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BRIEF INTERVENTION KIT

SAFE AND HEALTHY BODIES This kit guides schools on encouraging young people to optimise their wellbeing by supporting and improving their physical health.

headspace National Youth Mental Health Foundation Ltd is funded by the Australian Government Department of Health under the Youth Mental Health Initiative Program.

The SAFEMinds (Schools and Families Enhancing Minds): Supporting Victorian Schools to Intervene Early in Mental Health Project is funded by the Victorian Government Department of Education and Training.

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…changes in mood and behaviour that may indicate a child or young person is having difficulties managing emotional distress

…sensitively and competently about the child or young person’s circumstances

…appropriate first steps and possible referrals within or outside school setting to support the child or young person

NOTICE INQUIRE PLANNIP IT IN THE BUD!

SAFEMinds is a partnership between:

SAFEMinds is a partnership between:

INSTRUCTIONS

INSTRUCTIONS

Why Use the Safe and Healthy Bodies 3 Brief Intervention Kit in Schools?

Using the Safe and Healthy Bodies 4 Brief Intervention Kit

Tips for Engagement and Motivating Change 5

Confidentiality 6

Implementing the Safe and Healthy Bodies 6 Brief Intervention

WORKSHEETS

STEP 1: Introduce Safe and Healthy Bodies 7

STEP 2: Explore Sleep Habits 8STEP 3: Explore Diet Habits 9STEP 4: Explore Exercise Habits 10STEP 5: Summary and Goals 11STEP 6: Finishing Up 12APPENDIX A: Safe and Healthy Bodies Action Plan 13

FACT SHEETS

The Facts About Sleep 14The Facts About Diet 16The Facts About Exercise 18

CONTENTSWHY USE THE SAFE AND HEALTHY BODIES BRIEF INTERVENTION KIT IN SCHOOLS?With one in four young people experiencing mental health problems during adolescence it is important there are simple and effective interventions available in schools to optimise young people’s mental health. One way to achieve this is to use the Safe and Healthy Bodies Brief Intervention Kit to help young people understand the connection between their physical and mental health.

BENEFITS Emerging evidence suggests that brief interventions are useful

for those experiencing mild to moderate symptoms of depression and anxiety but they may also be beneficial to most young people1.

The delivery of this brief intervention does not require diagnosis or rely on clinical training or expertise.

The Safe and Healthy Bodies Brief Intervention Kit is economical and accessible in a school setting.

The brief intervention promotes self-efficacy and good life skills regardless of the individual’s situation.

The brief intervention aligns to key concepts and skills taught in the Health Knowledge and Promotion section of the Health and Physical Education AusVELS standards.

LIMITATIONS Evidence of the effectiveness of brief interventions in adolescent

cohorts is promising but still emerging.

The success of the brief intervention requires collaboration from the young person.

The brief intervention requires an adult to lead the discussion with the young person.

The brief intervention cannot replace appropriate case management of complex mental health issues.

The brief intervention is not appropriate as a stand-alone treatment for young people.

KEY MESSAGES TO BE REINFORCED THROUGHOUT THE SESSION There is a well-established relationship between positive physical

health and enhanced mood.

Sleep problems are common for people with mental health problems; particularly those suffering from depression or anxiety.

Symptoms of mental health problems can be made worse by poor sleep habits.

Sedentary behaviour is associated with poorer mental health and evidence suggests that increased levels of exercise can positively impact on mood and general wellbeing.

Emerging evidence suggests there may be an association between diet quality and adolescent depression2, highlighting the importance of diet in adolescence and its potential to modifying mental health over the life course3.

There are a range of recommended guidelines in relation to sleep, diet and exercise for children and adolescents to ensure they are looking after their physical and mental health.

Tracking sleep45, diet6 and exercise7 patterns against recommended guidelines can be useful in identifying problems or issues.

Creating a tailored Safe and Healthy Bodies Action Plan seeks to address physical health issues which may be contributing to low mood and/or emotional distress.

Monitoring progress helps to determine whether the young person is developing a pattern of restricted eating or over-exercising.

