Kids Helpline Overview 2013 is a summary and analysis of the key issues affecting young people in

Transcription

1 The Key Issues Affecting Kids and Young People in Australia in

2 Kids Helpline Overview 2013 is a summary and analysis of the key issues affecting young people in It is based on our contact with young people every minute of every day every 60 seconds a young person contacts Kids Helpline. Nobody knows young people like we do. Contents Kids Helpline has been operating for 23 years and is Australia s only 24/7 counselling and support service for young people aged between 5 and 25 years Kids Helpline is free, private and confidential. Support by qualified counsellors is provided via phone, web and . Web counselling is currently available from 12 pm to 10 pm (AEST) Monday to Friday and 10 am to 10 pm (AEST) Saturday and Sunday. We are a service of BoysTown, a not-for-profit organisation with over 50 years experience helping disadvantaged young people change their lives through employment, training, counselling and support services. Kids Helpline is 70% funded by the community through BoysTown Art Union ticket sales, as well as donations, corporate support and government grants. Help support Kids Helpline Key findings 2 Counselling sessions 4 Top five issues 6 Top ten issues by age and gender 9 Top five key issues by cultural background 15 Ongoing counselling 16 State-by-State 17 Trends 18 Increase in online contacts 21 How children and young people sought help 21 Referral to other support 26 Age, gender and background of children and young people 28 Top referring sources to Kids Helpline 33 Website 34 Kids School 35 Satisfaction with Kids Helpline 36 Data collection and limitations 38 1

3 Key findings In 2013, there were 700,649 direct contacts and self-directed help seeking website enquiries. These comprised: 72,416 counselling sessions with children and young people seeking help about issues and concerns (direct help-seeking) 158,318 support, information, referral, connection and/or engagement responses provided by counsellors via our telephone and online services 2,877 contacts with adults outside of Kids Helpline s target age range 337,234 webpage views of Hot Topics covering information on issues and coping strategies for a variety of problems (self-directed help-seeking) 124,044 webpage views of self-submitted stories of young people s problems and their experiences of contacting Kids Helpline (self-directed support and help-seeking) 5,760 connections with our Search for a Service function, which connects people with their local support services (self-directed help-seeking and referral) There were almost 390,000 attempts to reach our counsellors via telephone and online services (web and ). We responded to 60% or just over 233,600 of these attempts via telephone and online interactions. Just over 156,000 contacts, or 40%, went unanswered, many of these when children hung up after a few seconds. We encourage children and young people to keep trying to contact us if they are in need. Direct contacts and self-directed website help-seeking activities increased by over 55,000 or 9%. Children and young people from every State and Territory contacted us, generally reflective of the population in each area. One third of all Kids Helpline contacts were from clients living in regional and remote areas of Australia. There were 1,910 cases where Kids Helpline contacted other agencies to protect children and young people. These duty of care responses included contacting an emergency service or child protection agency. There was a 30% rise or an additional 107,505 in the number of webpage views to self-help resources on the Kids Helpline website, including Hot Topics. The most accessed Hot Topics were on bullying for children and cyberbullying for teens, while issues concerning peers was also of concern to both age groups. 2 3

4 Counselling sessions Counselling sessions increased by 1.5% with an additional 1,118 counselling sessions provided. The demand for ongoing counselling support for children and young people continues to increase, as our counsellors help them deal with severe, complex and often long-standing issues. Counselling sessions with children from culturally and linguistically diverse (CALD) backgrounds represented more than a quarter (26.4%) of all counselling sessions. These young people also preferred online counselling. There continues to be a significant increase in online contacts, with help-seeking via the online mediums (web and ) now accounting for 42% of all counselling sessions with Kids Helpline counsellors. Females made up the majority, over 80%, of counselling sessions. Counselling sessions with teens (13-18 years) increased, accounting for over 60% in Demand for counselling sessions increased 4 It makes you feel safe talking to an adult who talks to other people about their problems. Female, years of age 5

5 Top five issues The top five issues and concerns for children and young people overall were: 1. Mental health concerns 2. Family relationships 3. Emotional wellbeing 4. Suicide-related concerns 5. Dating and partner relationships Of particular note: Mental health and emotional wellbeing concerns (including, suicide, self-injury and grief concerns) presented by children and young people as the main concern during 44% of counselling sessions and as one of their concerns during 54% of all counselling sessions during the year. Family relationships continued to be the most common concern for children aged between 5 and 18 years for Kids Helpline in its 23 years of operation. More than one in five contacts were with children and young people seeking help about family relationships. In addition, one in five contacts were with children and young people seeking help about relationships with friends, peers, romantic partners and dating relationships. Violence children and young people sought help in significant numbers in relation to all forms of violence. Family violence and child abuse issues were a concern within more than 6% of counselling sessions. Self-esteem, self-image, self-concept or identity accounted for nearly one in 10 counselling sessions with a young person. Underlying issues assessed by counsellors suicidality, deliberate self-injury and mental health Suicidality, deliberate self-injury and mental health issues are assessed by counsellors regularly when a young person contacts Kids Helpline. These are in addition to counsellors recording the top concerns as expressed by young people on contact with the service. In 31,400 or 43% of all counselling sessions it was recorded that the client was assessed to be experiencing one of these issues in This was in line with 2012 results. Figure 2 Most Common Issues and Concerns during Counselling Sessions 2013 * 50% All Concerns Main Concern 40% 30% 20% 10% 0% 22.4% Emotional wellbeing Family relationships Mental health concerns 18.8% 17.9% 12.6% Suicide-related concerns 10.5% Friends/peer relationships Dating and partner relationships 9.9% 8.9% Self-image/self-esteem Child abuse (family violence) Self-injury/self-harm concerns 6.5% 5.7% 5.1% Bullying Study and education issues 4.5% 3.6% Loss and grief Physical health concerns 3.1% 1.9% 1.7% Substance use Body image I like that you don't have to be in crisis to talk to them. My counsellor, I can talk about anything at all to him. Me and my counsellor are a good fit we get along really well and I always feel really listened to. In my life I am less scared of problems because I know I will be able to talk to him about things. My mental health and coping skills have greatly increased. Female, years of age 6 *A complete list of the number and proportion of contacts for all concern categories is presented in Table 7 on page 40. 7

