By developing a trusting relationship where young people can confide in us their fears we can support them to begin a journey of recovery. Understanding the triggers, diagnosis and treatment options available to our young people assists us to guide them through the maze of service provision to find the right support options for them. It gives them back the strength they need to beat their anxiety.

Aaron Garth

Aaron Garth is the Executive Director of Ultimate Youth Worker. Aaron has worked as a youth worker in a number of settings including local church, street drug and alcohol outreach, family services, residential care, local government and youth homelessness since 2003. Aaron is a regular speaker at camps, retreats, & youth work training events and is a dedicated to seeing a more professional youth sector in Australia. Aaron is a graduate of RMIT University and an alumnus of their youth work program. He lives in Melbourne with his wife Jennifer & their daughters Hope, Zoe, Esther, Niamh and son Ezra.

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youth workers need to stop mental health stigma

Posted on October 2, 2014November 13, 2014 by Aaron Garth

In my class on mental health I often ask if we are beating back the stigma of mental illness. Students often say no… but after some thought and discussion they often change their mind. “We are beating back the stigma of anxiety, depression and body image” they would say. It is then that I ask them, “What would you do if you were running a youth program and one of the participants had a psychotic break?” Most of the students with fear in their eyes speak about keeping all the other participants safe while seeking help for the one having the break. This leads me to ask what they would do if one of their young people was depressed. No fear here, they would just get alongside the young person. Stigma is still very much at the forefront of challenges for mental health.

I agree with my students, we have made leaps forward. But, we still have a long way to go. While we have made great steps forward in areas such as anxiety and depression; eating disorders, schizophrenia and personality disorders to name a few are still very stigmatised. Much of the stigma still comes from fear. We fear that which we don’t know. When was the last time you saw a schizophrenic portrayed as “normal” in the media. they are always touted as weird, scary or worse. What about people with personality disorders how are they portrayed on film?

As youth workers we believe that young people have enough issues without having to add stigma to the list. However we as much as any member of the general public stigmatise mental illness. We don’t mean to do it, but in our fear we allow our prejudices to come to the fore. Fear comes from our lack of knowledge. As the general public knows very little about mental health so it is with youth workers. Even though our clientele are likely to have mental health issues we do not really study it and unless we spend significant personal resources we will have minimal understanding of brain disorders at best.

We must have an understanding of brain disorders

To stop the stigma of mental illness we must have a solid understanding of the causes, diagnostic criteria, treatment options and recovery options. We need to be better than we are right now. Unfortunately this means going against the grain. I was speaking to an educator recently who believed that because youth workers don’t diagnose we don’t need to know how a diagnosis is formed. It is this antiquated idea of youth work and how we support young people that causes stigma. The same educator could not see why we need to have more than mental health first aid as it is psychologists who will do the work. I mentioned that it was youth workers who often hold the cases and that most psychologists will only give a dozen sessions.

We need to have a better understanding of mental health. It stops the stigma!

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Aaron Garth

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Mental health… Do you understand?

Posted on September 29, 2014March 12, 2019 by Aaron Garth

Mental health is the leading health issue of our time!

It is the leading cause of preventable deaths in the western world. One in four of our young people will have a diagnosed mental health issue by the age of 25. Many of the leading mental health diagnoses are most prevalent in adolescence. Most of all mental health is an issue of which youth workers must have a rock solid understanding. Unfortunately, most youth work education gives a youth worker a passing knowledge at best… and this is dangerous.

[Tweet “At Ultimate Youth Worker we believe that all youth workers should have a first responder understanding of mental health.”] At Ultimate Youth Worker we believe that all youth workers should have a first responder understanding of mental health. In the same way that paramedics have enough understanding of medicine to save your life and get you to hospital, we believe youth workers should have enough understanding about mental health to assess, triage and refer to mental health clinicians. We need more training. We need more education. We need more understanding.

Most young people are thankful for our empathy and care… but know how limited our knowledge of their issues are. Over the month of October we will be devoting time to help you understand more about mental health. October is mental health month and as a treat each week we will focus on one mental health issue and give you more depth than any course you have ever attended. We want you to be the best you could possibly be, and to do that we want you to have the best resources possible.

