Transcript for
A national workforce survey of children’s mental health
Mel Goodyear (00:00): I think we’d be hoping to see a stronger relationship between having the knowledge and understanding the different skills involved in supporting child mental health and actual practice. That we’d have people confidently reporting that their regularly working in that holistic family focused way, that they have things in their toolkit that they can pull out at different times, that they understand what to do and how to recognise maybe some difficulties, but also protective factors as well, and that they feel that they have a favourable environment around them to do this type of work.
Narrator (00:43): Welcome to the Emerging Minds podcast.
Dan Moss (00:48): Hi everybody, and welcome to this Emerging Minds podcast. My name’s Dan Moss, and for the last five years we’ve been providing you with podcasts, which generally feature practitioners or families talking to us about children’s mental health. And the practitioners that we have been working with generally find new and innovative ways to really grapple with this idea of children’s mental health.
(01:13): And as it becomes more firmly into our public consciousness, practitioners around Australia are doing a lot of work to think about how they can help children to thrive, help children’s social and emotional wellbeing, particularly in the wake of recent challenges such as the COVID pandemic. So it’s particularly exciting today to have with me a couple of my colleagues from Emerging Minds and in particular from our Research and Evaluation team. So I have Dr Mel Goodyear, who is the Manager of the Research and Evaluation team here at Emerging Minds.
Mel Goodyear (01:48): Thanks, Dan. Thanks for having us.
Dan Moss (01:50): No worries. And Claire Marsh. Claire’s our Senior Research Officer in the Research and Evaluation team.
Claire Marsh (01:56): Hi, Dan. Thanks for having us.
Dan Moss (01:58): So why it’s so exciting to have both Mel and Claire with us here today is that they are going to be providing what is Emerging Mind’s first National Workforce Survey of Parent, Family and Child Mental Health. So Mel, I’m wondering if you can tell us a little bit about how this survey came about?
Mel Goodyear (02:18): Yeah. Thanks, Dan. As you said, that we have a number of practitioners that are engaging with our material and we were interested, I guess, to know what their current level of, I guess knowledge, skills and capacity around that child mental health work that they’re doing. And so we do do evaluation, we do ongoing evaluation to those poor practitioners out there, but we are learning to understand, I guess, how people change as a result of engaging with our work.
(02:50): But we were particularly interested in this survey to get a real snapshot across a wider scope of professionals, I guess, more than the people that are just engaging with us and to sort of see what is the current capacity or baseline capacity, if you like, of all Australian practitioners to work with children, families and parenting to better help that child mental health, early intervention and promotion aspect.
Dan Moss (03:16): Great. Thanks, Mel. And Claire, I’m wondering if you can tell us a bit about who it was that took the survey?
Claire Marsh (03:23): Yeah. Thanks, Dan. As you know, the workforce that is in the audience for Emerging Minds is really broad range of professions and so as Mel said, we were looking at trying to capture as many of those people in the health and social and community services workforces as we could. And we wanted to hear from people who work with children and people who work with adults as clients, but also families and just people who work in the sector, whether or not they work with clients directly or not.
(03:49): We were very happy that we had some great support from fantastic partner organisations who shared the survey link for us and that was sort of peak bodies and interest groups and government agencies helped share that survey link with their networks, which meant that we got thousands of hits on the survey, which we were really impressed with for our first major survey.
(04:08): And out of the few thousand people who attempted the survey, we ended up with 1,518 completed surveys. The respondents who took the survey were about a quarter each of social services workers, clinical health professionals and mental health professionals. And then the last quarter of people was made up of educators and a few other different roles. We found that kind of as expected with the type of professions that we were looking for, they were mostly female and the group was very well experienced in their disciplines.
(04:44): So the people who took the survey tended to be people who’d been in their roles for quite a number of years. But we were also pretty happy with the distribution across the different geographies. So all the states and territories of Australia were represented and country areas were well represented and sort of areas of different levels of socioeconomic disadvantage.
Dan Moss (05:05): Great. I mean, that’s an amazing completion rate to have. 1,518 practitioners across Australia I think talks really a lot about our current commitment to mental health across Australia. I’m wondering, with so many completed surveys, were there some main themes or key themes that really kind of shown out from the survey?
Claire Marsh (05:25): So the major overall sense that we got from the data is that workers across Australia were feeling moderately capable in sort of understanding and responding to children’s mental health, but there were some areas for improvement. There was sort of some particular domains that we had a look at where people didn’t feel quite as confident.
