Professor Philippa Collin [00:00:21] Good afternoon everybody and welcome to the Wellbeing Health and Youth NHMRC Centre of Research Excellence in Adolescent Health Webinar for July 2023. My name is Professor Phillipa Collin. I'm from Western Sydney University, I co-lead the Young and Resilient Research Centre within the Institute for Culture and Society, and I'm also a stream leader in the Wellbeing, Health and Youth CRE and it's my pleasure to be chairing this webinar. 

Professor Philippa Collin [00:00:53] We'd like to acknowledge the funding support of the NHMRC and the contributions of our research partners in universities across Australia that make our work possible. And we also acknowledge the traditional owners of country throughout Australia and recognise their continuing connection to land and water and culture. I'm joining you today from Westmead on the lands of the Dharug people and I extend my respects to elders past and present, and I also want to acknowledge any Aboriginal and Torres Strait Islander people who are joining us today. And also I want to acknowledge Aboriginal and Torres Strait Islander young people whose health we all work towards, noting that we can’t have health equity for all until we reckon with our settler colonial past and present. And I invite all of you who are here today to add into the chat an acknowledgement of the Aboriginal lands that you are working on and joining us from today. 

Professor Philippa Collin [00:01:59] So, this webinar series is part of the Wellbeing Health and Youth Centre of Research Excellence Community of Practice. Our intent with the Community of Practice is to bring together researchers, clinicians, policymakers and young people to share ideas and exchange information. And we invite you at the end of this webinar to check out more of the resources that we have on our website. During the webinar, we ask that you mute your microphones and have your video switched off. But if you'd like to say something throughout the webinar or indeed ask a question, you can use the chat panel on the right hand side. We'll have some time for questions and answers at the end of the webinar. And so I really strongly encourage you all to add your questions and ideas into the chat. 

Professor Philippa Collin [00:02:55] But now it's my absolute pleasure to introduce and welcome Dr. Benjamin Hanckel. I'm particularly excited because Ben is a long time and valued colleague of mine. He is associate sociologist at the Institute for Culture and Society and the Young and Resilient Research Centre at Western Sydney. His research examines youth health and wellbeing, social inequalities and health and social change with a particularly strong focus on the design and the use of digital technologies for wellbeing. Ben is also a past convenor of the British Sociological Association Youth Study Group and a convenor of the LGBTQI Conversation Group within Health Systems Global. He's been an incredible advocate for youth studies research both here and in other countries overseas and around the globe, as you can see. And we're very, very happy to be hearing from you today. Ben, welcome and thank you. 

Dr Benjamin Hanckel [00:03:59] Great. Thank you very much, Pip. And a huge thanks to Pip, Sharon and the team at the Wellbeing, Health and Youth CRE. for inviting me today. I really appreciate the invitation and I'm looking forward to sharing some recent work that I've been working on. Just before I begin, I just wanted to acknowledge that I'm on the ends of the Dharug people today, and I want to acknowledge Indigenous people past, present and future elders who are here with us today and whose lands we are on. 

Dr Benjamin Hanckel [00:04:36] Okay, so I wanted to but what I'm going to be talking about today is about a recent project that I've been working on with some really great collaborators of mine, looking at how young people support their friends through tough times and really trying to investigate how young people are accessing and engaging with informal support. But I begin, I just wanted to acknowledge those collaborators. So that includes Tom Riley and Steph Vassiliou at Batyr, which is a peer mental health foundation, as well as Erin Dolan, who is a clinical psychologist at Kiran Dolan and Associates, as well as Jasbeer  Mamalpurath and Amelia Henry, who are my colleagues here at Western Sydney University. So it's very much an interdisciplinary collaboration, which I hope everyone will find interesting as I kind of talk through some of the research and data from today. 

Dr Benjamin Hanckel [00:05:35] Okay. So what I want to do first is give a bit of an overview and picture of where young people are at the moment to provide some context to where this research is taking place. We know that young people experience and report mental health difficulties and distress across Australia. We know that's the case with higher rates than any other age group, particularly in relation to increasing rates of depression and distress. We know at the same time young people and this is happening contextually within a series of what's being called intersecting crises, and so those crises are COVID 19, the climate crisis, cost of living, precarity and housing unaffordability, for example, alongside persistent structural inequalities related to class, gender, sexuality, socioeconomic status, creating and exacerbating some of these tough times that young people face. So the rise in difficulties experienced, I think, necessitates a focus on the types of care and support young people are able to access in responding to tough times. So what is it that they're actually accessing, looking for, and how might we understand the types of support that they are getting and receiving? The focus of this paper, as I've said, is on informal support that young people provide their friends. 

