Croakey is closed for summer holidays and will resume publishing in the week of 9 January 2023. In the meantime, we are re-publishing some of our top articles from 2022.
This article was first published on Wednesday, July 6, 2022.
Courage, family support and the ability to silence inner critics can help turn adversity into positive change, according to leaders from health and other sectors speaking at the Giant Steps 2022 conference recently hosted by Safer Care Victoria.
In our final report from the conference, Croakey editor Jennifer Doggett provides a wide-ranging #LongRead for the Croakey Conference News Service.
Jennifer Doggett writes:
When Dylan Alcott was a child he and his older brother Zack would fight for control over the TV remote at their family home in suburban Melbourne.
Zack worked out he could put the family’s TV remote on top of the fridge when he went to the bathroom so that Alcott couldn’t change the channel while his brother was out of the room.
From the outside this may have looked like exploitation of Alcott’s disability; however, Alcott now describes this incident as one of the reasons behind his future success.
The Paralympian and Australian of the Year told the Giant Steps 22 audience that the authenticity of his brother’s attitude towards him made him realise that he could show up in the world on an equal footing to people without disabilities.
This gave him the courage and self-esteem needed to overcome feelings of inadequacy during his teenage years.
Alcott was one of a number of speakers at the conference who demonstrated the transformational power of storytelling and the value of learning from other people’s experiences and perspectives.
These speakers shared how they were able to draw strength from adversity, as long as they acknowledged the difficult and traumatic experiences and were given appropriate help and support.
Purpose and drive
In her keynote address, the founder of the Auburn Giants Football Club, Amna Karra-Hassan, described how her career achievements were motivated by growing up at a time when many Muslims experienced discrimination and exclusion. Early experiences at school, of being asked where she was from, gave her a purpose in life.
“I wanted to be the person who does something about the things I care about, like how people decided who I was before I even opened my mouth. Being angry about that fuelled my drive to succeed,” Karra-Hassan said.
Karra-Hassan has used her role to promote issues such as the mental health of women and girls, including creating a “Kick away the Blues” video to promote the benefits of talking about mental health and seeking help.
She urged attendees to embrace the difficulties they encounter in their lives as “discomfort is the elixir for mediocrity.”
“Get in the belly of the beast, otherwise things won’t change,” she said.
Karra-Hassan advised those wanting to shift the narrative to be clear on their aspirations and goals and to find like-minded people and work with them. She highlighted the importance of leaders making decisions that align with their values and of both being accountable and seeking accountability.
She also acknowledged the need for leaders to look after themselves, particularly given that there are always challenges.
She said that this can look different for everyone but for her, therapy has played an important role.
Strength and confidence
Alcott described how overcoming the challenges of having a disability gave him the strength and confidence to pursue professional and personal goals, such as competing at Paralympic Games in both wheelchair basketball and tennis.
He said the hardest thing to get over was people’s low expectations of the capabilities of people with disabilities.
Realising that he did not have to define himself by other people’s perceptions of him gave him the confidence to take on new challenges in his social and professional life.
“Be bold – if you put yourself out there, good things will happen,” he said.
Along with his advocacy in the media, Alcott has used his profile to set up the Dylan Alcott Foundation with the core purpose of helping young Australians with disabilities gain self-esteem and respect through sport and study.
He has also created the “Ability Fest” event – an inclusive festival with added accessibility (such as elevated platforms, Auslan interpreters, a chill zone and guide dogs) to raise funds for the Foundation.
The compounding impact of multiple unexpected and traumatic events on young people in Victoria was discussed by youth advocate, Zahra Sufeeya, who presented jointly with Dr Sandro Demaio, CEO of VicHealth.
Sufeeya shared how this string of events, which included bushfires, a pandemic, an earthquake and racially fuelled violence, have impacted her mental health and shaken her sense of a safe environment.
After talking to other young people in her community she realised that she was not alone in her experiences and then felt less isolated.
Sufeeya described how pausing and enjoying the little moments has helped her get through the past two years.