6 Suicidality Overall, counsellors assessed clients to have thoughts of suicide in 9,649 counselling sessions. This equates to around 25 counselling sessions each day and accounted for 13% of all Kids Helpline counselling contacts during the year. Deliberate self-injury and self-harming behaviours Counsellors responded to 15,948 contacts with young people assessed to have self-injury issues, accounting for 22% of all counselling sessions in This included when a young person had recently engaged in self-harming behaviour or was struggling to not harm themselves. Mental health issues A total of 24,538 or 34% of all counselling sessions were delivered to clients assessed by Kids Helpline counsellors as having a mental health issue in These clients may have either disclosed a previously diagnosed mental health disorder or illness or the counsellor assessed the presence of significant mental health symptomology consistent with one or more mental health disorders during the contact. Figure 3 Client identified and counsellor assessed issues across all Counselling Sessions * Top 10 Concerns for girls 5-12 years Figure 4 Top 10 Concerns for females 5-12 years across all Counselling Sessions Top 10 issues by age and gender Children (5 to 12 years) were proportionally more likely to contact Kids Helpline about family relationships, bullying, friend and peer relationships, child abuse, school authority issues and physical and/or sexual development. Teens (13 to 18 years) accounted for the greatest number of contacts and were proportionally more likely to contact Kids Helpline seeking help about suicide-related concerns, self-injury concerns, study and educational issues, body image, sexual orientation, sexual activity, pregnancy and homelessness. Young adults (19 to 25 years) were the group most likely to seek help about mental health concerns, emotional well-being, dating and partner relationships, self-image/ self-esteem concerns, physical health issues, substance use and legal, financial and employment issues. Number of counselling contacts 40,000 30,000 20,000 10,000 0 Deliberate self-injury issues 2013 All KHL 2012 All KHL 15,948 15,887 9,649 9,313 24,538 Suicidal thoughts or intent 24,912 31,400 31,042 Mental health issues One or more of the above* Number of counselling contacts 1,600 1,400 1,200 1, ,484 Family relationships 826 Bullying Friends/peer relationships Emotional wellbeing Child abuse Mental health concerns Suicide-related concerns Self-injury/self harm concerns Loss and grief Self-image/self-esteem 8 *It is not uncommon for mental health issues, suicidality and/or deliberate self-injury issues to be part of the complexity of issues for the same client. 9

7 Kids Helpline helps me by pushing me to achieve goals and work around things in my life, and issues which affect me more deeply. Working with Kids Helpline has allowed me to finish school and look toward the future, while I know I still have a massive long way to go, I don't think I'd be finished school without the constant support of my Kids Helpline counsellor - who knows where I'd be! Kids Helpline helps by giving me a safe place to come and work things through. I've found a place I can be open and honest and work through issues judgement free. I feel listened to and acknowledged - achievements, progress and hard times are recognised. Thank you Kids Helpline. Female, years of age Figure 5 Top 10 Concerns for females years across all Counselling Sessions Figure 6 Top 10 Concerns for females years across all Counselling Sessions Number of counselling contacts 8,000 7,228 6,912 7,000 6,000 5,000 4,000 3,000 2,000 1,000 0 Mental health concerns Family relationships Emotional wellbeing 5,889 4,827 3,959 3,597 Suicide-related concerns Self-injury/self-harm concerns Friends/peer relationships Dating and partner relationships 2,959 2,343 2,085 1,637 Child abuse Self-image/self-esteem Study and education issues Number of counselling contacts 6,000 5,292 5,000 4,000 3,000 2,000 1,000 0 Mental health concerns Emotional wellbeing 2,932 2,352 2,013 1,841 Dating and partner relationships Suicide-related concerns Family relationships Self-injury/self-harm concerns 1, Self-image/self-esteem Friends/peer relationships Physical health issues Child abuse 10 11

