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Adolescent Health 2005

What psychosocial
stage of development
does this illustrate?
Which developmental
theorist described this
stage of development?
"I would there were no age between ten and
three-and-twenty, or that youth would sleep
out the rest; for there is nothing in the
between but getting wenches with child,
wronging the ancientry, stealing, fighting.“
This is how he describes adolescents.
Fleming, T. Wood, S. (2002). Why Youth Health? In: Practice
Nurse. December 2002. See pgs … Bk. Readings).
McMurray, A. & Clendon, J. (2011). Ch. 7. Healthy
Adolescents. (pp 207-222). In: Community Health and
Wellness 4e Primary Health Care in Practice. Sydney.
Elsevier Australia
Ministry of Health.(2002) Youth Health A Guide to Action
Ministry of Health. Wellington. Ministry of Health.
Ministry of Health. (2008). Pacific Youth health: a paper for the
Pacific Health and disability Action Plan
Ministry of Youth Development.(MOYD) (2004. Youth
Development Strategy Aotearoa.
WHO (2012). Making health services adolescent friendly.
Developing national quality standards for adolescent friendly
health service. Retrieved from:
Centre for Youth Health :
Information and Youth Health Service training
(See Information for health Professionals)
The site below is currrently being updated: as at 6
Sept 2015.
 Let’s look at the health statistics at:
Instead: See some of the publications at this site:
Discuss the key social determinants of
adolescent health, risks and potential.
Discuss current major health issues for New
Zealand Youth
Outline the major barriers for youth in
Accessing Health Services
Discuss the qualities of Good Youth Health
Under-represented in health services
Social sphere they interact with is
‘At promise’ instead of ‘at risk’
Social determinants embedded in family,
school, neighbourhood and community is
crucial. Support versus failure to support
Strengths based approach
Health professionals interested in journey as
well as outcome
Most important social determinants to help
adolescent successfully navigate through this
time: family, school and social support.
Weight management and eating disorders. Quality
of family life crucial factor.
 Reduced physical activity
Strong link eating behaviours, stress and coping
Fast food outlets place for socializing
Most common eating disorders: anorexia nervosa,
bulimia and binge eating
 Linked to family conflicts and parenting styles
Compounding risks: alcohol, drug use and
tobacco smoking.
Proportion of youth who drink at dangerous
levels and engage in binge drinking is
In NZ's 50% of young men and one in three
young women aged 18-24 are considered to
have hazardous drinking patters.
Linked to unsafe sexual behaviours, MVAs
criminal behaviours and mental health probs.
In 21st century, depression considered the leading
cause of disability in world, effects 15-20%
Can also lead to some adolescents being subjected
to violence, bullying and adopting a lifestyle
detrimental to health
Social determinants of depression include family
factors, (E.g. having a mentally ill parent) interactive
relationships between parent and child.
Can lead to suicide
See Box 7.1 p 216 McMurray and Clendon (2011).
Self harm is rapidly increasing amongst
Often a repetitive act, cutting carving or
bruising parts of body,
In NZ study, 25% of female and 16% male
high-school students reported self harm
(Gardner, 2008, cited McMurray and Clendon
Over past 3 decades rates have declined.
Often warning signs: may signal their
intentions: talk of death or suicide, express
hopelessness, rage, anger, revenge or state
there is no way out.
May withdraw from friends and family
Unusual anxiety, sleep disturbances.
See Fig. 7.1 Triggers and precipitating events.
p 217 (McMurray and Clendon, 2010).
Prime Ministers initiative on better mental
health and well-being for young people.
 See Project initiatives in action
School-based health services making a
New Zealand’s young people are overrepresented in mortality and morbidity
statistics, and have high rates of preventable
diseases. The current health issues facing New
Zealand’s youth include:
 high injury rates – including injuries and
deaths from motor vehicle accidents
 high rates of suicide and suicide attempts
 alcohol and drug use and abuse
mental health problems – including increased
prevalence of depression and anxiety
sexual and reproductive health problems – including
high teenage pregnancy rates and increased number
of sexually transmitted infections
increasing rates of obesity and lower rates of physical
activity .
Pacific Youth ( see Reference List)
(Ministry of Health. 13 February 2008)
Young people aged 15 to 24 years have the highest
mortality rates for all young people and children
aged 24 years and under, and have had the smallest
improvement over the last few decades.