She also highlighted how she had used her experiences to inform her work as a youth advocate, connecting young people with the support of VicHealth in order to improve the health and wellbeing of young people in Victoria.
The importance of families
The importance of families, as a source of support, encouragement and a key component of resilience in later life, was highlighted by speakers who shared their diverse experiences of tragedy and trauma as children.
Musician, broadcaster, and author Clare Bowditch described how her parents taught her about hope and how their faith provided comfort after the death of her sister from a rare form of Multiple Sclerosis.
Bowditch said this taught her that “this isn’t all there is, there’s more”, helping her overcome challenges with mental health and eating disorders as a teenager and adult.
In his keynote address, Alcott, athlete, philanthropist, entrepreneur and 2022 Australian of the Year, discussed how support from his family got him through his difficult early years, involving long stays in hospital and multiple painful operations.
Family support was literally life-saving for another speaker, 18-year-old Elliot Nicholas, a transgender youth from Geelong.
Nicholas described how he struggled with his mental health at a school with a dominant heteronormative culture, and living without any contact with other transgender people.
At one point, Nicholas was so depressed that he thought he wouldn’t make it to his 17th birthday but support from his family and his parents’ acceptance of his identity enabled him to access the care that he needed.
Nicholas highlighted how his struggles to acknowledge his gender identity have motivated him to create safer and better educated environments for the LGBTQI+ community, including being involved in local school programs, Geelong’s local LGBTQI+ group GASP and in his role as Junior Mayor.
Dr Michelle Telfer, a paediatrician and adolescent medicine physician who specialises in providing gender-affirming care to transgender young people, emphasised how important family is for the mental health of transgender children.
“Having a supportive family is the primary influence over the prognosis for transgender kids. For those who don’t have a supportive family, or where the parents disagree on the need to acknowledge and support their child’s gender identity, the outcomes are quite poor,” Telfer said.
Nicholas explained the high risk of harm faced by transgender young people, including research showing that around 80 percent of trans kids under 25 have self-harmed and almost half have attempted suicide.
“Trans kids are 15 times more likely to self-harm than the general population,” Nicholas said.
Seeking help and inner critics
Speakers also discussed the importance of seeking help to deal with both external and internal criticism.
Bowditch recounted her experience with anxiety, fuelled by multiple traumas, including the death of her sister and the stigma associated with not having a body shape that met “acceptable” standards for that time.
One practical tool Bowditch found useful was the book ‘Complete Self-Help for Your Nerves’ by Dr Clare Weekes‘ whose message “to be kind to yourself, be hopeful and keep things simple” was exactly what Bowditch needed to hear.
She also discussed her strategy of giving her anxiety a name – in her case “Frank” – which allowed her to tell “Frank” where to go when required (also acknowledging that this is not a long-term solution).
Bowditch had some suggestions for participants wanting to tame their inner critic, reassuring them that it can be done, although she stressed that this doesn’t happen overnight.
These included identifying and naming self-doubts as well as finding light-hearted ways to tell an inner critic to go away. She also discussed finding an “inner champion” or listening to an uplifting song – Bowditch has a playlist that she has put together for this purpose.
Telfer discussed her experience as a target of a Murdoch media campaign against the gender-affirming health care she provided at her Royal Children’s Hospital clinic.
The hate campaign experienced by Telfer came on top of the challenges she was already facing during the pandemic as the clinical and research programs she managed expanded to meet rising demand for trans-medicine in children and adolescents.
Telfer outlined the key messages from the 45 articles written about her during this period which questioned her credibility, honestly and expertise, and failed to mention that she was an internationally recognised expert on transgender medicine with significant academic and research experience.
She said that she believed that the campaign was run to create fear and anxiety and exacerbate prejudice and stigma experienced by transgender youth.
This undermined the trust that patients and families of the clinic had in their doctors and also deterred people from seeking care.