8 From the counsellor s desk: dealing with suicide Every year, Kids Helpline counsellors engage with many young people across Australia who are struggling with thoughts of suicide. Discussions can be with people who have occasional thoughts of suicide, often as a way to escape their situation, through to those who are already enacting a plan to end their life. The counsellor will help the person to identify and build on their own strengths and resources to get the support they need. This could include getting extra support from a doctor or psychologist, developing strategies on how to manage difficult thoughts and feelings, and how to make safe decisions. The counsellor will respond in different ways depending on the situation, but the one thing that always remains constant is building rapport and trust and getting the young person help as quickly as possible. For the person contacting Kids Helpline with occasional thoughts or feelings of suicide, the counsellor will respond with empathy, work towards building a good trusting relationship with the young person and help them feel they have a voice. Over time, they will work together to understand the thoughts and feelings the young person is having and where these are coming from. For a person who has a more immediate intent to end their life, the counsellor will take a more instant approach, working quickly to establish the best way to get the young person urgent help. This may require an immediate intervention where emergency services will be contacted. The more information a young person gives, the faster it will be to get them help. It can be very challenging at times working with people in such a vulnerable place, but our counsellors are empathic and highly skilled in working collaboratively with those who reach out, ensuring they get the best support possible. Figure 7 Top 10 Concerns for males 5-12 years across all Counselling Sessions Figure 8 Top 10 Concerns for males years across all Counselling Sessions Number of counselling contacts Family relationships Bullying Emotional wellbeing Child abuse Friends/peer relationships Mental health concerns Suicide-related concerns Loss and grief Study and education issues Self-injury/self harm concerns Number of counselling contacts 1,400 1,200 1, ,193 Family relationships 1,143 Emotional wellbeing 1,086 Mental health concerns 841 Dating and partner relationships 715 Suicide-related concerns 655 Friends/peer relationships 418 Child abuse Bullying Study and education issues 319 Self-image/self-esteem 12 13

9 Top five key issues by cultural background Aboriginal and Torres Strait Islander backgrounds There was a total of 779 counselling sessions during 2013 with children and young people who identified as Indigenous. They were proportionally more likely to seek help about child abuse, self-image/self-esteem, body image, loss and grief, homelessness, substance use, and physical health issues (when compared with non-indigenous clients). Top Five Concerns of Indigenous Youth 1. Family relationships 2. Mental health concerns 3. Emotional wellbeing 4. Suicide-related concerns 5. Child abuse Culturally and Linguistically Diverse (CALD) backgrounds There were 7,581 counselling sessions with children and young people from culturally and linguistically diverse (CALD) backgrounds during Children from these backgrounds, not including Indigenous young people, are proportionally more likely to seek help about family relationships, emotional wellbeing, dating and partner relationships, friends/peer relationships, child abuse, study and education issues, self-image/self-esteem, employment issues and cultural identity concerns when compared with other clients. Top Five Concerns of CALD Clients 1. Mental health concerns 2. Family relationships 3. Emotional wellbeing 4. Dating and partner relationships 5. Friends/peer relationships Figure 9 Top 10 Concerns for males years across all Counselling Sessions Number of counselling contacts 1, Mental health concerns Dating and partner relationships Emotional wellbeing Self-image/self-esteem Friends/peer relationships Family relationships Suicide-related concerns Employment issues Drug and alcohol issues Loss and grief 14 15

10 Ongoing counselling Young people receiving ongoing counselling or intensive support through a case management model were predominately female (87%) and aged between 15 and 25 years (81%). Clients engaging in ongoing or case-managed support with Kids Helpline were proportionally more likely than first-time or occasional clients to be seeking help about mental health concerns, emotional wellbeing, suicide-related concerns, self-injury/self-harm concerns, self-image/ self-esteem, sexual assault, employment issues and physical health issues. Top concerns of clients engaging in ongoing counselling, including those receiving case-managed support 1. Mental health concerns 2. Emotional wellbeing 3. Suicide-related concerns 4. Family relationships 5. Self-injury/self-harm concerns 6. Dating and partner relationships 7. Friends/peer relationships 8. Self-image/self-esteem 9. Child abuse 10. Physical health issues Children and young people contact Kids Helpline from all over Australia The demand for Kids Helpline from each State and Territory in Australia was generally reflective of the actual population of children and young people living in each area. Kids Helpline also provides strong support to children and young people living in regional and remote areas. They tend to have less access and choice in support services due to the geographic dispersal of these services in non-metropolitan Australia. During 2013, 33% of all Kids Helpline responses were from clients living in regional and remote areas. Young people from regional areas were more likely to contact Kids Helpline via the telephone than via the online mediums, with 35% of telephone contacts from regional and remote areas compared with 30% of online contacts from regional and remote areas. Figure 10 Figure Number 10 of Responses Number of Responses State by State 16,362 Western Australia 1,243 Northern Territory 51,351 Queensland 13,414 South Australia 2,521 Australian Capital Territory 83,331 New South Wales TOTAL 233,611 59,419 Victoria 5,970 Tasmania 16 17