Dan Moss (05:43): So you’ve mentioned they’re moderately capable, so it sounds like there’s some increasing competencies being developed by practitioners, but we’ve still got a bit of a way to go. Mel, can you tell us a little bit about some of the challenges that might face practitioners?
Mel Goodyear (05:57): Yeah. That’s a good question, Dan. We did see that people were, I guess, starting to understand what child mental health is, but what we tended to see also was that, I guess, from that point of knowledge and skills that we’re building, there was a sort of gap between the knowledge and skills and also the way that people practise.
(06:20): And so people were scoring a lot higher on things like understanding the strengths and vulnerabilities that might contribute to child mental health, understanding what sort of factors in families known to be risk factors. And also I guess, understanding what might happen where there’s trauma and things like that in the family.
(06:40): But when it came to asking people about how they were working, about how they may engage parents around their children’s mental health, how they might identify early signs in children and infants, that practise was considered to be much lower than the knowledge and skills.
(06:59): The other part that we found really interesting was we really looked into children’s mental health, but also from the perspective of infants. And what we know is that from a lot of our other stuff is that infant mental health is something that’s difficult to understand in the workforce.
(07:16): And likewise in our survey it was actually quite low scored, I guess, across all Australian professionals. And that was regardless of the professional group and the context that they were in. It was quite consistently the case that Australian professionals were feeling less confident, particularly in recognising early signs in infants that may be coming into contact with them.
Dan Moss (07:42): Mel, I’m just wondering, is this often practitioners who might work with infants only occasionally or rarely? Did the data say something about that?
Mel Goodyear (07:50): I mean, we did tend to see slightly higher scores in those professions that you would expect like infant maternal and child health workers and things like that. But generally, we tended to see across the workforce that it was the lowest scored component of the survey for all professions. So it was something that everyone was saying that they needed a lot more support on, a lot more support to understand what is infant mental health, but to also understand how they can incorporate detecting, I guess, signs of mental health distress or factors that may influence infant mental health in their practice.
(08:28): It was particularly highlighted to us that a lot of professions that may be in that adult focused service delivery were finding as you would expect, infant mental health to be challenging. But what we have realised from a lot of our work is that, I guess, child mental health is everyone’s business and everyone in a way has a role that they can play.
(08:51): And when we think about those adult oriented services, we know that there are a number of parents that are often attending those services, but sometimes it’s the case that parenting status isn’t even identified in some of those services. And sometimes it’s the case that talking about parenting isn’t really part of the treatment model.
(09:14): And so for them, we thought that could be an area of focus for Emerging Minds where we really think about how we can support practitioners to have conversations not only about parenting, but also about what might be going on for infants. We know that particularly the relationship that a parent has with an infant is one of the really crucial protective factors, I guess. And we also know that some of those adult problems can restrict the resources that a parent might have to be able to give the child that relationship and attention that they need.
Dan Moss (09:52): Yeah. Great. Thanks, Mel. And I’m just wondering, do you think that the fact that we now have so many practitioners saying or responding that they need more information or to develop skills in this area, that that’s a very necessary step in our kind of, I suppose, national campaign to improve the mental health of children and infants?
Mel Goodyear (10:15): Yeah. I think it’s fantastic that they were able to let us know what they felt less confident in and what they felt more confident in. Another particular interesting area for us was looking at the impact of childhood trauma on child mental health and adversity. And we do hear a lot about workforces engaging with a lot of childhood trauma sort of knowledge and packages. We have them ourselves that are really highly sought after.
(10:46): But what we tended to see in the survey is another interesting result, while people felt generally that they were quite confident in that area, there was actually another difference there between understanding the theory, I guess, of how childhood trauma may result in difficulties for children and a disconnect we found in the results between what to do about it. So while there’s a great, it says to us there’s a great deal of literacy around this space, but actually there may be less understanding of what someone can do.
(11:20): And we have heard that people are looking for referral services in that space. So when they identify it, who do we refer to? But what they’re also struggling with is what they can do in that time that they’re holding that family, particularly when there may not be services available or long wait lists available for families to reach.
Dan Moss (11:40): Yeah. So this might be when a general practitioner is working with a child they know who’s been through trauma, and even though that’s not the purpose of them being there, they want to be able to provide some sort of service which will help that child to feel believed or to feel supported while they’re waiting for that service?
Mel Goodyear (11:58): Exactly. Exactly, Dan. And we also hear that there’s a lot of professions that are holding children, particularly GPs holding children with mild mental health issues that they may not reach a certain sort of level or threshold to get a sort of specialised mental health service. And sort of that leaves us thinking what’s going to happen to those families. They might get referred, I guess, to private psychology and there might be fees attached to that.