Adding to the distress experienced by her, her family, her team and the Royal Children’s Hospital management was the knowledge that this was impacting transgender youth and families as it questioned their right to live as transgender.
While ultimately Telfer was vindicated when the Australian Press Council found that The Australian had breached three of its guiding principles in their reporting on this issue, her mental health suffered from receiving hate mail, social media trolling, abusive phone calls and harassment.
She encouraged conference attendees to pay more attention to their own wellbeing in situations of professional and personal pressure rejecting the adage that “what doesn’t kill you makes you stronger.”
“Actually, whatever doesn’t kill you gives you trauma symptoms,” Telfer said.
Outside of her professional role as a doctor, Telfer has promoted the need for greater media diversity, including providing a submission to the recent Senate Inquiry into Media Diversity.
The conference also heard about the risks that leaders can take when challenging the status quo.
Dr Kedar Mate, President and CEO of the Institute for Healthcare Improvement, discussed the experiences of colleagues in the US who identified racial inequities in access to specialised inpatient heart failure care at a medical centre.
When they developed a program to ensure that Black and Latino patients received the same standard of care as the white population, the doctors were targeted by White Supremacists who threatened them and the hospital.
Mate stressed the need for more support for healthcare workers to speak out where they see injustice and inequity, particularly given the differential impact of the pandemic on people already disadvantaged.
“Over the past few years we have heard many stories of courage from healthcare workers –we need that and more for what lies ahead,” he said.
Small actions – big impacts
Along with examples of major accomplishments, including paralympic medals, national awards and best-selling books, speakers at Giant Steps also shared stories of how small actions at an individual level can have a big impact.
Mate told the story of an NRMA staff member sitting with a woman having a panic attack in her car after driving past the site where her son had been killed.
The woman had called the NRMA rather than a mental health service or professional because, in her words, “I knew they would come.”
This was described by Mate as the essence of trust “It’s giving someone exactly that they need when they needed it,” he said.
Nicholas discussed the isolation he experienced growing up as transgender without being aware of what this meant and not knowing anyone else who was transgender.
Along with his supportive family, Nicholas mentioned the crucial role played by his school principal, who (despite being “an old guy”, according to Nicholas) listened to Nicholas and his parents when they reached out for help.
His support and acknowledgement that he needed to do more at the school to support LGBTQI+ students made a big difference to Nicholas’s ability to feel confident in his gender identity and seek the support and treatment he needed.
The conference also heard examples of how individual decisions made by people at all stages of the health system can have long lasting and wide reaching ramifications.
Nicholas’s mother also mentioned how important it was that the GP they initially saw understood and was affirming of transgender issues. This positive experience of healthcare allowed them to trust that health professionals would provide them with safe and high-quality care and paved the way for them to access the clinic at the Royal Children’s Hospital.
Telfer also mentioned the decision made by then Minister for Health, Greg Hunt, to resist pressure from the Murdoch media for an inquiry into gender-affirming care and instead to ask the Royal Australasian College of Physicians to assess whether an inquiry was necessary.
They concluded that it wasn’t and recommended that this evidence-based model of care was made available to more young people in Australia.
This decision avoided what could have been a traumatic and damaging process for transgender Australians and professionals working in this area, forcing them to defend their rights to gender-affirming care.
The millions of individual decisions made by voters in the last federal election to reject the politicisation of transgender issues was also acknowledged by Telfer who welcomed the outcome, saying that it showed Australians want “kindness and inclusivity”.
Learning from other industries
Health is not the only area that has had to pivot and adapt to the changing pandemic environment; conference delegates had the opportunity to learn from the experiences of leaders in other sectors, including the arts, hospitality and education.
A panel session on Day One brought together a restaurant owner, primary school principal and senior manager from one of Victoria’s leading galleries to discuss how they managed the internal and external challenges of steering their organisations through the pandemic.
Henry Grossek, Principal of Berwick Lodge Primary School in Melbourne’s south-eastern suburbs, drew on his 50 years of experience in the Victorian public education sector to support both staff and students during Melbourne’s extended lockdowns.
