Get documents about "crisis
Document Sample
Challenge or Opportunity?
Crisis Situations/ Social Issues
GOAL
To identify crisis situations such as drug and alcohol addiction and abuse, suicide and family
violence and to know the appropriate steps to take to provide assistance
LEARNING OUTCOMES
After completing this module, participants will be able to
a.
i. identify the signs of drug and alcohol addiction and abuse, suicide and
family violence
ii. describe the limits of their own competency
iii. locate the appropriate information about making referrals
b. explain the factors that contribute to addiction, abuse, suicide and family
violence
c. assess when a person or family is in crisis and make referrals appropriate to the
situation
CONTENTS: PAGE NO.
Goals and Learning Outcomes 1
Contents 1
What to Do 2
Resource Material 4
Quiz 4
Context of Issues 5
Requirements for Workshop 6
Family Violence 7
Alcohol and other drugs 19
Where to go for help 32
Young people with drug problems: Why some and not others? 33
Young people and depression 40
Common Myths and Facts about Depression 52
Suicide Risk for young people with depression 54
1
What to Do
Step One Life As We Know It 1 hour
1. For the last 3 decades in New Zealand the social fabric of life has been changing
dramatically. We have been invaded by technology, isolated by demographic changes,
pounded by economic forces and hurt by corporate values. Something is wrong with
our society and this is evidenced by the increase in social problems like crime, poverty,
substance abuse, suicide and family violence. Try the quiz on page 4 to test your
knowledge of some statistics relating to some of these issues.
2. Describe a time in your life that presented some difficulties. Reflect on some of the
strengths you gained as a result. Discuss with your mentor.
Step Two Designing a Workshop 15 hours
3. Read the resource material on page 6 (requirements for workshop) and choose two of
the following topics to cover in a workshop.
a. Family violence
b. Abuse of alcohol and other drugs
c. Suicide and depression
4. Read the resource material and consider how you might utilise this in your presentation
5. Prepare a workshop, and send in:
a. A detailed presentation plan, including suggested timing of activities
b. Your reasons for the way you have designed the presentation
c. Any visual aids used
d. Notes for presenters use
e. A list of references used to create presentation
Step Three Reflecting on My Competence 4 hours
6.
a. Meet and talk with someone trained in one of the fields outlined in this module.
Find out how and why they got into the field; their range of experience within
the area; what training they have done and what advice they would give you as a
youth worker in this field.
b. Reflect on what you would need to do to become qualified in any one of these
areas and what your current level of competence is. Discuss with your mentor.
c. Write up a reflection of your interview and discussion, in a maximum of 500
words
7. Find out what agencies are available for families and young people in your community
needing assistance with these issues. Make a list of potential referral agencies in your
community, with contact details (you may be able to draw on material from other
modules for this activity).
8. Using the material provided, and any other resources you have available, consider the
task of encouraging a young person to discuss issues of family violence, alcohol and
CHURCHES YOUTH MINISTRY STUDIES 2 CHALLENGE OR OPPORTUNITY?
other drugs, and suicide and depression. Write a list of at least ten questions that you
believe would encourage a young person to talk to you, starting with several general
questions, and then focusing on the particular issue, as if a young person was beginning
to disclose to you. Share your questions with your mentor, and use the feedback to
make any improvements. Submit both the draft questions and the revised questions.
CHURCHES YOUTH MINISTRY STUDIES 3 CHALLENGE OR OPPORTUNITY?
Resource Material
Quiz
1. According to reliable estimates,
what percentage of all violence 5. The most commonly used drugs in
occurs within the home? New Zealand are
a. 50% a. Cannabis, alcohol &
b. 80% tobacco
c. 20% b. Tobacco, alcohol & Ecstasy
d. 35% c. Alcohol tobacco & cocaine
2. What percentage of domestic 6. Smoking kills about how many
disputes involves alcohol? people a day in NZ.
a. 60% a. 6
b. 30% b. 12
c. 90% c. 20
d. 25% d. 1
3. In 1998 alcohol was a contributing 7. What percentage of people who
factor in how many fatal road died by suicide in 1998 was aged
crashes? 15-24?
a. 144 a. 33%
b. 78 b. 75%
c. 53 c. 25%
d. 229 d. 66%
4. What is the second leading cause of 8. How many of these were male?
death in the 15-24 year age group? a. 1/3
a. Motor vehicle crashes b. 3/4
b. AIDS c. 1/4
c. Suicide d. 2/3
d. Cancer
Answers to Quiz
1.b 2.c 3.d 4.a 5.a 6.b 7.c 8.b
CHURCHES YOUTH MINISTRY STUDIES 4 CHALLENGE OR OPPORTUNITY?
Context of Issues
These social problems often occur in the context of families already struggling, pacing
immense pressure on them. It is easy to blame the family for their problems, increasing the
stigma and making it shaming for families to acknowledge difficulties and seek assistance.
As people working with young people affected by these issues it is important that we can
encourage families to break the silence. It is through acknowledging struggles that families can
also acknowledge their strengths and abilities. It is through the tough times that we develop
resilience.
The story of the people of God throughout the Bible and on through history shows the lives of
many people who have been able to overcome adversity through God‟s transforming power.
God is even inclined to use our weakness perhaps more often than our strength. Consider
Joseph who suffered violence at the hands of his family and eventually became not only the
instrument to save the people of Egypt but of his family also.
Consider Ruth and Naomi, forced to live in poverty resulting from the deaths of the males who
provided the income for their household. Their faith expressed in their staying together and
believing in the God of Israel lead them to a new life.
Consider Saul, so zealous that he tortured and imprisoned believers in the new Christian way,
before being converted himself. By the power of God‟s forgiveness new was able to be a
powerful instrument himself in the spread of the gospel.
Consider Mary, bearing the possibility of shame through being pregnant before being married
to her betrothed; the strength required for her to say “yes” to the angel; the strength required to
give up her son to death on the cross.
Forgiveness is not easy and sometimes we may not be able to forgive those who have hurt us
badly during our earthly life. It may take longer than that. But God does not expect us to bear
the burden of hurt and abuse on our own. God is always with us to take that load.
CHURCHES YOUTH MINISTRY STUDIES 5 CHALLENGE OR OPPORTUNITY?
Requirements for Workshop
1. Prepare a workshop presentation of approximately one and a half hours for either:
a) Parents OR b) Young people
2. Your workshop should cover two of the three main topics
3. The workshop must include some presentation of material by you; some visual aids
(eg:handouts, overheads, posters, brochures etc) and some group activities. Be aware
that there is a lot of material in the resources, and it is not expected that you cover the
breadth of that material in your workshop.
4. By the end of the workshop participants should be able to:
a. define the areas you have covered,
b. describe the effects of the issue on family and young persons,
c. list factors that contribute to the issue,
d. recognise indicators of the issue in young people
e. have some strategies for responding in appropriate ways.
5. Your workshop must include:
a. A warm up exercise relevant to the topic
b. A balance of some information giving and some activity
c. An opportunity for participants to discuss their personal experiences in a
supportive way
d. A brief concluding exercise
e. Some biblical material
Helpful Hints for Designing a Workshop
Think about structure – a beginning, a middle and an end
Think about how people will make notes – can you design handouts to assist this?
For effective learning people need to talk about their own experiences –make sure you
leave enough time for this
You won‟t have time for an activity on each of the five learning outcomes – some of it
will need to be covered by you in handouts and information giving.
CHURCHES YOUTH MINISTRY STUDIES 6 CHALLENGE OR OPPORTUNITY?
Family Violence
MYTHS AND REALITIES ABOUT VIOLENCE AND PARTNER ABUSE
People make a big deal about violence; it's not that common.
An estimated one in five girls and one in nine boys will be molested by the age of sixteen in New
Zealand. Up to one-quarter of women are hit during pregnancy. An estimated one-third to one-half of
households are affected by violence. Incidents are seriously under reported. It is seldom identified as a
separate crime and therefore doesn't show up in statistics.
She asked for it / she probably deserved it.
No one has the right to abuse another person. Violence against a woman is a criminal act. Violence
against any person is a criminal act.
She must really like the violence or she wouldn’t stay. (Masochistic)
Others do not understand why the battered woman does not leave, and assume the woman in some way
gets pleasure from the beatings. Psychological studies of the women involved do not support this belief.
There are many reasons for staying but pleasure from abuse is not one of them.
Why doesn't she leave?
It is difficult for many people to understand why the woman does not leave. There are many factors that
operate to make her leaving very difficult. Women have been brought up to
believe that their true fulfilment comes from being wives and mothers; family
and counsellors often encourage her to stay; some women do not feel they
have the physical resources (money, house) to provide for their children.
Finally many women are pursued and further abused when they leave and are
kept in a double bind whereby they are beaten if they stay and killed if they
leave.
It will get better.
The relationship will only get better once the man ceases to be violent and
controlling. The longer the cycle of violence continues the worse the violence
becomes.
Middle class women are not the victims of violence as much as working class women.
Violence occurs across all classes and socio-economic groups. It is reported less often amongst higher
socio-economic groups. It may be that with larger sections and better insulated houses the noise does
not carry.
Women in violent relationships are uneducated.
The education of women in relationships with violent men ranges
from basic to doctorate.
Women in violent relationships are crazy
This myth again focuses blame on the woman and her negative
personality characteristics. It is not supported by psychological
studies. "Crazy" behaviour adopted by the woman is usually her best
attempt to survive in a very difficult situation.
CHURCHES YOUTH MINISTRY STUDIES 7 CHALLENGE OR OPPORTUNITY?
Children need fathers
Children who grow up in families where there is violence are often emotionally scarred and grow up
repeating similar patterns in their own families.
Drinking causes violence
Alcohol and other drug use doesn‟t cause violence but may act as a „trigger‟ or be used as an excuse for
violenceReligious men are not violent
Men who have religious beliefs are just as likely as other men to be violent. Religious beliefs often
stress male superiority in the household. This thinking underlies violence.
Violent men are unsuccessful and without resources to cope with the world
Many violent men have educational, professional and work related resources and skills, which
they use, well outside the home. (e.g. Doctors, Lawyers, Politicians etc.)
Violent men are not loving partners
The violent man is often loving, sensitive and playful, and it is this side of his
personality that induces the woman to stay.
Violent men cannot control their violence
They often believe this. It is the belief of this myth, which enables them to
continue to avoid taking responsibility for it. They are quickly able to take
control when taught some strategies. Most men who are violent to their
partners are seen as very reasonable and 'respectable' outside the family,
indicating that they do have control over their violence because they can
choose when to use it
Which responses are surprising to you? Why?
Family Violence Defined
What is Family Violence?
It was once accepted that it was simply a physical violence inflicted by males against their female
partners in the home or within the family environment. However, as definitions of „partner‟ and
„family‟ have broadened during recent years, family violence has been extended to include the whole
range of violent or abusive behaviour in family relationships. The passage f the Domestic Violence Act
1995 has further widened the definition of violence and those who can seek help
It covers:
Male partner violence against women
Sexual violence against women partners
Child abuse and neglect
Child sexual abuse
Elder abuse and neglect
Allowing a child to witness family violence
It can also include:
Abuse between brothers and sisters
Violence by women against male partners
Abuse of parents by children
Violence within gay and lesbian relationships
Violence against flatmates, or anyone sharing accommodation or in a close personal relationship
Psychological abuse
Much family violence is perpetrated by men, and directed against women and children, although
CHURCHES YOUTH MINISTRY STUDIES 8 CHALLENGE OR OPPORTUNITY?
violence against children (except sexual abuse) is as likely to come from women as men.
Why might this be?
Family violence, in whatever form, is typically not random, but more likely to be part of a pattern of
systematic violence that gets worse over time. And it is not just about physical attacks or sexual abuse –
family violence also includes a range of emotional or psychological acts. Examples of abuse are as
follows.
Physical Abuse
At the core of family violence is physical violence. Physical violence is assault. Some assaults might
not draw blood or leave bruises, but it all forms a basis for control. Once physical violence has been
used, there is the fear that next time it might be worse.
Sexual Abuse
Rape or the use of force or coercion to induce a person to engage in sexual acts against their will.
Psychological Abuse
This can take the form of constant put downs and name-calling, intimidation and harassment that make
victims feel bad about themselves. It is likely to inhcloude lots of yelling and threats of physical
violence, threats to leave or even threats of suicide. Looks, actions and expression might be used to
instil fear. Items valuable to the victim might be smashed or pets harmed. It can also include mind
control games such as controlling someone‟s money, time, car or contact with friends as a way of
having power over them.
The Domestic Violence Act 1995 made psychological abuse an offence just like physical violence, and
provides means of protecting victims from it. The Act defines psychological abuse as “including
intimidation, harassment, damage to property, threats of physical, sexual or psychological abuse, and
(in relation to a child) abuse causing or allowing the child to witness the physical, sexual or
psychological abuse of a person with whom the child has a domestic relationship”.
Violence Against Women
This is the most common form of family violence. A useful description is found in the Declaration on
the Elimination of Violence Against Women, adopted by the United Nations in 1993.
The key aspects of the Declaration are that violence against women:
Violates their basic human rights
Is a manifestation of historically unequal power relations between men and women
Is a key mechanism placing women into a subordinate position to men
Is a gender-based form of discrimination
Prevents women from reaching their full potential
Is pervasive and occurs across the lines of income, class and culture
Particularly affects groups of women who are seen to be especially vulnerable, such as
indigenous women, refugee women, women living in remote or rural communities, destitute
women, women with disabilities
Has been highlighted as a problem by the women‟s movement internationally
The Declaration also says, in Article 1:
“…the term „violence against women‟ means any act of gender-based violence that results in or is likely
to result in, physical, sexual or psychological harm or suffering to women, including threats of such
acts, coercion or arbitrary deprivation of liberty, whether occurring in public or in private life.”
Violence Against Children
The Office of the Commissioner for Children uses a set of clear and simple guidelines defining child
abuse:
• Physical abuse – all physical injuries to children where there is knowledge that the injury was not
CHURCHES YOUTH MINISTRY STUDIES 9 CHALLENGE OR OPPORTUNITY?
accidental, or knowingly prevented
• Sexual abuse 0 the use of a child for sexual and/or personal gratification of someone who takes
advantage to their power and/or the child‟s trust
• Neglect – serious deprivation of necessities such as food, shelter, supervision appropriate to their
age and essential physical and medical care
• Emotional abuse – negative attitudes and behaviours on the part of adults, which severely impact
in the child‟s emotional and physical development.