(12:26): There’s likely to be fees, but there’s also a shortage of that workforce as well. So we find that some of these more general practitioners, I guess, are more than doctors, but are holding a lot of these families. And we think they’re crying out for a few little sort of practices, I guess, that they can do to hold that family and better help that family adapt while they’re going through this process, I guess.
Dan Moss (12:52): Yeah. Thanks, Mel. So you’ve talked a little bit about some of the challenges that I think we all consider within the practise of infant and child mental health. Claire, I’m wondering if you could describe the areas where practitioners were showing some more confidence and feeling stronger in particular areas.
Claire Marsh (13:11): Yeah. Thanks, Dan. I guess, we think it’s a really promising strength that workers were able to tell us in this survey. It was becoming clear in the survey data that us workers in Australia really do get the concept that children have mental health. And as you said before, that’s sort of being raised a bit more in our public consciousness now to think about children in terms of their mental health and their wellbeing.
(13:34): So the way people scored this survey suggested that there’s a good level of awareness. People are starting to understand concepts and understanding why it’s important to pay attention to children’s mental health. We also asked people in the survey if they felt like children’s mental health was relevant to their work, and most if not nearly everybody who responded to the survey felt like it was relevant to the work that they’re doing in at least some degree.
(13:59): And so some workers obviously were at the very top of that spectrum where if they’re working in mental health sector and with children, then they rated that very highly. But there was very few people who felt like it wasn’t relevant at all. And then the other thing we asked around was if it was part of their job responsibilities.
(14:17): And what we saw is that people who felt like children’s mental health was relevant to them, they felt a connection to it and whether they felt like that was part of their job responsibilities, those workers tended to rate their competencies that much higher than people who didn’t feel very connected to it as all. So we felt like that’s kind of presenting an opportunity there to build capacity and help workers find that connection and feel like this is work that’s important to me, and that’s sort of an opportunity to build on that knowledge and practise skills.
Dan Moss (14:51): So Claire, would it be reasonable to suggest or assume from this that there’s a growing number of practitioners maybe in the adult services as Mel was suggesting, who are beginning to become much more connected in this sense that child social emotional wellbeing is everyone’s business, that even if they’re not seeing a child directly, that there’s a series of questions that they can ask a parent about how their infant or child is going or how their adversity might be affecting their child?
Claire Marsh (15:23): Yeah. I think that’s definitely the sense that we got from the people who took the survey, is that there’s definitely that growing awareness. And that’s what we’d love to see at Emerging Minds is people engaging and bringing the child into the conversation in the work that they do.
Mel Goodyear (15:39): And for us as researchers, actually, it does indicate a shift, I would say. And we’ve been looking at workforce development in this area for nearly 20 years. And back then, particularly in adult mental health services, thinking about children was really seen as quite foreign and it was actually the role of other workers to do that.
(16:01): So to see that indication in the survey is actually quite remarkable really, and shows a real shift. We’ve also seen that happen as a result of engagement with some of the content around Emerging Minds and particularly some of the courses that they engage with, that over the years that we’ve seen a shift in now over overall evaluation as well.
Dan Moss (16:23): Thanks, Mel. So I mean, that’s really kind of heartening, isn’t it, to hear about some of these shifts in both adult and child services? But I’m just wondering if you can tell me just a little bit about what you think needs to happen to make sure that this shift in consciousness or kind of attitude or connection that those knowledges are supported by practices?
Mel Goodyear (16:45): Yeah. Yeah. And I think there is a lot of work to do in terms of workforce development around child mental health. And I guess, we think about child mental health like a continuum. So from children that are mentally well to showing some difficulties to maybe presenting with mental health conditions. That in a way, that continuum also needs to be applied if you like, to practitioners.
(17:12): So there’s a continuum of practice that we are kind of looking for. So I guess, there’s a lot of work that we can do in different contexts. Like you mentioned with the adult services, there’s a lot of support that we could provide practitioners to think about one or two questions they might ask about parents.
(17:31): There’s some work there also looking at how the system actually supports identifying parenting. Because sometimes the forms that they’re all doing don’t even register parenting as well. And that practitioner’s got a lot of things to do and so helping with some structures around the practitioner to help them think about this work is an important area. But also thinking about how we might support particular practices with children.
(17:57): So how we might give practitioners practice tips if you like, so that they can then incorporate them into their context. So on the one hand, we want people to have a broad range, I guess, of skills, but also we want them to have a few little things in their toolkit that they can pull out at different times that really has been shown to make a difference in terms of family functioning and also child mental health.