1 Parker et al, The effectiveness of simple psychological and exercise interventions for high prevalence mental health problems in young people: A factorial randomised controlled trial. Trials 2011, 12:76

2 Jacka et al 2010, Aust & NZ J of Psychiatry, 44: 435-442, Associations between diet quality and depressed mood in adolescents: Results from the Australian Healthy Neighbourhoods Study3 Jacka et al 2011, PLoS One, 6(9): e24805, A Prospective Study of Diet Quality and Mental Health in Adolescents4 raisingchildren.net.au/articles/sleep_early_teens.html

5 raisingchildren.net.au/articles/promoting_good_sleep.html/context/1069

6 eatforhealth.gov.au

7 health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines

Help a young person understand the connection between physical and mental health

Provide an opportunity for a young person to review their own behaviour in relation to physical health

Provide an opportunity for a young person to make a commitment to take action to improve their physical health

Help improve a young person’s overall mood and mental wellbeing by enacting these changes

THE SAFE AND HEALTHY BODIES BRIEF INTERVENTION KIT IS DESIGNED TO:

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SAFE AND HEALTHY BODIES BRIEF INTERVENTION KIT

INSTRUCTIONSINSTRUCTIONS

USING THE SAFE AND HEALTHY BODIES BRIEF INTERVENTION KIT

TIPS FOR ENGAGEMENT AND MOTIVATING CHANGE

The Safe and Healthy Bodies Brief Intervention Kit may be used as an aid for wellbeing staff in a one on one session or in a classroom setting to promote physical and mental wellbeing. It is designed for use with young people from upper primary and secondary year levels.

Wellbeing staff may use the Safe and Healthy Bodies Brief Intervention Kit with a young person who is struggling to cope with emotional distress and requires additional support. In these circumstances it should be administered by staff predominantly engaged in wellbeing roles (wellbeing coordinators, school nurses, year level coordinators, leadership staff, Student Support Services, primary welfare officers etc.). Treating young people with respect and engaging them in the process of change is essential. It is also important to assume that young people are doing the best they can to manage the situation.

The Safe and Healthy Bodies Brief Intervention Kit may also be used within a health class for students to check their health status and initiate discussions about the importance of developing healthy sleep, diet and exercise habits.

This brief intervention does not replace the need for a more thorough physical and psychosocial assessment for young people that present with emerging mental health symptoms. A referral to external health providers should be considered in these circumstances.

For advice regarding management of self harm in schools refer to the Responding to Self Harm in Schools Flowchart or guidance available within your state or sector (Victorian Government schools – education.vic.gov.au).

This Safe and Healthy Bodies Brief Intervention Kit does not include questions relating to suicide risk. If suicide ideation is intimated, no matter how often or how vague, a suicide risk assessment should be conducted by an appropriately trained person within the school setting. (Victorian Government schools should refer to: education.vic.gov.au/Documents/school/principals/health/suicideguidelines.pdf).

APPR

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Build rapport and express empathy – the cornerstones of all effective change conversations Listen carefully to the young person’s concerns and their physical health goals. Provide guidance and reassurance. Young people are still developing the skills they need to regulate their emotions

and make thoughtful decisions.

Work collaboratively Avoid being overly directive or confrontational as this is likely to increase resistance.

Consider a harm-minimisation approach Encourage the young person to cut back or reduce a particular behaviour as a useful first step. If the young person is

engaging in unhealthy behaviour (e.g. all night gaming, alcohol and drug use, excessive caffeine or sugar intake etc.), it may be unrealistic to expect a young person to change all of their behaviours at once.

ENG

AGE Develop collaborative relationship with the young person

Create a safe environment and develop alliance through collaboration, exploration and respecting autonomy.

Support and affirm Encourage the young person’s participation and interest in proposing strategies for change.

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Develop discrepancy Aim to develop a sense of discrepancy between how the young person sees their current situation (poor physical health

habits and low or erratic mood) and how they would like it to be.

Promote ‘Change-talk’ Use open ended questions which invite the young person to consider aspects of change (e.g. How might you like things

to be different? If you did decide to change, how could you do it? What reasons do you have as to why you want to change? How important is it for you to make the change about your…? What do you think you will do?).

Responding to ‘Change-talk’ (moving towards change) Respond by asking for them to elaborate, affirming the young person’s position, reflective listening, reframing

and summarising the young person’s arguments for change.

Responding to ‘Sustain-talk’ (sustaining current behaviour) Respond by emphasising personal choice and control while using simple and complex reflections. This is the opposite side

of the ‘ambivalence’ coin.

Roll with resistance Don’t argue for change and avoid using coercion, warnings or scare tactics. If the young person expresses resistance

(i.e. arguing, interrupting or ignoring) try doing things differently.