Dr Benjamin Hanckel [00:07:04] So help seeking includes both the formal services, so professional services and informal supports that are accessed by young people when they're going through tough times. To date, much of the literature has focused on formal support pathways, so that includes responding to barriers, to accessing mental health services, such as concerns of stigma and trust in professional support. And we know the barriers can lead to low rates of help seeking from professional sources and prevents disclosures around suicidal ideation. But I guess the broader literature has really focused on how do formal support pathways transition young people into programs and services. And much of this literature or much of the existing formal support that is available is very structured, the timing is very set in place and it's often inflexible and this often includes formalised peer support or peer based models as well. And so informalised peer based models have shown there are benefits definitely for the supported and the supporter. Formalised peer support programs often offer young people supervision and assistance to ensure safety within their support roles. While such formalised mechanisms have been shown to be important, there's actually been less of a focus on informal support provision for mental health, which is where I want to focus this discussion today. 

Dr Benjamin Hanckel [00:08:32] We know friendships and peers provide critical psychological and emotional support roles as young people transition from dependence to independence. Young help seekers report peers and friends as important and often the most likely avenue when they reach out for help. So I guess there's been limited research on specific health provision practices for those young people who are providing the support. But we do know that young people do take on help provision roles to support their friends. There are concerns about young people who are taking on these help provision roles around youth burnout, there's limited mental health training that they have beforehand to do these roles, as well as concerns about young people feeling responsible at times for their friends, which then goes on to impact their own mental health and wellbeing. We know this kind of help provision occurs across online and offline spaces amongst peers, that often young people are less likely to tell an adult or encourage a peer to seek help because of concerns about breaching trust and or confidentiality of their friends or perceiving that their friends tough time is not their story to tell. So often they don't tell an adult when their friends are telling them in informal settings about their experiences. 

Dr Benjamin Hanckel [00:10:01] So more broadly, in addition to all of this, I guess, is that this kind of sits against a backdrop of young people who are often positioned as at risk and passive recipients of expert care. This is in contrast to them being considered for their own expertise in help seeking pathways who have critical expertise to add, and, as these studies suggest, are active participants in caring for their friends. To this end, the team and I wanted to better understand the expert roles that these young people take on in providing care to their friends and how that takes place through a form of friendship and care. 

Dr Benjamin Hanckel [00:10:41]  In terms of the research focus, we're really interested in examining what informal support looks like amongst friends and then what more needs to be done through young people's experiences. To this end, we had three research questions we're asking: are young people supporting their friends through tough times and what does that look like? second question, what ways young people provide this support what are their practices, how are they doing, and thirdly what acceptable resources do young people need in place to support this work? So really interested in how these practices emerge and what that looks like for them. 

Dr Benjamin Hanckel [00:11:24] So this research took place from March to July 2022, so last year. It took place following COVID isolation measures in Australia, which I think is worth noting. We saw young people from Australia who are 16 to 25 years old, who had experienced supporting a friend in the past. We took a mixed methods approach, so this involved a national survey with 169 young people and focus groups with 34 young people from across Melbourne and Sydney. In terms of recruitment, we tried to advertise the study widely through Facebook, Instagram, LinkedIn and Twitter, so through social media sites as well as send it out to youth services and organisations to disseminate the recruitment information throughout their networks. I'll talk through this in a moment, but the goal really was using a mixed methods approach enabled us to understand, I guess, what was taking place, how often, and then kind of take that back into discussions with young people and draw that out and ask, tell us more about how this happens in practice and how this happens contextually for you? 

Dr Benjamin Hanckel [00:12:39] In terms of the survey, as you can see here, it ran from May to June last year. It included 169 young people. We pilot tested it with 14 young people who also edited the survey with us as well. They range from 16-19 , 78 people, 19 to 21 years, 33. And then over 22 we had 58 young people and we had a tick all that applied when it came to ethnicity and race, with young people reporting being Australian, European, Asian and or South Asian. And we had young people from most places across Australia and in terms of gender we had 87 people who identify as female, 25 male and 16 non-binary and or gender fluid. And in terms of the sample it was almost split half between heterosexual and non-heterosexual. 

Dr Benjamin Hanckel [00:13:43] In terms of the survey questions, the survey included mostly discrete variables. One measure the Natural Helper, a scale which was developed by Stalin, Hall and Hill, and I will talk through that shortly when I'm going through the findings in eight open text responses where we asked young people to find a tough time, to explain times when providing support had been easy and or difficult for them when they access support themselves, and if they did what would be considered acceptable support to them. 

Dr Benjamin Hanckel [00:14:19] We had five focus groups in total with 34 young people. We sampled young people from east Melbourne and western Sydney specifically, and those spaces were chosen specifically because of the variations in socioeconomic status as well as cultural diversity of both areas. We had 17 young people from western Sydney and 15 from south and eastern Melbourne. The focus groups  included diverse young people from each location in terms of ethnicities as well, so that included South and Southeast Asian, European, Indigenous and white Australian respondents. We had 19 women, 13 men and two non-binary and/or gender fluid respondents. 