EXTENT OF FAMILY VIOLENCE
Available statistics indicate family violence is widespread. It occurs largely against women
and children in the home. In recent times, however, family violence has become less acceptable
in the community, largely as a result of publicity by Government and non- government
agencies, such as the Police's 'Family violence is a crime, call for help campaign" and the
Children and Young Persons and their Families Service's Breaking the Cycle campaigns.
Violence occurs in all types of New Zealand homes - it is as likely to occur in a wealthy suburb
as a country town and is common in all families, religions, races and cultures. In most cases of
abuse, the abuser is well known to the victim - a family member, close relative or friend of the
family.
Changing public attitudes have revealed a truer extent of family violence than has previously
been identified. The public is showing more confidence in reporting family violence as the
message that it is a crime gets through. Police have also been dealing more seriously with
family violence - where previously mediation was often used to defuse a violent situation,
family violence is now treated like other cases of violence. Arrests are made where violence is
alleged and sufficient evidence obtained.
In 1994, for instance, when the "Family Violence is a crime" campaign was launched, reported
assaults on women by men rose 44 percent nationally over 1993 figures. Prosecutions of men
for this offence totalled 6684. The increase in reported violence overall in 1994 was 20 percent.
Establishing the true extent of family violence, is, however, still difficult. Before the recent
Police publicity campaign, for instance, it was estimated, based on overseas figures, that only
10 percent of family violence was reported. Findings of surveys are sometimes difficult to
draw conclusions from. Victims are often reluctant to report violence by members of their own
family; definitions of abuse are often not clear (some women might not have considered a slap
significant etc); women might have been reluctant to discuss problems with a stranger in a
telephone survey, and so on.
However, a recent report by Hilary Lapsley indicated that between 10 percent and 25 percent
of women had suffered from some form of abuse in the year leading up to the various studies
she looked at. A report by economist Suzanne Snively, The New Zealand Economic Cost of
Family Violence, assessed the cost of the violence to individuals and the community based on
different assumptions about the prevalence of the violence (the study used one in 10, one in
seven, and one in four in families). Assuming one in seven families experienced violence, it
directly affected more than 480,000 people, either as survivors (victims) or perpetrators in New
Zealand in 1994. The report indicated that the assumptions about the cost of family violence
were conservative. Although the base cost was $1.2 billion, it could be a lot higher.
ATTITUDES OF MEN
A recent report by Julie Leibrich, Judy Paulin and Robin Ransom - Hitting Home - revealed for
CHURCHES YOUTH MINISTRY STUDIES 10 CHALLENGE OR OPPORTUNITY?
the first time New Zealand men's attitudes and behaviours towards family violence and their
rates of abuse. '
For research purposes, the authors used a definition of abuse consisting of 22 specific
behaviours. Physical abuse included behaviours constituting gross physical assault - for
example, beating up their woman partner, choking or strangling her, using a knife or gun on her
- and behaviours such as pushing, grabbing or shoving their woman partner.
Psychological abuse included threats of violence and public humiliation, as well as swearing
and insults.
One in five men in the survey of 2000 men reported having physically abused their partner at
least once in the past year.
Two percent of men thought it was OK to hit a partner. However, when shown 20
circumstances that might spark abuse - such as catching her in bed with another man, she
spends too much money, she comes home drunk, or the kids keep crying all the time - 10
percent approved of hitting in at least one of the circumstances. Four in 10 of the men
disapproved entirely of hitting in all the circumstances and 56 said they did not strongly
disapprove of hitting in at least one of them. During the past year, 21 percent of the men
reported committing at least one act of physical abuse and 53 percent reported committing at
least one act of psychological abuse. Equivalent lifetime rates are 35 percent for physical abuse
and 62 percent for psychological abuse.
The most commonly reported acts of physical abuse were pushing, grabbing or shoving,
slapping, and throwing something at a woman. The most commonly reported acts of
psychological abuse were insulting or swearing at a woman partner, putting down her family or
friends, trying to prevent a woman partner from doing something she wanted to do (such as
going out with friends or going to a meeting), and throwing, smashing, hitting or kicking
something.
The report concluded that on average, New Zealand men had high general anger levels. It also
found that:
• 67 percent of men have personal knowledge of men hitting women - either they know a perpetrator
or victim of physical abuse, or they have witnessed physical abuse.
• 70 percent say domestic violence is a major problem, 20 percent say it is a minor problem and 1
percent say it is not a problem at all.
• 87 percent know, but 1 0 percent do not know, that hitting a woman is a crime.
• The most abusive men had the highest levels of anger and were most likely to blame women for
being abused.
• The more serious the abuse, the more likely the men who reported committing abuse were to agree
with the questionnaire statement: "Women should concentrate on being good wives and mothers
rather than on their rights."
• Men who tend to condone abuse of women are more likely to be older, yet men who actually do it
are more likely to be younger.
• Men who abuse women think the solution might lie in avoiding potentially abusive situations, or
in the Government improving support services.
Women's Refuge also provides some indication of the extent of family violence. It had 22,035
CHURCHES YOUTH MINISTRY STUDIES 11 CHALLENGE OR OPPORTUNITY?
clients in 1994, a figure likely to grow in the short term as family violence becomes more of a
public issue. in the long term, it is hoped the figures will decline. Of the 13,299 residents of
refuges in 1994, 5017 were women and 8282 were children. It had 8736 community cases and
ran 2060 education programme sessions for 9665 people.
CHILDREN
Children are often the forgotten victims of family violence, despite child abuse being
recognised as a serious problem.
While actual violence against children is a big concern, children are also harmed by the
violence they witness in the home. A study of the Hamilton Abuse Intervention Pilot Project
(HAIPP) by Gabrielle Maxwell revealed that children were at the house in 87 percent of the
incidents in which their parent was a victim of violence. A 1991 Women's Refuge study
suggested that, for women receiving help from refuges, 90 percent of their children had
witnessed violence and 50 percent of the children had also been physically abused. Twelve
percent had been sexually abused.
It is of concern that children not only see the violence, but also hear the shouting and crying
that go with it.
The HAIPP study showed that incidents brought to Police attention were mainly because of
men's violence against women. However, in many cases, violence towards children during
these incidents remained in the background. In New Zealand, hitting a child is still seen by
many as a legitimate part of parenting. The law (Section 59 of the Crimes Act, 1961) exempts
parents from an assault charge when they use "reasonable force" in disciplining their children.
EFFECTS OF FAMILY VIOLENCE
Many women and children suffer long-term mental and physical ill health as a direct result of
the abuse and violence. Feelings of fear, shame and guilt and threats of further abuse contribute
to stress and depression.
Whatever form it takes, family violence has a debilitating effect on the family group. In the
most severe cases, the victim has died from the injuries.
Physical injuries, the most obvious signs of abuse, can have long-term effects, but the
emotional trauma of living in an abusive family can also be long lasting.
Women and children subjected to constant abuse might feel powerless. They are likely to want
to please the abuser, despite being terrified, and hide the abuse from friends and neighbours.
They can become emotionally and physically exhausted. They might feel violated and
degraded, with a corresponding loss of self-esteem. Suicide can result.
EFFECTS ON CHILDREN
As both victims and witnesses of family violence, children can be
severely damaged. Children can suffer horrific injuries as the result of
violence in the home. Adults, because of their usually dominant
physical strength, can hurt children more than they ever mean to.
If their mother is subjected to violence, most children will know. They
often witness the traumatic beatings or the humiliation. Sometimes they
get involved, trying to help the victim by stopping the violence
themselves. They can get hurt, too, either by accident or as a side
CHURCHES YOUTH MINISTRY STUDIES 12 CHALLENGE OR OPPORTUNITY?
product of the attack on another victim.
Studies have shown children suffer long-term effects of witnessing abuse:
Increased illness
low self-esteem
Social problems
Failure at school
Violent delinquency
A United States study found that children who grew up in violent homes were twice as likely to
commit violent crimes as those who lived in non-violent homes.
Children who witness family violence have been shown to be more aggressive and anti-social
and to show more fearful and inhibited behaviours and to have lower social competence than
the norm.
88.2 percent of children in women's refuges who had witnessed the abuse of their mother
showed behavioural problems such as hyperactivity, anxiety or aggression that were severe
enough to be regarded as clinical problems.
The greatest long-term danger is perhaps that children accept that violence is acceptable
behaviour - that when an adult is angry or frustrated, violence is an answer.
Girls who see their mother abused can model their mother's behaviour, becoming fearful,
withdrawn and distrustful. Overseas studies indicate girls who have been in abusive families
are more likely to accept victimisation and violence from their friends and partners in
adulthood.
Boys might model their behaviour on that of their violent father. Boys can become aggressive,
bullying not only their friends and siblings as youngsters, but also
their mother. Studies have shown that, as adults, they are more
likely to beat their partners and commit violent crimes.
CAUSES OF FAMILY VIOLENCE
It has been stated many times that family violence is about power
and control - desire by an abuser to dominate a victim through fear.
The issue of cause is complex. Certainly there are triggers that can prompt violence: alcohol
and drugs, stress, unemployment and so on. Early research focused on probable causes such as
an abuser's violent past, inability to control anger and the victim's actions.
However, while these "causes" are valid as triggers to violence, they do not explain why family
violence is so widespread.
The answer is perhaps that abuse in the home environment has been socially accepted. Until
recent times, the law and many men, while not condoning family violence, saw it as a personal
problem that should be sorted out within the family. The home was no place for others to
interfere.
The law now sees things somewhat differently. Police initiatives in dealing actively with
violent situations in the home have begun to turn around the attitudes of society.
An abuser is no longer able to continue violent behaviour without the risk of neighbours,
CHURCHES YOUTH MINISTRY STUDIES 13 CHALLENGE OR OPPORTUNITY?
family and friends reporting it. And when it is reported, it is dealt with by the Police, the
Children and Young Persons Service and a justice system that recognise it is a crime.
Society is beginning to expect abusers to take responsibility for their actions and to be
punished; to get help, to do something about their behaviour.
The Justice Department report, Hitting Home, provided an interesting insight into the reasons
men felt they acted violently.
What was revealed was that men tended to blame women for being abused. Shown 20
circumstances in which a man hits a woman, nearly two thirds of the men blamed the woman
alone for the hitting in at least one of the circumstances. Off the top of their head, the men
attributed physical abuse to social problems and personal characteristics, saying alcohol was a
cause, as was financial or job problems, the dynamics of the relationship, the man's personality,
family background, stress and the woman's behaviour.
Interestingly, while alcohol was initially cited as a cause for abuse, with more careful thought
the men often said dealing with an alcohol problem was not a way of reducing abuse. A man
coming home drunk might be more likely to abuse his partner, but it is unlikely the reason he is
abusing her is alcohol. Other factors are likely to be more important.
When social expectations about "what it is to be a man" could not be met, there was distress, a
sense of powerlessness and a wish to regain power. If a man cannot break away from society's
expectations, change the frustrating circumstances or communicate and deal with his stress, he
is likely to be abusive towards his partner, the Hitting Home report concluded.
POWER AND CONTROL
An abuse intervention programme was established more than 10 years ago in Duluth,
Minnesota. From the experience of the women identified as victims of
abuse came the Power and Control Wheel, representing what happens in
a violent family. The Power and Control Wheel was also a cornerstone
of the Hamilton Abuse Intervention Project. The wheel illustrated that
family violence was about power and control and indicated that it was
more than just physical abuse. A Wheel of Equality was developed that
looked at alternatives to the use of violence.
CHURCHES YOUTH MINISTRY STUDIES 14 CHALLENGE OR OPPORTUNITY?
CHURCHES YOUTH MINISTRY STUDIES 15 CHALLENGE OR OPPORTUNITY?
RECOGNISING ABUSE
You might be a parent, friend, relative, neighbour, teacher church minister or doctor. You might suspect
abuse, but do not know the signs. The following tips give some indication that abuse has occurred
Whether through fear, shame or any other reason, a victim can become very good at hiding the signs of
violence in the home. Some of the indications a victim might show are:
Non-specific complaints
Depression that she or he won't explain
Taking more pills or alcohol than normal
Bruising or difficulty moving
Excessive concern with housework or the relationship
Tiredness
Becoming isolated from people close to her or him
Making last-minute excuses not to see people close to her or him
INDICATORS :
WOMEN WHO SHOW THESE SIGNS MAY BE FAMILY VIOLENCE VICTIMS
Physical Indicators
Grip or teeth marks, strangulation or suffocation
Injuries on areas covered by clothing
Injuries during pregnancy, bruises on stomach
A series of accidents with suspicious or recurrent cause
Injuries that don't appear to be accidental
Recurring headaches
Bruises, burns (cigarette or stove)
Fractures (including teeth)
Ruptured ear drum
Sexual assault
Stressed, tired, run-down
Behavioural Indicators
Discrepancy between the injury seen and the explanation given
Embarrassed and evasive about the cause of injuries
Lack of concern about injuries, or blames herself
Wearing sunglasses when it's not bright, avoiding eye contact, hair hiding face
Missed appointments with inconsistent excuses, or sudden changes in attendance patterns
Delay between time of injury and help-seeking
Tension when accompanied by partner, partner dominant and speaks for her
Mate or partner presenting the woman as mentally ill
Wearing clothes inappropriate for seasons
Anxiety, depression, eating disorders
Suicide attempts
Low self esteem
Alcohol and drug abuse, tranquilliser or sedative use
CHURCHES YOUTH MINISTRY STUDIES 16 CHALLENGE OR OPPORTUNITY?
Children are either aggressive, timid, over-compliant, or extremely protective of mother
No money, isolated, no support system
Damage to home – holes in walls and doors, broken appliances and furniture
Avoidance of home visits
Children
General signs of physical abuse can include upset such as:
Moodiness, irritability, excessive crying
Loss of appetite - changes in eating habits
Changes in behaviour at school, or towards other people, regularly missing school
Personality changes
Dirty appearance, inadequately dressed for the climate
Withdrawing into themselves
Being afraid to go home, running away
Undernourished and not taken to the doctor when ill
Inability to concentrate
Having unexplained fears - of the dark, of being alone, of specific people (even relatives and
friends), of places (bedrooms and toilets)
Sleep disturbances - nightmares, fear of going to bed or sleeping alone
Unsupervised for long periods
It can also be indicated by physical signs: bruises, burns, fractures, scalds or grazes. The injuries might
be accidental, but if a child seems to be hurt often, the injuries are getting more serious, or there's
something odd about them, it could be abuse.