PLAN

Recognise and consolidate commitment to change Assist the young person to maintain motivation to change by exploring options and negotiating a change plan.

Promote self-efficacy Aim to develop and increase the young person’s confidence that making and maintaining change is possible (e.g. brainstorm

goals and develop strategies to achieve them, beginning with ones that are easily attainable in order to build confidence).

The following tips8 have been adapted from a Motivational Interviewing Approach to guiding behaviour change in young people. The aims of motivational interviewing are to assist people to change their behaviour whilst respecting the person’s choices about the change.

8 Evidence Summary: The effectiveness of Motivational Interviewing for young people engaging in problematic substance abuse, headspace.org.au/what-works/evidence-maps

Summarise comparisons between young person’s physical health patterns and recommendations

Brainstorm health optimising activities with the young person

Record agreed actions to optimise physical and mental wellbeing

Agree timeframe for follow up discussion on progress

Ask a range of specific questions relating to the sleep, diet and exercise habits of the young person

Compare young person’s results to recommended guidelines to identify potential areas of concern (i.e. sleep, diet and exercise patterns do not meet recommended guidelines)

EXPLAIN RATIONALE SUMMARISE

Explain the relationship between mood and physical health

Engage young person using motivational interview techniques to invest time in the exploration of their sleep, diet and exercise habits

IDENTIFY ISSUES

THE SAFE AND HEALTHY BODIES PROCESS

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WORKSHEET


INSTRUCTIONS

CONFIDENTIALITY

IMPLEMENTING THE SAFE AND HEALTHY BODIES BRIEF INTERVENTION

INTRODUCE SAFE AND HEALTHY BODIES Confidentiality is a major concern for young people. Many young people may be concerned that what they say will be shared with their parents, friends, or other people within the school. It is important that confidentiality is discussed from the outset of the session and revisited as necessary throughout any discussions with the young person.

Confidentiality means that what is discussed with the young person is not repeated to others, unless it is deemed to be helpful and there is expressed permission from the young person. The three main exceptions where it may be necessary to break confidentiality are when:

The young person is at risk of harming or killing themselves.

At risk of harming someone else or committing a serious criminal offence.

If they are being threatened or harmed (physical/sexual abuse) by someone else.

This is called ‘conditional confidentiality’.

Teaching professionals are also subject to Mandatory Reporting laws in suspected cases of child abuse and neglect (only mandatory for a young person under the age of 16).

It may also be that disclosure is necessary in order to obtain information from other agencies or to engage other agencies to support the young person. A release of information form would need to be signed by the young person and their parents or carers to facilitate this process.

RAISING AND DISCUSSING CONFIDENTIALITY Ask the young person their understanding of confidentiality.

Explain confidentiality and the limits to this. Confidentiality must be assured and limits to confidentiality discussed.

Discuss consent to contact other sources when necessary.

Decide with the young person what issues will be discussed with parents or carers and how parents or carers may be involved. This is dependent on factors such as age, living arrangements, cultural expectations and the level of autonomy and closeness within the family.

NB: Personal information provided by the student during this session should be held in private storage according to the school’s document management policy if any of the information is retained within the school.

DUTY OF CARESchools are committed to providing safe, secure and stimulating learning environments for all students. It is fundamental to acknowledge that each teacher is a vital source of support and influences the success and wellbeing of their students.

School staff are bound by legislation and held to a high standard in relation to caring for their students. This is called ‘duty of care’ and means that you need to take all reasonable steps to prevent any foreseeable health and safety risks to the young people in your care. This includes, but is not limited to:

Providing suitable and safe premises.

Providing an adequate system of supervision.

Reporting incidents where you believe the student is at risk outside of the school setting.

Implementing strategies to prevent bullying.

To implement the Safe and Healthy Bodies brief intervention you will need to arrange a 30–45 minute session with the young person. It is also important to ensure that the venue for your meeting is safe, private and comfortable and that you will not be interrupted.

Begin the session by acknowledging the reasons for meeting and ensure the young person understands how confidentiality works. Talk a little about how they are feeling and then introduce Safe and Healthy Bodies, explaining the rationale for using it.

Safe and Healthy Bodies is not designed to be used during the first contact with a young person, rather as a tool for a follow up session.

