Young People

The Australian Institute of Health and Welfare (AIHW, 2021a) defines a young person as someone aged between fifteen and twenty-four years old. Young people in Australia account for approximately 12% of the population or 3.2 million people (AIHW, 2021a). The proportion of the population that young people represent has been in decline due to low birth rate and a longer life expectancy the proportion has declined from 17% in 1971 to 12% in 2020 (AIHW, 2021a). Like all demographics young people face specific physical and psychological challenges these include ear infections, sexually transmitted diseases, ADHD, anxiety, depression, alcohol and substance abuse (Centers for Disease Control and Prevention, 2021b).

Depression

Depression is a common psychiatric disorder which is experienced widely across all demographics, depression can also be known as major depressive disorder or clinical depression. Depression is characterised by persistent symptoms of sadness, lack of enthusiasm and a lack of pleasure from activities which were previously rewarding. Depression can have long lasting impacts on a person’s life and can reoccur throughout a lifetime (WHO, 2021b). The cause of depression is often an interplay of multiple factors impacting on a person’s social, emotional, physical, spiritual and psychological wellbeing (WHO, 2021b).

A person suffering from depression may have several observable behaviours, but for these behaviours to be diagnosed as depression they must be persistent for two or more weeks. A person suffering from depression may experience some of the following symptoms; sad, anxious, or “empty” mood, feelings hopeless, pessimism, irritability, feeling guilty or worthless, loss of interest or pleasure in hobbies and activities, decreased energy, moving or talking more slowly, feeling restless, difficulty concentrating or remembering, indecisiveness, difficulty sleeping, rising early, or oversleeping, appetite and/or weight changes, thoughts of death or suicide, or suicide attempts, aches or pains without a clear cause. (NIMH, 2018). Depression is generally associated by a persistent low mood.

A young person with depression will often withdraw from friends and family, this may be observed both at home and at school, this is important for parents to note as teen withdrawal is often accepted as a normal part of adolescence (Rubin et al., 2009). A change in sleep patterns could be observed by parents or self-reported by the teen, this may look like them staying up late, waking very early or oversleeping. Whilst it is considered normal for teens to need a greater amount of sleep than adults, approximately eight to ten hours a night, regularly exceeding this may be cause for concern (Hirshkowitz, et al., 2015; Italiya & Nakhat, 2019). A lack of sleep or poor-quality sleep can impact how a young person functions in their daily life, they may seem clouded, slow in speech and reactions, and lacking in motivation and energy (Richter, 2015). A lack of energy and motivation may see young people withdrawing from extracurricular activities which once brought them great enjoyment as well as difficulties getting to school and engaging with curriculum.

Evidence of Symptoms

Depression has observable symptoms which in isolation or observed on a rare occasion may be innocuous, however when there are multiple symptoms, or these symptoms are observed over a prolonged period these symptoms may need further investigation. Within a school setting there are several ways to gather data which may assist in understanding a young person better. The following will discuss cognitive, behavioural and social observable behaviour which teachers may report to the school Guidance Officer as well as how a Guidance Officer may gather data.

Whilst there are a large range of symptoms which may be present if a young person is depressed there are signs that teachers and the school community can look out for to help identify depression to ensure that a young person is referred to receive appropriate assistance as soon as possible. As teachers spend time with students on a regular basis across a large period, they are often able to observe changes in a student’s temperament and motivation levels. A Guidance Officer may ask class teachers to complete a survey to report on the student’s behaviour, motivation and achievement in class and give teachers the opportunity to note if they have observed any changes. In class teachers my observe a reduction in motivation and effort when completing tasks this may include a lack of effort or failure to submit tasks (Al-Qaisy, 2011). A change in a student’s academic achievement and effort may be highlighted in school report cards. This data can be gathered from a source such as OneSchool which will give an indication of the student’s academic achievement across their schooling history. If there is a noted drop in achievement this would be noted as evidence of change. Poor memory and recall may be observed through questioning or formative feedback in the classroom. Studies have shown that adolescents with depression are more likely to recall negative experiences and interactions and prioritise these memories over general memories (Oliver et al., 2019).