Emotional abuse is more difficult to identify, but children might:
Tend to believe they are bad and worthless
Have problems getting on with others, or be hard to live with
"Shut off", or become too good
Have difficulty controlling anger
With sexual abuse, children might:
Complain of pain or irritation in the genital area, or get infections and urinary problems
Start doing something they've grown out of - such as crying, wetting or soiling their pants, or
clinging
Have inappropriate sexual play
Give a coded message, or they might say directly they are being abused
HELPING A VICTIM
If you suspect a close friend or relative is being abused you could start by talking to them. Some tips that
will help when you do that:
Become informed - learn to recognise family violence when it occurs. Think about the causes and
effects of family violence. Reading this thoroughly will help your understanding of the problem and
offer some solutions.
Listen to your family and friends when they want to talk about their problems.
Encourage the person to talk, but don't pry.
Believe what you hear and do not underestimate the danger for the victim. Be willing to talk about
the emotional and physical harm that can result from remaining in, or returning to, a violent
relationship. Stress the serious nature of family violence. For example, according to 1994 Police
statistics, one woman dies every five weeks in this country as a result of family violence.
Help them develop a safety plan, and work out what to do in a crisis. Explain to them that ignoring
a beating is dangerous. The beatings usually get worse as time goes on. Let them know about the
CHURCHES YOUTH MINISTRY STUDIES 17 CHALLENGE OR OPPORTUNITY?
facts you have found regarding abusive relationships.
Offer practical support. Tell them about the help agencies and about the steps to take if there is a
crisis. Offer help with any other matters, such as child care, transport, financial assistance.
Reassure them that they are not to blame, that they are not alone, and that leaving is not desertion.
Help them come to their own decisions about what to do. Show them that you support them no
matter what they decide.
Do not judge them. Their beliefs and values might be different from yours. Show them you accept
these differences.
Help them identify their options and the consequences.
Let them know their feelings are normal - many women experience family violence.
Go with them if they need your support.
Do not confront the other partner
Show them respect and your belief in their ability to cope with change.
It is vital that you assure victims that the information they give you won't be repeated to anyone else.
Discuss their situation with others only if you have the victim‟s approval and you want to enlist
practical help. The only exception to this confidentiality rule is if the victim has disclosed that children
are being or have been abused.
The victim, of course, might not want to talk about the problem, or even recognise that it exists. If you
are not able to gain their confidence, talk to a help agency in your area. They have trained staff who can
advise you what to do or make discreet inquiries about the victim's welfare.
The Department of Social Welfare and Te Puni Kokiri have produced an excellent directory called
Reach Out Toro Mai which lists agencies available to help. You can get a copy through most Citizens
Advice Bureaus.
CHILDREN
In the case of children, it is advisable to take action if you know or believe a child is being abused.
Children need special support, as they are often unable to take action to keep themselves safe. You
might be able to offer help and support to the family. If a child is at risk, contact the Police or Children
and Young Persons Service. A Police officer or social worker can then take appropriate action to protect
the child.
SUSPICIONS
If you merely suspect family violence or abuse is occurring, should you report it?
The first question to ask yourself is: is the victim safe? If the answer is "no", take immediate action by
contacting the Police or your local Children and Young Persons Service office.
If the answer is "yes" but you are still worried about their well-being, contact a help agency.
You can talk confidentially with them about what you know. They will probably have a better idea
whether abuse is occurring and will certainly know what can be done to help.
People, especially those not close to a victim, might be reluctant to report violence or abuse because
they feel it is none of their business or they might be wrong.
Can you live with the possibility of violence, or even death, if you do nothing?
One of the most frustrating aspects of working with victims of domestic violence is when
they return to the abusive relationship. This is, however, very common. See if you can
find out why and write a paragraph about it. A useful resource book may be Invisible
Wounds by Kay Douglas and it should be available through your local library.
Alcohol and Other Drugs
CHURCHES YOUTH MINISTRY STUDIES 18 CHALLENGE OR OPPORTUNITY?
Substance Abuse Causes
Historically most cultures have used mind altering substances. It is very difficult to identify only one
cause of substance abuse. It is easier to notice a myriad of contributing factors that are interrelated
Why is substance abuse a problem?
Substance abuse is a major cause of premature death, preventable ill-health and social harm throughout
the population (Dunbar, 1994) It causes psychological harm in the community. Further costs of
substance abuse to the individual include the „4 Ls‟:
Liver physical harm from substance related disease or trauma
Lover relationships, marital and family problems; domestic violence
Livelihood employment problems, absenteeism, poor work performance
Law legal difficulties, drink driving, possession of illicit substances
The abuse of alcohol, cannabis and tobacco now pervades NZ society and dominates youth culture. A
national survey conducted in 1998 by Dr Sally Casswell and Adrian Field of Alcohol & Public Health
Research Unit, University of Auckland, used a sample of 5,475 people aged 15-45 years, drawn from
across NZ who were interviewed by telephone. They identified the following:
Alcohol
Alcohol was the most commonly used drug in NZ. Some 90% of men and 85% of women
had tried alcohol, and only slightly lower proportions had consumed alcohol in the last 12
months.
Almost half of the men aged 18-24 drank six drinks or more per occasion at least weekly.
One in three women in this age group, drank enough to feel drunk at least weekly.
Comparison with a 1995 national survey on alcohol suggested an increase in the
proportion who reported drunkenness, particularly among women.
Alcohol was most frequently seen as having a harmful effect no energy an vitality, and
also financial position. Men were more likely than women to identify these harmful
effects.
Tobacco
Tobacco was the second most commonly used drug in the national survey. Almost
two-thirds of the sample had tried tobacco, and more than a third had used tobacco in
the past 12 months, with the rates for men slightly higher than those for women.
Smoking one or more cigarettes per day was most common among men aged 18-34
and women 18-29.
Women were more likely to smoke between one and ten cigarettes daily, while men
were more likely to engage heavier levels of smoking (11 or more cigarettes per day)
A majority of smokers felt their use was more than they were happy with.
Cannabis
Cannabis was the third most popular drug in NZ, and the most popular of the illegal drugs.
Although half of the sample had tried marijuana, the majority did not use I on a regular basis.
Twenty percent of the sample had used cannabis in the last year and 15% described themselves as
CHURCHES YOUTH MINISTRY STUDIES 19 CHALLENGE OR OPPORTUNITY?
current users. More men than women, and more 18-19 year olds were last year users and current users.
For most people who had tried marijuana, use tended to be occasional rather than regular. Only 24%
had used marijuana more than twice in the last 12 months.
Use of cannabis more than ten times in the last 30 days was confined to a very small proportion of the
sample (3%) and only 1% were daily users.
The average amount smoked during an occasion was less than one joint and once again men and
younger people smoked more.
The majority of marijuana users had first tried in before the age of 18, and almost half had tried it by age
16.
Most people who had tried marijuana no longer use it. The main reasons for stopping or limiting use
were: not liking marijuana; concern over physical and mental health; it was no longer fun or becoming
boring; and having new friends or social scene.
The small group of respondents who were using more marijuana did so because of its increased
availability; enjoyment of the effect; to forget, escape or cope with problems; new friends and social
pressure.
Those who never used marijuana were most likely to say they simply didn‟t like using the drug or felt
no need to do so, followed by health reasons, and to a lesser extent the risk of
being caught or fear of the law, and not being in the social scene.
One in four of those who had never used marijuana had had the opportunity in
the past year to use the drug; this was most common among younger people.
Teenagers – do they need special care?
This is an important transition period when the individual matures from
childhood to independent adulthood. This period of change, growth,
experimentation and maturation is often turbulent, causing distress to both
teenager and parent.
Misuse of alcohol and drugs is commonplace during the 13-23 years period due mainly to peer pressure
and the attraction of experimentation. Occasionally this has disastrous effects, but most frequently over
time and with maturation there is a spontaneous reversion to normal drinking behaviour and little or no
other drug use. Problems are more common among young men than women but are increasing in the
latter. Polydrug misuse is a common pattern with alcohol, nicotine, cannabis and prescription drugs
commonly misused.
Look for the high risk groups
Those with a family history of addictions
Those with a broken or dysfunctional family
School drop-outs and the long term unemployed
Those living on the street or involved in crime and prostitution
Those with psychiatric or personality disorder
CHURCHES YOUTH MINISTRY STUDIES 20 CHALLENGE OR OPPORTUNITY?
What are the main complications?
Young people usually have less tolerance to alcohol and drugs resulting in episodes of intoxication.
This combined with immaturity and risk taking leads to a high rate of 'accidents' of all kinds with
occasional premature death or disability
• Motor vehicle and other accidents
• Suicide
• Drug overdose
• Violent behaviour, rape, crime. STD, unwanted pregnancy
• A drift towards alcohol or drug dependence
• The disruption of education, career and social maturation
What to look for
Frequent or severe episodes of intoxication
Unusually high tolerance to alcohol or drugs
Amnesic blackouts after intoxication
Change in behaviour and personality
Loss of interest in sport, recreation, or education
Rebellious attitudes and unexplained mood changes
Social withdrawal and depression
Unusual difficulties in coping or achieving
How to help the teenager and the family
Don‟t panic. Remember long term outcome is usually satisfactory. Be on the alert for danger
signals
Interview the young person in a non-authoritarian way, seeking to identify with them while
exploring any family, school, social or life problems before focusing on the level and consequences
of alcohol drug use
Interview the parents alone and then with the teenager to define the seriousness of the problems, the
strengths and weaknesses of the family relationship and if there is a family predisposition to
substance misuse
Peers, teachers and school counsellors may provide information but permission should usually be
obtained
Concentrate on positive solutions to life problems, moving the teenager to responsible
independence
The alcohol drug problem can he handled with 'concerned confrontation‟ setting agreed limits to
safe use or abstinence and providing additional education and support
More advanced cases should be referred for intensive counselling and/or family therapy in a centre
sensitive to young people's needs
Family members should be encouraged to join support groups such as Tough Love, Alanon,
Alateen, and PRYDE
No matter how difficult management may be, try to keep the teenager engaged in therapy to reduce
harm and to capitalise on future movement towards spontaneous recovery
Prevention of teenage misuse
There is some uncertainty about the efficacy of preventive educational programmes
Those using 'scare tactics' and information only about the ill- effects of various drugs appear to he
ineffective and may stimulate experimentation
CHURCHES YOUTH MINISTRY STUDIES CHALLENGE OR OPPORTUNITY?
Programmes more likely to be effective.
Begin at an earlier age - junior school
Are part of general life and health education
Emphasise positive health values and body image
Develop self awareness, self esteem, personal responsibility for decision-making
Teach social problem solving skills and assertiveness in response to peer pressure
ALCOHOL, CANNABIS AND TOBACCO ARE THE THREE MOST POPULAR DRUGS IN
NEW ZEALAND. READ ON TO FIND OUT MORE ABOUT EACH ONE.
Alcohol
Alcohol is one of the most extensively used drugs in the world because it is legal and widely
available, and in moderate doses pleasurable without being harmful. It has many forms but has
ethanol as its common ingredient, acting as a relaxant by way of being a central nervous system
relaxant.
The Alcohol Liquor Advisory Council (ALAC) recommends sensible drinking limits as
follows
Female 2-3 standard drinks 3-4 times per week
Male 3-4 standard drinks 3-4 times per week
Calculation of Standard Drinks
(A Standard Drink contains approximately 10mls of ethyl alcohol)
Beer 250ml glass = 1std drink
600ml can = 2 std drinks
750ml bottle = 2.5 std drinks
Wine 100ml glass = 1 std drink
750ml bottle = 7.5 std drinks
Fortified wine 60ml glass = 1 std drink
250ml glass = 4 std drinks
750ml bottle = 12.5 std drinks
Spirits 1 nip = 1 std drink
250ml glass = 10 std drinks
500ml bottle = 20 std drinks
750ml bottle = 30 std drinks
Physical damage can occur where consumption is higher than safe levels outlined. These safe
levels are aimed at preventing social, physical and psychological problems
developing. However, individual factors play a considerable part in this
equation. Below are listed some factors which increase susceptibility to the
actual and/or long term ill effects of alcohol use:
Female sex – higher proportion of body weight is fat
Pregnancy. Especially in first 8-12 weeks the recommended dose is nil
Lower lean body weight
Drinking on an empty stomach – more rapid absorption into the blood
Younger age (under 18) due to reduced tolerance
Older age (over 70) due to loss of tolerance
CHURCHES YOUTH MINISTRY STUDIES CHALLENGE OR OPPORTUNITY?
Combination with other depressant drugs e.g. sleeping tablets, tranquillisers, anti-depressants and
narcotics
Combination with drugs irritating the stomach e.g. aspirin, steroid, anti-inflammatory drugs
Other illness e.g. infection, heart/lung disease, diabetes
Psychiatric illness
Why do people start drinking?
ALAC Info. 30/10/93 Roger Martin Manager Information Services
At the age of ten around seventy five per cent of all New Zealand children either do not drink at
all or drink less than once a month, and only in small amounts on each occasion. By the time
they are 20 only about five per cent of these young people will be classified as abstainers. In the
ten year period between the ages of 10 and 20 therefore, a substantial change occurs in most
young people's drinking behaviour. What are the major influences at work to cause this
change?
Being a Teenager
Although the word 'adolescent' has been used in the English language since the 15th century its
widespread use along with the 20th century American word 'teenager' is linked to the growth of
industrialisation, urbanisation and compulsory secondary education. The words describe the
arrival of an intermediate age category between childhood and adulthood when people have
left childhood but are not considered adults because of continued dependency on the family for
financial and other support. There is, in essence, nothing particularly substantial about being a
teenager except to say that you are 'becoming an adult'.
Drinking alcohol, particularly for boys, has come to be regarded, rightly or wrongly, as one of
the signs that independent adulthood is arriving. This symbolic nature of starting to drink
alcohol as a sign of adulthood has to some extent been reinforced by the parallel growth during
the late 19th century and early 20th centuries of the temperance movement whose influence
caused law changes progressively removing young people from adult drinking places and
whose impact is still to be seen in the provisions of the current liquor laws which try to prevent
people of under 18 from drinking in bars.
The major survey of young people's drinking habits in New Zealand was done in the late
1970's, a survey of 3000 young people in Forms 2,4 and 6. This showed that the frequency of
drinking, and the amount drunk on each occasion, grew as the young people got older and
gradually converged on adult patterns.
Parents
Parents are a crucial influence on the initiation of drinking behaviour as most children have
their first taste of alcohol at home with their parents, and some three quarters have their first
taste before the age of eleven. Parents may also act as role models for their children so that, as
they get older, children will tend to mimic the drinking patterns of their parents.