An initial session is required to determine if the Safe and Healthy Bodies Brief Intervention Kit would be a helpful tool to the student of concern. It is also important to ensure the young person is willing to engage in the process – do not force or coerce the young person to take part. It can be helpful to consider when doing the session might be most beneficial to the young person.

SUGGESTED PHRASE“ I am aware you have been having a tough time lately. One of the things that sometimes helps when you are having a tough time is to have a look at how you are taking care of your physical self. Looking after your body by exercising regularly, eating well, getting regular sleep and reducing stress can really improve the way you feel and think. This is especially important if you are going through a tough time – or recovering from one.” 9

CONFIRM HOW THE SESSION WILL RUN“ So, what we could do is run through a series of questions about your sleep, diet and exercise patterns and have a chat about how these may be affecting your mental wellbeing at the moment. I can tell you a little more about how your physical health can impact on mood and then maybe we can talk about what you would like to do next. I will take a few notes so we don’t forget what we’ve discussed.”

INVITE YOUNG PERSON TO PARTICIPATE “ So I wonder if it this sounds useful – would you like to give it a go?”

If schools do not exercise this duty of care, they may be liable to potential legal claims of negligence.

As part of your duty of care, you also need to be careful when offering advice to young people. It’s important that you limit your advice to areas within your own professional competence and within the role that has been allocated to you by your principal. It’s important that you ensure that the advice you give is correct and in line with the most recently available policies from your school, State Government or education sector (Victorian Government schools should refer to the School Policy Advisory Guide – education.vic.gov.au/school/principals/spag/safety/pages/dutyofcare.aspx).

1 Introduce the Safe and Healthy Bodies Brief Intervention

2 Explore Sleep Habits

3 Explore Diet Habits

4 Explore Exercise Habits

5 Summary and Goals

6 Finishing Up

THERE ARE SIX KEY STEPS TO IMPLEMENTING THE SAFE AND HEALTHY BODIES BRIEF INTERVENTION SESSION:

NOTES Insert notes in this section about young person’s background or previous session details that may be relevant to the Safe and Healthy Bodies session

9 Youth Beyond Blue Factsheet, Staying Healthy, youthbeyondblue.com

1STEP

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WORKSHEETWORKSHEET

EXPLORE SLEEP HABITS EXPLORE DIET HABITS A good night’s sleep helps both mental and emotional resilience, while chronic sleep disruptions could increase negative thinking and emotional vulnerability.

PROMPT QUESTIONS In the past two weeks on average how many

hours of sleep are you getting per night? Do you often have trouble getting off

to sleep? Do you often have trouble waking up? Do you have interrupted sleep (wake in the

middle of the night and have trouble getting back to sleep)?

Do you feel refreshed when you wake up? Doyouhavedifficultystayingawakeduring

the day? Have your sleep patterns changed recently

(i.e. getting more or less sleep)? Do you have any electronic devices in

your room? What is your pre-sleep routine?

(Exercise/food/TV etc.)

A well balanced diet provides all the essential nutrients needed for your brain to function well; helping to keep you both physically and mentally healthy.

PROMPT QUESTIONS Can you tell me what you had to eat today?

What does your average breakfast, lunch and dinner consist of?

Do you snack between meals?

Do you drink caffeine? If so how much per day?

Do you drink energy drinks or soft drinks? If so how many per day?

Do you drink alcohol? Smoke?

Have you tried or used drugs? What have you tried lately?

Do you ever skip meals? If so how often?

How much water do you drink each day?11

10 sleepeducation.net.au/sleep%20facts.php 11 Better Health Channel, betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Alcohol_and_teenagers

3STEP

2STEP

GUIDELINES/RECOMMENDATIONS

Hours of sleep – Primary school: 10–12 hours per day. High school: 8–10 hours per day.

No TV/computer games one hour before bed. No TVs in bedrooms.

Monitor mobile phone use in bed.

No coke/caffeine, high sugar or spicy food 3–4 hours before bed.

Ensure relaxing and regular bed time routine – relaxation techniques such as breathing.

No vigorous exercise one hour before bed – it raises the body temperature.

Finish eating 2–3 hours before bed – digestion competes with sleeping – hot milk is OK.

Make sure the bedroom is comfortable (temperature, light, noise).

Bedtimes and wake times – try and keep these regular10.


Eat regularly throughout the day.

Choose less refined high sugar foods and drinks and more wholegrain cereals, pulses, fruit and vegetables.

Include protein at each meal.

Eat a wide variety of foods.