Dr Benjamin Hanckel [00:15:02] In terms of the way that we operated with the focus groups, it  took place throughout the period in which the survey was being completed. And so we were taking results from the survey back into the focus group and asking questions about the findings that were happening now. We had a pre group activity for each focus group where young people were asked to watch two service provider videos on YouTube which provide guidance for informal support. And then we asked them in the focus groups whether that reflected their experiences or not and why, and to talk us through what their practices looked like every day. And there were similar experiences across the group. As well as that each focus group had what we call an iterative prototyping co-design component, and that was really just asking what needed to be done to support young people who were young supporters or providers and reimagining and validating the proposed solutions from one focus group to the next, and just asking the next focus group if they saw the same solutions as being as beneficial as the previous group as we went through there, and it's a method I've used in the past which is quite productive for working through possible solutions to problems or challenges people face. 

Dr Benjamin Hanckel [00:16:20] And then the final focus group was completed after all the surveys were closed and that focused on validating findings from across the data set and the ideas presented across focus groups and survey data and ensuring it was aligned with young people's experiences and what they felt the types of work that they did as young help providers. 

Dr Benjamin Hanckel [00:16:51] So, to get into the findings. At the start of the survey, we asked young people to define a tough time. This definition describes tough times for the young people in the study. It illustrates the ways young people are talking about the varied ways tough times impact emotional wellbeing and mental health outcomes. So as you can see here, and I will just read through, we compiled this from all the definitions that were submitted:

"Tough times are where circumstances in your life are dragging, weighing you down, where you feel like you are surviving but not living. Your brain is under strain. Life is testing your resilience and you feel like giving up as life feels like a chore."

"Tough times can be struggling socially, emotionally, financially or physically, where relationships are hard and you feel alone or unseen."  

"Tough times leave you be feeling lonely, sad, depressed, stressed, anxious, overwhelmed, uncomfortable and empty." 

"Tough times can be acute or chronic and is a challenging time where I need the support of others." 

Dr Benjamin Hanckel [00:17:54] . So I think it's worth keeping this definition in mind as we go through the next few slides and think through how young people are supporting their friends through tough times and what tough times mean to them. 

Dr Benjamin Hanckel [00:18:09]  Supporting friends. So young people reported on average supporting their friends about 3.5 hours per week, which equates to about 182 hours per year. Of the sample, 94% had provided support to friends with mental ill health. When we asked who provides the most support to a friend, 76% of people in the survey said it was friends, followed by mental health professionals at 57% and then parents and guardians 41%. And being a supporter was seen as being a definition of a good friend. And I think this is really interesting because I want to think through as we talk through this and maybe this will come out in the questions today or following discussion about the entanglement between support, care and friendship, which is something that I really want to focus on as we move through this. And Shalani provides an example of this. "I think like being a good friend actually means that you should be there for them or you should at least want to be there for them and see what ways to support them. Like, even if it's not what they need, at least having that intention to want to help them when they're in a low, like when they're stressed." In a very similar way Mackenzie notes. “Yes, I think it's easier and less confrontational talking to friends rather than family or professionals.". So you see this role of friendship as being critical and important to the young people in the study. 

Dr Benjamin Hanckel [00:19:40] We also asked about their capabilities to support friends, so this comes back to the validated measure that we used in the survey, the Natural Helper scale. So on the Natural Helper scale, which measures how capable young people felt to help their friends, young people reported medium and high scores, indicating that they did feel capable to support their friends. So there is a capability or awareness and ability to support friends. Interestingly, 87% of young people likely to access support were likely to access support for themselves while supporting their friends. So young people would be likely to access that support through a peer or friend, a parent or carer, or less likely through professional support. And 22% actually spoke about reaching out to support themselves after they'd supported a friend. So we see this, and I guess this is why I've got this icon here, this kind of interesting cyclical kind of relationship here between supporting friends, but also being supported when you're supporting friends as well, often through a friend, which I think there's something interesting here about the role that friendships play in creating space and expertise for providing support. And I have an example here, I guess, of how one young person navigated this. So this is Ash:  "When supporting my friend. I wouldn't say who the person is to my other friend. I'd probably say, What would you do if someone came up to you and they said, like, what would you do about that? What would your approach be? I wouldn't say the name just in case that person didn't want other people to know or something like that, or just you're not going to create any awkwardness. I probably just make it a hypothetical, even though I know that I was talking about a real situation." This is a way to these conversations and get expertise and information without necessarily exposing the friend. There's this kind of trust and confidentiality and maintaining that trust and confidentiality which sits behind a lot of this support and friend help provision. And I want to kind of think through this as we keep talking as well. 

