WSLHD Youth Health Annual Report
NSW Health WSLHD Youth Health Annual Report
ANNUAL REPORT 2021
Acknowledgements
3
Overview
4
About Youth Health
6
Our Services
8
Emergency Department Care Navigation
8
Counselling
8
Community Access Team
9
Groupwork
9
Worker on Duty
10
Medical and Nursing
10
The Middle Years Project
11
Thriving Families
11
Wellbeing and Health In-Reach Nurse Coordinator
12
Youth Transition Project
13
Youth Council
14
Future Directions
15
ACKNOWLEDGEMENTS Western Sydney Local Health District acknowledges the first people of the land. The overarching Aboriginal nation in Western Sydney is the Darug nation. We pay our respect to Elders past, present and emerging. We acknowledge the significance of land, water, spirit, kinship and culture, and the importance that these elements have to the health, well-being and future of the Aboriginal community.
Young people aged 12-24 years make up approximately 16% of the population in Western Sydney Local Health District (WSLHD). Many young people living in western Sydney experience good health and wellbeing, accessing primary and specialist (community and inpatient) health care on an as-needs basis. However, this is not the case for all young people, particularly for those who are members of priority populations, who often experience barriers to accessing the right health care at the right time.
Whilst tackling COVID-19 through testing, treating and vaccination, WSLHD Youth Health Services have continued to work towards improving the health and wellbeing of young people in western Sydney.
was an enormous year for Western Sydney.
We were faced with a global pandemic which saw our District as the epicentre of the Delta outbreak. This variant of COVID-19 placed unprecedented pressure on our health systems and further amplified many barriers young people experience to receiving the right health care at the right time. Young peoples’ health and wellbeing is influenced by a range of factors and experiences during adolescence and early adulthood. It is an important period for early intervention in health concerns, whether they be physical, emotional, psychological, cognitive and/or social.
In 2021, some of the key focuses of Youth Health Services included:
Increasing accessibility of services for young people through enhanced collaboration and training provision for non-youth health services within WSLHD, Increasing health promotion, education and early intervention through the commencement of Wellbeing and Health In-Reach Nurses in local schools, Enhancing care coordination and integration for vulnerable young people through the Emergency Department Care Navigation role, Enhancing access to youth health services for young people who identify as culturally and linguistically diverse, refugees and/or Aboriginal or Torres Strait Islander, and Improving transition care for young people with chronic conditions and/or disabilities that is person-centred, holistic and integrated. The future of western Sydney communities relies on strong, healthy and resilient young people. We are committed to ensuring that young people in western Sydney have the best opportunity to achieve their full potential and recognise that promoting health and wellbeing is essential to this.
The NSW Youth Health Framework 2017-2024 recognises the importance of ensuring young people in NSW are healthy, safe and well. It identifies three goals to achieve this:
The health system responds to the needs of young people, including targeted responses for vulnerable young people
Health services are accessible and young people are engaged and respected
Young people are supported to optimise their health and wellbeing.
The ongoing impacts of COVID-19 saw disruption to many of the ‘norms’ of young people’s lives, including opportunities to participate in traditional forms of education, paid employment, socialisation and community activities. This has particularly impacted young people’s mental health and wellbeing, driving increased demand for clinical care and peer support. To meet the growing and changing health needs of young people in western Sydney, 2021 saw multiple Youth Health services pivot and adapt to continuing providing health care and wellbeing services to our youth.
Western Sydney Local Health District (WSLHD) Youth Health services are a unit with Priority Populations, Integrated and Community Health. Youth Health services provide a coordinated, holistic and multifaceted approach to young people through early intervention, response and capacity building initiatives across WSLHD.
WSLHD Youth Health Services operate out of High Street Youth Health Service (HYSHS) at Harris Park and Western Area Adolescent Team (WAAT) situated in Mt Druitt. These sites host the following specialised services:
Services are provided to young people aged 12-24 years who are connected to the WSLHD catchment area. The primary target group for service provision is young people who are marginalised, disadvantaged or at risk, with a particular focus on young people who are homeless or at risk of homelessness. Youth Health Services provide information, support, consultation, counselling, healthcare coordination, therapeutic group work, access to dental assessment, basic needs services, medical and health promotion activities to young people in WSLHD who meet the criteria. To best meet the needs of young people these services are offered both on site and via outreach as appropriate.