Include oily fish (omega 3 fatty acids) in your diet.

Maintain a healthy weight.

Maintain adequate fluid intake – drink at least eight glasses of water per day and limit caffeine intake.

The safest level of drinking for teenagers is no drinking, especially for young people under 15 years of age. If older teenagers do drink, parents can minimise the risks by providing adult supervision and encouraging consumption within the adult guideline for low-risk drinking (two standard drinks in any one day).

NOTES NOTES

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WORKSHEETWORKSHEET

EXPLORE EXERCISE HABITS Physical exercise is not only good for your body; it can positively impact on your mood and general wellbeing.

PROMPT QUESTIONS How would you categorise your level

of activity in the past two weeks? (Very active/Active/Not Active)

Do you walk to school, walk the dog or participate in a team sport?

Do you engage in any regular exercise? If so what form of exercise?

How long is each session of exercise? How often?

How would you rate the intensity of this exercise? (Low/medium/high)

Who do you exercise with? (Alone, in a team, with friends, with family etc.)

If you are not involved in any exercise – why not?

How much time do you spend watching television or on your computer after school?

4STEP


Young people aged 13–17 years should do at least 60 minutes of moderate to vigorous intensity physical activity every day.

Physical activity should include a variety of aerobic activities, including some vigorous intensity activity.

Engage in activities that strengthen muscle and bone at least three times per week.

Do more activity – up to several hours per day for additional health benefits.

Minimise the time they spend being sedentary every day.

Limit use of electronic media for entertainment (e.g. television, seated electronic games and computer use) to no more than two hours a day – lower levels are associated with reduced health risks.

Break up long periods of sitting as often as possible.13

13 health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines#apa1317

SUMMARY AND GOALS Many young people do not recognise unhelpful or dangerous lifestyle patterns because they see their activities as simply part of a young person’s lifestyle. The challenge lies in helping the young person to see health risk-taking behaviours as problems and then identifying alternatives ways to cope and behave.

5STEP

GUIDELINES FOR SUMMARY DISCUSSION

Ask the young person to provide an overall summary of the sections. In most cases there are strengths and potential, as well as problem areas.

Discuss the benefits of improving overall physical wellbeing in terms of health, lifestyle and mood. Focus should be on the areas where the young person did not meet the recommended guidelines for optimum wellbeing.

Set specific goals with the young person – ensuring the goals are small/achievable to start with to build confidence.

Discuss how they will track their progress and whether they would like a follow up session to review their progress and adapt or set new goals.

Ensure the young person builds in some small rewards for themselves as they reach their wellbeing goals.

Use the Safe and Healthy Bodies Action Plan in Appendix A to make notes and any actions the young person commits to.

Consider using popular phone apps that might chart a young person’s sleep, diet and exercise, for example, ‘Sleep Cycle’ or ‘myfitnesspal’.

PROMPT QUESTIONS Ok so can you share with me your understanding about the connection

between sleep, diet and exercise and mood? (Fill in any gaps in understanding using information from the fact sheets on sleep, diet and exercise).

Can you recall a time when your energy levels or mood were better than they are now?

Can you identify any behaviours in relation to sleep, exercise or diet that might have been different to what they are now?

In reviewing your own behaviour in relation to sleep, diet and exercise; can you see any opportunities for change which may enhance your physical health now? Are you ready to change?

How do you plan to start making change?

When are you planning to begin some of these new activities?

What will you do to reward yourself if you achieve your goals this weekend/week/month?

NOTES NOTES

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WORKSHEETWORKSHEET

SAFE AND HEALTHY BODIES ACTION PLANAAPPENDIX

AREAS FOR IMPROVEMENT

ACTIONS TO IMPROVE WELLBEING (What are you planning? Who will support you?

How will you remember?)

BY WHEN?

SLEE

PD

IET

EXER

CIS

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FINISHING UP At the conclusion of the session review what has been said and ensure there is a clear plan for what happens next.

Are there any follow up sessions?

Do others need to be informed/involved in supporting the young person to achieve their goals?

What will they do when another problem arises?

Who can they talk to for help in the future?