11 Case study of a young girl s experience with bullying. Ten year old Mia* contacted Kids Helpline to talk about bullying at school. Mia s mother and father are from Sierra Leone and Mia was born in Australia. She talked of being teased about the colour of her skin and the food she ate at lunchtime. A boy said her food was disgusting and would make people sick. Other children told her they did not want to touch her for fear they would become the same colour as her. The counsellor helped Mia to explore her thoughts and feelings about the bullying. Mia appeared sad and confused about what was happening. They worked on validating and normalising Mia s feelings and thoughts of being upset when teased. Together, they explored her understanding of bullying and discussed why some children engage in bullying behaviour. Through goal setting, the counsellor was able to speak with Mia about ways to cope with being teased at school and who to turn to for support. She was encouraged to let her teachers know about the bullying and to reconnect with Kids Helpline whenever needed. Mia agreed to phone Kids Helpline if she experienced further incidents of bullying. *Name changed for privacy. Trends 1.Mental health and emotional wellbeing concerns Over the past nine years, Kids Helpline has seen an increasing trend in the number of contacts from clients seeking help about their own mental health and emotional wellbeing. During 2013, mental health and emotional wellbeing concerns, including suicidality, self-injury and grief concerns, were presented by clients as their main concern during 44% of counselling sessions (31,830 sessions) and as one of their concerns during 54% of all counselling sessions during the year (39,295 counselling sessions). This was an increase from 51% the previous year there were 2,710 more counselling sessions from young people with these concerns during 2013 compared with Family relationships There was a decrease in the number and proportion of counselling sessions with children and young people during 2013 seeking help about family relationships compared with the previous year. However, after 23 years of operation, family relationship concerns continued to be the most common concern for clients aged between 5 and 18 years contacting Kids Helpline. 3. Peer and partner relationships There was a decrease in the number and proportion of counselling sessions with children and young people during 2013 seeking help about relationships with friends, peers, romantic partners and dating relationships. Figure 11 Counselling Sessions 2013 v 2012 Trends % % 22.7% Family relationships Mental health concerns 18.8% 21.3% 17.9% 15.5% Emotional wellbeing 12.6% 12.2% Suicide-related concerns 10.5% 11.9% Friends/peer relationships Dating and partner relationships 9.9% 11.2% % 8.1% Self-injury/self-harm concerns Self-image/self-esteem Child abuse and family violence % 7.7% 5.7% 5.2% 5.1% 5.5% 4.5% 4.4% Bullying Study and education issues 3.6% 4.4% 3.1% 3.5% 1.9% 2.1% Loss and grief Physical health concerns Substance use (drug and/or alcohol) 1.7% 1.9% Body image

12 Increase in online contacts Kids Helpline has seen an increase in the number of contacts via the online mediums of web and counselling. Help-seeking via the online mediums now accounts for 42% of all counselling sessions with Kids Helpline counsellors. Over the past five years, young people have increasingly sought help for their issues and concerns via web counselling and , with 3,500 more counselling sessions delivered via these mediums during 2013 than the previous year and more than double the number of counselling sessions via these mediums than during The significant increase in online help-seeking behaviour during 2013 was via web counselling. How children and young people sought help They seem to know how you re feeling and how to make you feel better, they give you information and explain why certain things may be happening. It also feels good to talk to someone and get it off your chest. Female, years of age Direct contact Children and young people directly contacted Kids Helpline counsellors in significant numbers during 2013, with 389,968 attempts to reach Kids Helpline s telephone and online services. Counsellors responded to 60% of all these contacts. We provided 233,611 telephone and online interactions. 161,195 counsellor responses via telephone and online services consisted of a diverse range of interactions with children, young people and adults who were seeking support, connection, information, or engaging using creative and innovative ways to test out help-seeking or to indirectly seek assistance. Children and young people s rates of help-seeking remained high in 2013, with 389,968 attempts, or 32,497 average monthly attempts, to reach a Kids Helpline counsellor via telephone and online services. Counsellors responded to 233,611 (60%) of these contacts. Approximately 3,700 telephone calls were answered by counsellors each week, a total of 190,142 during Each week, counsellors engaged in approximately 840 online interactions. In total, 71,335 online contacts were received and 43,469 (60%) responded to, equating to almost 6,000 additional online responses than was provided during A total of 18,678 real time web contacts and 24,791 responses were provided during Top concerns by method of contact It is likely that young people s preferences for, and barriers to, seeking help are driven by a combination of ease of access, privacy, age of the child and the type of concern. Direct comparison of help-seeking rates between communication mediums is not necessarily a reflection of children and young people s preferences. For example, young people s level of engagement with web counselling may be significantly influenced by access. Unlike access by telephone, web access is only offered at certain times of the day. Currently these hours are from 12 pm to 10 pm (AEST) Monday to Friday and 10 am to 10 pm (AEST) Saturday and Sunday. This is due to the financial capacity of Kids Helpline to resource the service. Counselling During 72,416 of the telephone and online interactions, children and young people were directly seeking help about their issues and concerns: 42,128 telephone and 30,288 web and counselling sessions. This was a 1.5% increase on the 2012 figure of 71,

