Health promotion is something that we're funded for so we like to think we do it well when we when we're given it. It’s again a little bit reliant on how many people we have to be able to manage all of our requests.
Basically, how Family Planning NT works is health promotion requests come in, they may request like I mentioned earlier from disability groups, support groups and organizations such as Anglicare and maybe from schools. There's certainly some schools that gets us in every year in/year out because they think their school students are understanding it, and they have good evaluations of the classes, and that the children feel that that curriculum has been met. We've had teaches that have said that they feel more relaxed about having that possibility, if a student comes up and divulges that they've been touched inappropriately then how can they manage it, how can they handle it, and they feel confident because it's not a skill that someone will maybe give them in their three years at the university but it's a skill they need.
When a request comes in we just see who's available at our education team or community educator and can we do it. Can we meet that need or can we change the date, so that's how we book it. We try to do as much education around the Darwin, Palmerston, Alice Springs regions and Katherine. We have education programs out bush in the community, we'll maybe offer some sort of community health promotion.
We’ve done that with Strong Women and certainly in some remote communities, we've met with Strong Women and talked with their young people to give them information about women's health, and what they should be looking out for, when they should go and see their doctor or nurse in the clinic. So, it just depends on who needs us, and usually a lot of groups do and we can't meet the demand.
When I think of health promotion TEAMhealth, because we are so broad in the supports that we offer I think that we are tackling many of the different social determinants of health.
Whether that's a combination and safety so obviously people need housing and safety and safe place, and exercise, a healthy lifestyle, good food in order to have good mental health.
We have our accommodation services obviously supporting in that area.
Then if there is thinking of specific projects for mental health promotion an example that we did recently was a collaboration with an organization called Mind Blank, and what we did was a Northern Territory or Top End tour.
Mind Blank is a performing arts organization based around mental health and mental wellness and so we went into a range of schools.
I think we reached about 3,000 students so we went to Darwin, Palmerston, we went to Daley River community, Gunbalanya and Belyuen communities into the schools there and more broader sort of just community shows that we did.
What that was an interactive theatre, so how that was promoting mental health was they told a story of a young girl and her how her life sort of unfolds and she ends up very unwell and suicidal.
They re-tell the story and allow the children, that's school-aged children ten and upwards and we did have some adults as well, to interject in the story and say well what could we do here which in terms of health promotion it's making it okay and comfortable for children to talk about mental health in front of their peers which is really important.
Then secondly, to actually see how the story unfolds when a different Road or a different behaviour or caring for someone in that sort of vulnerable position that they might have been in makes a difference it's like that fork in the road
I think there's so many youth at the moment who are in that position like that whether they're being bullied in the playground or whether they themselves know they've been at times a bit of a bully they know all this could actually be that fork in the road for someone else.
It was a powerful performance in that way, so that was a fantastic example that we did recently.
As we’ve said before we really hone in on the seven things that people can do to cut the risk of cancer so all those lifestyle factors: quitting smoking and getting regular screening, being sun smart, living a healthy lifestyle through exercise, and healthy eating and maintaining a healthy weight.
One of the main programs you might be familiar with is the SunSmart program which is run through schools and early learning centers throughout the Territory. I do a lot of work in schools running education sessions with the schools, also working with the schools around policy development as well in terms of putting together really good sun protection policies for the schools. Making sure that they keeping up-to-date with best practice as well and reviewing their policy on a regular basis.
We've recently gone into health promotion and under a different bucket of funding from the Department of Sports and Recreation. We do some services in in the general community for increasing physical activity and health education. We pair that with some of our dieticians doing some work
As a recent example, we did a six-week group with physical activity and healthy eating with the dietician and the health promotion officer for COTA which is a seniors group. That ran that over a period of time just to get some more physical activity involved. Then some easy ideas for that group particular issues are small easy to manage meals that aren't overwhelming for them to make so short and easy making it easy
Health promotion is something that we're going into more and looking at more opportunities. There’s so much out there to be done, it's a big area
I think good health promotion is really delivering of a person who knows the information and feels comfortable in talking about it. Sexual reproductive health is a very delicate topic, a lot of parents cringe at even thinking about their children asking the questions to them so we've had parents. We've had educating parents to sort of say look don't think of it as something special it's just part of normal life and it’s just a process that everyone will go through. Sexual reproductive health has always got a bit of a stigma attached to it, like oh my gosh it's something that we don't want to talk about.