Suggested phrase for concluding final session:

“ So we have had a chat today about how your body and your mind are connected and the way that taking care of your body actually helps the way you feel overall. Taking care of our body – is also taking care of our mind. You have agreed on some things that you can do to help yourself and I think it’s really important that you stick to these things, and notice the effects they are having on how you are feeling. Sometimes these changes take a little while to kick in. It takes a bit of effort but in the end is really worth it. You have shown great courage today in looking at the things that might be contributing to your situation, and I really think if you stick to your plan, you have the power to change your situation for the better. I would be happy to meet with you again in [XXX weeks] to have a chat about how you are feeling after putting some of your actions in place.”

6STEP

NOTES

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FACT SHEETFACT SHEET

THE FACTS ABOUT SLEEPTHE FACTS ABOUT SLEEP

Sources

This information has been adapted from Dr Sarah Blunden’s Adolescent Sleep Facts Sheet, sleepeducation.net.au/Docs/Adolescent's%20Sleep%20Facts%20Sheet.pdf

THE IMPORTANCE OF SLEEP

Sleep is important for physical and mental health. All body systems involved in either physical or mental health do not function well without sleep.

Sleep is important for the body to rest and repair its systems.

Sleep happens in two stages, non Rapid Eye Movement (non-REM) sleep and REM sleep.

Non-REM sleep occurs in four stages and is vital to get the body systems rested, this process is called homeostasis. A growth hormone is also produced during non-REM sleep, which causes children to grow and develop.

REM sleep allows us to dream and studies have shown that dreaming allows us to learn. People who don’t dream or get REM sleep will not learn as efficiently.

HOW MUCH SLEEP DO YOUNG PEOPLE NEED FOR OPTIMUM PHYSICAL AND MENTAL HEALTH?The current thoughts are that teenagers need about nine hours per night. Most teenagers get between 7–8 so they are in ‘sleep debt’.

TECHNIQUES TO IMPROVE SLEEP1. Psychological – Are they worried, stressed, anxious or depressed?

This can be addressed by talking with a mental health professional, school counsellor or even a good friend. Relaxation and exercise are excellent ways of learning to relax the mind and the body so sleep is easier.

Routine is important – going to bed and waking at the same time every day helps establish a pattern.

2. Physiological – (Body and physical health)

Are they sick? If so, it is important to see a health professional.

There are other physiological reasons for poor sleep – it is worth speaking to a health professional if other factors have been ruled out.

3. Environmental and behavioural – Are they ready for sleep?

Is the room too dark or light or noisy or hot?

Have they had too much coffee/energy drinks throughout the day?

Avoid heavy exercise three hours prior to bed.

Turn off all screens at least 30 minutes prior to sleep.

POSSIBLE REASONS FOR DISRUPTED SLEEP PATTERNS IN YOUNG PEOPLE1. Circadian (sleep/wake) rhythm factors

During adolescence there is a delay in the time when melatonin (one of the hormones which makes us sleepy) is released from our brains to our bodies. This may mean that adolescents are not tired until later in the evening and may then find it hard to get up in the morning.

2. Social changes and pressures

Adolescents have a lot going on in their lives (phone, TV, jobs, social activities, school, sports, more homework, worry). Sleep is sometimes low on the priority list and is often given up for these other things.

SLEEP DEPRIVATION AND SCHOOL BEHAVIOURThe prefrontal cortex is an area in the brain that controls important tools in the body that affect learning.

This particular part of the brain needs lots of sleep to function efficiently. When the prefrontal cortex is affected by a loss of sleep, people can find it difficult to:

regulate learning

regulate emotions and behaviour

remember or concentrate on information

plan ahead.

These effects are cumulative, meaning that a person will not just suffer from one effect of sleep deprivation, they will all pile up, decreasing their knowledge base.

If learning becomes difficult due to lack of sleep a young person may become frustrated and lose motivation to continue.

EFFECTS OF SLEEP DEPRIVATION Sleep deprivation may affect the following areas:

Physiological/Physical health (cardiovascular and endocrine systems).

Psychological (emotional and mental health).

Psychosocial (behaviour, peer relations, family relationships).

Cognitive (learning, attention, problem solving).

PSYCHOLOGICAL EFFECTS OF SLEEP DEPRIVATION Depression

Anxiety

Mood swings and changes

Increase in frustration

Decreased ability to concentrate resulting in the decreased ability to learn

PHYSICAL EFFECTS OF SLEEP DEPRIVATION An increase in accidents, resulting from clumsiness.

Increase in obesity; lack of sleep mixes up your appetite hormones so you feel hungry when you shouldn’t.

Sickness; the immune system cannot be repaired and rested, resulting in decreased efficiency.