Friends
The influence of friends drinking patterns is added to that of parents as teenagers become more
independent of family authority. Young people will associate closely with those members of
their peer group they feel most comfortable and at ease with so drinking will be part of the
activities they engage in. Overseas research suggests that the most frequently quoted reason for
drinking to do with immediate feelings and consequences is 'having a good time with my
friends' though heavier drinkers tend to mention negative reasons more often such as to relieve
boredom, get away from problems, anger and frustration.
CHURCHES YOUTH MINISTRY STUDIES 23 CHALLENGE OR OPPORTUNITY?
Media and Advertising
Before the teenage years begin and young people start to experience for themselves the effects
of alcohol, much of the information and expectations they get about the role of alcohol comes
from television and advertisements. Many well known soap operas - Coronation Street, East
Enders, Shortland Street - focus on life around a pub/bar, and drinking occasions on many
programme series occur more frequently than in real life. When eight and nine year olds have
been asked about the effects of alcohol the most common response is 'getting drunk' and more
mention television as a source of information than mention other members of the family.
Although corporate and sponsorship advertising is not meant to be directed at young people,
many young people see the adverts as a matter of course and there is some evidence that this
advertising creates strong positive associations for the companies' products among young
people. More recently, various alcohol education programmes have been marketed to
secondary schools by ALAC, the police and a number of educational trusts to give young
people a broader and more objective perspective on which to base responsible drinking
decisions.
Drinking Problems
All teenagers will be affected by the above factors to differing extents. The most recent survey
of drinking in New Zealand of a sample of 14-65 year olds indicated that young people are
over-represented in the heavy drinking groups. Overseas research suggests that many young
people who are heavy drinkers and who experience drinking problems are characterised by
some or all of the following factors not found in those who drink in safe amounts:
They take their first drinks earlier in life
They come from disorganised and poorly parented families so that relationships between
parents and children are weak
As a result the influence of friends is stronger, starts earlier, and the friendship group has
heavy drinking behaviour
The parents are heavy drinkers
When still children they are aggressive, hyperactive, antisocial and do poorly at school.
Drugs
How can I tell if a young person is using drugs?
This is difficult. Many of the often quoted signs of drug-use – red eyes, skin problems,
lethargy, or excessive bursts of energy – could just as easily be signs of flu or the sort of
hormonal changes common in puberty.
Sudden changes in behaviour and mood are common in adolescence too: a sudden need for
privacy, outbursts of irritation, rebelliousness, or giggling, or periods of day dreaming are part
of normal teenage behaviour and usually don‟t have anything to do with drug use.
Most drugs cost money. Teenagers who want to use them need money to buy them. Teenagers
who have a lot of spare money are more likely to use alcohol, tobacco and other drugs than
those who don‟t.
If a teenager suddenly needs a lot of money for un specified purposes you may want to check
this carefully. If you know the young person well and know what‟s happening in their lives,
you will be better able to know if some changes are cause for worry or not.
It is important not to panic or play detective. This can cause mistrust and fear and exaggerate
the differences between you. If you‟re worried and you‟re not sure about what you should be
CHURCHES YOUTH MINISTRY STUDIES 24 CHALLENGE OR OPPORTUNITY?
doing, you can always get expert help or advice.
CANNABIS QUIZ
Mark True (T) or False(F) beside each statement then check the answers below.
1. Cannabis acts as a stimulant on the body (speeds the body up)
2. Cannabis is harmless because it is „natural.‟
3. Marijuana can be addictive
4. Marijuana can slow down reflexes and affect co-ordination
5. Marijuana contains slightly less tar than tobacco
6. Marijuana is an effective treatment for depression and other mental health problems
7. Most people use cannabis
8. It is illegal to drive a car under the influence of marijuana
9. Marijuana can affect learning
10. The main chemical in cannabis that affects the brain is called “HTC”
11. It is legal to possess marijuana in NZ as long as you have less than 5gms
12. Marijuana can cause hallucinations
13. Cannabis can affect memory in some users
14. Marijuana always has a calming effect on the user
15. Some people need professional help to quit cannabis
Cannabis Quiz Answers
1. Marijuana is a depressant drug. This means it depresses (or slows down) central nervous
system function. Reflexes are slowed down and co-ordination and judgement are affected.
2. Many 'natural' products can be harmful. Marijuana is no exception.
3. Some people do become addicted to marijuana. It is not as addictive as cigarettes (nicotine)
however.
4. See answer to question 1.
5. Marijuana smoke has about three times as much tar as tobacco smoke.
6. Marijuana is known to make many mental health problems worse.
7. About 40% have tried it but only about 12% (one in eight) are current users. Only 3% use
weekly.
8. It is illegal to drive while under the influence of any substance that affects judgement and
co-ordination.
9. Marijuana affects short-term memory and can make it difficult to learn new things.
10. The chemical is THC - or tetrahydrocannabinol.
11. It is illegal to possess any amount at all.
12. High doses can cause the user to see, hear or feel things that are not real. This can be very
scary.
13. True. It can affect short term memory
14. False While marijuana often has a calming effect it can also produce feelings of panic and
paranoia especially in inexperienced users.
15. True. Many long-term users need professional help and counselling to successfully quit
marijuana.
CANNABIS/MARIJUANA: FREQUENTLY ASKED QUESTIONS
In this resource, the words cannabis and marijuana are used interchangeably. Strictly speaking, cannabis is the
CHURCHES YOUTH MINISTRY STUDIES 25 CHALLENGE OR OPPORTUNITY?
correct name for a variety of preparations made from the plant Cannabis sativa. Marijuana refers only to the leaves
and tops (flowers) of the plant, and does not include the hashish resin. However, the word marijuana is used
frequently in this resource to include all forms of cannabis because it is more familiar to most readers .
1. What is Cannabis?
Cannabis sativa is a flowering plant from which various drug preparations containing THC can be
obtained. THC (or delta-g-tetrahydrocannabinol) is the main active ingredient, which produces the
intoxicating effects. THC is a central nervous system depressant with hallucinogenic properties. A non-
potent strain of cannabis (Indian hemp) can be used in the production of paper, textiles and clothing.
Three common forms of cannabis are: marijuana, hashish (hash) and hash oil.
Marijuana is made from the dried leaves and flowers of the plant. It is the most common and least
powerful form of cannabis. Marijuana is normally smoked in hand-rolled cigarettes called 'joints', or
packed into a small 'cone' and smoked in a water pipe known as a 'bong' or a 'bucket'.
Hashish is small blocks of dried cannabis resin. The concentration of THC in hashish is higher than in
marijuana, producing stronger effects. Hash can be added to tobacco and smoked, or baked and eaten in
foods such as 'hash cookies'.
Hash oil is a thick, golden-brown to black oily liquid that can be extracted from hashish. It is usually
spread on the tip or paper of cigarettes and then smoked. Hash oil is the most powerful form of cannabis.
In New Zealand, marijuana and hash oil are more common than hash.
2. How many people use cannabis?
According to the Drugs in New Zealand Survey (1993), 43% of the sample population aged 15-45 had
used cannabis at least once. Use was more common in males and peaked at 65% in 20-24 year old men.
It is likely that 50% or more of our young people will have tried cannabis by the time they are 18
Although 43% of the sample had tried cannabis, half of these had used it less than five times. This shows
that most people who try it don't continue to use it on a regular basis. About 12% were described as
current users, which meant they had used cannabis in the last 12 months and would continue to do so.
Only about 3% of the sample had used cannabis 10 or more times in the last 30 days.
The survey mentioned above was not carried out New Zealand-wide. Some regions will have cannabis
use levels much higher than these figures.
3. What are the immediate effects of using cannabis?
The immediate effects depend on the strength of the dose and the size, mood and tolerance level of the
user. The effect on a person cannot be predicted with confidence as people react differently to drugs,
including cannabis.
Some people do not experience anything. However, the most frequently reported positive effects include
relaxation and feelings of well being, lowered inhibitions and enhanced sensory perceptions. The
intoxicating effect can be similar to that produced by alcohol. A person 'high' on marijuana often
becomes giggly. Physical effects include red eyes, increased appetite, dizziness and impaired
co-ordination and balance. Although most of the psychoactive effects wear off within a few hours, THC
can be stored in body fat for up to 28 days.
Some first-time users report negative effects like headaches, nausea, fainting, mental confusion, or are
otherwise very disturbed by the experience. As stated earlier, some users have no apparent reaction. The
stronger forms of hashish and resin cannabis can produce hallucinations, similar to those of
hallucinogenic drugs such as lysergic acid diethyl amide (LSD).
CHURCHES YOUTH MINISTRY STUDIES 26 CHALLENGE OR OPPORTUNITY?
When cannabis is combined with other drugs, such as alcohol, the effect can be greater than when it is
used alone.
4. Is cannabis harmful?
Adolescence is typically a time of experimentation and some young people experiment with drugs, such
as tobacco, alcohol and cannabis. Use of cannabis, like use of alcohol and tobacco, should not be
encouraged.
All drug use carries risk of harm to the user or for other people who may be affected by the user's
behaviour. The extent of the risk is largely dependent on the type of drug, the amount taken, the
frequency of consumption, the context in which it is used and the user's susceptibility.
Research on the effects of cannabis is still in its early days. There is a great deal we don't know about the
effects. Many effects of tobacco smoke are only just being discovered and tobacco has been researched
far more extensively than cannabis to date. 1
Apart from the potential negative effects (mentioned in 5), cannabis use poses risks due to intoxication,
and possible physical and psychological harm, especially with heavy or long-term use. Cannabis
intoxication leads to reduced concentration and slower reflexes and co- ordination. Operating machinery
may become more dangerous.
If cannabis (or other drug) use complicates the user's life, or prevents them from participating in or
performing important tasks, they may have a dependence problem for which they need help. Drug use
may be a way of controlling feelings and coping with emotional pain but it does not resolve problems.
5. How does cannabis affect the body?
Damage is done to the respiratory system through smoking marijuana. Marijuana smoke contains tars
and carcinogens similar to tobacco smoke. Smoking marijuana may be linked to cancers of the mouth,
tongue and throat.
Regular or heavy use can affect memory and concentration and reduce motivation. These effects are
probably reversed when use is ceased. Heavy use or 'binges' can produce an intense toxic shock
syndrome or 'cannabis psychosis‟, which can last for several weeks.
There is a need for more research into the risk of harm to people who have pre-existing conditions such
as high blood pressure, cerebrovascular disease and coronary atheroscierosis. Heavy cannabis use may
cause symptoms of chronic bronchitis.
6. How long does it stay in the body?
The main psychoactive component of cannabis, THC, is stored and accumulated in fatty tissue
throughout the body, including the brain, liver and reproductive organs. THC is then gradually broken
down and released into the bloodstream over days and even weeks.
THC has a 'half life' of 3-5 days, which means that after this time, half of the THC has been removed
from the body. After another 3-5 days only a quarter remains and so on.
THC has been detected in body tissue 28 days after initial use. While THC stored in the body does not
appear to remain psychoactive, the possible health consequences of this storage are not fully understood.
7. What is the effect of combining cannabis and other drugs?
Combining cannabis with other drugs such as alcohol or prescribed drugs can increase or alter the
effects, with unpredictable results. It is always risky to combine drugs, whether they are legal or illegal.
This is particularly so for users with a low tolerance level.
Cannabis can suppress vomiting which means that if a person smokes it after drinking large amounts of
CHURCHES YOUTH MINISTRY STUDIES 27 CHALLENGE OR OPPORTUNITY?
alcohol, vomiting may be suppressed. This could cause a variety of problems, as the alcohol
concentration in the body will rise even higher making overdose a possibility.
8. Can cannabis use lead to addiction?
The short answer is 'yes'. People can become dependent on cannabis. Both 'physical dependence' and
'psychological dependence' have been demonstrated, although the distinction is not regarded as
important. However, it is not nearly as addictive as drugs such as nicotine, cocaine and heroin.
Physical dependence occurs when the body has adjusted to the presence of a drug so that symptoms of
discomfort and even pain are experienced when the drug is withdrawn or use is ceased. Psychological
dependence occurs when a person is preoccupied with the effects of a drug and craves it persistently.
Some cannabis users experience problems controlling their use and heavy users and long-term users
report the development of tolerance and a withdrawal syndrome when they cease or reduce use. The risk
of dependence increases with frequency of use and the amount used.
9. Does use of cannabis lead to use of other illegal drugs?
Some people assert that marijuana is a 'gateway drug' to other illegal drug use. The Drugs in New
Zealand survey found that while 43 per cent of 1 5- 45 year olds had tried cannabis, only 1 per cent had
tried heroin, 5 per cent had tried stimulants and 3 per cent had tried cocaine.
In other words most users of marijuana do not go on to use other illegal drugs.
10. What is the law regarding cannabis?
Marijuana is a Class C drug. Hash and Hash Oil are Class B drugs. The use, possession, cultivation and
supply of cannabis are illegal in New Zealand.
'Use' includes smoking, inhaling fumes, or otherwise introducing a 'drug of dependence‟ or 'dangerous
drug' into a person's body. 'Use' also includes introducing or administering a drug to another person.
„Possession' means having the drug in personal custody or control. This can include drugs on a person,
in their car, in their house or garden, unless they can prove the drugs are not theirs.
'Cultivation' includes planting, growing, tending and harvesting a prohibited plant. Watering one plant
or harvesting one leaf is cultivation.
'Supply' means passing a drug or 'prohibited plant' from its source to the user. it includes manufacturing
a drug to be sold, or exchanging drugs for something else. Offering to sell or supply a drug to someone is
trafficking; so too is the intention to sell a drug.
Penalties can range from a fine to anything up to 14 years in jail.
Juveniles (under 18) may be treated more leniently than adults.
Amphetamines (Speed)
Amphetamines have several slang names – speed, uppers, diet pills,
brownies and more.
Speed is a powerful stimulant – it speeds up the functions of the central
nervous system. It lifts mood, prevents, sleep, suppresses appetite and
prevents fatigue. Speed is made illegally and usually appear as a white
powder and occasionally in liquid. Speed used for medial reasons are in tablets
The effects of speed depend on the amount taken; the person‟s experience with the drug; their
expectations; their moodl; and how th drug is taken. Effects also depend on the drug‟s quality
and purity. A small amount can increase breathing and heart rate, heart palpitations and cause
anxiety or nervousness. Higher does can make these effects more intense. Sweating, headaches,
CHURCHES YOUTH MINISTRY STUDIES 28 CHALLENGE OR OPPORTUNITY?
dizziness and a rapid or irregular heartbeat might result. Some people might become hostile and
aggressive.