13 Strengthening families Sixteen year old Evelyn* called Kids Helpline because she d heard about the service at school and thought it could help. She and her mum argue and yell at each other several times a week. Evelyn was really upset and stressed because of the tension at home. Evelyn and her mum used to get along really well but now nearly every conversation turned into an argument. She was thinking about running away. The counsellor explored the issue with Evelyn and looked into how the stress at home had been affecting her. Evelyn said her mum was very protective and they often argue about Evelyn wanting more freedom. She said her friends have more freedom than her and that she feels like she s being left out in her friendship group because she misses out on many social activities. The counsellor let her know that Kids Helpline gets lots of calls from children saying their parents can be too protective. The counsellor asked Evelyn if she had spoken with her mum about just how upset she was. Evelyn said she had not spoken with her mum about how she was feeling. The counsellor suggested Evelyn find a time when she and her mum were both calm and ask to have a chat with her about their arguments. The counsellor discussed strategies for managing stress, including exercise and mindfulness. Evelyn said she would try these things and would call the counsellor next week to let him know how the chat with her mum went. *Name changed for privacy. Types of counselling interventions There has been a consistent rise in the complexity of issues presented to Kids Helpline over the years. In reply to this, the service has increasingly offered more continuity of counselling responses and a greater volume of intensive and planned counselling responses to clients. Young people with severe, complex and long-standing issues benefit from working with a service on a regular or ongoing basis (ongoing Table 1 Type of counselling interventions Counselling Sessions 2012 Counselling Sessions 2013 Number % Number % First-time contact with Kids Helpline 20, , Occasional^ contact with Kids Helpline 14, , Ongoing counselling (including those receiving case-managed support ) 30, , Total 65,695 * ,195 * 100 * These percentages were related to counselling sessions where type of counselling assistance was known. There were 5,221 counselling sessions in 2013 where type of counselling assistance was not recorded. counselling). This usually includes speaking predominantly with one or two key counsellors, who become familiar with their concerns. Similarly, case-managed support, a model of care that offers more intensive support, is also offered to clients to ensure numerous different needs can each be considered and planned for. Sometimes, this means linking the young person with face-to-face services and developing joint or wrap-around case management plans. ^ Occasional contact is those individuals who have previously contacted Kids Helpline but who have not been engaged in ongoing counselling. Contact with Kids Helpline has been intermittent. The increased number and proportion of contacts from clients receiving ongoing counselling support in 2013 follows a 10-year upward trend, with this counselling response now offered at 14 times the rate it was during Table 2 Top concerns identified by young people via telephone counselling * Response rate increased Rank All Concerns N Children Teens Young Adults (Rank Order) (Rank Order) (Rank Order) 1 Mental health concerns 9,285 Family relationships Family relationships Mental health concerns 2 Family relationships 7,721 Bullying Mental health concerns Emotional wellbeing 3 Emotional wellbeing 7,096 Emotional wellbeing Emotional wellbeing Dating and partner relationships 4 Suicide-related concerns 4,998 Friends/peer relationships Suicide-related concerns Family relationships 5 Dating and partner relationships 4,909 Child abuse Dating and partner Suicide-related relationships concerns 6 Friends/peer relationships 3,586 Mental health Self-injury/ Friends/peer concerns self-harm concerns relationships 7 Child abuse 3,040 Loss and grief Friends/peer Self-image/ relationships self-esteem 8 Self-injury/self-harm concerns 2,993 Suicide-related Child abuse Self-injury/ concerns self-harm concerns 9 Bullying 2,029 Self-injury/ Bullying Child abuse self-harm concerns 10 Self-image/self-esteem 1,954 Study and education issues Study and education issues Physical health issues 22 *The numbers for suicidality, deliberate self-injury and mental health issues as top concerns identified by young people are different to those underlying issues assessed by counsellors when young people contact the service. (Refer Underlying Issues Assessed by Counsellors - Suicidality, Deliberate Self-Injury and Mental Health on page 6) 23