EmergencyDepartment CareNavigators
The Middle Years Project
Thriving Families NSW
Wellbeing and Health In-Reach Nurses
61% of known clients identified as female, 37% identified as male, 1% transgender and 1% non-binary.
Most clients seen by Youth Health services reside in Blacktown (53%), Cumberland (16%) and Parramatta (16%) LGAs, with only 8% of clients residing outside of WSLHD area.
21% of known clients identified as Aboriginal or Torres Strait Islander. 9% of clients were born overseas.
55% of clients have had current or past involvement with DCJ.
41% of clients with a physical health condition also have multiple mental health concerns.
6% of clients identified as having a chronic illness and 4% identified as having a disability.
78% of clients who had experienced trauma also had mental health concerns.
20% of clients with mental health concerns are enrolled
but not attending school, with 48% not working or studying.
12% of clients who are homeless have physical health concerns, whilst 24% have mental health concerns.
38% of clients with DCJ involvement have multiple mental health concerns.
Counselling
Youth Health provides counselling to young people connected to the WSLHD catchment area aged 12 – 20 years. The primary target group for service provision is young people who are marginalised, disadvantaged or at risk, with a particular focus on young people who are homeless or at risk of homelessness. Young people who are marginalised tend to have poor supports, are most often isolated and generally have histories of neglect and/or trauma that increase the risk of mental health issues and suicide. Clients may present to counselling to address a range of issues including but not limited to: problems with mood, substance use, self-harm, suicidal ideation, behavioural problems, violence, emotional regulation, and family relationship problems. active clients (238 at WAAT and 123 at HSYHS). Of these active clients, 241 were new referrals in 2021. The capacity of the team was challenged across the year, with redeployment of half of the counselling team to the COVID Support Hub for several months. To meet physical distancing requirements and public health orders across COVID-19, there was a necessary reduction in face-to-face service provision. This saw the Counselling team pivot to provide alternative service delivery models including telehealth. Across 2021, 22% of occasions of services were provided through phone or audio-visual modalities. For many vulnerable clients however, telehealth was not an effective service delivery model due to access or environmental limitations. In such cases, limited face-to-face services were provided or care was adjusted to a maintenance focus until face-to-face sessions could return. In 2021, the Counselling team provided occasions of service (1,598 at WAAT and 1,008 at HSYHS) to
Emergency Department Care Navigation
The Emergency Department (ED) Care Navigation project aims to enhance health care navigation for marginalised young people to reduce re-presentations to emergency departments. The ED care navigator works with young people to improve their access to primary and community health care, reducing their reliance upon ED. This position has a focus on young people without a mental health diagnosis or who do not meet mental health service criteria to enhance access for this cohort to primary and Community Health.
In 2021, the ED Care Navigator provided
occasions of service to
active clients across WSLHD’s
Emergency Departments. Throughout 2021, the ED Care Navigator was unable to attend EDs due to the pandemic and was required to implement alternative methods of identifying and supporting patients. Whilst ED staff still notified the care Navigator of some presentations, much of this was achieved through patient screening via FirstNet and Powerchart records. Additionally, the ED Care Navigator was redeployed for a significant time to Testing and Vaccination clinics and supported Fit Testing and PPE training within ICH.