Dr Benjamin Hanckel [00:22:05] When asked how they support their friends, young people consistently responded that it depends. Young people are providing their friends with this personalised support, and this personalised support requires tailoring responses based on individual needs, situations and context. So you have Shalani here who says, "I feel like it's just sort of a case by case basis because I think it depends on the type of stress, tough time and also how close you are to the person". Malis says, "I think it just depends on the person and sort of like their approach to certain things. It also just depends on the context." And then Ruth says, "It really depends on the friend, how close you are and the way they prefer to communicate”. And just make note, this is the answer when we ask the question, what do you have to do when you support a friend or what does that look like? And it becomes very much about, Oh, it depends. It's on a case by case basis. 

Dr Benjamin Hanckel [00:22:55] And so this is where we see the emergence of what we're calling the bespoke model, this kind of personalised support which considers the very nature of friendships, their friends, differing needs, the context and situation to provide a tailored approach to support. And I want to talk through how this emerges over the next few slides. But just to go around the circle that we have. So personalised support depends on whether you're alone with someone, you’re in groups, whether it's in a public place. It depends on whether it's online or offline, it’s often a mix of both. It depends on your capacity to respond, your own health and well-being and your ability and knowledge to be able to respond to another young person's or your friend’s needs. The time in which it's taking place. So it depends on whether there's other structures like their classroom settings, which impact the time in which you can kind of ask about help, but also depends on whether it's in the present or whether it's a future time in which you're creating space for your friend to talk. It depends on cultural factors. They talk about how they very much take into account peers and friends cultural identities and ethnicity. Depends on the closeness of a friend as well as the severity of the issue. And then what you do about it is a combination of these aspects of personal  life support. 

Dr Benjamin Hanckel [00:24:29] Our next question then kind of became how then do you enact bespoke support? What does that look like as this happens? This a bit of a road map this next slide as to where we're going in the next section of the talk. But I want go through what happens when young people are starting to identify and support a friend: noticing something is wrong when they start a conversation, how they provide the right support, determining whether a friend needs external support and how they manage their own self-care and feelings, responsibility for the support that they provide their friends. 

Dr Benjamin Hanckel [00:25:14] To start with noticing when support is needed. So to identify if and when a friend needs support, young people spoke about how they would often identify inconsistencies and or changes in a friend's routine, behaviour and or mood. This would often signal they might be going through a tough time. So Josh here says "it could just be something like them not being as talkative as usual or maybe sitting in the back of the classroom and they may sit at the middle two desks or something. And then like when we're talking about texts, you know, sending really short messages just straight up. Yes. No messages kind of thing instead of longer messages." So they're really attuned to their friends practices and their rhythms and when things seem off. So in a similar way, Lara  talks about online spaces. So Lara says here, "normally I can tell when my friends have had a tough week, especially over social media, because you can tell by how much they're active and when you like, for example, with Snapchat, send each other photos back and forth, and you can just kind of tell like from those photos." So such inconsistencies in friend's patterns, rhythms and routines when noted across online and offline settings, as Lara indicates here, where young people would be interacting with their friends often on a daily basis. And they're very aware how this might be an indication of their friend's mental health or the tough times they might be experiencing and might be a time to approach a friend and engage with them and see if they need support. 

Dr Benjamin Hanckel [00:26:53] So when recognising a friend may need support, young people spoke about the careful ways they created spaces to be available for conversation with friends. So this often meant having careful conversations where Padma explained, "you kind of tailor the conversation to what they need and what they require most". Omar as well, like others, spoke about starting an open conversation about something else because people are usually not comfortable with giving an answer straight away. So you start off with something outside of what's the issue, maybe about a game or something else until it feels comfortable enough”. And I think there is some gendered aspects to this to kind of talking about supporting a friend and moving into a discussion about mental health. But everyone spoke about the need to kind of tailor the conversation to fit the person and pad the conversation initially at the start, often to then go into a more of a deeper conversation if your friend wanted to, about providing support and then kind of almost finishing the conversation with something more jovial or joyful that would bring your friend's mental health back up or make them feel kind of relief coming out of that deeper conversation. That's the way they kind of framed it. 

Dr Benjamin Hanckel [00:28:17] And it's worth also noting that places were carefully chosen as well. So at school, for instance, young people would talk about finding private spaces to discuss over lunch, some people spoke about choosing the end of the school lunch bench where they could have a private conversation or walking to a classroom in between classes to check in with friends. And such conversations were happening across school via text message. One person said discussion started on the train on the way home, and then he and his friend continued those discussions over a text message once they got home. But they spoke about it also happening when they're going on walks on weekends via direct messages on social media or when they were driving as well. So these kind of conversations are happening in a lot of places, but there's these careful strategies behind the conversations and I guess the emotional labour that young people are putting into making sure that their friends are in an okay space, but they carefully move into those conversations. 