Long-term use can cause health problems. These include malnutrition, reduced resistance to
infection, emotional disturbances and periods of psychosis – the suffering from delusions and
hallucinations. Symptoms include hearing voices, paranoia and a fear of harassment. Regular
users can develop a tolerance to speed – they need more to get the same effects as before. Some
people can become dependent on speed. If they can‟t get it they might panic or become anxious.
Withdrawal can occur when a dependent person stops using speed or severely cuts back their
use. Symptoms include fatigue, hunger, deep depression; disturbed sleep, irritability, agitation
and anxiety.
Speed is often cut with other substances, so what exactly is in the drug being taken is often not
known. Speed poisoning or overdose can cause brain haemorrhage, heart attack, high fever,
coma and, occasionally, death. Most deaths are caused y accidents while under the influence of
speed.
Ecstasy
Ecstasy is the common name for the long-winded Methylene-DioxyMethAmphetamine, or
MDMA It is a synthetic drug usually sold as small pills that come in a variety of colours and
sizes. It is also available as powder and can be snorted or injected.
Ecstasy is new to New Zealand and it is know to have led to at least one death. In 1998 a young
woman collapsed and died from massive swelling of her brain after taking the drug before
going to a nightclub in Auckland. She overheated and drank a lot of water, which her body
could not get rid of. Instead of caused her brain to swell, leading to her death.
Ecstasy is a stimulant – it speeds up the functions of the central nervous system. Ecstasy‟s
effects depend on the amount taken; the person‟s experience with the drug; their mood; and
how the drug is taken. Effects can also depend on the drug‟s purity. The effects can start after
about an hour and can last up to six hours – even up to 32 hours. Immediate effects can include
increased feelings of self-confidence, well-being and feeling lose to others; higher blood
pressure, body temperature and pulse rates; jaw clenching; teeth grinding; sweating;
dehydration; nausea; anxiety. Ecstasy heats the body, so users need to sip water to prevent
dehydration. Drinking water does not reduce the effects of Ecstasy, it only prevents
dehydration. But then, drinking too much water might lead to serious health complications in
some people. Ecstasy might also produce „hangover‟ effects.
Symptoms can include loss of appetite, insomnia, depression and muscle aches. It can make
concentration difficult – particularly on the day after Ecstasy is taken.
Higher does of Ecstasy can produce hallucinations, irrational behaviour, vomiting and
convulsions. Evidence suggests that long-term use of Ecstasy might cause damage to the brain,
heart and liver. Overdoes of Ecstasy can happen and some deaths have been related to
overheating and dehydration. People can develop tolerance to the pleasurable effects of
Ecstasy: more Ecstasy is needed to get the same effects as before.
Other drugs are often used with Ecstasy to cope with some of its undesirable side effects. Little
is know about the effects of these combinations. In general, health risks tend to increase when
two or more drugs are used together, particularly if the does are large.
It is illegal to use Ecstasy in New Zealand
CHURCHES YOUTH MINISTRY STUDIES 29 CHALLENGE OR OPPORTUNITY?
Hallucinogens
These are a group of drugs that can change your perception, making you see or hear things that
don‟t exist. They can produce changes in thought, sense of time and mood. Some hallucinogens
occur naturally in plant species, e.g. mushroom and cactus. Others such as LSD are made in
factories.Cannabis, Ecstasy and cocaine can cause hallucinations at very high doses, but strictly
speaking are not hallucinogens. LSD is known as acid, is odourless, white and tasteless. It is
usually soaked into small decorated squares of absorbent paper and taken orally. Each square is
one dose.
The effects of hallucinogens depend on the amount taken; the person‟s experience with the
drug; their expectations; their mood; and how the drug is taken. The effects can depend on the
drug‟s quality and purity. The effects usually begin within 30 minutes and are at their strongest
in 3 to 5 hours. The effects can be felt for up to 12 hours. The hallucinogenic experience, or
tripping as it‟s often called, will vary from person to person. The effects can range from feeling
good to an intensely unpleasant time commonly known as a bad trip. This can include feelings
of anxiety, fear, or losing control.
Other effects are a sense of time passing slowly, feelings of unreality; feelings of separation
from the body and an inability to concentrate. Intense sensory experiences, such as brighter
colours and a mixing of the sense, such as hearing colours might be felt.
Hallucinogens are rarely used daily or regularly, but when they are, tolerance develops quickly.
In other words, a user needs to take more to get the same effect. Some users have unpredictable
„flashbacks‟ – they relive the drug‟s effects while not using it.
It is illegal to use LSD in New Zealand
Volatile Substances
These are compounds that give off vapours or fumes at room temperature. They are commonly
known as solvents or inhalants. They include: butane gas, aerosol sprays, petrol, glue,
correction fluids and paint thinners. Their effects depend on the amount inhaled; the person‟s
experience with the volatile substances; their mood; and how the drug is taken.
Immediate effects are similar to those of alcohol and include feeling
less inhibited, disoriented and uncoordinated. The effects come on
more quickly because the substances enter the blood stream from the
lungs instead of the stomach. The effects last for one to five minutes
and are usually over within 30 to 60 minutes of sniffing. Hangovers and
headaches often occur after the immediate effects wear off.
Research evidence suggests that short-term use of volatile substances
rarely cause permanent damage. Effects are reversible if the person
stops using the inhalants. The long-term use of aerosols and cleaning
fluids can damage the kidneys, liver and the brain, but this is rare. The long-term use of leaded
petrol can cause leukaemia and various types of cancer because lead accumulates in the body.
Other physical effects of petrol sniffing can also include: anorexia, seizure and “sudden sniffing
syndrome” – caused by heart failure, which might result if a person does strenuous exercise or
has a sudden fright straight after sniffing. This is rare. The harms most associated with volatile
substances are in how and where they are sniffed. Regular users can become dependent no
volatile substances. The possibility of developing tolerance is small. It is not illegal to inhale
volatile substances in New Zealand
CHURCHES YOUTH MINISTRY STUDIES 30 CHALLENGE OR OPPORTUNITY?
Steroids
Anabolic androgenic steroids are artificial versions of testosterone, the hormone that makes
most males generally bigger, stronger and hairier than females. Males and females have
testosterone in their bodies, the only difference being that, overall males have more than
females.
Some athletes believe that anabolic steroids increase lean muscle mass, strength and endurance.
But scientific evidence has shown that anabolic steroids improve only physical performance
because of some of their effects that help with training and motivation – for instance, euphoria,
aggression, lessening of fatigue and quicker recovery time.
The use of anabolic steroids can have serious side effects. Not all people will feel these to the
same degree. Possible physical side effects of anabolic steroids include jaundice, permanent
liver damage, liver tumours, diabetes, acne, heart problems, high cholesterol levels, blood
poisoning and HIV through sharing of needles, euphoria, depression, improved self-esteem,
mood swings, violent or aggressive behaviour and paranoia.
There is also the danger of using black market products that might have been diluted with other
substances, some of which might be toxic. Some steroids come in tablet form. Others are
injected into muscle.
Long term effects of anabolic steroids are unknown. There are no “safe” doses, so even a doctor
cannot safely prescribe anabolic steroids for no-medical use. Even when anabolic steroids are
used for medical purposes, they are used when other drugs have been unsuccessful.
From: Alcohol and Drugs “Safer Communities Together” Police Managers‟ Guild Trust
CHURCHES YOUTH MINISTRY STUDIES 31 CHALLENGE OR OPPORTUNITY?
Where to go for help
Foundation for Alcohol and Drug Education - FADE
Produces a wide variety of material, including the informative What Drug is That?, which contains information on
more than 20 drugs.
PO Box 33-1505 Takapuna Auckland (09) 488 1298 Fx (09) 488 1212
PO Box 249 Christchurch (03) 366 4019 Fx (03) 366 8861
Alcohol Advisory Council - ALAC
ALAC is New Zealand‟s principal statutory adviser on alcohol-related matters. Its work includes policy advice to
the Government and other policy makers. Has an immense library of fact material about alcohol and its effects on
us and our community.
ALAC National Office PO Box 5023 Wellington (04) 472 0997 Fx (04) 473 0890
www.alcohol.org.nz central@alac.org.nz
Directory of Alcohol and Drug Treatment Services in New Zealand
This directory contains details of all alcohol and drug treatment, self-help, health promotion, drug education and
information-advisory research services in New Zealand. Hundreds of them. It is produced in bound folder form
every year. It is also available on disk. The booklet would be more suitable for professionals such as counsellors,
GPs, Police and youth workers.
CCCAD PO Box 13 496 Christchurch (03) 379 8626 Fx (03) 377 5600
cccad@xtra.co.nz
Drug Abuse Resistance Programme DARE
Aims programmes at children in primary and intermediate schools. DARE is in a new programme with the Police
youth education service to empower young people to avoid illegal drugs and make sensible choices about their use
of alcohol and other legal drugs.
DARE PO Box 50744 Porirua (04) 238 9550]
darenz@xtra.co.nz www.dare.org.nz
Life Education Trust
Commercial Union House 142 Featherston St Wellington
(04) 472 9620 Fx (04) 472 9609
CHURCHES YOUTH MINISTRY STUDIES 32 CHALLENGE OR OPPORTUNITY?
Young people with drug problems: Why some
and not others?
Alison Marsh (Precis)
Drug use by young people in our society is common. The majority of young Australians aged
14 to 24 years drink alcohol, about half have experimented with marijuana, at least 10% with
amphetamines and a smaller minority with other illicit drugs (Department of Human Services
and Health, 1994).
For most young people this drug use is experimental or recreational and relatively
unproblematic (Glassner & Loughlin, 1987; Moore & Saunders, 1991) and the majority curtail
or cease illicit drug use, and adopt moderate drinking patterns as they assume adult roles.
(Kandel & Raveis, 1989). This, is not to imply that drug use, licit or illicit, is a risk-free
business, but that most young drug users negotiate the risks associated with their drug use
without coming to undue harm.
Youth drug use is best understood in the context of adolescent development. Adolescence in
our society, with extended schooling, a depressed job market, and often prolonged economic
dependence, is commonly a time of few responsibilities and considerable frustration (Glassner
& Loughlin, 1987). Adolescence is also a time when experimentation is central to attempts to
establish independence from parents. It is therefore little wonder that drug use, already
modelled by adults in our society, is seen by young people as a 'badge' of maturity and a way to
have fun. It is also understandable that 'inquisitive and independently-minded individuals', as
Moore and Saunders have termed them, often choose to use drugs, frequently those their
parents disapprove of, as one of their means to explore the world, experience new sensations,
take risks, define their self-identities, and assert their independence from adults.
In other words, most youth drug use is best conceived as transitional behaviour that occurs
within normal development from adolescence into adulthood. Indeed, there is evidence that
some drug experimentation may be indicative of greater psychological health than either heavy
use or abstinence (Shedler & Block, 1990; Glassner & Loughlin, 1987)
What, however, of the minority of young drug users for whom drug use escalates to the point
that it significantly interferes in such areas of life as family, health, work, study and
psychosocial development? Why does this happen to some and not others? This chapter will
focus on the factors associated with the development of problematic drug use and attempt to
distinguish them from those associated with the relatively unproblematic drug use engaged in
by the majority of young drug users.
The definition of problematic drug use is not clear cut, and is to some extent situationally,
historically, culturally, politically, and legally determined. For the
purpose of this chapter, problematic drug use refers to heavy use
characterised by frequent intoxication. This drug using behaviour carries
considerable risk of problems relating to intoxication (such as overdose,
accidents, fights, trouble with peers and family), and of problems related
to regular use (such as poor work and academic performance, health
problems and dependence).
CHURCHES YOUTH MINISTRY STUDIES 33 CHALLENGE OR OPPORTUNITY?
Factors associated with non- problematic drug use
Factors specific to the development of heavy problematic drug use can only be identified by
virtue of their difference from those involved in recreational youth drug use. Unfortunately,
much research on youth drug use has been coloured by assumptions that 'use' equals abuse' and
a consequent lack of distinction between heavy problematic use as opposed to recreational use.
This has led to many contradictory claims about the role of „pathology' and 'deviance' in youth
drug use
Nevertheless, some broad generalisations can be made about the factors influencing
recreational drug use among young people.
Drug use is functional in that most say they use drugs out of curiosity, boredom, or to feel good when
interacting with their peers (Glassner & Loughlin, 1987 Johnston & O'Malley, 1986).
Peer associations are consistently the strongest predictors of drug use and this influence appears to operate via
selection of similar friends who then reinforce the individual's norms and behaviours (Oetting, & Beavais,
1987; Simons, Conger & Whitbeck, 1988).
Illicit drug users have weaker bonds to family and school than those who do not use illicit drugs (Jessor &
Jessor, 1977; Simons et al., 1988).
Parental attitudes to, and use of, drugs are important predictors of drug use, as are factors such as the quality of
the parent-child relationship and discipline style (Brown, 199l; Glynn & Haenlein, 1988).
Personality traits such as rebelliousness, extroversion, stress on independence and nonconventionality have
been found to relate to drug use but they are much weaker predictors than peer influences (Oetting & Beavais,
1987).
Non- participation in conventional activities has also been linked to drug use (Kandel & Raveis, 1989).
These predictors of recreational drug use among young people leave considerable variance
unexplained, much of which is likely to be accounted for by broader environmental influences
(Jessor, 1991)
Factors that Influence the transition from recreational to heavy problematic drug use
INDIVIDUAL FACTORS
There seems to be a link between a persons inability to self-regulate their behaviour in the
development of some addiction behaviour (Heather, Mille and Greeley 1991) Some of the
components of self-regulation include adequate monitoring of internal cues such as blood
alcohol level, adequate monitoring and evaluation of one‟s behaviour, the ability to maintain a
focus of attention in the face of interference and distraction, and the ability to suppress
behaviour and delay gratification.
It is important to emphasise that not all adolescents with drug problems have self-regulatory
deficits. Some may have good self-regulation skills but choose not to use them because they
have no wish to regulate their drug using behaviour. It does appear, however, that a lack of
self-regulation, whether due to organic deficits, faulty learning or choice, can predispose some
individuals to addiction problems.
There is also considerable evidence that emotional distress predicts problematic but not
recreational drug use. Internal psychological processes such as the alleviation of depression,
diminished self-respect, low self-esteem and lack of confidence appear to play a role in the
development of heavy problematic drug use Studies show that this works in two ways -
indicating causality in both directions. For example, Freidman et al. (1987) found that prior
psychological problems significantly predicted heavy drug involvement and visa versa; Kaplan
et al. (1986) demonstrated that psychological distress at the time of drug initiation predicted
CHURCHES YOUTH MINISTRY STUDIES 34 CHALLENGE OR OPPORTUNITY?
escalation of drug use, and Kaplan (1990) found that continual daily use of marijuana and/or
other illicit drugs was significantly associated with depression and anxiety in early adolescence,
and these symptoms increased significantly with ongoing use.