Community Access Team
Groupwork
The Community Access Team (CAT) takes a multifaceted approach to working with clients and the community in western Sydney, providing services across health care coordination (HCC), health education and health promotion. CAT provides health care coordination through case management to clients aged 12-24years. After a comprehensive Youth Health assessment, each client receives an individualised client led case plan focusing on the social determinants of health including accommodation, financial security, education, food security, advocacy, and any related health needs. Clients accessing CAT support often have and/or continue to experience a level of trauma that impacts health seeking behaviour. As a team, Community Access can assertively support clients in reaching their full potential working within the principles of social justice – equity, access, participation, and rights. In 2021, much of the HCC provided by CAT was in response to the pandemic. There was a significant amount of work undertaken in supporting vulnerable young people who were required to isolate. This included supporting access to safe housing in which to isolate and ensuring provision of sustainable food and basic needs supplies. CAT staff worked with local organisations to source food hampers and essential household items and toiletries as well as clothes and female ‘dignity packs.’ CAT also supported several other local services & teams within Priority Populations to access food hampers and basic needs hampers for their clients. CAT worked closely with the Youth Health Nursing Team and the ICH Covid Vaccination Outreach Team to enhance community partnerships and establish outreach vaccination clinics targeting vulnerable communities across the LHD. Outreach clinics were established in identified areas where clients & community members had limited access to transport and other mainstream services. In 2021, CAT provided occasions of service (358 at WAAT and 559 at HSYHS) to active clients (55 at WAAT and 48 at HSYHS).
As part of early intervention work undertaken by Youth Health, the service delivers a variety of health education groups with the purpose of delivering a harm minimisation message. These groups focus on key health areas such as mental health, sexual health, alcohol and other drugs as well as wellbeing groups such as RAGE. Groups are targeted at young people who are potentially disengaged from generic services and supports and may miss out on important health messages/ information. The provision of group work provides a supportive environment for young people who can share similar experiences and enables learning through an informal education approach. CAT saw a rise in demand for groupwork in 2021, as young people sought opportunities for social engagement after exiting lockdown in 2020. Due to ongoing lockdowns and public health orders around COVID in 2021, Youth Health attempted several on-line groups and some live streaming of programs with varied success. Youth Health delivered Health Education groups in 2021 for vulnerable and/or at-risk young people within WSLHD in a range of settings including NGOs, Youth Centres, Behavioural Schools and alternative education settings. As an extension to our Health Education groups for young people, CAT facilitated an education group for parents to Help Understand Teen Health Issues. The program helps parents learn how to talk to their adolescent children about current health issues. In partnership with the Aboriginal Health Team, the Community Access Team facilitated the Burudi Bada program which focuses on healthy eating, art, and gardening skills to increase capacity and health outcomes. Team members from across Youth Health also facilitate the Essential Youth Healthcare Skills Training which is part of the Youth Health Training Initiative. EYHS aims to develop the skills of health professionals to engage, assess and respond to the health needs and risks of young people, and to reduce barriers to young people accessing health services. Due to Covid restrictions, only one of four planned workshops were completed in 2021.
Medical and Nursing
Medical and Nursing services are provided within Youth Health Services that are specially designed for young people. Services provided include comprehensive nursing and medical health assessments, preventative primary health care (immunisation, contraception, STI testing, medical/health screening as appropriate), limited primary medical care, referrals, and nurse-led health care navigation through the ED outreach service. In early 2021, the Nursing team were focused on providing COVID-19 testing in an outreach modality. Youth health nursing staff were at the forefront of developing, implementing, and delivering pop-up testing clinics targeting vulnerable populations in response to outbreaks. After the success of the 2020 Influenza vaccination program for vulnerable populations, this was replicated in 2021 with the delivery of COVID-19 vaccinations to vulnerable cohorts. Additionally, the nursing experience in Youth health was called upon to support the ICH COVID team to establish outreach services and community partnerships, including vaccination clinics targeting housing estates, specific multi-cultural groups and other vulnerable populations. The Nursing team supported the ICH COVID team to deliver over 2300 first and second dose COVID 19 vaccinations to vulnerable and at-risk populations within the LHD, with high uptake of second dose vaccinations amongst our clients. The Nursing team also provided an opportunity for any unwell consumer to present to the vaccination outreach clinics for COVID testing whilst not mixing with the general population through targeted screening and intervention. The nursing team also worked in collaboration with the Community Access Team and community partnerships to provide food hampers for vulnerable clients presenting to the vaccination outreach clinics as well as referral to internal and external services for clients in need of further assistance.