Teachers may also observe a change in student’s social interactions. Students suffering from symptoms of depression may withdraw from their friends and peers (Rubin et al., 2009). When gathering data from teachers it is important to enquire about the student’s social interactions, this may include observations in class and on playground duties, it would also be of benefit to speak to the teachers who run any extracurricular activities which the student may be involved in. Students with depression may also have an interpretation bias and interpret interactions with peers in a negative way which may cause them to report negative interactions with peers on a regular basis (Oliver et al., 2019). It may also be observed that students try to avoid large crowds such as assemblies, this may be noticed by students arriving late on assembly days or being absent. Agoraphobia and social anxiety are often comorbid with depression; therefore, the avoidance of social interactions and large groups could be a sign of depression (Breier et al., 1984).

There may be noted changes in behaviour depending on the symptoms of the individual. Students may appear sadder and more irritable than usual (NIMH, 2018). Students suffering from depression may also have difficulties concentrating in class this may be perceived as the student being unmotivated or noncompliant. A sudden or sharp rise in behaviour records for a student may indicate that they are facing some difficulties, this data may be gathered from the school’s behaviour specialist or from a data report such as behaviour history on OneSchool. Students with depression may have difficulties sleeping (Short et al., 2013). Students may arrive to school late and seem very tired or complain that they have not been sleeping properly, this can also be observed in an increased number of days absent. A students attendance record will tell a story of late arrivals and days absent; this could be valuable data when gathering information about a student and a possible psychopathology.

Impact on the Individual and Interactions

Depression can impact on young people’s everyday life both whilst suffering from depression and potentially later in life. Secondary schooling is a time in person’s life when many skills are developed and refined (Geldard et al., 2019). A young person will develop social skills during their adolescence, however those with depression will often avoid social situations and withdraw from peers, this can have a lasting impact as they may continue feeling anxious about social interactions (Elmer & Stadtfeld, 2020). If a young person is depressed interactions may change, there can be an increase of conflicts within the family, however parents can look to be supportive model problem solving for their teen to assist them in building resilience (Sheeber et al., 2001). A student’s willingness to engage with school during periods of depression can influence future outcomes such as academic achievement and future employment. Schools must be aware of how they can best support their students.

Suggested Interventions

When suspected that a student may be depressed, or the school has received information that a student is receiving care for depression the Supporting students’ mental health and wellbeing procedure (Department of Education, 2021b) would need to be followed to put appropriate supports in place. If a staff member raises concerns about a student, this will be investigated. This can be done by surveying teachers, analysing behaviour and attendance data, speaking with the student and their parents. If there is cause, a complex case management process will begin with a case management team assigned (Department of Education, 2021b). Parents will be contacted and it is recommended that during this initial contact discussions are had around concerns that have been raised, what has been observed to validate these concerns and what the rest of the process may entail. When contacting the parent, it would be advisable to discuss the Supporting Students Mental Health Form 1 and Form 2 with the parent to gain consent to communicate with health care providers about the students need and condition (Department of Education, 2021b). In an Education Queensland school, these support provisions would need to be recorded in OneSchool. When creating a complex case record the presenting conditions must be documented, this is where the gathered evidence can be recorded in one place (Department of Education, 2020). When working with the student and their parents, if they are not already seeking external support, the Guidance Officer may refer the student to an external agency such as Child Youth Mental Health Services. This external referral would also be recorded in the complex case record (Department of Education, 2020). Within the school there are also adjustments which could be made to support the student depending on the stressors such as an adjusted timetable, regular counselling with the Guidance Officer, referral to the school nurse, adjusted assessment conditions, inclusion in school-based support groups, and connection with a case manager. All adjustments would need to be recorded as well as communicated appropriately with staff and approved by the principal.