Drug users shed further light on the role of emotional distress in heavy problematic drug use.
Almost all young drug users say they use drugs to feel good, to escape, to seek personal
identity, and to rebel against authority. However recreational users are more likely to report
using drugs out of curiosity and to have fun socially, whereas heavy users often report being
motivated to relieve personal distress, cope with negative emotions (anger, loneliness,
frustration and boredom) or to improve self-concept (Johnston & O'Malley, 1986; Miller &
Sanchez, 1987, cited in Miller & Brown, 1991).
FAMILY FACTORS
A number of researchers have emphasised the role of early caregiver - child interactions in the
development of heavy and problematic drug use (Shedler & Block, 1990; Diaz & Fruhauf,
1991; Glynn & Haenlein, 1988). Shedler and Block (1990) found that when their subjects were
pre-schoolers, the mothers of subsequent heavy users were perceived as different from other
mothers. The mothers of subsequent heavy users were observed to interact differently with their
children by being hyper-critical and rejecting and not sensitive or responsive to their children's
needs. Although they gave their children little support and
encouragement, they were simultaneously pressuring and over
concerned with their children's performance. Diaz and Fruhauf (1991)
have also highlighted the importance of the early caregiving
environment in enabling the child to develop internal self-regulatory
mechanisms through interaction with caregivers. They suggested that
failure in such development might result when the environment is
unable to provide the necessary opportunity and support for the child's increased autonomous
functioning. This may occur when the early caregiving environment is disorganised, chaotic or
permissive and also when it provides too much external structure and little opportunity, support
or demand for the child to function independently. In addition, children with difficult
temperaments may overtax the regulatory ability of the caretaking environment, thus increasing
the risk of self-control deficits. Diaz and Fruhauf emphasised that self-regulation deficits and
consequent addictive behaviours are not typically consistent across time and situations, and are
only likely to appear in situations which over-tax self- regulation mechanisms.
Glynn and Haenlein (1988) reviewed the literature on discipline style and concluded that
democratic discipline within the family, as opposed to laissez-faire or authoritarian, is
consistently found to have the most positive effect on the prevention of serious drug problems
among young people. Extremes of laissez- faire (neglect) and authoritarian (abuse) are
frequently linked with drug problems (Brown, 1991; Glynn & Haenlein, 1988).
Parental drug use, family disruption, problematic parent-child relationships, and negative and
rejecting parental reactions to their offspring's drug use have also been implicated in drug use
escalation. In the research, different definitions of some of these factors have led to
contradictory conclusions being drawn about their influence on escalating drug use (Brown,
1991; Glynn & Haenlein, 1988; Glassner & Loughlin, 1987). Disagreement exists regarding the
levels of parental drug use associated with youth drug problems. However, it is generally
agreed that consistent parental drug use is commonly found to predict heavy youth drug use,
perhaps by teaching the young person that drugs are the way to cope with life (Brown, 1991;
Glynn & Haenlein, 1988).
CHURCHES YOUTH MINISTRY STUDIES 35 CHALLENGE OR OPPORTUNITY?
Brown (1991) noted that some studies which have concluded that family disturbance and
disruption are of relatively minor importance in predicting youth drug use have used such loose
definitions of disruption as divorce or separation, and have frequently left heavy drug use
ill-defined. Most rigorous studies find that severe disturbances such as childhood physical and
sexual abuse, severely disturbed parents, and high levels of family disputation are predictive of
persistent and destructive drug use (Brown, 1991; Glynn & Haenlein, 1988; Coombs &
Coombs, 1988).
Poor parent-child relationships are consistently found to be a strong predictor of the escalation
of drug use (Glynn & Haenlein, 1988; Glassner & Loughlin, 1989; Coombs & Coombs, 1988).
Poor relationships are characterised by a lack of basic care, inconsistency of expectations, poor
communication and a perception on the young person's part of an absence of parental love and
acceptance (Glynn & Haenlein, 1988; Glassner & Loughlin, 1989). Glynn and Haenlein
suggest that the perception of an absence of parental love and acceptance may be more
important in predicting drug use than either discipline style or family disruption on their own.
Negative and rejecting parental reactions to their offspring's drug use have been found to
increase the probability of drug use escalating (Coombs & Coombs, 1988).
PEERS
For those whose home life is unrewarding or who find little security in, and affiliation with
conventional social networks, drug-using peer networks may provide alternative sources of
support and reward (Coombs & Coombs, 1988; Brown, 1991). Kaplan, Martin and Robins
(1984) found evidence for the following mechanisms in the development of heavy drug use: a
perception of being rejected by non-drug using peers; family and school; self-disparagement;
motivation to diverge from conventional expectations and attitudes; and association with illicit
drug using peers. Coombs and Coombs (1988), however, studied a group of US youth and
found that the process of establishing oneself in a drug using peer group may be a far more
challenging, positive process than the reactive, negative one implicit in Kaplan et al's
explanation:
... the escalation stage is a period of learning and development, of
challenge and struggle and, from the perspective of the user, of
achievement ... "It is a time,' one said, "of beginning to view yourself as
a dope fiend and finding pleasure in taking hold and advancing."
(Coombs & Coombs, 1988)
Also relevant to the issue of peer influences is a study of heroin use and
addiction among American soldiers returning from Vietnam by Robins,
Davis and Wish (1977). They found that black inner city youth who had used drugs before
service were most likely to use in Vietnam and back home, but that the rate of post-Vietnam
addiction was lower among this group than among the white, suburban, older post-Vietnam
users. The important issue here is that norms were undoubtedly more anti-drug among the
white, suburban, older sample than among black inner-city youth. The authors concluded that
drug use which violates the social norms of the sub-group indicates an unusually strong
compulsion to use and predicts addiction. The common finding that the earlier the age of drug
experimentation the more likely the development of heavy problematic drug use (Simons et al.,
1988) may also be related to this issue in that younger adolescent drug users are more likely
than older ones to be flouting sub-group norms.
This discussion highlights the importance of considering youth drug use in context. Sub-groups
which strongly discourage drug use are less likely to foster drug use but more likely to have a
CHURCHES YOUTH MINISTRY STUDIES 36 CHALLENGE OR OPPORTUNITY?
higher proportion of serious drug problems among users than subgroups which are more
accepting of drug use.
BROADER ENVIRONMENTAL INFLUENCES
Among other factors, drug availability, price, law enforcement practices and socio-economic
circumstances all contribute significantly to drug using patterns among youth. As Jessor aptly
noted:
The ultimate importance of the social environment cannot be gainsaid. The distribution of a
variety of adolescent risk behaviours reflects circumstances of poverty, racial/ethnic
marginality, and limited life chances, as well as the presence of an underground structure of
illegitimate opportunity. (Jessor, 1991)
In Australia, poverty, homelessness and unemployment are significantly associated with heavy
problematic drug use among young people. These young people frequently cite boredom,
anxiety, depression and frustration as their reasons for using drugs (Brown, 1991), and using
drugs as their main source of fun (Hirst, 1989).
Conclusions
This discussion leads to the conclusion that although peers and environmental factors play an
overwhelmingly important role in all adolescent drug use, family factors and emotional distress
may be crucial in predisposing young people to make the transition to heavy problematic drug
use. It appears that early parent-child relationships may mediate the development of self-
regulation skills (although for some, lack of self-regulation may be organically based).
Parent-child relationships in early childhood and adolescence, along with severe family
disruption, also contribute to young people's sense of alienation from conventional sources of
reward (family, school, and work) and to emotional distress, and hence the attractiveness of
heavy drug involvement as an alternative source of reward and a way to cope with negative
emotions. Consistent parental drug use is also implicated, and high quality parent-young person
relationships appear to play a protective role in the development of youth drug problems.
Common responses to youth drug use are based on fear, and the mistaken assumption that all
drug use is automatically harmful. This leads to the conclusion that drug use must be stopped at
all costs, and anything less is failure.
There is often little attempt on the part of parents, schools, the community, the law, the media
and politicians, to take account of the meaning of drug use to young people, or to try to ensure
that the large number of young people already using drugs come to as little harm as possible.
Most existing responses marginalize users and are likely to exacerbate any predispositions to
alienation and emotional distress, which in turn is likely to encourage more drug use.
It is obvious that the prevention and treatment of youth drug problems requires more than
telling those at risk of severe problems to 'just say no' to drugs. It is no easy task to undo the
results of early family experiences. Teaching parenting skills to parents of young children may
help prevent later problems, but frequently it is the parents of children at less rather than the
greatest risk who attend such training. Teaching adolescent - parent communication skills may
also help for some. With severe youth drug problems however, the extent of past and present
family disruption is often such that it is not possible to involve parents. The question becomes
how can we, in any small way, offset the effects of childhood and family experiences for youth
at risk of developing severe drug problems?
If we were to speculate upon the basic needs of such a person, they might include the need to
CHURCHES YOUTH MINISTRY STUDIES 37 CHALLENGE OR OPPORTUNITY?
develop more effective self-regulation skills and the need to belong to and receive positive
rewards from aspects of society other than drug using peer groups. The development of
self-regulation skills involves such factors as learning how to plan and foresee consequences,
how to make decisions, and how to problem solve. Helping young people feel they belong
involves providing school and community settings which do not exclude them because they use
drugs, but try to provide alternative sources of reward and self-esteem to compete with
involvement in drug use. Such settings, given the right balance between encouraging autonomy
and providing boundaries, may foster the development of more effective self-control skills.
Speculation aside, research is needed into why some young drug users who appear to be at risk
for the development of severe drug problems do not develop them. Research is required which
explores the young people's points of view about their drug use, its meaning to them, the ways
in which they regulate it, and how it varies according to ongoing social and environmental
circumstances. Only in this way can protective factors for young drug users at risk of
developing serious drug problems, be identified.
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Community Involvement Centre, Prahran.
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The family context of adolescent drug use. New York: Haworth Press, Inc.
Department of Human Services & Health (1994). Statistics on drug abuse in Australia 1994. Canberra:
Commonwealth of Australia.
Diaz, R., & Fruhauf, G. (1991). The origins and development of self-regulation: A developmental model
on the risk for addictive behaviours. In N. Heather, W. Miller, & J. Greely (Eds.), Self-control
and the addictive behaviours. Sydney: Maxwell Macn-Lillan.
Freidrnan, A., Utada, A., Glickinan, N., & Morrisey, M. (1987). Psychopathology as an antecedent to,
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Glassner, B., & Loughlin, J. (1987). Drugs in Adolescent Worlds: Burnouts to Straights. Hong Kong-
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Heather, N., Miller, W., & Greely, J. (Eds.). (1991). Self-control and the addictive behaviours. Sydney:
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Hirst , C. (1989). Forced exit-a profile of the young and homeless in inner urban Melbourne: Report of
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Jessor, R., & Jessor, S. (1977). Problem behaviour and psychosocial development: A longitudinal study
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Jessor, R. (1991). Risk behaviour in adolescence: A psychosocial framework for understanding and
action. Journal of Adolescent Health, 12, 579-605.
Johnson, J., & Kaplan, H. (1990). Stability of psychological symptoms: Drug use consequences and
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Johnston, L., & O'Malley, P. (1986). Why do the nation's students use drugs and alcohol? Self-reported
reasons from nine national surveys. Journal of Drug Issues, 16(1), 29-66.
Kandel, D., & Ravels, V. (1989). Cessation of illicit drug use in young adulthood. Archives of General
Psychiatry, 46, 109-116.
CHURCHES YOUTH MINISTRY STUDIES 38 CHALLENGE OR OPPORTUNITY?
Kaplan, H., Martin, S., & Robins, C. (1984). Pathways to adolescent drug use: Self- derogation, peer
influence, weakening of social controls, and early substance use. Journal of Health & Social
Behaviour, 25, 270- 289.
Kaplan, H., Johnson, R., & Bailey, C. (1986). Self-rejection and the explanation of deviance:
Specification of the structure among latent constructs. American Journal of Sociology, 92,
384-411.
Miller, W., & Brown, J. (1991). Self-regulation as a conceptual basis for the prevention and treatment of
addictive behaviours. In N. Heather, W. Miller & J. Greely (Eds.), Self- control and the
addictive behaviours. Sydney: Maxwell Macmillan.
Moore, D., & Saunders, B. (1991). Youth drug use and prevention of problems: Why we've got it all
wrong. International Journal of Drug Policy, 2(5), 29-35.
Oetting, E., & Beavais, F. (1987). Peer cluster theory, socialization characteristics, and adolescent drug
use: A path analysis. Journal of Counselling Psychology, 4(2), 205-213.
Robins, L., Davis, D., & Wish, E. (1977). Detecting predictors of rare events: Demographic, family, and
interpersonal deviance as predictors of stages in the progression toward narcotic addiction. In S.
Strauss, H. Babigian & M. Roff (Eds.), The origins and course of psychopathology: Methods of
longitudinal research, New York.. Plenum
Shedler, J., & Block, J. (1990). Adolescent drug use and psychological health: A longitudinal inquiry.
American Psychologist, 45(5), 612- 630.
Simons, R., Conger, R., & Whitbeck, L. (1988). A multistage social learning model of the influences of
family and peers upon adolescent substance abuse. Journal of Drug Issues, Summer, 293-315.
CHURCHES YOUTH MINISTRY STUDIES 39 CHALLENGE OR OPPORTUNITY?
Young People and Depression
(Resources from Young People and Depression – a comprehensive resource for people working with youth.
Produced by the Mental Health Foundation of New Zealand 1997)
WHAT IS DEPRESSION?
Life is full of „ups and downs‟, and most people have periods of experiencing the 'blues' or feeling
'down'. Depression is not just 'feeling blue' or „down in the dumps‟, and it is more than experiencing
normal grief and sadness after a loss.
Depression is an illness. Like many illnesses, it affects the whole person - his or mental, emotional and
spiritual well-being. Depression is also an experience which allows one to assess the difficulties in one's
life and to change and grow. Depression is a lasting state of distress which persists over a period of time
- two weeks or more. As with other illnesses, biological changes may take place. Because a wide range
of symptoms can occur, depression is often a confusing illness to diagnose.
There are generally considered to be three categories of depression which may be described on a
continuum from MILD to MODERATE to SEVERE. Rating Scales have been developed which can
help mental health workers differentiate with some precision among them. The following definitions
indicate in no more than a general sense the degree of severity of depression.