Worker on Duty
Vulnerable and at-risk young people accessing Youth Health are some of the most disadvantaged within the Western Sydney Local Health District (WSLHD). The Worker on Duty (WOD) service provides a gateway into youth health services and acts as a point of access for support which some young people may find difficult to access through other means. The WOD is a pivotal role in supporting young people as well as a resource for internal and external services. WOD works within the Youth Health Model under the premise of “no wrong door” and will endeavour to support all those who have contact with the service. This may be with the support offered within Youth Health or with external agencies/programs. Access to this Service can be achieved in a myriad of ways including but not exclusive to primary and secondary referrals through telephone, e-referral and self-referral and via presentation to the service. Medicare cards are not required, an initial assessment is conducted, and a triage system is in place to ensure those who require a service receive one in a timely manner.
In 2021, WOD provided
occasions of service (520 at HSYHS 259 at WAAT) to
active clients (202 at HSYHS and 135 at WAAT).
Youth Health remained one of the few services that operated in a manner allowing clients to present or directly contact the service. As well as providing ongoing support to our cohort of patients, the WOD had a significant number of contacts from other service providers for support for clients who would normally be outside of our age range or catchment area. In such cases, the WOD would attempt to link these clients with appropriate services or provided one-off assistance.
In 2021, Medical provided services to
active clients (48 at HSYHS and 46 at WAAT), with a total of
occasions of service provided.
Nursing provided care to
active clients (185 at HSYHS and 117 at WAAT), with a total of
occasions of service provided.
Thriving Families
Thriving Families NSW provides targeted support to meet the needs of vulnerable young parents aged 25years and under and their children (0-5years). The project aims to enhance the wellbeing of vulnerable young families and decrease the likelihood of them reaching crisis point by ensuring young parents have access to age-appropriate, strength-based, wraparound services that meet the needs of the family. The approach includes pregnancy and post-pregnancy support meetings, outreach services provided by a multidisciplinary health team, and a dedicated care coordinator to help the family navigate the service system and build a network of supports to empower vulnerable young families and help them thrive. Prior to COVID-19 restrictions, there was the opportunity in 2021 for a parenting group to run at Riverstone Community Centre which allowed clients to seek expertise support from the Thriving Families NSW Child and Family Health Nursing and Thriving Families NSWMidwife. With the re-introduction of COVID-19 restrictions, the parenting group transitioned to an online group. Many families within Thriving Families NSW had lost their source of income or were unable to continue seeking work due to COVID-19 restrictions. Food hampers and basic need hampers were provided to clients to support them through this time.
The Middle Years Project
Youth Health, WSLHD provides Speech Pathology services to young people aged 12-24 years who are connected to the WSLHD catchment area. Services are also provided to the Middle Years Project, to students in Years 5-8 at Willmot Public School, Noumea Public School and Chifley College Shalvey Campus. The Middle Years Project recognises the “middle years” are a critical period for students as they experience physical, cognitive, social, and emotional challenges. The Middle Years Project is a partnership between NSW Department of Education, NSW Department of Communities and Justice, WSLHD, NSW Police and WentWest. The primary target group for service provision is young people who are marginalised, disadvantaged or at risk, with a particular focus on young people who are at risk of disengaging from the education system and those who have difficulty engaging and participating in their communities due to communication difficulties. Due to maternity leave, this position was vacant for most of 2021. Although several attempts to fill this position were made, this proved unsuccessful. The Speech Pathologist returned in November 2021 and was able to reconnect with schools and develop plans in conjunction with the program partners for 2022. Given the impacts of COVID-19 throughout 2021 on school attendance and operation, many identified students of the program will require additional increased interventions to support their progress.
Thriving Families in WSLHD had a total of
active clients in 2021, with
of these being new referrals.
In 2021, 43% of services were provided via telehealth (phone or audio-visual) to navigate the requirements of COVID-19. The team completed 29 Family Plan Meetings and 39 Family Plan Reviews during 2021. Thriving Families NSW evaluation was completed in partnership with UNSW in 2021, with recommendations for 2022 and beyond. This includes recruitment to a Clinical Nurse Specialist Role and a Youth Health Worker-Mental Health role to provide specialist mental health and child and family health literacy, support and education to clients and staff. Further, offering of need-based groupwork such as ‘Circle of Security’ and ‘Tuning into Kids’ will be provided to appropriate families.