Dan Moss (18:24): That’s really fascinating because just thinking about this podcast series, we know what our audience and practitioners out there really love or enjoy is hearing about practitioners, the micro skills or the step-by-step approaches that they take in their work. And so it kind of stands to reason, doesn’t it, that this would be popular given what you’re finding in your survey?
Mel Goodyear (18:46): Yeah. Yeah. And we did look in the survey also about what are the things that are most connected with practice? And interestingly, it is the strongest, I guess, predictor of people improving their practice is having the skills and knowledge. And I know we are talking about people having a bit of a gap between knowledge and practice, but basically what we know is we’ve got to try and improve the skills and help them transfer those in practice in their context to actually then deliver better support for families and children in their everyday work.
Dan Moss (19:21): Yeah. Thanks, Mel. That’s fascinating. Claire, the survey, I believe also asked workers about the use of Emerging Minds learning resources. And we’ve talked about that a little bit here, but what else did that show?
Claire Marsh (19:34): Yeah. We were very happy with the way that the survey was disseminated out because it meant that while we used our own channels to put the survey out, we did end up with a lot of Emerging Minds’ usual audience and people who’ve used our resources, which was about half the group. But we did also have quite a good group within the survey of practitioners who had maybe only heard of Emerging Minds and not really used the resources or people who’d never heard of us before at all.
(20:03): So what that allowed us to do was then sort of have a look at differences between those two groups. So as researchers, we called this group that had used Emerging Minds the Exposed group, they’ve been exposed to the program. And then we had our Aware Only group. And our people who’d never heard of us before, we sort of used as a Control group.
(20:22): And what we found was that the Exposed group tended to rate themselves higher on their capability and their competence across the different domains of child mental health that we measured, and they had higher scores than the Aware group and even higher again than the Control group.
(20:38): So we were kind of looking at this group of users who have actively done learning through Emerging Minds learning and looked at our resources, were rating their capability sort of up to 15 to 20 percent higher than those who’d never used Emerging Minds before.
(20:53): So for us, that tells us that there’s a relationship between using learning products and building better capability. And Mel talked before a bit about some of the other evaluation activities that we do here, and we have a look at people who use the e-learning and that shows that they improve their learning when they do courses.
(21:15): We also have a longitudinal study of some users as well, which shows that the practices and the knowledge that they gained through the resources tend to be maintained over time. So then when we found similar results in our survey, I felt like that’s really promising and gives us a lot of confidence in the quality of the products to be able to start working towards bridging that knowledge practice gap as well.
Dan Moss (21:39): So Claire or Mel, whether it’s practitioners using Emerging Minds products or other products, would it be a fair assumption to say that there is evidence of a growing level of connectedness or mental health champions amongst practitioners throughout Australia that this cohort is growing in both their experience and their competence?
Mel Goodyear (22:01): Definitely. I think not only this survey tells us that, but also the users engaging with Emerging Minds is growing over time. Particularly during COVID, there was something like a thousand percent increase in people accessing Emerging Minds. And you could understand that. I think in a way the COVID pandemic and maybe issues associated with disasters, and we’ve seen a lot more impact of that, that child Mental health is something that is talked about a bit more freely in society.
(22:34): And we are seeing that transfer to practitioners as well, looking for ways that they’re seeing the effects of it, I guess, and they’re looking for ways to work with it. So before we used to hear a lot more about referral, but what this survey is telling us that they’re looking for referrals for these children, but this survey’s actually telling us, given they are moderately capable, they’re saying that they are moderately okay, there’s room for improvement, but they’re moderately okay in this space to do some of this work, which is pretty remarkable and nice and positive for the future.
Dan Moss (23:09): And you’ve spoken a little bit about this, but what are these results in the medium to long term? What do they mean for workforce development in the area of child mental health?
Mel Goodyear (23:19): Yeah. Well, I guess, the survey is really important for us to give us an indication of what the current baseline is. So this is the current baseline that tells us about existing needs. As I said before, we saw a really significant need in infant mental health.
(23:34): And since that survey has happened, there’s actually been a significant amount of resources that Emerging Minds has produced around infant mental health in that practice. We’re really hoping that maybe some of those resources will have shifted, I guess, the confidence that people feel in this area. So everyone out there that contributes to our evaluations and our surveys, we thank you, but also look out for the next one as well.
Dan Moss (24:00): So thinking about looking out for the next one, if people are wanting to get involved in this survey or future surveys, Claire, what can they do?