Severe Depression- is present when a person has nearly all of the signs of depression, and the
depression almost always interferes with his or her ability to initiate, enjoy, and perform a range of
activities. Severe depression is very debilitating, interfering with daily life and
work.
Moderate Depression- is present when a person has some signs of depression
which often interfere with the person's life.
Mild Depression -is present when a person has a few signs of depression,
requiring a greater effort to function normally.
COMORBIDITY
With adolescents depression often occurs in combination with other disorders.
This is known as 'comorbidity'. “One of the most consistent findings has been
that most children with depressive disorder have associated comorbidity, the most likely being conduct
disorder, anxiety states and school refusal, hyperactivity, drug use or anorexia nervosa.”(Watkins, 1995)
Other types of mood disorder include:
Chronic Low Grade Depression. (known as Dysthymia or Dysthymic Disorder) Dysthymia greatly
affects the quality of life of the person experiencing it. There is a sense of gloom, a lack of pleasure in
life, low self-esteem and little confidence. For a young person to be diagnosed as having chronic low
grade depression (Dysthymia), the symptoms of altered mood must be present for at least one year. If
Dysthymia presents during the teenage years, it may be expressed as irritability.
Chronic Low Grade Depression is equally common in boys and in girls and increases with age, affecting
one in ten people in the 45-64 age group (Oakley-Browne et al. 1989.) This condition is likely to lead to
social avoidance and low self confidence which will affect the social, vocational and personal
development of a young person. Moreover there is an increased risk of a Major Depressive Episode and
possibly a suicide attempt.
Manic Depression or Bipolar Disorder This illness is marked by extreme swings of mood. These
changes are more intense than the changes of mood which are part of normal life. Usually there is a
'high' (manic) phase alternating with a „low‟ (depressed) phase, with a period of normal mood level in
between. There are wide variations, however This illness affects about 30,000 New Zealanders and their
families.
CHURCHES YOUTH MINISTRY STUDIES 40 CHALLENGE OR OPPORTUNITY?
Postnatal Depression Depression occurring after the birth of a baby, an illness experienced by
10%-15% of women. Risk factors, (Hunt et al. 1995) such as poor social support, relationship
difficulties, and stressful events indicate that the adolescent mother may be vulnerable to postnatal
depression.
Seasonal Affective Disorder - SAD Depression coinciding with the onset of seasonal changes.
Substance Induced Mood Disorder Alcohol and other drug misuse can change the body's
chemistry, causing depressive symptoms.
INCIDENCE OF DEPRESSION
Precise data relating to the prevalence of depression in the community are unavailable because it often
goes unreported. However, even the conservative figures we do know indicate that depression is a major
health problem in New Zealand. 'There are about as many people with depression as there are people
with asthma. " (What is Depression? National Health Committee, 1996). The following information is
generally accepted in the literature:
Depression can affect people of any age, culture, and occupation.
About ONE in every SEVEN people.... in New Zealand will develop a Depressive Disorder during
their lifetime. (Wells et al. 1989)
In any two week period, ONE in TWELVE people will have a Depressive Disorder: 6.4% will have
Dysthymic Disorder, and 3.7% will have a Major Depressive Episode. (Oakley-Browne et al. 1989)
Depression is one of the three most common mental health problems in young people. (Along with
alcohol and drug misuse and addiction and anxiety disorders).
The first onset of a major depression often occurs in mid to late adolescence. Adolescents who
experience depression are at risk of having a recurring episode of depression.
Chronic Low Grade Depression (Dysthymia) often precedes a Major Depressive Disorder.
Depression is a significant problem for young people who are in custody or who are shelterless
(homeless). Clinical Practice Guidelines: Depression in Young People, Draft Document,
September, 1996. NHMRC, Canberra.
Comparative data from Canada, Germany, United States, and New Zealand indicate that major
depression rates have been increasing. Since 1945 the onset of depression has been occurring at an
increasingly earlier age, a trend that has been more marked in recent years, especially among young men
horn since the 1960s. (Weissman et al. 1977)
Studies in New Zealand have found that the prevalence of depression increases with age in adolescence,
with a three-fold increase post puberty, and 'about equal prevalence among boys and girls until 15 years,
after which there appears to be a greater prevalence in females. ' (McGee et al. 1992). Although the
incidence of young women being diagnosed with depression is higher than for young men, it is not
known whether this indicates a greater willingness to seek help on the part of the women.
DEPRESSION IN YOUNG PEOPLE
Adolescence is a period of transition between childhood and adulthood. For the purposes of this
resource the term adolescence applies to young people in the approximate age range of 12 to 20 years.
Adolescence is a time of adaptation and integration into broader society, including establishing one's
own identity. It is a time of major physical, emotional, intellectual and social changes for the young
person.
Adolescence is a vulnerable time for depression as it is a period characterised
for many young people by:
Natural mood swings
Self-consciousness
Concerns over body image
Precarious self-esteem, dependent on outside circumstances
CHURCHES YOUTH MINISTRY STUDIES 41 CHALLENGE OR OPPORTUNITY?
Relationship problems and break-ups
A future that is beginning to exert fears and pressures
A lot of natural idealism which the day-to-day realities of life constantly threaten
Attempts to establish sexual identity and security
Concerns about sexuality and sexual behaviour
Exposure to peer group pressure
Exposure to alcohol and other drugs
Frequent value conflicts with parents
Acute academic pressures
Transition from school to the public arena
(Adapted from Mourant, 1989)
Depression in young people is similar to that in adults in many respects. For example, a young person
may have clinical depression if they have had a number of the signs of depression for two weeks or
more, as in adults.
The key differences are in the manner of presentation. That is in a young person the signs of depression
may be expressed differently than in an adult. This can result in depression in young people going
undetected.
Checklist for the Signs of Depression in Young People
Rey (1995) outlines the following checklist to help parents of adolescents become aware of possible
signs of depression in their adolescent children:
Your adolescent child probably suffers from Depression if he or she:
Has shown a marked change in character, a decline in school work and a changed relationship to family
and friends
and
appears unhappy, tearful, down in the dumps or complains of sadness or emptiness
or
has lost interest or enjoyment in most activities and pastimes previously enjoyed and at the same time
has shown four or more of the following symptoms:
1. Appetite or weight has changed considerably (has lost or gained a substantial amount of
weight)
2. A change in sleeping pattern: can't sleep at night or sleeps too much
3. Is restless, agitated (pacing, wringing hands) or has slowed down (e.g., spends hours
staring in front, finds it hard to move)
4. Has lost a lot of energy, complains of feeling tired all the time
5. Feels worthless or complains of feeling inappropriately guilty ('everything is my fault',
'I am bad')
6. Believes that life is not worth living, there is no future and will be better off dead
Examples of the signs of Depression
People working closely with adolescents are finding Rey's checklist a useful
guide if they are concerned that a young person's behaviour has changed
significantly. The following signs of depression in young people have been
observed by workers in the community: they may make depression difficult to
identify, but they are very important as they provide early warning signs, and
opportunity for early intervention:
Changes in character
CHURCHES YOUTH MINISTRY STUDIES CHALLENGE OR OPPORTUNITY?
Irritable; e.g., snapping at people for no apparent reason
Physically aggressive or verbally aggressive
Abandoning favourite hobbies or sports
Passive TV watching
Risk-taking; e.g., dangerous driving
Misuse of drugs and alcohol.
Changes in school behaviours (including training courses and work settings)
Frequent absences from school through 'wagging'
Gets poorer grades for assignments than formerly
Complains of being bored. Becomes disruptive in class
Loses interest in activities which once were fun
Finds it harder to stay on task. Loses concentration
Mentally confused. Finds decisions difficult to make
Cannot remember commitments: doesn't turn up to appointments
Has difficulty staying still or conversely, is lethargic
Projects personal difficulties on to others; e.g., bullying
Sets self up for rejection by peers and/or teachers. Takes on the victim role
Changes in relationship to family and friends
Stops going out with friends; shows no interest in group outings
Increase or decrease in sexual activity
May start associating with a different peer group
Expresses negativity about family
More than normal conflicts with parents and siblings
Changes eating and sleeping habits
Changes in feeling, thinking and perceiving
Expresses inappropriate guilt
Feelings of not being good enough, worthlessness, failure
Expressions of hopelessness: nothing to look forward to
Speaks in a monotonous or monosyllabic manner
Preoccupied with self, withdrawn, shows inner distraction
Cries easily, looks sad, feels alone or isolated
Fears about having to be perfect. Fearful of doing something bad
Incidents of self-injury. Ideas of killing self
HOW YOUNG PEOPLE DESCRIBE THEIR
DEPRESSION
While mood swings, anxiety and bouts of loneliness may be
a normal part of growing up, it is very important that young
people with depression are „heard‟ and their feelings heard,
acknowledged and understood. Many „acting out‟
behaviours are dismissed as typical adolescent storminess.
Often they are cries for help or signs of a problem.
CHURCHES YOUTH MINISTRY STUDIES CHALLENGE OR OPPORTUNITY?
John, 19 years 'Depression feels like falling out of a plane without a parachute.
Sean, 16 years 'There aren't any words to express the confusion of feelings.
Courtney, 14 years 'It‟s a deep hole that you feel you can't climb out of.'
Andy, 16 years, 'It's hard for people to understand unless they've experienced it
themselves. It's very hard to concentrate on things you like doing. You feel like
you can't do it anymore.'
Rebecca, 17 years 'It sort of becomes a daily habit .... being sad.'
Paul, 'I had no energy at all. I felt totally wiped out.'
Sara, 'My sadness became a part of my life. I walked around with tears in my
eyes.
Jean, I was sleeping all the time. I would sleep for fifteen hours and still look tired.'
Chris, 'All I wanted was peace of mind.'
John, 'You go through hell but you do eventually come out of it.'
Cindy, 18 'I felt as if a dense dark cloud was around me.
Ernie, 16 „I was often impatient with my friends. They didn't want to be around me any more.
Jill, 17 'My parents were always proud of my school reports, but when I got depressed my brain felt sort
of blocked off. I couldn't take anything in any more. I started getting awful reports. Then everyone said
I was lazy, so I felt even worse.'
CULTURAL PERSPECTIVES
„Feeling Depressed is an experience that crosses the borders of culture, although not always called
"depression ". How this experience is described varies according to where you are in the world‟. (Losing
the 20th Century Blues, Western Australia Association for Mental Health, 1995)
Different cultures may describe depression as: having darkness in the heart, like the sky is covered by
dark clouds every day, even when the sun is shining; like fire burning in the heart, grieving without a
death; my wairua is being squeezed.
Maori youth and depression
Depression in Maori young people, like substance use and misuse, is increasing significantly. Maori
rates of first admission to psychiatric services have increased dramatically over the last 30 years, while
pakeha rates have remained stable (Trends in Maori Health, Te Puni Kokiri, 1993). These increases may
not be fully appreciated without an awareness of the following concepts, which, although identified
separately here, are to be regarded as an integrated whole:
Cultural Well-being
„Cultural well being is seen (by adult Maori) as a pivotal component in identity formation by young
Maori.‟ (Youth Mental Health Promotion, Ministry of Health, 1996). Conversely, cultural alienation
with resulting low self-esteem is a major contributing factor in the high rates of mental ill-health among
young Maori. Good health is seen as a taonga enabling participation, belonging and self- esteem. (Te
Puni Kokiri, 1993)
CHURCHES YOUTH MINISTRY STUDIES 44 CHALLENGE OR OPPORTUNITY?
The Importance of Tikanga Maori
In the course of recent research examining the reason why young Maori left school before the age of
sixteen, Maori young people claimed that to be able to join a cultural group at school and to learn te reo
„gave them a sense of identity which the6y felt they had not been able to get elsewhere‟. (Kua Korero
Nga Akonga; Puni Kokiri, 1994).
The Maori Holistic Perception of Health
For Maori, the customary Western practice of distinguishing between physical and mental health
without due regard for the spiritual, is alien . One Maori view, the Whare Tapa Wha Model, compares
health to‟the four walls of a house, all four being necessary to ensure strength and symmetry, though
each representing a different di.mension: taha wairua (the spiritual side), taha hinengaro (thoughts and
feelings) taha tinana (the physical side), taha whanau (family).' (Whaiora, Durie,.1 994).
The Importance of Whanau
'Among Maori, the whanau is generally considered as the basis of social organisation'. (Ministry of
Health, 1996). The needs of young Maori (rangatahi) are traditionally met in the supportive environment
of the extended family. 'Those (rangatahi) who are not secure within the culture of their whanau must
struggle with their identity and may, as a result of this conflict, be at risk of health problems.' (He
Matariki, PHC 1995).
The Central Nature of Spirituality
'Taha wairua is generally felt by Maori to be the most essential requirement for health.... Without a
spiritual awareness and a mauri (spirit or vitality, sometimes called the life force) an individual ... is
more prone to illness and misfortune. ...Belief in God is one reflection of wairua, but it is also evident in
relationships with the environment. Land, lakes, mountains, reefs have a spiritual significance .... and
are regularly commemorated in song, tribal history, and formal oratory.' (Durie, 1994).
For many young urbanised Maori, living in a diversity of cultural worlds, the feeling of alienation from
these spiritual influences, in association with other precipitating factors, may lead to depression. 'These
transitions (from rural to urban, and the changing nature of modern society) have inevitably caused
social upheaval and psychological damage for many young Maori, evidenced by high levels of mental ill
health and substance abuse.' (Ministry of Health, 1996)
Unique Signs of Depression in Young Maori
Whakamomori is defined as 'a deep-seated underlying sadness - a process which left untreated, will lead
to acts of desperation'. (Maori Perspectives on Depression, Mental Health Foundation, 1995). It is
sometimes described as an 'inbuilt tribal suffering'.
Most of the signs of depression set out in the previous chapter also apply to Maori youth. There may be
some cultural differences, however, and these signs may include:
Suggestions of breaches of cultural protocol
Preoccupation with a close relative who has recently died
Irritability and/or uncharacteristic aggression
Issues of injustice (especially cultural) experienced by the person or their whanau, which have
resulted in:
- intense internalised shame or guilt (Puuhi)
- intense externalised shame or guilt (sometimes described as whakama - although this does not have a
negative connotation).
Unresolved grief or loss - of persons or status.
Somatic complaints without an apparent physiological cause.
(Guidelines for the Treatment and Management of Depression by Primary Healthcare Professionals,
National Health Committee, 1996.,' )
CHURCHES YOUTH MINISTRY STUDIES 45 CHALLENGE OR OPPORTUNITY?