Organisations such as BeyondBlue and Headspace have fantastic resources aimed at young people and their families. They give a cursory understanding of the issues and provide a comforting nudge in the direction of support. As a tool for youth worker knowledge however they are limited. As youth workers we are often in a position to first identify mental health issues in young people and as such we need to have a better grasp of the issues. We must gain more than a mental health first aid certificate if we are to truly support our young people to recover their mental health.

Knowledge is power. It is also responsibility.

Aaron Garth

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Mental health should be a major part of a youth workers training.

Posted on January 8, 2014May 26, 2020 by Aaron Garth

I am currently developing curriculum for the diploma of youth work here in Australia. This curriculum is focused on youth mental health. There are many of my colleagues who believe that any form of specialist training of youth workers is degrading our profession. That to develop a new focus in our training is to minimise our effectiveness as an industry to ourselves. However, as should be apparent to long time readers, we disagree completely.

We have said before that we believe the time has come for a complete rethinking of the current youth work curriculum. One area we believe has been sorely missing for decades is that of mental health. If one in four young people will have a diagnosed mental health issue it is our responsibility to have a strong understanding of the area. We believe that youth workers should gain at least an emergency triage level understanding of mental health.

If you are a youth work educator, a service manager or a team leader we believe it is your responsibility to impart on your junior staff and students a need for new knowledge. In particular and one of the easiest to impart would be that of mental health. Do you do this at the moment? What curriculum do you use to teach mental health?

Let us know!

Aaron Garth

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R U ok? a daily question for great youth workers.

Posted on September 11, 2013May 26, 2020 by Aaron Garth

Tomorrow is R U OK day here in Australia. R U OK day is an initiative to help the general public support their friends, families and colleagues speak about mental health. The basic idea is to ask people if they are ok and to let them know you are there to help if they need it. As a youth worker this is a daily task with our clients… but it is just as important to do this with our colleagues.

The latest statistics are showing us that an alarming number of youth workers are leaving the sector after little more than eighteen months in the field. We are seeing youth worker burnout coexisting with depression, anxiety and many other mental and physical health issues. So why aren’t we asking if our colleagues are ok? Wouldn’t it make sense for managers and colleagues to look out for each other? For organisations to require their staff to look out for each other? For staff to be allowed to deal with their stress?

On this R U OK day why not ask your colleagues if they are ok? The answer may surprise you.

Aaron Garth

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Youth Work 2.0: A manifesto for the future.

Posted on August 20, 2013May 26, 2020 by Aaron Garth

We are on the brink of disaster! Our education of youth workers, lack of ongoing professional development opportunities, lack of self-care and professional support is leading to an under resourced service system at the breaking point. recently we heard that the revolving door at the end of youth work qualification is spitting people out of the sector 18 months after qualifying. This is a disaster!!!

When Ultimate Youth Worker began we saw these issues and asked ourselves what would youth work look like if it was properly resourced and supported post qualification, A second generation or 2.0 software update if you will. We wondered what it would take to bring us back from the edge. The list was long and extensive. Over the last year we have spruiked some of our ideas, but here are the two issues we see as critical to our coming year and advocacy in the sector.

First and foremost we need a sector that is resilient. The revolving door needs to be slammed shut. Lets be honest… as a sector we really suck at self care. We don’t teach it in our courses, we don’t do it in our organisations and our supervisors don’t know how to guide us through the difficult times. There are a few exceptions but the weight of stats and anecdotal evidence is against us. Self care must become a core component of our education and our practice.
We must get rid of our obsession with the idea of generalist youth work. That is a minimalist approach to a work which requires more of us. We need to be training specialist youth workers. Every degree should have an honours year where we specialise in an area of practice. AOD, Mental Health, Justice, Homelessness whatever the area young people are found there should be opportunities for specialisation. In particular we believe we should be training better youth mental health specialists at a bare minimum.

These are just two areas we will be advocating for and providing support in throughout the next 12 months and beyond. We have a long way to go but we must take the journey.

What do you think???

You can also leave us a comment below or post a comment on facebook and twitter.