We have people out there that want to use the wrong terminology of body parts, we don't believe that should be the case we think that the educators that we send out use correct terminology. They make it not look like some sort of special topic that needs to be laughed about, it is a normal process of life and it's something that we shouldn't be frightened of and I think that we do that well. I think all the Family Planning around Australia and the Globe do it well because we are comfortable with the topic and I think that's where it can get a little bit out of whack .
I know that when we have question time with different groups we've often put question boxes in to try and make it private so people don't get laughed at if they ask a very unusual question. Some of those questions are really out there, and someone’s written that down and really wants to know about it and they're not going to find that in a magazine. Some of the questions that we ask we've been asked questions like and for example why is sperm salty. How do you get twins. Can you can you get pregnant underwater, I mean it's still myths around there that have been going around for 50 years and even though education says yes, you can get pregnant if you have sex under water they still think that you don't.
We seem to have the next generation is better than the last but we still need to make it better.
Some of the biggest challenges for health promotion in the mental health sector would be, I’d say stigma is one. I suppose with your more physical health areas people tend to think it is external factors or the environment or something that has made people unwell. Whereas with mental health obviously people tend to internalize or blame the individual which is really not the case, and so I think when you are trying to promote mental health people tend to move away a little bit from it and think well that's not me and that's them That can make actually promoting mental health or your service in the community a little bit tricky or they don't want to be seen with you and those sorts of things can be challenging so I think it's up to us to continue in the way that we are to normalize it
Because you know having poor mental health at one point or another in your life is normal, we're all on a continuum of good and worse or poor or whatever however you want to talk about it mental health. I think the more that the community is aware of that, the better it is for everyone and the better we can actually promote it.
Evaluation we do in a few different ways so I think getting feedback from the people we work with is hugely important. We do yearly survey called Your Experience of Service Survey from as many participants as possible. We’re doing this for the second time this year where we asked them a lot of questions about the impact the service has had on their well-being, a range of things like how welcome they felt, how safe they felt, and just to basically evaluate whether our services need particular improvements or changes that we can make for the following year and putting those into practice.
We also evaluate projects that we do, so the example that I gave of the collaboration with the Mind Bank, the performing interactive theatre, at the end of each show we gave all the youth that were there just a really simple feedback form to ask them did they learn something about mental health that day, do they feel more confident to then go out and practice help seeking behaviours following the performance.
Has what we've done made a difference, has there been an outcome or a change and so we do try and do feedback pretty consistently across the projects that we do
Some of the challenges with health promotion in the Territory are how much of a diverse community we've got. Culturally diverse as well, as I said before the Territory’s a very big place and the population scattered all over the place so I'm trying to engage all those people around the Territory in an equitable manner and really getting out there getting health promotion messages heard.
I think another challenge in terms of delivering health promotion in the Territory is changing people's stands on certain issues, sometimes people can be quite stubborn in their views on what what's good for them so changing attitudes and behaviours. As I said before repetition is really important in that sense, so drumming the messages into them.
It’s a problem with a lot of services is we want immediate result, if we don't get immediate result we decide to throw it in the bin and walk away.
It also means then that a lot of programs are cyclically funded, they don't make that result really quick we don't get refunded, five years later someone comes up with exactly the same idea and it gets funded and we just repeat the churn and the wheel over and over again.
We need to have a bigger broader look at lots of different strategies to engage different groups in different ways that they need and think of it as an overarching policy and way forward rather than just nitpicking little individual things.
Evaluation is extremely hard and to do a proper evaluation you need to put a lot of resources into teasing out all the areas. That is a challenge for health promotion.
Another challenge is of course the immediacy of acute care funding needs, means that you always pull from the buckets, then we’ll fund that later when we've got the opportunity to fund that.
If we just resourced it properly and let it be to grow and develop as it needs to and not cut it every five years because of a budget problem we would get a lot further down the track, so that's a personal bugbear.
The key to is success of any health promotion is evaluation and every project that we do we evaluate the outcomes. The biggest challenge to good health promotion is ensuring that the message particularly from cardiovascular perspectives is the messages that we're trying to get out from a public perspective are understood and translated.
Then from a clinical perspective some of those challenges are ensuring with the amount of information for clinicians that is in the market that we can be heard in terms of the importance of the health messaging for cardiovascular disease.