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FACT SHEETFACT SHEET

THE FACTS ABOUT DIETTHE FACTS ABOUT DIET

Teenage boys and girls aged 14 to 16 are eating only half the recommended serves of fruits and vegetables per day.

(2007 Australian National Children’s Nutrition and Physical Activity survey)

EATING WELL

Good food is important in maintaining mental health as well as physical health. In general eating a nourishing diet can improve your overall sense of wellbeing.

Eating well means having a wide variety of healthy foods including plenty of vegetables, fruit and cereals (like bread, rice and pasta), some lean meat, chicken or fish, dairy products (milk, yoghurt, cheese) and lots of water. It’s a good idea to avoid fatty foods and foods with lots of sugar in them. Excessive dieting and over-exercising may put young people at risk of developing an eating disorder.

There are some excellent resources out there which provide detailed information about the mental health benefits that certain foods provide. Here is a good place to start: Beyond Blue Fact Sheet #30 Healthy Eating for people with depression, anxiety and related disorders beyondblue.org.au/the-facts/recovery-and-staying-well

This fact sheet has been adapted from the following sources:

Youth Beyond Blue Factsheet, Staying Healthy, youthbeyondblue.com

Jacka et al 2010, Associations between diet quality and depressed mood in adolescents: results from the Australian Healthy Neighbourhoods Study, Aust & NZ J of Psychiatry, 44: 435–442, 2007

Australian National Children’s Nutrition and Physical Activity Survey – Key Findings, health.gov.au/internet/main/publishing.nsf/Content/phd-nutrition-childrens-survey-keyfindings

Feeding Minds: The impact of food on mental health, mentalhealth.org.uk/content/assets/PDF/publications/Feeding-Minds.pdf?view=Standard

AUSTRALIAN DIETARY GUIDELINES 1–3

1. To achieve and maintain a healthy weight be physically active and choose amounts of nutritious food and drinks to meet your energy needs.

Children and adolescents should eat sufficient nutritious foods to grow and develop normally. They should be physically active every day and their growth should be checked regularly.

2. Enjoy a wide variety of nutritious foods every day from these five food groups.

Vegetables, including different types and colours

Fruit

Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley

Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans

Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat

Dink plenty of water

3. Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.

Limit intake of foods high in saturated fat such as many biscuits, cakes, pastries, pies, processed meats, commercial burgers, pizza, fried foods, potato chips, crisps and other savoury snacks.

Replace high fat foods which contain predominantly saturated fats such as butter, cream, cooking margarine, coconut and palm oil with foods which contain predominantly polyunsaturated and monounsaturated fats such as oils, spreads, nut butters/pastes and avocado.

Limit intake of foods and drinks containing added salt.

Do not add salt to foods in cooking or at the table.

Limit intake of foods and drinks containing added sugars such as confectionary, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks.

If you choose to drink alcohol, limit intake. For women who are pregnant, planning a pregnancy or breastfeeding, not drinking alcohol is the safest option.

FOOD AND MOOD There is evidence of a relationship between diet quality and emotional adjustment.

Greater fruit and vegetable intake is associated with a lowered risk of depression and general distress.

The association between diet quality and depression has been established over and above socioeconomic and family factors.

FOOD AND THE BRAINWhile genes and environment play an important role in brain development, diet is another factor that influences the health of the brain. This is partly because much of the brain’s structure is derived directly from food. So it is easy to see why what we eat will have a dramatic effect on our thoughts and feelings. Just as the products that we put into a car affect its performance, so the engine of our thoughts and feelings is designed to work most effectively when certain nutritional requirements are met.

The brain is acutely sensitive to what we consume in our daily lives. To remain healthy, it needs different amounts of the following essential nutrients:

Complex carbohydrates

Essential fatty acids (EFAs)

Amino acids

Vitamins and Minerals

Water

ALCOHOL AND DRUGSTaking drugs or drinking alcohol has negative effects on the mind as well as the body. They can contribute to, or trigger, mental health problems in some young people. If a young person has an existing mental health problem using alcohol or drugs can cause more problems than either issue on its own. The safest level of drinking for teenagers is no drinking, especially for young people under 15 years of age. But if older teenagers do drink, parents or carers can minimise the risks by providing adult supervision and encouraging consumption within the adult guideline for low-risk drinking (two standard drinks in any one day).