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Aaron Garth

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2013 Australian Youth Affairs Conference wrap-up

Posted on August 9, 2013August 4, 2014 by Aaron Garth

From August 5-7 the team from Ultimate Youth Worker attended the Australian Youth Affairs Conference in Adelaide, South Australia. The conference was hosted by the Australian Youth Affairs Coalition the peak body for young people and the youth sector in Australia. For three days we covered the topics ‘youth participation’, ‘advocate for change’ and ‘support the sector’. On the third day our Director, Aaron Garth, spoke as part of the morning plenary session and delivered a training session on the development of a self care plan.

Aaron Garth presenting at the morning plenary.

Throughout the conference two themes emerged for the Ultimate Youth Worker team which we have been spruiking for well over a year. The first was the need for youth workers to have a better understanding of mental health. Whether it was the delivery of the mental health report card by Batyr and Young and Well CRC or the City of Casey youth services speaking about their online mental health tool, there was a clear need for youth workers to have a solid understanding of mental health and its effects on young people.

The second was how poor the understanding of self care strategies is in the youth sector. So many of the people we spoke to were near burnout or had people in their teams struggling with the weight of their roles. Many of the youth workers we spoke with spoke of pressures on them from their organisations and managers to do more with less resourcing and support.

Delivering the self care planning session.

The AYAC2013 was a great success. But in our eyes it just confirmed what we have been saying for over a year. Look after yourself and know more about mental health.

Aaron Garth

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Guest post on youthsectorblog.

Posted on June 22, 2013August 4, 2014 by Aaron Garth

Our guest post is being published on the collaborative blog youthsectorblog.wordpress.com today – it’s a frank discussion on the lack of mental health training given to youth workers in the current youth work curriculum. Feel free to post in the comments about how witty, insightful and amazing it is!!!

If you’ve come to Ultimate Youth Worker after already reading the post on youthsectorblog.wordpress.com – WELCOME!!! We hope you found it witty, insightful and amazing too!

We’re really glad you’ve come to check us out. Here’s a quick guide to us as a company:

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You should already be on our blog page, so you can scroll down and read some of our recent posts. To see older posts, there are a few ways of doing this:

Click on “older posts” at the bottom of this page
Click on one of the categories on the right hand side of the page to read specific types of posts (e.g. professional identity, youth work, self care etc)
Use the “blog archive” on the right

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We’d love to connect with you in the following ways:

Subscribe to receive our posts via email (you can do it on the right hand side of this post) – you’ll receive one email a week with that week’s post(s). Don’t worry, we’ll never spam you or sell your details.
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Once again, thanks for visiting Ultimate Youth Worker! We hope you find some useful stuff on our blog. If you know any youth workers or youth pastors, we’d love for you to tell them about us – each week we provide a new post so keep on coming for more thoughts on youth work.

Aaron Garth

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Mental state exam for youth workers: Cognition

Posted on May 24, 2013May 26, 2020 by Aaron Garth

Second last post this week for our series on Mental State Exams. Over the past few weeks we have been building an understanding of the core components of a mental state exam so that we can support our young people as best we can. This week I was speaking with a youth worker in one of Victoria’s largest Christian denominations about a mental health conference he was at. I was reminded about how important it is for all youth workers to have a strong understanding of mental health. So far we have discussed how a young persons appearance, behaviour, speech and language, mood and affect, thought process and content and their perceptions can provide indicators as to their mental state. Today we discuss how a young persons cognition can provide insight into their current mental health status.

In this section of the Mental State Exam we are looking at a young person’s level of alertness, orientation, attention, memory and executive functions. It is often this part of the MSE which requires the use of structured tests in conjunction to unstructured observation. However, an astute youth worker can use the basic understanding learnt here to gain a base level to work from. Cognition is observed through judging alertness, orientation, attention and concentration, memory and executive functioning.

When observing alertness we are looking into the young person’s level of consciousness i.e. awareness of, and responsiveness to their environment. Their level of alertness may be described as alert, vigilant, clouded, drowsy, or stuporous. If you are on a camp or at the end of a long Friday night youth group then alertness may be low. Conversely, on your way to a concert or game of laser tag alertness may be quite high. There are many factors which you must take into account when observing alertness. Rock, paper, scissors is a great game for testing the alertness of a young person.