Dr Benjamin Hanckel [00:29:19] Also, interestingly, they spoke about asking more than are you okay? So in having these conversations, young people emphasised it was, as I said, asking more than just are you okay? Ash, for instance, said explicitly that it requires asking more than a kind of empty question about are you okay. It requires being a lot more specific and directing questions with a bit more intent. It came out in the interviews and in the focus groups and discussions about you have to be able to express genuine care and Ash continued, "it requires these specific directed questions". Ruth  said this in a similar way: "I like to check in with how people are feeling. It's like if someone gives you the blanket, I'm good. How are you? You have to go. No, actually, how are you going? Like what's been going on? How are you feeling today? Tell me what you've been up to. I find that's a really good way to sort of break through and get people to open up." So there's this kind of emotional you could call it emotional labour or like strategies that are in place to get their friends to open up and to have some of these conversations about the tough times that they might be experiencing and how they can support them in some way. 

Dr Benjamin Hanckel [00:30:41] So letting your friends know you are available also served the purpose of letting your friend know that you're available in the future. So when I mentioned the kind of time or temporal kind of aspects before, this was about saying, Yes, I'm here now, but if you're not okay to speak now, we can also speak in the future. Kylie said, "If they brush you off, they still kind of remember you as a person willing to listen to them when they are ready to open up, which I think is important”, she says. "Just like saying, hey, are you okay? 'm here for you if you need me saying, like, I've noticed you've been doing this. Just let me know. I know you might not be open to talk about it right now, but maybe we can have a conversation in the future." This kind of idea of, I guess, like planting a seed and providing young people with a space with friends to know that you will be there at a future point. And I think this time or temporal dimension is really interesting and kind of this indication of it being available for the future. Some people spoke about this as being on standby, and if they need to provide more direct support, they'll be on standby and ready to do that when that is required. So Malis, for instance, said, "I think it's really important to sort of be on standby, so just be sort of there for your friend and just listen to them if and when they need it." And being there on standby, kind of being present when a friend was going through a tough time or ready for a future presence when they're needed. And in terms of being needed, support kind of came up in the data set as both emotional and material. So the support often that was provided was emotional support. But young people also spoke about how the provision of support also involves sharing or providing additional material resources, which included housing support, direct financial support, as one young person put it, cash support, and another person provided some financial support for a friend when she lost her mum or it could be a resource that they couldn't easily access, such as an Uber or taxi to get home when a tough time or threat was an immediate concern. And so Caren provided this example here. She said, "My friend had issues in a past relationship, there was violence involved and I got a message at 2 a.m. that said, I'm leaving my girlfriend's house like I'm going to go home. And then it was like, okay, I've been drinking, I can't come get you, but I'll jump in an Uber, what do you need it went straight there rather than sort of just like, oh well, your partner shouldn't have done that. It was like, okay, let's get you out of harm's way. And then when you're ready, we can talk about what happened and what you need and what we can do in the future and things like that". So this idea that I guess support can be both emotional and material. So Karen here mentions how she's immediately supporting her friend as well as being prepared for a future conversation as well, where she will be able to have an ongoing conversation about this to support her friend as and when she needs it. 

Dr Benjamin Hanckel [00:33:46] And people also created spaces for their friends to be vulnerable and use listening as a critical practice when providing support. One aspect of supporting friends was to, as Ruth said, to validate how they feel. And as Ari says here, "remind them their issues are valid and heard". Others contrasted listening as a particular practice, even though sometimes they wanted to provide a specific solution to a friend's problem. As Malis said, "I think a lot of the time someone wants to feel comfortable opening up. It's like sometimes they don't need a solution to the problem. They just want to be able to be vulnerable and sort of have that emotional support". And the young people we spoke to are very aware of this, of creating these spaces where young people could, I guess, feel a sense of vulnerability or have a space to be vulnerable, but also be validated as well. 

Dr Benjamin Hanckel [00:34:43] Feedback or solutions were offered some of the time, but again, it was dependent on the friend and situation. For instance, Geeta provided solutions when she knew a friend would be willing to take feedback on of any kind. Karen reflecting on some of their friends noted that they're fairly knowledgeable in what ails them, but less so about what to do about it, and indicated it can sometimes be useful to share the free resources that you can access with them. And I'll come back to the resources shortly. 

Dr Benjamin Hanckel [00:35:13] In addition to the support and the strategic conversations they were having, there was also the ongoing checking in after having some of these conversations. So some people had very planned check ins. Sometimes someone would say, okay, after two weeks and checking back in with you after a month, I'm checking back in with you. They also might be checking in with them after they've seen a therapist or checking in to confirm they're okay after a moment of support. It often involved a lot of humour, you know, light-hearted general check ins and videos, gifs, emojis. Some people spoke about having whole conversations with gaffs and emojis on their direct messages on social media. And part of that, I think, was taking away the seriousness of it, but also doing check ins with friends. And it’s probably not that surprising but checking in became quite commonplace during COVID, and some people spoke about this kind of COVID check in fatigue that had happened during that time. But because of the circumstances and isolation, a lot of people were checking in with friends during that time. 

