The Youth Health Forum, set up under the auspices of the Consumers Health Forum of Australia, recently held a national summit to develop priorities for change in health and healthcare in the lead-up to the next federal election.
The Croakey Conference News Service has been covering the event: you can bookmark our stories here.
For this final article, we asked a number of young people across Australia, including some of the #YHFSummit presenters/participants, to talk about their key messages to politicians, policy-makers, health professionals and health services.
A clear message is that current systems are not working for young people, who want a greater say in politics, policy and service delivery.
More young people in politics
Swathy Santhakumar
Project Coordinator, Marie Stopes Australia
Q: What are your key messages on what needs to be done at the following levels to improve health and healthcare for young people: politically, in policy, and service delivery?
Politically. As a collective, we’re turning away from traditional politics. Instead, we find our community and voice through grassroots platforms. We know politics is an important part of the democratic landscape but currently our governments are a poor representation of Australia and the people who live in this country.
We need to create an environment which encourages more young people to get actively involved in politics. This means providing more opportunities for young people to have a say on government decisions and support more young people to run for parliament.
Policy: Healthcare policies need to be co-designed with relevant stakeholders including young people who have diverse experiences to be fit for purpose.
Consultations are a great start, but young people need to be actively involved in the process of creating policies which affect the way they access healthcare.
Service delivery: We need to make service delivery more accessible by having better financial support systems, especially for services that young people access the most (for example, mental health and sexual and reproductive health services).
Whilst we know that the use of technology in healthcare is only going to become more pronounced, we need to ensure that there is digital inclusion. Everyone throughout Australia should have quality access to the internet and new technologies which increase the uptake of healthcare services. Current temporary telehealth measures through Medicare should be made permanent.
Teach future healthcare providers EARLY how they can provide culturally sensitive and inclusive healthcare services. This should begin at university.
Implement youth-led training to educate current health workers on how to provide health services to young people.
Q: What advice do you have for health organisations wanting to engage with young people and/or what do they get wrong?
Young people have access to more information at our fingertips than anyone else, so engaging with us is not as hard as you may think. Think about our main sources of information:
- Online: short, snappy, shareable content across multiple media platforms.
- We turn to our friends and peers for health information and advice.
Remember that “young people” are as diverse as the rest of society. What works for one of us, may not work for the rest.
Q: What would the health system look like if young people were in charge?
Greater accessibility to healthcare services including better financial support, simplifying access to services and information developed specifically for young people.
Increased digital healthcare technologies that are inclusive.
Increased CHOICE in healthcare settings (types of care, who provides care, how we receive care).
Q: Any takeaways from the summit?
Young people ARE proactively looking for how we can best lend a voice to improving healthcare services in Australia – the YHF Summit is a great example of this.
We need key decision makers to let us in, take on board what we say and create an environment which encourages more young people to voice their experiences and opinions and become more actively involved in changing the landscape of healthcare.
Focus on rights and communications
Tayla West Chong
Kalkadoon, Waanyi, Garawa, Djakunde, Casual Administrative Officer at Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM)
Q: What are your key messages on what needs to be done at the following levels to improve health and health care for young people: politically, in policy, and service delivery?
Politically: Give youth the opportunity to speak out on their own health issues, this is more likely to be heard by their counterparts and empower their community to address the health issues on their own.
Policy: Young people are unaware of their rights and aren’t likely to report on adverse healthcare interactions. Young people need to be educated on the policies created to protect them when interacting with the healthcare system. For example, the Anti-Discrimination Act of 1991 is something I was unaware of until my second year of university but would be useful for youth who are discriminated against by their health providers because of their young age.
Service delivery: Young people sit in a grey area between adults and children, It should be somewhat of a specialty or an area of experience for someone to work with young people. I believe there should be staff employed who are knowledgeable and possess the communication skills to provide effective health care to young people and that they should not be lumped in with either adults or children depending on what end of the scale they are on.
Q: What advice do you have for health organisations wanting to engage with young people and/or what do they get wrong?
I think health organisations should focus on the quality of their staff and in my experience, it can be one of their biggest downfalls due to lack of staffing or inadequate employment screening.
For whatever reason, the health of young people is often put in the wrong hands in terms of frontline staff, staff that aren’t comfortable or confident with promoting health to this vulnerable group. I want to make it clear that I don’t believe young people should be employed in these positions to deliver to other young people because although they have the personal experience and can relate to their patient, this does not mean they all have the interpersonal skills to provide adequate health care to fellow youth.
Q: What would the health system look like if young people were in charge?
If young people oversaw the designing of the health system, I believe external communications such as texting, calling and teleconferences would be the most used form of interaction with health professionals, especially for the youth.
Because of the increased access, clinic waiting times would be reduced, more patients would be able to be seen, there would be a lesser occurrence of unnecessary clinic visits and resource expenses would be reduced.
Lived experience and leadership
Is Hay
Facilitator and Advisor, Youth Disability Advocacy Service (YDAS), Victoria
Q: What are your key messages on what needs to be done at the following levels to improve health and health care for young people: politically, in policy and service delivery?
Politically: Key message: young people are tired of being used as a political scapegoat during times of government failure (ie. ‘young people being risky is key reason for worsening COVID-19 cases’ etc). We deserve better than to be ignored until we can be used to falsely move blame from those in power.
Policy: Key message: young people need meaningful and paid opportunities to not just contribute, but inform and lead, policy changes in health and healthcare, as they disproportionately impact our experiences and communities.
Service Delivery: Key message: our healthcare systems are not working for disabled young people, and mass change, led by us and our needs, is needed in order for them to actually be serving our communities.