14 Navigating peer dynamics John* had been making frequent contact with Kids Helpline for 18 months. The 15 year old lived in a rural area and did not feel he had things in common with his peers. John did not feel a connection to the other males at school who enjoy sports or gaming and was finding it harder and harder to cope with his emotions. He expressed feelings of isolation and loneliness due to disconnection from his peers. Through counselling, John identified that not having friends was resulting in a belief that he was not worthwhile or worthy of being cared about. He was able to see that this is due to not feeling connected with people in his community. The counsellor and John talked about what his interests were, examining his values and beliefs. They discussed ways to cope with emotions and looked at practical ways to seek out and engage with people with similar interests. *Name changed for privacy. Table 3 Top concerns identified by young people via web counselling* Rank All Concerns N Children Teens Young Adults (Rank Order) (Rank Order) (Rank Order) 1 Mental health concerns 3,411 Family relationships Mental health concerns Mental health concerns 2 Family relationships 2,321 Friends/peer relationships Family relationships Emotional wellbeing 3 Emotional wellbeing 2,310 Bullying Emotional wellbeing Dating and partner relationships 4 Friends/peer relationships 1,715 Emotional wellbeing Friends/peer relationships Suicide-related concerns 5 Suicide-related concerns 1,705 Suicide-related concerns Suicide-related concerns Family relationships 6 Dating and partner relationships 1,459 Mental health concerns Self-injury/ Self-image/self-esteem self-harm concerns 7 Self-injury/self-harm concerns 1,455 Child abuse Dating and partner Self-injury/ relationships self-harm concerns 8 Self-image/self-esteem 1,161 Self-injury/ Self-image/self-esteem Study and education issues self-harm concerns 9 Study and education issues 837 Self-image/self-esteem Study and education issues Physical health issues 10 Bullying 648 Study and education issues Bullying Friends/peer relationships *The numbers for suicidality, deliberate self-injury and mental health issues as top concerns identified by young people are different to those underlying issues assessed by counsellors when young people contact the service. (Refer Underlying Issues Assessed by Counsellors - Suicidality, Deliberate Self-Injury and Mental Health on page 6) Table 4 Top concerns identified by young people via counselling * Rank All Concerns N Children Teens Young Adults (Rank Order) (Rank Order) (Rank Order) 1 Family relationships 3,589 Family relationships Family relationships Mental health concerns 2 Emotional wellbeing 3,532 Emotional wellbeing Mental health concerns Suicide-related concerns 3 Mental health concerns 3,521 Bullying Emotional wellbeing Emotional wellbeing 4 Suicide-related concerns 2,400 Friends/peer relationships Suicide-related concerns Dating and partner relationships 5 Self-injury/self-harm concerns 1,985 Child abuse Self-injury/ Family relationships self-harm concerns 6 Friends/peer relationships 1,899 Suicide-related concerns Friends/peer relationships Self-injury/ self-harm concerns 7 Dating and partner relationships 1,252 Self-injury/ Dating and partner Physical health issues self-harm concerns relationships 8 Child abuse 1,120 Mental health concerns Self-image/self-esteem Friends/peer relationships 9 Bullying 1,012 Self-image/self-esteem Child abuse Self-image/self-esteem 10 Self-image/self-esteem 1,008 Loss and grief Bullying Loss and grief *The numbers for suicidality, deliberate self-injury and mental health issues as top concerns identified by young people are different to those underlying issues assessed by counsellors when young people contact the service. (Refer Underlying Issues Assessed by Counsellors - Suicidality, Deliberate Self-Injury and Mental Health on page 6) 24 25

15 The counsellors are very friendly and understanding. It helped just to talk through my problems with someone who was very kind-hearted. Female, years of age Referral to other support Across all counselling sessions, counsellors were able to directly assist 54,728 (76%) young people contacting the service without referring them on to another agency. For those 24% of counselling sessions in which a referral was required: Just over 7% (5,152) resulted in the child or young person being referred to another service for ongoing support, including crisis responses and three-way link-ups with both the client and another agency. 13% (9,495) were referred to their doctor, school/guidance counsellor, mental health worker or other generic service. In 4% (3,037) of sessions, counsellors were unable to provide a referral because either no appropriate service was available or the young person finished the session before a referral could be discussed. This may have been because they did not want to engage in the process, were reluctant to disclose identifying information or were not ready to seek face-toface help. Duty of care contacting other agencies to protect young people Responses required to protect children and young people, such as contacting an emergency service or child protection agency, are carried out on a daily basis by Kids Helpline counsellors and supervisors. During 2013, there were 1,910 such instances

16 Age, gender and background of children and young people Females accounted for the majority of counselling sessions in 2013, with the proportion of males contacting Kids Helpline consistent with helpseeking trends for males in the majority of counselling services. Males preferred to use the telephone to seek counselling, with 72% of their help-seeking via this medium. Boys and young men account for 22% of all telephone counselling contacts and 12% of online counselling contacts. More than six in 10 counselling sessions or over 60% were with teens aged between 13 and 18 years during Compared with the previous year, there was an increased number of counselling sessions with teens. Kids Helpline counsellors provided 1,356 additional counselling sessions with this age group in Figure 12 Counselling Contacts % of distribution by gender Figure 13 Counselling Contacts % of distribution by age of client 18% 12, % 29.2% Distribution by gender Distribution by age of client 82% 59, % Female contacts 5-12 years Male contacts years years 28 29

17 During 2013, Kids Helpline saw a consistent rate of contact from Indigenous children and young people of culturally and linguistically diverse backgrounds (CALD) compared to The background of clients was recorded in only 28,690 (40%) of counselling sessions, therefore the following figures are likely to be a significant under-representation of the actual amount of counselling with culturally diverse clients. Kids Helpline knows its clients Overall: 779 (2.7%) counselling sessions were with Indigenous children and young people, and 7,581 (26.4%) counselling sessions were with children and young people from CALD backgrounds. Young people from CALD backgrounds demonstrated a preference for online counselling: the proportion of contacts from this group via online (33.0%) was substantially higher than those via the telephone (24.7%). Figure 15 Cultural Background of Clients 2.7% 26.4% Figure 14 Counselling Contacts distribution (Number) by age of client p Distribution by age of client 45,000 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5, ,066 15, years 40,057 9, years 18,996 31, years Cultural background of clients 70.9% Indigenous CALD Other *These percentages were related to contacts where age was known. There were 7,297 contacts during 2013 where age was not recorded. *Proportions based on counselling sessions in which background of client was known