Dr Benjamin Hanckel [00:36:24] Just some quotes to illustrate check ins. Shalani here: '"I'll just give them a call a couple of times a week or however much they need and just like follow up, I guess because they obviously felt comfortable enough to tell you they've started seeing someone, a therapist, I'll follow up with them." And Ruth talks here about how this has to be done carefully, Ruth says "maybe check in later, but not like constantly hassling them to respond". So there’s this careful kind of friendship. Check in, but not overdoing it as well, which seems to come out here. 

Dr Benjamin Hanckel [00:36:57] They also spoke about the role of culture. And this was quite interesting because maybe it talks to the ethnic and racial diversity in the sample, but also the awareness that a lot of young people's backgrounds who are their friends and how they wanted to be conscious of that. So they spoke about how they tried to take into account the complex histories of mental health and how it might be understood culturally differently by friends and families. Young people were careful not to generalise based on culture, rather, culture was positioned as one part of a personalised support that had to be considered when supporting their friends. So this was part of this bespoke model. Shalani says here, "thinking about cultural values as well, because I feel like sometimes, depending on the culture of the friend, or like the values that they've been brought up with that can sort of determine what they need as well to like help with things". So there was a consciousness there about the types of solutions they might offer or the types of reactions they might have to some of the ideas that were presented. 

Dr Benjamin Hanckel [00:37:57] They also spoke about wanting to have the right knowledge for the situation and specifically actively seeking out information that could help their friends or themselves as supporters when they need to. So when young people did not have the lived experience to draw on that was related to a friend's tough time, they often spoke about actively seeking out information to better understand what their friend was going through. Shalani here talks about, "So it's more the things I personally have an experience of I don't or something that I haven't had the experience of before, saying I go and seek out information, look things up, as they say. And then Padma kind of in a similar way talks about “the number of times I've gone on to Google to just be like how to support a friend whose pet has just died or something like that. Like, I just google everything because I don't know what else to do". So there's this kind of active seeking out of resources and information to support young friends as well as ensuring they have the best possible information to give their friends the information that they need. 

Dr Benjamin Hanckel [00:39:06] In terms of professional services and where fit into this mix. When professional services were engaged with and these were varied, it might be best conceptualised along a spectrum from providing a friend with professional resources or contacts to specifically reaching out to an adult or professional on their behalf. So you see here what I guess we can read down the bullet points, which kind of are the spectrum. So it could be anywhere from finding online resources and forwarding those details to a friend and lists of accessible professionals. Some people took a friend along to a mental health professional or actually organised and called a mental health professional to organise a visit for them. Whereas others would talk to someone in their immediate family or network to get their friend the support they needed. So this was often considered a last resort, but definitely happened. And just on this last point, I think Lara's example is quite interesting about how she navigates this space between talking to an adult and still kind of maintaining the confidentiality and trust of a friend, and the tensions that arise in doing that. So as she says, "this is going to make me sound like a terrible person. But I've had friends who have kind of confided in me about like issues, and they’ve obviously not told their parents. But I have said to their parents, oh yes something's up, you know, she's really something might not go well. And then they've gone on to like seek therapists and things like that outside of school and outside of that just with the family thing". So interesting kind of tensions and difficulties, I think, that are experienced in providing this support. 

Dr Benjamin Hanckel [00:40:44] Talking to adults more generally, and I want to focus in on this because there was quite a bit of discussion and back and forth about the tensions of talking with adults and the limitations and possibilities of that as well. So they avoided mostly unnecessary engagements with adults as they had been entrusted with the support of their friends and often adults were seen as not understanding mental health more generally. They were also worried that adults, particularly in school, would unnecessarily escalate the issue or paradoxically not treat it as important enough. And they often spoke about school counsellors who could go either way but would be a concern for friends who are going through tough times if they spoke about it. 

Dr Benjamin Hanckel [00:41:32] However, there was a bit of a threshold for seeking professional help. So these two quotes give an indication of how this threshold works. "When that friend has exhibited signs of extremely dangerous mental health related behaviour, I know I do not have the proper qualifications to help them. I refer them to professional help and try to step back from helping them". And this other person says "nothing has ever stopped me. I always help my friends. The only exception is when I can tell it's really serious and we need professionals to get involved. So I try not to get too attached so the person will accept professional help". 