Wellbeing and Health In-Reach Nurse Coordinator
In 2021, our three WHINs partnered with the following schools in western Sydney: Granville South Public School Granville South Creative and Performing Arts High School
The Wellbeing and Health In-Reach Nurse Coordinator (WHIN) program is a partnership between NSW Health and NSW Department of Education. WHINs are co-located within schools in western Sydney and work closely with the school’s wellbeing and learning and support teams. The underlying assumption is that improved access to health care will improve student health and wellbeing, which will support improved educational outcomes and engagement.
Chifley College Shalvey Campus Lethbridge Park Public School Arthur Phillip High School Fowler Road School
The WHINs provided
occasions of service to
active clients since commencing in May 2021.This is an incredible achievement in the first year of the program in WSLHD.
Youth Transition Project
Youth transition care is the process of planning, preparing and moving young people with chronic health conditions or disabilities from child to adult oriented healthcare services. Transition is multidimensional and requires a person-centred, coordinated approach that meets an individual’s developmental and psychosocial needs. Supported youth transition care improves health outcomes for young people. It prevents disengagement from health services and reduces avoidable hospital presentations and admissions. The WSLHD Youth Transition Care Project officer position secured permanent full-time funding within Youth Health, Integrated and Community Health in 2021. This position supports the development of strategy, processes and mechanisms that holistically support young people in transition care throughout the LHD. The role works closely with The Children’s Hospital at Westmead (CHW), Trapeze (The Sydney Children’s Hospitals Network [SCHN]) and the Agency for Clinical Innovation (ACI) to foster partnerships that support the transition of young people with chronic conditions in western Sydney. There are several committees, departments, advisory groups and working groups across WSLHD, SCHN and ACI that bring together key stakeholders in youth transition care for western Sydney. Some of these include: CHW and WSLHD Strategic Transition Care Committee CHW Transition to Adult Care Committee Adolescent and Young Adult Medicine (WSLHD) Adolescent Medicine (CHW) WSLHD Youth Council SCHN Youth Advisory Council
In 2021, COVID-19 brought about many challenges for young people transitioning. Physical distancing requirements and visitor restrictions impacted the ability for transition support services to accompany young people to their first appointments with adult services. Many services pivoted from face to face to telehealth appointments, impacting the ability to develop rapport and build trust between young people and their with new adult clinicians. As services were forced to reprioritise clinical services with several staff redeployed to COVID, there have been subsequent delays in transition or changes to transition pathways across the state. As some services temporarily paused clinics, closed books to new referrals, operated at reduced capacity or redefined referral criteria, there has been an increase in wait times for many clinics across western Sydney, impacting the timeliness of transition care for several young people. WSLHD, CHW, Trapeze and ACI are committed to identifying the barriers to transition and working with clinical teams across all services to improve this experience for young people and their parents and carers.
This year we said farewell to some of our Youth Council members. Thank you to the following departing Youth Council members for your enthusiasm, contributions and advocacy in 2021:
Youth Council
WSLHD places high value on youth participation to involve young people as active members of the decision-making processes for issues that affect their healthcare. The WSLHD Youth Council is made up of young people aged 16-25 years. Its role is to provide information and local perspectives to improve the quality and safety of healthcare, the provision of patient-centred and youth-friendly healthcare and improve the health of young people in western Sydney. The WSLHD Youth Council is supported by many people and roles both internal and external to the LHD. We would like to acknowledge the enormous support of the Integrated and Community Health directorate, in particular Youth Health. The Youth Council acknowledges the many opportunities and ongoing support provided by Youth Health which is integral to the success of the Council’s work. We are very thankful to the WSLHD executive team and our key partners, who work to embed consumer participation in the LHD. Above all, the Youth Council would not exist if not for the young people committed to working towards better health outcomes for other young people in western Sydney. The passion, insights and advocacy provided by this group of young leaders has led to innovative outcomes. The Council’s work illustrates the power of young people when they are supported to raise their voice.