18 Provides a sense of direction that maybe otherwise is lacking in the domestic or school environment. Advice and emotional support is issued, and the consistency of being able to contact the same counsellor implies that if their initial advice failed to eradicate the issue, a prevailing solidarity between the counsellor and yourself instils a faith that they will assist you in overcoming the issue, no matter how major, minor, quick or enduring that issue may be. Female, years of age Top five referring sources to Kids Helpline Whenever it is possible, Kids Helpline counsellors ask the child or the young person How did you hear about Kids Helpline? During 2013, 11% of young people who contacted the service were able to provide this information. The top five sources for referrals to Kids Helpline are presented in the table. Table 5 Referring sources to Kids Helpline Name of No. of Referral Source contacts % Friend/family 7, School 6, Internet 4, Other agency 4, TV 1, Other 1, Total 25,

19 Website In 2013, there were: 717,138 visits to the Kids Helpline website 2,645,463 webpage views. Of these, there were almost 470,000 views to the self-directed help-seeking sections of hot topics, self-submitted stories and connections with other support services. Website Hot Topics Children, young people and adult carers have increasingly been accessing self-help resources from the Kids Helpline website. These resources are developed by clinical supervisors and researchers and are designed to provide information and strategies to assist the user in responding to common issues and concerns. There was a 30% (107,505) rise in the number of webpage views to self-help resources on the website in There was some similarity in the subject matter of self-help resources being accessed by children and teens. Both of these age groups were concerned about bullying. For children, the hot topic on bullying was the number one accessed self-help resource, whilst for teens cyberbullying was seen as a critical concern as evidenced by it being the most viewed Hot Topic. Issues concerning peers was also of interest to both children and teens. The hot topics on peer pressure and fights with friends were the third and fourth most accessed by children. In relation to teens, peer pressure was the second most sought after Hot Topic. For adults their interest centred on how to support children and young people in relation to anxiety, cyberbullying and cross-cultural issues. Kids School Kids School is a free program which allows Australian primary schools to invite Kids Helpline counsellors into their classrooms via video link or phone. From June to December 2013, 2,043 primary school students participated in the Supported by Table 6 Top Five Hot Topics Children Teens Adults Topic No of Unique No of Unique No of Unique Page Views Topic Page Views Topic Page Views 1 Bullying 2,851 Cyberbullying 13,475 Anxiety 15,459 2 Staying Safe Online 2,474 Peer Pressure 11,792 Cyberbullying 13,396 3 Peer Pressure 1,845 Leaving Home 11,618 Cross Cultural 9,976 Differences 4 Fights with friends 1,747 Family Relationships 8,988 Being Resilient 8,484 5 Being Different 1,236 Body Image 8,496 Body Image 8,201 Teachers are able to determine what topic they d like their class to engage with or sessions can be tailored around the most common issues children look up on our website. These include bullying and cyberbullying, friendship, coping with change at school and family issues. Students have the opportunity to talk with a counsellor during a group discussion about things impacting their lives. Sessions aim to improve mental health literacy in primary school aged children, promote resilience and encourage help seeking behaviours. Teachers are involved in booking the session, assisting the counsellor to develop the session topic based on the needs of their class and school, and play an important role in co-facilitating the session with the Kids Helpline counsellor. Each session has been developed in line with the General Capabilities of the Australian Curriculum. To find out more or book a session visit or contact or school@kidshelp.com.au 34 35

20 Where I would usually feel embarrassed, ashamed or insecure about my problems and how big or little they were, or scared of what people may say to my problems, Kids Helpline was a place I knew I could have complete confidence in the knowledge that they would be supportive, and not judge my problems. An outsider's perspective and ideas of what to do or how to deal with various issues is also very helpful. Female, years of age Satisfaction with Kids Helpline Kids Helpline strongly believes that the voice of young people is a critical driver for the continuous improvement of the service. Consequently, every year we survey young people regarding their levels of satisfaction with the service. In 2013, feedback was received from 778 children and young people. Respondents were across all age groups including a mix of males and females as well as those contacting for the first time and more than once. Participants were also recruited across all contact methods including phone, web and . This was the most heavily subscribed client satisfaction survey ever undertaken by Kids Helpline. Client satisfaction was gauged by understanding what overall level of assistance the respondent experienced, along with questions about recommending friends to the service and their intention concerning using the service again in the future. Overall client satisfaction with Kids Helpline was very positive. In total, 88.4% of callers felt they been assisted by Kids Helpline (Figure 16), and 93.7% agreed that they would recommend Kids Helpline to a friend (Figure 17). In relation to the last statement, this was an increase from 89% in On the question as to whether young people would use Kids Helpline in the future to seek assistance with a problem, almost 86% said that they would recontact. (Figure 18). Figure 16 Figure 17 Figure % Overall, did 88.4% Kids Helpline help you? 6.3% Would you recommend Kids Helpline to a friend? 93.7% 14.1% Would you contact a Kids Helpline Counsellor in the future if needed? 85.9% Yes Yes Yes 36 No No No 37

