1. Dr Simon Denny Department of Paediatrics, Child and Youth Health School of Population Health, University of Auckland

2. Update on results from youth2000 – the national youth health survey of secondary school students Results on school bullying, inclusion, and health services Value to schools

3. National Youth Health Surveys  Series of national survey of the health and wellbeing of New Zealand Secondary School Students. ○ 2001 ○ 2007 ○ 2012  Large national surveys – over 25,000 young people have participated  Run by the Adolescent Health Research Group at the University of Auckland

4. Background  Adolescent Health Research Group formed in late 1990’s  Consultation and collaboration Building on previous NZ research Number of advisory groups: Maori, Pacific, Asian, Young people and School Principals  Strengths – local results for communities, contemporary data and consistency over time

5. 200120072012 Schools114 (86% response)96 (84% response)91 (73% response) Decile low med high n 26 49 39 % 22.9 43.1 34.2 n 15 52 25 % 16.3 56.5 27.2 n 26 36 29 % 28.6 39.6 31.9 Students9,567 (73% response)9,107 (74% response) 8,500 (68% response) Gender Male Female n 4,414 5,152 % 46.1 53.9 n 4,911 4,187 % 54.0 46.0 n 3,874 4,623 % 45.6 54.4 Ethnicity Māori Pacific Asian NZ Euro Other n 2,325 768 679 5,219 417 % 24.7% 8.2% 7.2% 55.4% 4.4% n 1,702 1,178 1,310 6,871 817 % 18.7% 10.2% 12.4% 52.8% 5.8% n 1,701 1,201 1,051 4,024 511 % 20.0% 14.1% 12.4% 47.7% 6.0% >1 ethnic groups 29%39%42%

9. Family Relationships

10. School Relationships

11. Parent participation in school

12. Risky driving behaviours

13. Suicide attempts & depressive symptoms %

14. Activity, food and body size

15. Substance use

16. Sexual and reproductive health

17. Violence

19.  “Young people are more violent and young women are becoming just as violent as young men”  “The majority of adolescents are sexually active”  ‘P’ use is widespread among young people

20. Been in serious physical fight in the last 12 months 2001 and 2007 Male Female

21. Percentages of students who have had sex

22. Students who have used 'P' or pure methamphetamine

24. Youth Health in New Zealand Source: Youth’07

26. MainstreamAlternative education Noel et al, 2013 JPCH

27. Healthy Mixed Distressed Risky High decile schools Low decile schools Source: Youth07 CMDHB Data Secondary school students attending school within CMDHB Health concerns by school decile (n = 1529)

29. Students experiencing weekly bullying

30. Received nasty or threatening messages By mobile phoneOn the internetBy mobile phoneOn the internet Received unwanted sexual material Students experiencing cyber-bullying during the last year 2007 2012

31. Source: 2007 National Youth Survey

34. No car No phone No computer Parents worry about having enough money for food Overcrowding Moved homes 2 or more Living room or garage used as bedrooms Both parents unemployed

36. No household deprivation Moderate household deprivation High household deprivation 80% 15% 5%

40. Episode of low mood 31% Self-harm 8% Suicide Attempt 4.5% 7% 12% 70% 5% 4% 2% <1%

45. Suicide attempt in the past 12 months (%)

48. How do school environments play a role?  Supportive school environments  Prevalence of GLBT bullying  Teachers reports of GLBT supportive environments

49. Supportive school environment (Student report) Depression symptoms (RADS-SF) Depression among male same-sex attracted students and supportive school environments (Student report) Same-sex attracted students Both-sex attracted students Opposite-sex attracted students

50. Supportive school climate (student report) Suicide risk Suicide risk among male same-sex attracted students and supportive school environments Same-sex attracted students Both-sex attracted students Opposite-sex attracted students

52. School Health Services Survey  All schools that took part in the youth12 were invited to participate in school health services survey  Clinic leaders were contacted by phone and asked to fill in an on-line survey of health services in their school. They were also asked to provide contact information for all health professionals working in the school.  All health professionals were then contacted and asked to complete on on-line survey on their work in the school.  One hundred and twenty-nine health professionals were identified as working in one of the participating Youth12 schools. Of these, one hundred and thirteen (n=113, response rate 87.6%) replied to the health staff survey.

53. Level of health services in schools

54. Linking student health outcomes to health services  No randomised trials of school health services  Can’t link individual use of school health services to health outcomes  Need to look at overall levels of student health and wellbeing in each school  Also need to account for background characteristics of students

55. Less depression symptoms Less suicide risk Level of health service Regular clinics from visiting HP++ One person on-site++ Health team on-site+++++ Infrastructure Hours of nursing/ 100 students+++ Hours of GP/ 100 students++ HEADSS screening++ Facilities+ Training and continuing education Youth health training – post grad+++++ Peer review group+ Collaboration and support With pastoral care team With local GP/ PHO+ Team meetings Specialist support – mental health

56. Less binge drinkingCigarette/ marijuana use Level of health service Regular clinics from visiting HP- One person on-site- Health team on-site+ Infrastructure Hours of nursing/ 100 students Hours of GP/ 100 students HEADSS screening Facilities Training and continuing education Youth health training+ Peer review group Collaboration and support With pastoral care team With local GP/ PHO Team meetings Specialist support – mental health

57. Association between nursing and doctor hours and self-reported pregnancy Denny et al, AJPH 2012 p = 0.03

59. Value to schools  Individual school reports – comparing your school to national data  Reporting on National Administration Guidelines for your BOT (NAG 5)  Direct benefit to students – through better and more responsive health services

60. Acknowledgements  Students, staff and schools participating with the youth2000 surveys  Funders  Ministries of Youth Development, Social Development, Health, Education and Justice, the Department of Labour, the Families Commission and the Health Promotion Agency  Investigators  Terryann Clark, Terry Fleming, Jennifer Utter, Pat Bullen, Ben Dyson, Sarah Fortune, Roshini Peiris- John, Fiona Rossen, Janie Sheridan, Tasileta Teevale