young & healthy in tairawhiti

Young & Healthy in Tairawhiti

Manu CaddieManu CaddieManu CaddieDecember 2007December 2007December 2007

Tairawhiti Health Services Plan for Young People


Ministry of HealthYouth Health: A Guide to Action (2002)GOALS:1. A safer, more supportive environment for New Zealand�s young people

Young people�s health is affected by what is happening in their families and whanau, with friends and in school. Families, schools, communities, and local and central government agencies all have a role to play in improving young people�s health and keeping them well.

2. A measurable improvement in young people�s mental healthNew Zealand has high rates of youth suicide, particularly among rangatahi, and high rates of mental illness and drug and alcohol abuse. Devising effective ways of keeping young people mentally healthy is a priority.

3. A measurable improvement in young people�s physical healthTaking risks and trying new things are integral to young people�s lifestyles. Finding ways of reducing the negative outcomes is part of the action plan.

4. Young people influencing health policy and programme developmentYoung people want to be actively involved in decisions that affect them and in decisions about their own health care. Programmes and services work better when young people participate in their design and/or delivery.

5. A higher level of knowledge about youth health and youth health servicesYouth health has been relatively neglected as an area of focus for research and medical specialisation. The action plan encourages the systematic acquisition and sharing of knowledge about youth health and youth health services.

6. High-quality, youth-friendly, accessible health servicesExisting health services often present barriers to young people. Cost, confidentiality, and privacy are issues for young people.

There are four population-specific goals:7. A measurable improvement in the health of rangatahi8. A measurable improvement in the health of Pacific young people9. A measurable improvement in the health of disabled and chronically ill young people10. Better health outcomes for young people with multiple disadvantages


Ministry of Youth DevelopmentYouth Development Strategy Aotearoa (2002)

Six principles of youth development:

1. YOUTH DEVELOPMENT IS SHAPED BY THE �BIG PICTURE�By the �big picture� we mean: the values and belief systems; the social, cultural, economic contexts and trends; the Treaty of Waitangi and international obligations such as the United Nations Convention on the Rights of the Child.

2. YOUTH DEVELOPMENT IS ABOUT YOUNG PEOPLE BEING CONNECTEDHealthy development depends on young people having positive connections with others in society. This includes their family and whanau, their community, their school, training institution or workplace and their peers.

3. YOUTH DEVELOPMENT IS BASED ON A CONSISTENT STRENGTHS-BASED APPROACHThere are risk factors that can affect the healthy development of young people and there are also factors that are protective. �Strengths-based� policies and programmes will build on young people�s capacity to resist risk factors and enhance the protective factors in their lives.

4. YOUTH DEVELOPMENT HAPPENS THROUGH QUALITY RELATIONSHIPSIt is important that everyone is supported and equipped to have successful, quality relationships with young people.

5. YOUTH DEVELOPMENT IS TRIGGERED WHEN YOUNG PEOPLE FULLY PARTICIPATEYoung people need to be given opportunities to have greater control over what happens to them, through seeking their advice, participation and engagement.

6. YOUTH DEVELOPMENT NEEDS GOOD INFORMATIONEffective research, evaluation, and information gathering and sharing is crucial.


Tairawhiti District Health BoardStrategic Plan 2005-2010

Regional Health Priorities:� Reduce the rate and effects of heart disease and stroke.� Reduce the rate and effects of diabetes.� Reduce the rate and effects of cancer.� Reduce the rate and effects of severe mental health and addictions.


� Project commenced September 2007� Process to date:

� purpose and process set by TDH� Project Leadership Group established: Nathaniel Ratapu, Daniel

Hellesoe, Riria Stuart, Shiane, Melanie, Suzie Scott� Advisory Group: Hayley Johnstone, Keriana Brooking, Janette Varley,

Tina Ahuriri, Robert Hunter, etc.� focus groups: high schools, Square Pegs, CCS, teen mums, etc.� interviews: health professionals, school staff, youth workers, etc.� surveys: online surveys, Tairawhiti Youth Survey, Youth 2007, etc.� experience of existing regional youth health services


� Do we know about young people in Tairawhiti?� 4,008 aged 10-14yrs� 3,315 aged 15-19yrs� 2,313 aged 20-24yrs� 22% of region aged 10-24yrs� 38% of region are under 25yrs� highest rates of smoking in the country� highest rates of regular physical activity� highest rates of teenage pregnancy� highest rates of Te Reo Maori speakers


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Population aged 10-24yrs on Census Night 2006East Coast = 10%, Gisborne City = 75%, Western Rural = 15%

Age at which people in Tairawhiti die (2002-2004)

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Suicide deaths by DHB 2003-2005 (per 100,000)


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hospitalisation rates for intentional self-harm


Young People in Tairawhiti (2007)� Young people have great aspirations, they do like living

in Tairawhiti in the main, and see themselves coming back here in the future, if they are leaving

� 64% felt their life had a strong sense of purpose and direction, similar proportion responding that they get along well with people their age

� 98% feel safe �all of the time� at home� 85% feel safe at school all or most of the time� 25% wish to continue learning after the age of eighteen


Smoking, Drugs and Alcohol

� 12% of young Pakeha women aged 12-14 years old said they are regular smokers.� The same number of young people in this age group had also experimented with drugs in the

preceding 6 months.� There is a close correlation between smoking and drug use. If someone smoked they were very

likely to experiment with drugs. Less than 5% of those who reported using drugs recently did not smoke.