Q: What advice do you have for health organisations wanting to engage with young people and/or what do they get wrong?
A: Firstly, ensure you gain our perspectives before moving forward with any projects or changes. Do this in a meaningful and accessible way, not just a once off consultation, but require paid co-design spaces full of diverse young people to be embedded into organisations. Know that our lived experience is expertise, and that ‘professional qualifications’ are not required for us to know what is best and needed for our communities.
Q: What would the health system look like if young people were in charge?
A: If young people could design the healthcare system it wouldn’t be for-profit! Its entire purpose would be to serve its participants (not customers), and that wouldn’t be limited by budgets.
It would be led by lived experience, with substantial numbers of disabled, LGBTQIA+, BIPOC and intersectionally identified people in service roles, and the rest would be allies.
Healthcare would be an actual safe space where we could expect and rely on the system to support us in a timely, affirming and accessible way.
Social determinants of health, a call for action
Georgia Gardner
Youth Health Forum young leader
Q: What are your key messages on what needs to be done at the following levels to improve health and health care for young people: politically, in policy, and service delivery?
Politically, we tend to see that the needs and perspectives of young people are known, but there is a lack of will to respond to them. I believe this furthers the divide, resentment, and disengagement that keeps young people out of political life.
The social determinants of health, including financial security, housing, education and employment, continue to be at the core of the conversations about youth health and wellbeing.
Simple, known changes, like increasing income support above the poverty line, are discussed ad infinitum, yet we see little action. Sustainability and climate change are increasing concerns for the health and well-being of young people, who will shoulder the consequences of today’s political decisions and inaction.
Policy: A policy shift is needed towards long-term, sustainable funding with a focus on cross-sector collaboration and well-being beyond mere health. Meaningful systemic change is difficult in short-term funding rounds and impossible when we work in silos and fail to leverage the expertise of other sectors, including designers, communicators, artists, and more.
Data will also be vital to support evidence-based innovation and improvements. How can we know the true state of youth LGBTIQA+ health – and decide what funding is needed – when our census refuses to capture inclusive gender or relationship information? How can we embed health and well-being in all policy, when we don’t measure or frame the health impact of policy with equivalent metrics to economic impact?
Service delivery: Collaborative and considered design of services is key. Involving young people and lived experience – and paying for their time and expertise – will be essential in the future of health service development and delivery. Remaining agile and responsive is a vital part of the continuous improvement cycle.
Q: What advice do you have for health organisations wanting to engage with young people and/or what do they get wrong?
Don’t wait for perfect conditions to engage, because they aren’t coming. Do your best. Be open to feedback and change. Remain curious and creative.
Q: Any takeaways from the summit?
A: We know what we need to do to improve Australia’s health system and the health of Australians. We’ve known for years and decades. Why do we still so struggle to do it?
A young Minister for Youth
Jasmine Elliott
Youth Health Forum member, Chair of the Australian Medical Students’ Association Rural Health Committee
Q: What are your key messages on what needs to be done at the following levels to improve health and health care for young people: politically, in policy and service delivery?
I feel like I could write for days under these banners, so I’ve included my top three for each heading!
Politically: Increased representation of young people in positions of power, including a young Minister for Youth.
Accountability frameworks for the involvement of young people in upstream (i.e. policy, funding) and downstream (i.e. service delivery and research) decisions pertaining to health delivery.
Future-focussed investment, including climate action and in a robust health workforce.
Socially: Ongoing financial support in the context of COVID-19 and preexisting underemployment of young people.
Ongoing research into the social determinants of health for young people and corresponding investment recommendations to improve these.
More flexible and affordable education and employment options
Service delivery: Flexibility of eligibility criteria with regard to age and condition severity to acknowledge variation in circumstances (e.g. a young person who is 18 but has lived independently for years compared a 20 year old who lives with, and is strongly connected to family).
Acknowledgement and utilisation of digital technologies in health literacy, service administration, records.
Transparent communication of cost prior to service delivery to allow young people to make decisions.
Q: What advice do you have for health organisations wanting to engage with young people and/or what do they get wrong?
Something which really came through in the (summit’s) conversation station on access and digital health is that engaging with young people isn’t a chore.
Consumer engagement and codesign are not meant to be activities which make work harder but ones that make it easier. The concept of giving young people a seat at the table and involving them from the beginning of the journey is far more effective than trying to shift a pre-existing entity based on feedback after-the-fact.
Often, organisations get this wrong by seeing a problem, coming up with a solution and “checking” the solution with young people, under the belief that this is codesign and understandably being frustrated when they have to significantly change their strategy, or it isn’t what young people want. Instead, let young people define the problem, partner with them to develop solutions and create something that is both provider and user friendly.
Q: What would the health system look like if young people were in charge?
I think it’s important to remember that we aren’t always asking for the health system to change for everyone when we call for youth representation in its governance.
We’re asking for a system that suits the people it’s caring for. For young people that looks like a health system which is more agile and adaptable to the needs of a diverse range of people, whether this is due to cultural background, sexual or gender identity, living situation, geographical or financial access.
It looks like a health system which involves young people at all levels of decision-making and service delivery and in all steps of the processes. It is a system which empowers young people to be collaborators on their health, rather than mere participants in a pre-existing model of care.
Q: Any takeaways from the summit?
For me, it was so exciting to see so many people so passionate about youth health – from young people to care providers, it was clear to me that there is a wealth of people eager for change in this space.
I think often we work and advocate in our own pockets and events such as the YHF Summit allow us to see that there is engagement across the sector – some amazing examples and role models to learn from going forward.