Claire Marsh (24:12): Yeah. So in addition to this fabulous podcast, we will also have a summary of these themes from the results of this first survey, which you can access through our website and maybe some infographics or little bits of information that might be useful for workers to understand what’s going on in their sector or their area. We’ll also have a full longer report if anybody would like to read a bit more detail about that information.
(24:38): You can get in contact with us if you’d like to learn more about the findings. But yes, also, we would like to highlight that we’re running the survey again in 2023, and we would love to include even more of the workforce in the next one if we can. Yeah, anybody who’s working in health, social, community services, we’d love to hear from you and let us know what’s going on in their area.
(24:59): There was a few workforces that we didn’t get very high numbers for in the first survey that we would love to hear from especially. So people like GPs, paediatricians, primary healthcare nurses, first responders, and emergency management workers. And then in terms of geography, we’d love to see a bit more representation from the NT, Tasmania, ACT and sort of more remote areas. We were very happy to have 1,500 people take part the first time around.
(25:26): And yeah, we would love to beat that number if we can. And yeah, let everybody know that there’s also the incentive of winning one of six iPads to go into the draw to win an iPad if you take part in the survey. So people can watch out for our posts on social media and the website and the newsletters and check newsletters from your network. So we’ll try and post a link as far and wide as we can.
Mel Goodyear (25:50): And I guess, it’s important for people to know what we do with this information as well. It not only internally helps us make decisions about what sort of workforce packages that we need to develop, but we also connect with other key stakeholders. We’re connected with policy level people at the Department of Health Commonwealth.
(26:12): We’ve also done presentations with all the PHNs, primary health networks across Australia, presenting those results really as a way to, I guess, get them thinking about child mental health and how they can plan and better support services and practitioners in their regions. We look specifically at different groups as well, and we work with peak bodies as well to help translate that data.
(26:39): As well as for the general audience, we will be translating it through a number of products that Claire talked about. I think that’s really important that we, while we are researchers and evaluators, we’re interested in people using the data for a greater benefit, I guess, and to help them make future planning decisions and things like that into the future.
Dan Moss (27:01): And Mel, you’ve been doing similar evaluations for quite a while now. Looking forward towards the future, if you were to provide an evaluation or a survey such as this in three or four years time, what would you be hoping to see from that?
Mel Goodyear (27:16): Well, that’s a good question. I think we’d be hoping to see a stronger relationship between having the knowledge and understanding the different skills involved in supporting child mental health and actual practice. That we’d have people confidently reporting that they’re regularly working in that holistic family focused way, that they have things in their toolkit that they can pull out at different times, that they understand what to do and how to recognise.
(27:47): Maybe some difficulties, but also protective factors as well. And that they feel that they have a favourable environment around them to do this type of work. We’re interested in exploring this idea of childhood trauma and adversity and the gap or the disconnection with practice.
(28:06): So some of that is understanding what other practices in that space that we need to encourage. But also we’re interested in thinking about how people respond, like first responders, how they might feel about seeing a child who might be in distress when they come into contact with a family, and that they have ideas as to what they can do in those few moments of contact.
(28:28): We know that some of this work for families makes a big difference, even though it may be one or two questions that the practitioner’s asking. And so what we hope is that the general practitioner out there, or the specialist practitioner out there really has those qualities and professional attributes that will take them forward in helping a lot of families across Australia.
Claire Marsh (28:54): To add to that, I think if we looked at this data again in a few years time, I think what we would love to see is some of those practitioners and professionals in roles where maybe child mental health is not top of mind, where thinking about the children or the children’s wellbeing is perhaps not your core business, we’d love to see some of those roles and practitioners feeling more confident about bringing the child into the room and into the conversation and trying to build up some capability in yeah, some of those roles where there’s opportunities to provide support or yeah, help build capacity in parents.
Dan Moss (29:32): So Dr. Mel Goodyear and Claire Marsh, that’s been such a fascinating conversation with both of you today about the first Emerging Minds National Workforce Survey. Look forward to having you back and continuing the conversation in the future. Thank you so much.
Mel Goodyear (29:48): Thanks so much for having us.
Claire Marsh (29:49): Thanks, Dan.
Narrator (29:51): Visit our website at www.emergingminds.com.au to access a range of resources to assist your practice. Brought to you by the National Workforce Centre for Child Mental Health, led by Emerging Minds. The National Workforce Centre for Child Mental Health is funded by the Australian Government Department of Health under the National Support for Child and Youth Mental Health Program.