MYTHS ABOUT DIETThere are lots of myths about healthy food. Don’t make food choices based on false beliefs. Suggestions include:

Compare the prices of junk foods against the price of healthier food options to see that ‘healthy’ doesn’t always mean ‘expensive’.

Experiment with different foods and recipes. You’ll soon discover that a meal cooked with fresh ingredients always beats a limp burger or soggy chips.

Try different ‘fast’ options like whole-wheat breakfast cereal, muesli, wholemeal bread, wholegrain muffins, fruit, yoghurt or pasta.

Don’t think that your diet has to be ‘all or nothing’. Eating well doesn’t mean you must be a health food freak. A good diet allows for treats occasionally.

CAFFEINECaffeine is a stimulant drug that acts on the brain and nervous system. In small doses, it can make you feel refreshed and focused. In large doses, you are likely to feel anxious and have difficulty sleeping. Like many other drugs, it is possible to develop a tolerance to caffeine, which means ever greater doses are needed to achieve the same effect. Caffeine intake should be investigated if a young person is showing symptoms of irritability, inability to sleep, interrupted sleep or stomach upsets. Energy drinks typically have more caffeine and sugar than soft drinks.

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FACT SHEET

THE FACTS ABOUT EXERCISETHE FACTS ABOUT EXERCISE

EXERCISING WELL

Sedentary behaviour is associated with poorer mental health and evidence suggests that increased levels of exercise can positively impact on mood and general wellbeing.

AUSTRALIA’S PHYSICAL ACTIVITY AND SEDENTARY BEHAVIOUR GUIDELINES

FOR YOUNG PEOPLE (13–17 YEAR OLDS)

Being active is important for everyone. Keeping physically active and limiting sedentary behaviour is not always a priority for young people, but it is important. These guidelines are for all young people, irrespective of cultural background, gender or ability.

Physical activity guidelines

For health benefits young people aged 13–17 years should accumulate at least 60 minutes of moderate to vigorous intensity physical activity every day.

Young peoples’ physical activity should include a variety of aerobic activities, including some high intensity activity.

On at least three days per week young people should engage in activities that strengthen muscle and bone.

To achieve additional health benefits young people should engage in more activity – up to several hours per day.

Sedentary behaviour guidelines

To reduce health risks, young people aged 13–17 years should minimise the time they spend being sedentary every day.

Limit use of electronic media for entertainment (e.g. television, seated electronic games and computer use) to no more than two hours a day – lower levels are associated with reduced health risks.

Break up long periods of sitting as often as possible.

This fact sheet has been adapted from the following sources:

Physical Activity Guidelines for Young People Aged 13–17, health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-phys-act-guidelines#apa1317

Exercise and Depression Fact Sheet, The Black Dog Institute, blackdoginstitute.org.au

Parker et al, The effectiveness of simple psychological and exercise interventions for high prevalence mental health problems in young people: a factorial randomised controlled trial. Trials 2011, 12:76

The make your move – Sit less – Be active for life! brochure (PDF 401 KB) | HTML presents the guidelines and provides further information and advice about physical activity and sedentary behaviour (sitting) for young people.

EXERCISE AND THE BRAINResearch suggests that regular exercise may increase the level of brain serotonin, a neurotransmitter involved in regulating mood, sleep, libido, appetite and other functions.

Exercise can also increase the level of endorphins in the brain which have ‘mood-lifting’ properties.

REGULAR EXERCISE MAY ALLEVIATE SYMPTOMS OF DEPRESSION BY: Increasing energy levels

Improving sleep

Distracting from worries and rumination

Providing social support and reducing loneliness if exercise is done with other people

Increasing a sense of control and self-esteem, by allowing people to take an active role in their own wellbeing

M T W TH F

THE EVIDENCE Numerous studies have shown that people who

exercise regularly experience fewer symptoms of depression and anxiety than those who do not exercise regularly.

Several trials have shown that regular exercise of moderate intensity can be an effective adjunctive treatment by itself for both melancholic and non-melancholic depression.

Two trials have found that 16 weeks of regular exercise is equally effective as antidepressant medication in the treatment of mild to moderate depression.

Research also suggests that exercise can further assist individuals with depression who have only partially responded to an antidepressant medication.

Both aerobic exercise (e.g. brisk walking, cycling or jogging) and resistance or strength training (e.g. weight-lifting) have been found to be helpful in treating depression.

Exercise interventions for children and young people show positive short-term effects on self-esteem.

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