He described how the lockdowns exacerbated existing inequalities among students, particularly those who could not access health and educational assessments needed to obtain support for their learning needs.
A major focus for Grossek was to keep staff morale up and to celebrate successes as a team and as a broader school community.
He also acknowledged the need to do more to support the vulnerable kids in the community who have fallen further behind as a result of the pandemic.
Restauranteur Guy Grossi described how disheartening it was for him to have to tell his staff that they had to stay home when the lockdown started.
He described this as “worse than the financial aspect” given the passion his staff had for creating high quality dining experiences for their customers.
Grossi made efforts to keep in touch with his staff, eventually starting “Grossi a Casa”, a home delivery service for their food, which brought the team back together and provided both financial support and professional satisfaction for his workers.
Particular efforts were made by Grossi to keep immigrant workers employed as, unlike his Australian employees, they didn’t have access to the Job Keeper subsidy.
One lesson Grossi had for the health sector is to prioritise work life balance in order to maintain mental wellbeing and maximise performance.
“We would rather have more people with less work so people can give their best. The human side of work life balance is more important than ever before,” he said.
At the National Gallery of Victoria, Michele Stockley’s job is to expose the gallery to new audiences and enable visitors of all backgrounds and experience to find meaningful connections with art and design.
Over the last two years this has included overseeing a rapid transition to online delivery of programs and finding new, creative ways to connect with the community during extended closures to ensure the gallery can continue to contribute to the cultural, educational and social wellbeing of the community.
Stockley’s message for health organisations struggling in the current environment was to focus on their strengths. For the gallery this was their high-quality content which they were able to provide digitally in order maintain their engagement with the community.
Courage to change
The need for courage to address systemic system failures was highlighted by Mate, who began his keynote address by reading out the names of the children and teachers killed in the school shooting in Uvalde, Texas on 24 May.
He acknowledged the anger and frustration felt by many about the failure of authorities to respond to calls for change, in this and other areas of public policy with harmful and unjust impacts.
“Taking action is restorative,” Mate said when urging attendees to keep striving for change, “If there’s something you can’t conscience, there’s healing in taking action.”
Mate called on healthcare workers to “seek out moments of contradiction and call them as we see them and face them in relationships grounded in trust and courage” as he argued for systemic change across the health sector.
“The goal should not just be to fix pot-holes but to pave a new road,” he said.
He emphasised the need to overcome the inertia of entrenched institutions and systems in healthcare, arguing that “The first law of improvement is that every system is perfectly designed to get the results it gets.”
Mate called on healthcare workers to commit to calling out injustices and inequities in the health system: “Do not walk by – unless we stand up for that, the system won’t change,” he said.
Listening to the community
The importance of community partnerships was stressed in the joint presentation by Demaio and Sufeeya, who discussed VicHealth’s response to the pandemic and its approach to health promotion (doing things ‘to’ people, rather than ‘with’ people).
Demaio outlined three critical tracks of work that VicHealth identified during early on in pandemic:
1) Business as usual – keeping staff and programs stable as much as possibly could
2) Supporting government in its pandemic response as part of the public sector
3) Organisational reform and change – in order to meet the rapidly evolving situation and responding to people’s needs and demands for healthcare.
As part of this process, VicHealth identified a need to address the health of young people and went out to the community to find out what young Victorians wanted money spent on. They nominated:
1) Flexible, non-competitive options to be active
2) Improved access to fresh and healthy food/food security
3) Opportunities for social connection to improve mental health.
This led to development of the “Future Healthy” program, and the “The Big Connect” project, a $5 million initiative which aims to create 100, 000 new social connections.
Sufeeya discussed the co-design of this project that provided empowerment and inclusion for young people and allowed them to have their experiences and views heard.
She added that it is great to have support of organisations like VicHealth enabling co-design.
“We need to have young people involved in creating a healthier future for young people. There is a beauty in having different experiences – it gives us a wider body of knowledge,” she said.