Monique Van Acquoy
Bec Copping
Kasin Ahmet
Amar Hamed
A warmwelcome to our incoming Youth Council Members for 2022:
Diane Otim
Gauri Sharma
Goween Abdalla
Imaaz Ahmad
Haiwad Rashtia
Rebecca Yu
Ruth Wigley
In 2021, the Youth Council met virtually due to COVID-19 restrictions. The meetings provided the Council an opportunity to work on several projects to support the health of young people in western Sydney in the midst of the pandemic, including: Youth Action consulted the Youth Council on a health literacy project involving the development The Youth Council created a #NoFilterTalkBox Podcast series with our Youth Health Doctor, answering a number of health-related questions submitted by anonymous young people in western Sydney. These were posted on our Facebook page https://www.facebook.com/YouthHealthWSLHD. The Youth Council provided consultation to a range of clinical services within Western Sydney, including the development of the WSLHD Young People’s Health Strategy, development of a Youth Health Virtual Group, WSLHD Youth Mental Health services and with WSLHD Corporate Communications around youth-friendly COVID vaccination efforts and Stay at Home promotion. of online health promotion and education resources targeting several health issues affecting young people.
Youth Health, WSLHD is committed to ensuring young people aged 12-24 years have the best opportunity to achieve their full potential, by promoting and improving health and wellbeing.
Strategic priorities of Youth Health for 2022 and beyond include:
Developing and implementing the WSLHD Young People’s Health Strategy, which will identify our LHDs priorities for improving the health, wellbeing, and access to healthcare among young people across our district. This document will be based on the specific needs and priorities of local young people and the state-wide priorities articulated in the NSW Health Youth Health Framework 2017-2024. Growing the influence and impact of the WSLHD Youth Council, recognising their importance as central partners in improving youth health outcomes. Continuing to partner with health services to ensure young people are engaged and have a voice in health service design, delivery and improvement. Continuing to partner and collaborate with internal and external stakeholders to build trusting collaborative relationships with young people. This will enhance the assessment of young people’s need, provision of holistic care to young people and help young people navigate and access other parts of the health and community system. Strengthening the processes and systems that support young people with a chronic illness and/ or disability transitioning from paediatric to adult care settings, to ensure they receive effective and appropriate care, are supported to manage their care and can be as independent as possible.
There is real opportunity to focus on improving access to the right health care at the right time for young people who are members of priority populations.
ABORIGINAL AND TORRES STRAIT ISLANDERS
REFUGEES OR NEWLY ARRIVED MIGRANTS
YOUNG CARERS
YOUNG PEOPLE WHO ARE PREGNANT AND/OR PARENTING
IDENTIFY AS SEXUALLY AND/OR GENDER DIVERSE
HAVE A CHRONIC OR COMPLEX HEALTH CONDITION
HAVE EXPERIENCED FAMILY, INTIMATE PARTNER OR PEER VIOLENCE
HAVE A DISABILITY (PHYSICAL OR INTELLECTUAL)
HOMELESS OR AT RISK OF EXPERIENCING HOMELESSNESS
WESTERNSYDNEY LOCAL HEALTHDISTRICT YOUTHHEALTHSERVICES High Street Youth Health Service (HSYHS) 65 High Street, Harris Park Phone (02) 8860 2500 Western Area Adolescent Team (WAAT)
Buran Close, Mt Druitt Phone (02) 9881 1230 www.wslhd.health.nsw.gov.au/Youth-Health-services
@YouthHealthWSLHD
@westernsydneyyouth
WESTERNSYDNEY LOCAL HEALTHDISTRICT PO Box 574 Wentworthville NSW2145 +61 2 8890 9902 WSLHD-OfficeoftheCE@health.nsw.gov.au www.wslhd.health.nsw.gov.au
@WesternSydneyHealth
@WestSydHealth
Western Sydney Local Health District
@humansofthehospital
YOUTUBE
Western Sydney Health
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