Introduction by Croakey: Young health leaders are developing a comprehensive call to action on improving health and healthcare for young people, with an urgent focus on dealing with the disproportionate toll they have experienced from the pandemic.
An online national summit was held by the Youth Health Forum last week to inform policy priorities in the lead up to the next federal election, building on the Life transitions and youth pathways to health services report it published last year.
The Youth Health Forum is a network of more than 80 young leaders from across Australia, set up under the auspices of the Consumers Health Forum of Australia, to determine and champion youth perspectives on the current health system.
Marie McInerney reports on the forum below, with additional stories to come, including a Q&A with a number of #YHFSummit presenters and participants. Bookmark our Croakey Conference News Service coverage here.
Marie McInerney writes:
As they deal with the long-term impacts of COVID and the escalating crisis of climate change, young people are looking for stronger systems, policies, infrastructure and services that support their health and healthcare and to be counted as “experts in our own lives”.
Last week’s Youth Health Forum (YHF) National Summit, ‘’Youth voices shaping health”, heard wide-ranging challenges for better health and better health services and for action on global health and the social determinants, including education, housing, and employment.
At the heart of their discussions were calls to be more involved in decisions that affect them, for greater respect for young people as both health ‘consumers’ and ‘creators’, and acknowledgement of the toll of the pandemic.
“At all levels of government, we are seeing policy makers struggling to engage with young people and a lot of young people feeling frustrated, unrepresented and disconnected,” said YHF member Georgia Gardner, opening a session on ‘What are the policy makers missing?’
The breadth and depth of change needed, particularly for those young people and communities which find themselves marginalised in the current health system, was illustrated at the end of a ‘conversation starter’ session on cultural diversity and health promotion, when a facilitator summed up the issues that had emerged:
COVID/the vaccination rollout, how it’s failing a lot of communities. Mistrust in the health system, racism, importance of cultural competency.
The importance of lived experience and intersectionality.
Putting perspectives of not just migrants and refugees but also advocating for international students and their rights to equitable health care.
Ensuring approaches (for participation of young people) are not reactive and that whole communities are not just an overthought but part of process from the first….
A future where we are all represented”.
Five areas of concern
To work towards a set of recommendations for action, Youth Health Forum leader Jahin Tanvir, a Youth Ambassador with the WH&Y Centre for Research Excellence in Adolescent Health, and strategist Andrew Hollo, worked with participants and session leaders to capture hundreds of ideas for change under five key areas of concern that emerged early in discussions.
The key areas were:
- How can we become better informed?
- How can we better include young peoples’ perspectives?
- How can we improve services for young people?
- How can we improve health tech that young people use?
- How can we improve our pandemic response?
Hollo said it was clear the COVID-19 pandemic had to be a standalone theme, in recognition of the “loss, grief and missed opportunities” it had imposed, and a real sense from participants “that you can’t earn this time back”.
The mapping sessions refined the focus for each and generated ‘asks’ that will be developed into a summit call to action in coming months.
You can read the full document developed in open forum sessions here, and a selection of insights and asks below.
See also below three storyboards of the sessions developed by Devon Bunce from Digital Storytellers.
1. How can we become better informed?
Focus: Ideas for better data about young people and for better understanding among young people
Some of the asks:
- Include LGBTIQ people in the Australian Census.
- Ask young people what data is meaningful and important to them.
- Co-design research and data capture.
While Australia has big data holdings about young people and their health, there are still many gaps that urgently need to be filled, particularly around age, sex, Aboriginal and Torres Strait Islander, culturally and linguistically diverse, refugee and migrant, disability, gender and LGBTQIA communities and issues, the summit was told.
Presenting on the Australian Youth Development Index, Katie Acheson and Gemma Wood from Numbers and People Synergy (NAPS) said it sought to capture data in six domains: health and wellbeing; education and skills; employment and opportunity; civic and political participation; safety and security; and community and culture.
The latter was emphasised as critical by Aboriginal and Torres Strait Islander people during wide consultations on the Index, they said.
While most people would think Australia would do well, given its wealth, it only ranks 29th out of 181 countries and only 56th on health and wellbeing, according to the 2020 Global Youth Development Index that’s also just been released, “scoring poorly” on mental health, drug use and alcohol abuse, Acheson and Wood said.
But their main message to the summit was the need to improve the capture, consistency and availability on data on young people in Australia. To do that, they suggested:
- protesting funding cuts for the Australian Bureau of Statistics
- encouraging organisations that do good surveys to have more consistency over time and “people on the ground, who young people trust, asking good questions that data custodians and researchers want to know”
- urging organisations/universities to make their research available publicly.
2. How can we better include young people’s perspectives?
Focus: Ideas for empowering young people to participate, for governance that enables young people to be represented, for getting the lived experience of young people better heard.
Some of the asks:
- Pay young people for their time and expertise (in codesign/consultation).
- Have lived experience at the heart of service design, and from the start, including letting young people ‘road test’ new programs.
- Consider “reverse mentorship” where young people’s expertise, including with digital technology, are valued and rewarded by management.
- Embed young people at all levels of governance.
- Do consultations directly with young people in rural, regional and remote areas, instead of sending in “consultants from Canberra”, and make use of digital technology where it can help with distance and access.