Orientation is assessed by asking the young person their name, age etc (orientation to person) where he or she is (for example what building, town and state) and what time it is (time, day, date). What we are looking for is that they are oriented in person, place and time. People who have taken a big knock on the football field and are dazed are often asked these questions to observe whether they have a concussion. In the drug and alcohol field we often use these questions when people seem substance affected to judge how affected they are.

Attention and concentration are assessed by using structured tests such as series seven tests, or if you are in a pinch getting them to spell a five-letter word backwards), and by testing digit span. Here we are looking to see if the young person can keep their focus and concentration whilst completing given tasks. These tests are great for judging inebriation, attention deficits and anxiety.

Memory is assessed in terms of immediate registration (repeating a set of words), short-term memory (recalling the set of words after an interval, or recalling a short paragraph), and long-term memory (recollection of well known historical or geographical facts). If there is a severe issue with memory it may indicate dementia or neurological issues. Short term memory loss can be a symptom of anxiety.

Executive functioning can be screened for by asking the “similarities” questions (“what do x and y have in common?”) and by means of a verbal fluency task (e.g. “list as many words as you can starting with the letter F, in one minute”). The mini-mental state examination is a simple structured cognitive assessment which is in widespread use as a component of the MSE. These tests are looking at higher order brain functioning and a persons ability to stay on task. This is important for their ability to think in a critical way.

Note: The kind of brief cognitive testing discussed here are regarded as a screening process only, and any abnormalities should be more carefully assessed using formal neuropsychological testing.

Stay tuned for our final segment next week: Insight and Judgement.

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Aaron Garth

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Mental state exam for youth workers: Perception

Posted on May 18, 2013May 26, 2020 by Aaron Garth

Well there are only three more posts left in this series. We have been building an understanding of the core components of a mental state exam so that we can support our young people as best we can. This week I was speaking with a youth worker in one of Victoria’s largest Christian denominations about a mental health conference he was at. I was reminded about how important it is for all youth workers to have a strong understanding of mental health. So far we have discussed how a young persons appearance, behaviour, speech and language, mood and affect and their thought process and content can provide indicators as to their mental state. Today we discuss how a young persons thought content can provide insight into their current mental health status.

Today we look at perception. Perception in the broadest sense of the world is how we sense the world through our five major sense: sight, touch, taste, smell and hearing. The three categories of perceptual disturbance are hallucinations, pseudohallucinations and illusions.

A hallucination is defined as a sensory perception in the absence of any external stimulus, and is experienced objectively by the young person eg. they see it and you don’t. Hallucinations occur in any of the five senses, although auditory (hearing) and visual (sight) hallucinations are the most frequently observed. Auditory hallucinations are typical of psychosis and symptoms such as ‘voices talking about the young person’ and ‘hearing one’s thoughts spoken aloud’ are indicative of schizophrenia, whereas second-person hallucinations such as ‘voices talking to the young person threatening or insulting or telling them to commit suicide’, may be symptomatic of psychotic depression or schizophrenia. Visual hallucinations are more likely suggestive of organic conditions such as epilepsy, drug intoxication or drug withdrawal.

An illusion is defined as a false sensory perception in the presence of an external stimulus, in other words a distortion of a sensory experience, and may be recognized as such by the subject. The best example I can think of is mime artist or the visual illusions of Giuseppe Arcimboldo. The old adage that your eyes play tricks on you is no more true than when we think of illusions. Illusions in themselves are not necessarily an indicator of mental illness but could mean a physical disorder or intoxication.

One of Giuseppe Arcimboldo’s illusions

A pseudohallucination is experienced in an internal or subjective space such as ‘voices in my head’ and is regarded as akin to fantasy. Other sensory abnormalities include a distortion of the young persons sense of time, for example déjà vu, or a distortion of the sense of self (depersonalization) or sense of reality (derealization). These symptoms could be suggestive of dissociative disorders, epilepsy or brain damage.

Aaron Garth

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