Dr Benjamin Hanckel [00:42:23] Just to go back one slide that last point from the quote at the bottom where the person says, I try not to get too attached so the personal will accept professional support. There's this focus on attachment and detachment and self-care that also came up in the dataset. And I want to just focus on that for a moment. So young people across the findings spoke about how they need to ensure they have the capacity and that their own well-being is met before they support their friends. Often this was learned from taking on too much previously when they didn't have the capacity to support their friends. And so this was one of the reasons they often chose not to support their friends or they created some boundaries around when that friendship could be engaged with. This was about self-care. So for Jay here, they say "so you feel responsible. I definitely learned that one person cannot do everything. You have to understand that you need to like, step back and while you know you feel honoured, I guess to be that person, you can't be that person 24/ seven and you need to know where your boundaries are". So it's kind of about setting boundaries. In a similar way and this is where I guess it's about self-care and not supporting at times. Celine said,  "Ultimately you can help your friend, but then you have to make sure that you're okay first to do that as well". And Ash said, "I think another important thing is being able to say no to friends that are going through tough times. And I know that probably sounds counterintuitive, but when you're in a really bad headspace yourself trying to help someone else, when you're really feeling like in my experience, I've been to really low points and then all the friends have been like, I am feeling like this. And I'm like, Look, I don't know what you want me to do. I'm not doing so well and that kind of stuff". And I think that's a really interesting kind of learned behaviours or practices here about how to kind of push back and present in a way that you can provide and not provide support at particular times. There was also the fear of not saying the right thing to a friend when you want to reach out for support. So you just wouldn't support in those circumstances and you wouldn't even stop those careful conversations because you would be worried about putting the friendship in jeopardy. And then that other aspect of not supporting was when systems or infrastructures didn't allow you to create or engage in that support such as digital devices in schools not being provided or not allowing digital devices to be used, which then stops access to such support. 

Dr Benjamin Hanckel [00:45:00] Pip, I'm seeing you on the screen, I'm nearly done. Ari sums it up here by saying "I feel like giving support, it's 's not a formulaic thing". So this brings us back to the bespoke model. So just very quickly, young people are tailoring care to respond to their friend’s needs. This is not one moment of care, but ongoing kind of online and offline care, which relies on a bespoke model of care designed to respond to individual friend’s needs. So this logic of care relies on careful negotiations, considerations of where their friends are at and care is relational in this way and not time bound. And it's co-produced with friends, as I've said before, is entangled with friendship. So it's situational, it takes place with the resources that people have access to. But I think also pushes back against these youth at risk models and actually locates young people as experts of care. And I think actually it can teach us quite a bit about the kind of expertise or logic of care that can help us in our practices as well. And I wanted to finish, I guess, with this point about how we see young people being very careful in implementing bespoke models, are engaged in this emotional work, it's there because the current systems don't always meet their needs. The formalised adult led interventions don't always meet the needs of what they want. Adults are often seen as not able to understand necessarily the mental health or tough times they're experiencing. And it's not a time bound service, but something that young people can support each other doing. And I think that there's something for us to learn through that, but also understand how young people are  navigating this space. So I will stop there.  

Professor Philippa Collin [00:46:56] I was also really struck by the sophistication of what the young people that you spoke with had to say, and particularly the way that they're grappling with actually a lot of complexity and a lot of uncertainty in that care work. I mean, as you said, I think we appreciate the way in which you've drawn out the ways in which they have this expertise or are experts in care. I guess, to kick us off, I just wanted to ask, to your final point around the whilst they do draw on professional resources and encourage their friends to access professional services, there are some tensions around that in terms of what they see the benefits being. But there's also that other issue around access to professional care. So given the amount of work that young people are doing, what can we learn from this in terms of, I guess, not overburdening young people in this care work and making sure that there is that kind of scaffolding of services and professional help that reflect the kind they’re after. 

Dr Benjamin Hanckel [00:48:24] So that's a good question. But also, I think a big question. There's a couple of things here. I think there's a recognition of the way that services are already difficult to access at times. Some people don't already know about what services are available as well. So that's kind of like one part of this equation that's kind of happening. Young people are struggling to locate, identify the best resources that are out there. They're using those resources that they have. Some young people said, we don't have all the resources that we need, so I wouldn't necessarily know where to send my friend. But in most cases they had some ideas on where they could send their friends. To the second part of your question about what we can learn through this process and not overburdening young people. I think it's a tough question. I think they are aware of taking on too much responsibility and I think this is the kind of question you're asking how do we learn from that? And I think it's about ensuring they have the capacity and capabilities to be able to either step back or connect them to those services that are available and know of those services where they are and the resources that are available. And if there are online resources, for instance, being able to connect people to these online services. 

Professor Philippa Collin [00:50:14] What was their experiences in an emergency. So I think there was one example which started to speak to this, but could you talk more about what you found from the research in that regard? 