� Drugs are readily available and most young people knew how to access drugs. � Girls in particular voiced their desire to help friends keep away from drugs, in each forum young

people talked about a personal association with someone who they believed was badly affected by drugs.

� Alcohol was mentioned as being essential for a party �to rock� according to young party goers.� One in three young people spent more than three hours per week partying where a lot of alcohol

was being drunk. � 60-70% of 17-19 and 20-24 year old age group spent more than three hours a week at parties

where a lot of alcohol was being consumed� And 14% of 10-11 year olds and 25% of 12-14 year olds� Some young people think of drink driving as being safer than walking home. � In rural areas getting home from parties was an issue.


Key Questions:� What do we know about the health status of young people in Tairawhiti?� What do different stakeholder groups believe are priorities for youth health

and wellbeing in Tairawhiti?� young people (at school, out of school, disabled, gay/bi/trans, cultural groups,

urban/rural, male/female, older/younger, etc.)� government (MOH, DHB, MSD, MOE, etc.)� whanau (parents, caregivers, grandparents, siblings, peers, etc.)� youth health professionals (health promoters, medical practitioners, educators,

counselors, researchers, youth workers, etc.)� What do we see as the best way to achieve the best results?� What has worked well, or not so well, that we can learn from?� Who needs to take how much responsibility for which issues with what

resources by when?


Ideas for youth health services:

�I believe a youth health centre and a one stop shop for youth are great ideas as it allows young people to access services they need and may not even know about. It should also help them to access some of the services they may feel to embarrassed to access as it will all be in the same place and no-one would need to know what they are there for. There are always the sticky questions you have though, like:

� How do you cater for the different ranges of youth you are trying to provide the services for?

� How do you ensure you get to a range of youth so as not to be dominated by one group of people?

� How do you make it a safe zone?� How do you deal with privacy issues between agencies?� Where would you put it and who would be there?�


Ideas for improving health and wellbeing of rangatahi Maori� tell them to bring a friend along with them to check ups� new things for youth and family involvement� start with the families. Get the nan and pa sorted, the mum and dad, and then start

on the kids. The whanau needs to be healed before you can help the kids. It is a waste of time working with the young person if they are going back to the same unhealthy household at the end of the day

� have market type days in each suburb with information stands plus youth bands and interactive stuff (e.g. competitions, relays, tug-of-war, karaoke, etc)

� work like a village each doing their best to grow together where it takes one village, one town, one small city to raise a child

� sorry do not understand this question � I do not know what rangatahi means� having places that are easily accessed that provide a safe and confidential place that

people can go and talk to someone or ask health related questions.� making fruit cheaper� make up like a class where they can go to learn about

stuff and keep fit, study, go for help or do homework�this could help keep them off the street and out of trouble!


What does a healthy young person in Tairawhiti look like?Someone who is happy and healthy. At ease with who they are and someone who knows its OK to be themselves. They play some type of sport, whether its running, rugby, table-tennis, pool, swimming. Enjoy doing what they love. Someone who spends time with their family and friends, at the beach, on the farm, in town or just at home. Someone who smiles.


Guidance Counsellors feedback:� �Young people sponge up decisions and atmosphere that is set by older

people so they are a product of an unhealthy society, this macho culture works for men and it works against us, works in sports and not in love and relationships.�

� �Poor diet message have to go to the families, young people don�t get a say in that stuff.�

� �It is always the ones who need it the most that don�t access because they aren�t brought up to do that, so we are teaching them to do that from school by bringing all health services that we can into schools.�

� �Screening for hearing and eyesight is being picked up as a behaviour problem in the classroom, this needs sorting.�

� �Dentists need a more proactive approach to young people and need to go to them, to get young people into the pattern of accessing these services.�

� �Young people feed off the media the same as everyone else.�


Social Worker feedback:� �Lots of services do bits and pieces but it is never a complete holistic service

at one place because of not enough human resource.�� A specialist team [should] be located at a one stop shop including male and

female Maori and PI well trained youth workers, practise based on research, team to assess young people and then deliver prevention/education, long term and ongoing, access the psychologist/psychiatrists, access to other specialists, more human resources available to deal with young people before they get to ideation of suicide

� �We need more residential and home centres like mental health model but a home of holistic care.�

� Te Mauri O Uenuku rasies awareness around suicide warning signs and risk factors. [The] Public Health Unit were supporting these initiatives, this work needs to be valued more.

� Rangatahi Health Centre worked well (Turanga Health)� In Rotorua there is success because everybody supported it and young people

were involved from the start.


How do we increase:1. community support for positive youth

development?2. youth participation in decision-making?3. our local knowledge base about youth health

and youth health services?4. access to high quality, youth-friendly

services?

young & healthy in tairawhiti

Health & Medicine