An overriding theme through the day was the need for young people to have a strong voice in the development of policy, programs and services that was “not tokenistic”, didn’t happen after the fact, allowed young people to ‘test drive’ programs, is presented in ways and on platforms that young people could access, and that includes diverse voices.
One resounding message was that this means acknowledging value, “If you want young people to show up, you need to pay them for their time,” said Caitlin Figuerido, Co-Chair of the Australian Youth Affairs Coalition (AYAC).
“I think we can all agree that consultation is different to codesign,” said Corin Boughton National Director, Programs and Operations at Carers Australia, urging governments to be more prescriptive in their funding guidelines to ensure young voices are heard and for stronger internships or cadetships as part of a “reverse mentorship model”.
Participants were able to sit in on a masterclass on co-design from Kelly Ann (KA) McKercher, who later tweeted a number of principles and tips, including some contributed by summit participants.
- Partnering with young people where young people lead (not just participate in other people’s activities.
- Community and peer-to-peer research and action.
- Prioritising relationships, building capability, using participatory means, sharing power.
- Working together across the entire project lifecycle — from scoping, through discovery, design and implementation.
- Checking in regularly with participants to ensure it’s working for everyone.
- Using plain language and accessible resources.
- Involving young people in identifying the problem AND the solution.
- Debriefing to ensure the young person feels confident that their input was represented.
- Peer advisors to support.
- Adults gathering information from young people only to make decisions without them.
- Running a single event or workshop and expecting systems change.
- A perception that young people are under-skilled when they are the only experts of their experience.
- Assuming young people don’t want to know about which jurisdiction will affect the co-design project.
- Recruiting mostly/all white, cis-gendered and non-disabled young people and adults to co-design.
- Asking young people to work within an existing problem-frame.
- Professionals failing to acknowledge their positionality.
3. How can we improve services for young people?
Focus: Ideas for more relevant services co-designed by young people, for services being more affordable for young people and for better understanding of young people by health practitioners
Some of the asks:
- Stop both lack of curiosity and “inappropriate curiosity” from health practitioners (raised for LGBTIQ+, Aboriginal and Torres Strait Islander and culturally diverse young people).
- Make health care more accessible and navigable for young people.
- Greater diversity of health practitioners.
- Young people training health practitioners.
- Focus on wellbeing, not pathology.
- Access to affordable health care for all, including international students, and casualised/gig economy workers.
- Improve NDIS accessibility and make qualified medical professionals assess applications instead of people not in health.
“I work as a mental health support worker, and my gender diverse clients have IMMENSE issues with hospital services not respecting their pronouns/gender identities,” said one participant. “It shouldn’t be the onus of trans consumers to constantly battle…just to feel safe and respected.”
Another participant commented: “The more serious clinical settings you get, the less you see peers and lived experience present.”
4. How can we improve health tech that young people use?
Focus: Ideas for better platforms/apps accessible by young people
Some of the asks:
- Address problems of digital access in regional, rural or remote areas and for different communities, including people with disability.
- Bring together health apps into one place instead of requiring users to download several, separate applications.
- Continuous feedback via paid beta testers, focus groups and input from young people from diverse backgrounds.
5. How can we improve our pandemic response?
Focus: Ideas for better acknowledgement of COVID-19 as a significant life disruptor for young people
Some of the asks:
- Provide ‘above poverty’ levels of income support (including a universal basic income?) and a big focus on economic participation, including rights to equal education.
- Involve young people in the pandemic messaging and how it relates to schooling, employment, funding etc, “at a time that is extremely stressful and constantly changing, unclear messaging only exacerbates that”.
Opening the summit, co-host Roxxanne MacDonald, a CHF director and Orygen Australia research project officer, said she was “starting where I have to start, which is with COVID”, so big is its toll on and implications for the health and health care of young people.
“We all know it has hit young people the hardest,” MacDonald said, noting how it has “smashed” critical transitions and milestones at a time when young people were already facing challenges in mental health, employment and housing and “exacerbated the inequalities already existing in our community, especially for those who are marginalised”.
“We know young people will continue to experience the impacts of COVID long after the last lockdown, and we have more challenges to face, particularly climate change,” she said.
MacDonald said addressing those challenges meant a focus not just on physical and mental health, but on the environment, employment, housing “and our sense of belonging and connection to our community”.
Digital stories of the discussions
See the three storyboards of the sessions developed by DevonBunce of Digital Storytellers
Twitter threads from summit sessions:
- Opening and data development:
- Roxxanne MacDonald, CHF Board Director, Luke Catania, YHF national coordinator, Acknowledgement of Country by the Kari Singers, and Katie Acheson and Gemma Wood from Numbers and People Synergy
- What are policy makers missing?
- YHF young leader Georgia Gardner, with Caitlin Figueiredo, Co-Chair Australian Youth Affairs Coalition, UNICEF Ambassador Franklin Hooper and Corin Boughton from Carers Australia
- Developing ideas for the future
- Mapping session led by YHF member Jahin Tanvir and strategist Andrew Hollo
- Young people as change makers
- YHF leaders Jasmine Elliot and Zinab al Hilaly with mental health expert Professor Pat McGorry and adolescent medicine physician Associate Professor Michelle Telfer
- Shifting the focus from health to wellbeing in governments
- Roxxanne MacDonald speaks to VicHealth CEO Sandro Demaio.
- Developing calls to action
- Summary of ideas to develop into the summit calls to action.
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