21 Privacy and confidentiality is assured Data collection and limitations Coping and not cutting Kids Helpline counsellors record non-identifying information at the end of every telephone or online session. There are a maximum of 38 different fields where data may be logged. However, only 10 are mandatory (including date, time, length of session, cultural background, frequency of contact, main concern or problem, problem severity, referral, and whether the client was experiencing thoughts of suicide or engaged in deliberate self-injury). Ideally, counsellors enter information for each field. In reality, however, the amount of information recorded about each session varies due to the following reasons: Privacy and confidentiality Kids Helpline offers itself to young people as a private and confidential service. Frequently clients choose not to reveal details about themselves, particularly those that might in their view lead to identification. Sensitivity of information the nature of some contacts is such that direct information gathering is either contraindicated or proves difficult. The length or nature of the call is such that even basic data collection is impossible or irrelevant. Other issues that need to be considered in relation to the data within this report include: Repeat contacts children and young people are free to use the service as often as they need. Therefore, data reported may include repeat contacts made by individuals across a period of time. Indeed, for many young people, the sense of connectedness Kids Helpline provides is a key preventative tool for serious issues such as mental health concerns and self-harm. Multiple concerns many young people s issues are multifaceted, spanning across more than one of the 55 problem types. Counsellors record the one problem type that was the primary concern for the client. Missing data Kids Helpline has adopted a policy of recording data in each field in such a way as to identify incomplete, unknown or blank responses. All statistical information reported is therefore based on those instances where the information is known. Statistical significance all stated data comparisons have been assessed against a 95% confidence interval. Fifteen year old Anna* contacted Kids Helpline to talk about conflict with her carers, a relationship breakdown with her girlfriend and struggling to keep up at school. She said she had been cutting her arms and legs with a razor blade each night before bed. Her carers did not know she did this because she hid her cuts with jumpers and long pants. Anna didn t know why she cut herself. She only knew it was helping in the moment, but maybe not, in the long run. The counsellor listened, getting to know what was going on with Anna, letting her know she had a voice. The next week, Anna called and asked to speak with the same counsellor. Anna had cut herself in the toilets at school after running into her ex-girlfriend. The counsellor and Anna talked about what had triggered Anna to cut herself. Anna linked this to feeling upset about seeing her ex and failing a maths test. Through exploring what usually happens before Anna self-harmed on this and other occasions, the counsellor helped Anna to gain an insight into things that triggered her self-harm. Anna s counsellor referred her to a website that talked about the reasons why people self-harm, and demonstrated alternative ways to cope. A week later, Anna spoke with the counsellor again. After looking at the website and thinking about their previous phone call, she realised self-harm was a way of expressing sadness, anger and frustration. She wanted to look at healthier ways of doing this. They talked about alternative strategies Anna could use when she felt like self-harming. This included: listening to music, writing her feelings down in a notebook and letting her carers know when she needed some space. Eventually, Anna was able to open up to her carers about the self-harm and get extra support from a counsellor at her school. Anna said she no longer self-harmed and thanked the counsellor for her ongoing support. *Name changed for privacy

22 Table 7 Number and proportion of contacts by type of concern Concern Main Concern All Concerns Main Concern All Concerns Number % Number % Number % Number % Mental Health and Emotional Wellbeing 28, , , , Mental health concerns 11, , , , Emotional wellbeing 6, , , , Suicide-related concerns 5, , , , Self-injury/self-harm concerns 3, , , , Loss and grief 1, , , , Friends, Peers, Partners and Dating 12, , , , Dating and partner relationships 6, , , , Friends/peer relationships 5, , , , Family Relationships 10, , , , Child-parent relationships 6, , , , Other family relationships 2, , , , Changing family structures 1, , , , Parenting own children Identity and Self concept 3, , , , Self-image/self-esteem 1, , , , Body image , , Sexual orientation , Gender/sex identification Disability-related concerns Cultural identity Violence and Abuse (non-family) 4, , , , Bullying 2, , , , Sexual assault or abuse , , Dating and partner violence Harassment and assault (non-sexual) Sexual harassment Child Abuse and Family Violence 3, , , , Physical abuse 1, , , , Sexual abuse , , Emotional abuse , Neglect of child Exploitation by family member Exposure to family violence Living-in-care issues School, Education and Work 2, , , , Study and education issues 1, , , , Employment issues , School authority issues Physical or Sexual Health and Development 3, , , , Physical health concerns 1, , , , Pregnancy-related concerns , Sexual activity Physical/sexual development Contraception/Safe sex Homelessness and Basic Needs Assistance 1, , , , Homelessness , Practical/Material assistance Financial assistance/concerns Substance Use, Addictions and Risk Taking , , Substance use (drug and/or alcohol) , , Addictive behaviours (not drugs/alcohol) Physical risk-taking Gang/cult involvement Offending, Abusive or Violent Actions Illegal/offending behaviour Abusive or violent actions Sexual violence/offending actions Total 71, % 72, % They are experienced people that help others with anxiety, bullying problems, etc, to get on their feet again. Male, years of age 40 41