Dr Benjamin Hanckel [00:50:46] There's a bit of a threshold as I was talking about before so that when the young people would come to them seeking their support in for instance like you say an emergency or a period where they wouldn't be able to deal with it, then they would escalate the issue. The escalation would often happen through someone they trusted, and that would often be a either service provider or an adult in that situation. There’s this threshold where once it becomes past the point at which they can't deal with it or they need to provide something to their friend, they would seek out resources and or adults quite quickly and connect the young person to that as a resource. It wouldn't be something that they would necessarily sit on, but they would assess the situation. We spoke about it when we were developing this research and report as triaging. So young people are involved in a lot of triaging to something, whether it's to services, to further discussions with them, to support of some kind, and this would be part of this triaging process. I think there's space to enhance capacity and capabilities of young people to do this triaging work. And maybe that's about ensuring they have the resources, not necessarily through formalised settings. It can be just so they have that kind of informal support in place and the resources, but it would be so they triage more effectively perhaps. But then it comes back to Pip's, I think, original question. What happens when there's limitations in the services or services are currently dealing with capacity issues, where do they go? 

Professor Philippa Collin [00:52:28] Harvey has a question just about the relationship between the survey and the focus group data and the way in which you worked with those different data. Could you say a little bit more you mentioned the way in which you worked with, it could you expand on it, explore some of those things. What Harvey's asking is if you used a process of triangulation or something else to kind consider the more nuanced data in the focus groups in light of the survey? 

Dr Benjamin Hanckel [00:53:13] Yes. So the short answer is that there was a lot of back and forth between the survey and the focus groups. What we did was we started the focus groups and then developed the survey based on what we were hearing in the focus groups. I think we'd already done two focus groups by the time we developed the survey and then got feedback from the young people. And as we were hearing results coming out of the survey, we took those into the focus groups and we did a final focus group after the survey had finished to validate the findings that we're hearing and clarify anything that was still outstanding that didn't seem to be either matching up or whether there were tensions or challenges that we just wanted to kind of work through in the final focus group.   

Professor Philippa Collin [00:54:23] I'd like to end with a question on the recruitment process and then the role of friendships and informal support in the general sector more broadly, because I think that sort of is like one of the big insights from this research. And I guess what I'm thinking there isn't much of a space for friendship oftentimes with some of those other supports and resources, particularly professionals and adults and young people's lives. So if you could tackle the recruitment one and then perhaps speak to this question of the role of friendships to take us out. 

Dr Benjamin Hanckel [00:55:12] In terms of recruitment, we recruited across social media channels. We did use a little bit of paid advertising so that the project was funded in part by Batyr and in part by internal Western Sydney University funding as well, the Vice-Chancellor's Research Fellowship that I had. And so we used some of that funding to support some recruitment advertising. But we also sent those posters that we developed through youth organisation networks and channels that we had access to and through the youth sector. Some of you may have actually seen it when it was going out. We tried to spread it as widely as possible, but for the focus groups, because we focused in on western Sydney and east and south Melbourne, we sought out youth organisations in those spaces and schools to try and push out the recruitment into those spaces where young people might already be accessing some of the services there. 

Dr Benjamin Hanckel [00:56:15] In terms of the second question about how we might think about the role of friendships and informal support. I think it's a good question. I guess I put it up as a provocation I think it's a difficult one to locate where friendships might kind of fit within the mental health sector because these are important for the young people that we spoke to. So what we've done, I'm just kind of flicked back a couple of slides here. I don't know if everyone can see this, but we've got some general recommendations and some clinical recommendations. So the general recommendations talk to emphasising the importance of friendship and I guess enhancing the capabilities and capacities of both service providers and parents and I guess teachers and educators as well in recognising the importance friendship plays in supporting friends and ensuring that they have the resources to support each other. The clinical recommendations talk to how this actually might be brought into the clinical setting. So how can we bring young people and the friendship, and sometimes the friends, into the clinical setting with young people, recognise the role friends might play in actually setting up clinical encounters so engagements with psychologists and counsellors, as much as asking about friends in the clinical setting itself. We've developed up a tip sheet as well that might be for service providers to give young people who are in those clinical settings to tips to think through how they can support their friends, if their friends are going through tough times, because the people who are seeking therapists, counsellors, in those clinical encounters, they might be both friends who are being supported as much as they are friends who are supporters as well. So recognising those dual roles that people play I think are really critical. 

Professor Philippa Collin [00:58:40] Thank you especially for walking us through the research and the findings there were quite a few comments from people very appreciative of the level of nuance and insight that this research has provided. I think we'll also be able to share after the webinar, the links and the information to the report so that people can look that up, especially those tips and recommendations on the clinical findings. So thank you very much for a really fantastic webinar. We'll see you all again next month.