 The leading causes of death for youth aged 15 to 19
years are unintentional injury (38.5%) and suicide
 The leading causes of death for people aged 20 to
24 years are unintentional injury (29.6%) and suicide
 The mortality rates for Māori youth are around
twice that for non-Māori youth.
(Ministry of Health. 13 February 2008)
Youth motor vehicle crash death rates halved
in the 10 years from 1990-1999
Youth suicide figs. Trending downwards for
last 5 years.
Increased knowledge and skills re what
clinical skills likely to be effective with youth.
Youth health is taught at post-graduate level to
health professionals
Youth specific health services with emphasis
Provision of youth-friendly services by
primary care and specialist providers
Asian Youth
Risk Factors and Risky Behaviours.
By time participants were 21 years old, 17 of original
1,020 had died. 6 from road crashes, 7 were injury
related. (See pg. 31 NZ Youth health Status Report
(2015 are now 42 yrs old)
This site gives you a brief overview of the study. (for
interest only)
See pg.250-251.
The teenagers brain is not the same as adults
in the:
Ability to make sound judgement when
confronted with complex situations.
Capacity to control impulses.
Ability to plan ahead.
Pre frontal cortex is not fully mature until 30
Frontal Lobe: self control judgement, emotional regulation,
restructured in teen years
Corpus callosum: intelligence, consciousness, and self
awareness, full maturity 20’s.
Parietal Lobes: integrate auditory, visual and tactile signals,
immature till age 16.
Temporal lobes: emotional maturity, still developing age 16.
Do not assume that
risk taking in young
people equals
problematic or self
destructive behaviour.
Personal Factors : Characteristics: genetics,
sensation seeking, chronic illness, mental
health disorder. Prenatal/Perinatal stress,
early deprivation.
Family: Poverty, stress, conflict, chaos,
parental changes, abuse, neglect.
External: school failure, exposure to
violence, availability of weapons, substances,
poor skill development.
Assist in stretching boundaries
Act as diversionary or distractive behaviour
Alleviate boredom
Social connection/initiation-rite of passage
Assist in problem solving-form of action
Assist in identity formation
Testing personal capabilities & safety points
Assists in cognitive &emotional development
Matching to level of developmental
 Safe environment
 Accurate information
 Significant presence of protective
 Early intervention of adults in response
to behaviour.
Development is a life long process, what
takes place in adolescence is interconnected
with development & experiences in
childhood and adulthood.
Young people are still developing their skills
Impulse control
Complex thoughts.
Ability to spring
back in the face
of adversity.
 Lower
vulnerability in
the presence of
Personal Characteristics:
*Intelligence, locus of control, self esteem
*Parents presence &connectedness
*Connectedness to other adults, school,
neighbourhood, peers.
Significant and multiple
Lowest rate of physician visits
Gray (1994) – 50% of young people had
wanted to access a health service in the
last 6 months but had not done so. Why?
Has it improved since then?
Experiential exercise. (Make you own
notes re. barriers after this).
 Availability
 Visibility
 Locally delivered
 Quality
 Affordable or free
 Easy to Access
 One stop shop:
 Staffed by people
who can relate to
young people
Who are:
Non judgemental
Maintain Confidentiality
Maintain Privacy
Are culturally
Reference: MOH.
(2002).Youth Health.
Guide to Action. P. 17
What Works.
Programmes that are:
focus on improved social
involve family and consider the
social contexts
are coherent and easy to use
this requires professionals to
redefine roles and to be youth
Specialist Nurses at The Youth Health Clinic in
South Auckland at the Centre for Youth Health
Ministry of Health. Nurse Led Clinic: Youth
Health. South East City Primary Health Org.
Capital Health Wellington MOH.(2005).
Youth Health Hub at 18 Lincoln Road.
Hayter M; Harrison C (2008). Gendered
attitudes towards sexual relationships among
adolescents attending nurse led sexual health
clinics in England: a qualitative study. Journal
of Clinical Nursing; 17(22): 2963-71 .
Have a look at the film on
this site:
 CPAG film "Nurturing our
future. See under
In the next session we will develop skills and
knowledge required to work effectively with
young people.
See Lecture 2.
The resources in the next few slides for
interest only. Check them
out if you want to know more than
the “Must Knows” in the present Part
One of this Youth health Workshop
Summarize the main points for yourself here.
If you have time: check out this TED talk on
the adolescent brain.
Making health services
adolescent friendly
Developing national quality
standards for adolescent friendly
health services
Department of Maternal, Newborn, Child and
Adolescent Health. (2012)
Open Youth Mental Health Project Initiatives
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