How To Help
Use the list of options later in the resource. But if you are non-Maori, also remember the following when
working with young Maori people:
1. Once there are indications of any of the signs outlined in the previous paragraph, 'especially any
involving tapu and death, serious consideration should be given to involving Maori health
workers and/or Maori elders adept and experienced in Maori mental health and spiritual issues.
Assistance may be found from Maori community health workers and Maori health units
2. 'Ensure that a young person is aware of services that have a history and capacity to assist Maori
in a culturally appropriate manner' Ideally it is preferential that they consult with Maori services
for cultural understanding and safe practice.
3. If the cultural services are not available in your area or if the young person makes a choice not to
consult with cultural resources, you will need to ensure that you have adequate background
knowledge and be sensitive to cultural matters.
4. Even if a referral is made, you should continue to be available to and supportive of the person.
Wherever possible joint responsibility preferably with written agreement on roles and
responsibilities, should be arranged.
It must also be recognised that it may not be easy to find culturally appropriate services in your area, as
these services are not equally distributed throughout the country. Lack of access to culturally
appropriate services is a significant issue for Maori mental health, and the further development of these
services is essential.
PACIFIC ISLAND YOUTH AND DEPRESSION
'Nearly half of the Pacific Islands population in New Zealand (47%) is under the age of 20 years. '
(Guidelines for the Treatment and Management of Depression by Primary Health Care Professionals,
National Health Committee, 1996) Pacific Islands people traditionally perceive health to be wellness.
Illness is an altered state of wellness.
Holistic Health View
The traditional Samoan view of holistic health encompasses the following dimensions, 'interwoven and
intricately inter-related with each other. '(Other Pacific Islands nationalities may have similar views, but
it will be important that you appreciate the specific cultural differences between Pacific Island nations.)
The first dimension is the base foundation (Fa'avae), representing the extended family (Aiga). The
Pou-tu (four main posts) represent:
1. the dimension of spirituality (Fa'aleagaga);
2. the physical dimension (Fa'aletino), which is the well-being of the body and is measured by the
absence of illness and pain;
3. the mental dimension (Mafaufau), the well-being of the mind;
4. the dimension of 'other' (0 Isi Mea), including finance, gender, education, employment, age, sexual
orientation, etc.
Above the foundation and four posts is the roof (Falealuga), representing the dimension of culture
(Aganu'u). (Guidelines for the Treatment and Management. of Depression by Primary Healthcare
Professionals, National Health Committee, 1996)
Other factors to consider
Signs and symptoms of Major Depressive Disorder vary greatly between the Pacific Islands
cultures.
Problems such as Depression may be described in the spiritual dimension. Depression is the
symptom of altered states of wellness in other dimensions (family and other). This impacts on the
CHURCHES YOUTH MINISTRY STUDIES 46 CHALLENGE OR OPPORTUNITY?
mental, physical, cultural dimensions.
Issues of traditional values and beliefs versus the values and beliefs of the New Zealand- born also
impact on spirituality.
In addition to the signs identified for young people in general are the parameters of shame and guilt.
Hauntings (Ma'i Aitu) over long periods of time, coupled with guilt and shame, can be mistaken for
a depressive disorder.
(Guidelines for the Treatment and Management of Depression by Primary Healthcare Professionals,
National Health Committee, 1996)
How to Help
Assessment and intervention require gender, age, and culturally appropriate intervention. Guidelines for
The Treatment and Management of Depression by Primary Health Care Professionals states that,
Use of anti-depressants or counselling and mainstream psychological interventions seldom has
an effect on Pacific Islands youth due to poor compliance coupled with guilt and shame issues
surrounding talking to someone outside of the family.
The Guidelines recommend that: When treatment for Major Depressive Disorder is indicated for a
Pacific Island person, a number of factors need to be taken into account when selecting the appropriate
intervention and provider:
the person should be offered the option of an appropriate Pacific Islands healthcare worker(s,
guidance from a Pacific Islands service or recognised local or community organisation is
recommended
inclusion of a religious minister, pastor or priest (Faifeau, Akoako) may be offered. Elder (Matua)
intervention may be offered if requested by the depressed person
alternative healing such as traditional healers (Fofo, Taulasea) may be offered, particularly if
requested by the depressed person
inclusion of a support person(s), advocate, family, or significant others for the depressed person is
vital.'
Identification of an appropriate advocate and ongoing support person within the family is very
important.
consultation with a mental health professional is also important.
REFUGEE POPULATIONS AND MIGRANT CULTURES
Refugees
If you are working with young people who are refugees from their country of origin, you should be
aware of the specific factors that may impact on their mental health. These factors include the effects of
war and torture-trauma, the effects of life in refugee camps, cultural alienation and culture shock, loss
and grief issues, poverty and language difficulties.
„Teenagers may carry a great burden in refugee families, frequently acting as cultural brokers. They live
in two worlds … Students themselves often report that they are desperately
unhappy at times … They often feel they are underachieving and are
acutely aware of the gap between them and other students… They have
few friends other than those in their own ethnic community… They rarely
have anyone to share their worries with‟. (Refugee Youth, Elliot et al.
Mental Health News, Winter, 1995)
CHURCHES YOUTH MINISTRY STUDIES 47 CHALLENGE OR OPPORTUNITY?
Migrant Cultures
Other migrant cultures to New Zealand also have mental health needs that are unique. Young people in
migrant families are often caught between two worlds, and the expectations of them at home and in their
family may be quite different to those experienced at school (e.g., male/female roles). These pressures
become risk factors for mental health problems.
When considering the mental health needs of refugee and migrant youth, you should also consider
culturally appropriate solutions and supports, and the importance of language differences.
RISK FACTORS CONTRIBUTING TO DEPRESSION IN YOUNG PEOPLE
There is no one cause of depression in adults or adolescents. Causes or factors contributing to depression
tend to come from a combination of sources – societal, biological. lifestyle, family background, physical
and spiritual factors.
The following is a list of the factors that may contribute to Depression
Family History of Depression. If there is a family history of depression (especially parental) then a
young person is at increased risk of developing depression. However while research shows that inherited
factors may be involved, this does not mean that a child has to develop depression – depression will
probably still be triggered by a specific problem or stress overload
Associated Conditions (comorbidity) There is a strong association between depression in young
people and anxiety disorder, conduct disorder, substance abuse, attention deficit/hyperactivity disorder
(ADHD) and eating disorders.
Biological Changes Sometimes no obvious reason appears for depression to have developed, and
biological factors may be the cause. The biological changes that occur during depression are to do with
the brain‟s chemical messengers called neurotransmitters. These messengers help control emotions – the
two key messengers are serotonin and norepinephrine. The levels of theses increase and decrease to
change our emotions and when they are „balanced‟ we feel the appropriate emotion for the occasion.
When someone is depressed the neurotransmitters are out of balance and the person may, for instance,
feel sadness when we would expect them to feel happy.
Whether biological factors are the cause or the result of depression is still known, but it is important to
understand that these changes do take place during depression and can trigger many of the symptoms
that subsequently appear. Understanding these biological changes also helps people to appreciate that
depression is an illness. For these reason it is not helpful to tell a young person to „snap out of it‟, „pull
themselves together‟, or „cheer up‟ just as we don‟t tell someone with pneumonia to „get out of bed and
enjoy life.‟
Stress Some stress is a normal pall of life. The human nervous system is designed to cope with a degree
of stimulation and challenge. The danger lies in being subject to too much stress or not enough stress.
This can result in physical and mental ill-health. It must also be remembered that each person has a
different optimum level of stress, and what may be challenging for one person may be distressing for
another.
Depression can be associated with stressful events such as:
sexual, physical and emotional abuse
changes in the body
learning to be independent
difficulties with friendships and relationships (including break-ups)
pressure by friends to behave in a certain way
CHURCHES YOUTH MINISTRY STUDIES 48 CHALLENGE OR OPPORTUNITY?
dealing with sexual development and sexual feelings
coping with possible attraction to the same sex
the expectations generated by TV
conflict between family cultural values and peer group pressures
exposure to cultural misunderstanding
seeking a sense of self and place in the world
tensions within family relationships
not enough money in the family
unresolved grief from death or loss
academic pressures, fear of failure
living with put-downs and criticism
employment concerns
parental conflict
Negative thinking patterns and negative self-talk Self-talk is the conversation we have with ourselves
in our minds. It arises from environmental messages and can be either positive or negative. Feeding on
negative self-talk creates discomfort and unhappiness. Negative self-talk has been called 'the
pathological critic'. Regular self-criticism can lead to a depressed mood.(Adapted from Mellon, 1990)
Physical Illness Some physical illnesses (such as multiple sclerosis, thyroid problems, glandular fever
and anaemia) can cause changes in the body chemistry that cause depressive symptoms. Other physical
illnesses may contribute to depression because they are painful or change your life.
Hormone Levels Hormonal imbalances have been linked to depression, although which comes first, the
imbalance or the depression is still not clear.
Alcohol and other Drug misuse Alcohol and other drug use and misuse can change the body‟
chemistry, causing depressive symptoms or worsening depression. Sometimes young people with
depression use alcohol and street drugs to make them feel better (self-medication), but in the long term
they lead to other social and physical problems.
Nutrition Research shows that vitamin and mineral levels can affect mental health and serotonin
balance. This may be a factor for young people who lead much of their lives „on the streets‟ and are not
able to have a balanced diet.
Spiritual Deprivation In cultures which focus on materialistic values, neglecting the spiritual
dimension can affect mental and physical well-being.
CONCLUSION
The list of factors that contribute to depression indicate that if we are to improve the mental health status
of the young people of New Zealand we need to commit resources and energy at many levels. Protective
factors for young people against developing depression must be provided and these include: building a
more just and equitable society; increasing individual and family life skills and resources; providing
effective youth mental health support services; developing policies that value young people and their
contribution to society
Because thoughts of suicide or death are often a part of depression, it is vital that you consider the
safety of a young person with depression
WAYS OF HELPING
There are many ways of helping a young person with depression or a young person at risk of developing
depression. Here are some examples:
1. Education
Education is important because it it helps the young person to realise they are not alone - 'it's not just
them'; it clarifies uncertainty and misconceptions; and knowledge allows the person to understand signs
and triggers, and intervene early to help themselves.
CHURCHES YOUTH MINISTRY STUDIES 49 CHALLENGE OR OPPORTUNITY?
2. Managing Stress
Stress is a natural occurrence in life and everyday stress is necessary for growth
and development. However, too much stress over a long period can cause us to
become tired and rundown, and can contribute to depression. Help the young
person to understand the effects of stress, an also the stressors that are affecting
them. Together you can plan ways to change both the stressor and/or their
response to it.
3. Reducing/stopping alcohol and other drug use
Misuse if alcohol has been associated with increased rates of depression.
Alcohol actually depresses mood, so although it may provide temporary relief,
you end up with more problems. Other drugs such as cannabis, can also have an
effect on mood.
It is important that young people understand that alcohol and drugs can cause
biological changes leading to depressive symptoms. Although they may seem a
„solution‟ to problems, they can become a problem in their own right. Alcohol
and other drugs also contribute to a young person becoming less inhibited and
more impulsive, and this may mean increased risk taking behaviour (including
suicide). Referral to an alcohol and drug service may be helpful.
4. Sleep patterns
There is some evidence for a relationship between the disruption of sleep patterns and depression. Good
sleep patterns are important for treating depression, and also for preventing
relapse. Things that can improve sleep patterns include: regular exercise, eating
early in the evening, avoiding stimulants such as coffee (and other
caffeine-containing drinks e.g. coca-cola) or cigarettes for several hours before
bedtime, developing an evening routine to relax, and not lying awake for hours
- get up, read - and then sleep. Some herbal teas have a relaxing effect. Warm
milk drinks can help.
Sleeping pills may be beneficial for a short time, but they can cause
dependence. They should not be used for a long period on a regular basis.
4. A Balanced Diet
Contact your local Public Health Service for information about diet and food groups. A balanced diet
prevents tired and run down feelings resulting from poor diet. Under or over eating is a symptom of
depression and it is so easy to eat junk food. Some evidence exists that carbohydrate enriched foods
improve mood.
Food sensitivities, and deficiencies of key vitamins and minerals (such as Vitamins B1, B3, B6, B12, C,
zinc, iron and folic acid) have also been associated with depression, as has excess lead and vanadium in
the body. (Davies and Stewart, 1987)
6. Physical Exercise
Some form of exercise is beneficial, and improves mood. If the young person is lacking in motivation
this can be difficult, and again they need your support and practical help. This may be an area that
friends can help in by encouraging participation, (e.g., biking together to events.)
When someone has depression it is important that the goals set are achievable ones. A gentle form of
exercise may be best to start with.
7. Coping Strategies
We often learn our coping strategies for life‟s challenges as children. Sometimes these include negative
thinking patterns, low self-esteem, and inadequate knowledge and skills for dealing with challenges. We
may also have difficulty asking for help and see it as a weakness.
CHURCHES YOUTH MINISTRY STUDIES 50 CHALLENGE OR OPPORTUNITY?
If you are working with young people you will already b using a range of strategies to assist them to
build their self esteem and develop healthy coping skills. If you are working with a young person who is
depressed it is worth reviewing their problem solving skills and social skills with them. Particularly
focus on exercises that build self-esteem and confidence. Accepting compliments and refusing
put-downs is useful (Mellon, 1990)
8. Relaxation Techniques
Identify techniques that the young person finds relaxing. These may include:
learning deep breathing methods, physical and mental relaxation techniques
(e.g. meditation) listening to music, developing a creative prayer life.
9. Changing Negative Thoughts/Negative Self-talk
'Self-talk is the conversation we have with ourselves which only we can hear.
It can be either positive or negative ... Positive self-talk is like good food. We
can make ourselves feel happy and strong when we feed on it. Negative
self-talk is like contaminated food. We can make ourselves feel unhappy and
weak when we feed on it.' (Mellon, 1990)
10. Planning The Day
A young person may need assistance with planning their day/week. Ensure
that they include activities that they enjoy doing, and break down difficult
tasks into smaller parts. It may be helpful for them to include other people in
some activities, to assist with motivation. Remind them that depression does
pass, and to focus on one day at a time. A long period of withdrawal or
inactivity means young people can 'get out of touch'. They may need
assistance to establish links/activities.
11. Monitoring
Monitor the young person's situation by maintaining regular contact with them, and reviewing their
situation and support needs. Regular contact with other people involved in the young person's care is
always preferable (within the guidelines of the Privacy Act)
12. Ensuring help/support for family members
This will not always be appropriate, but it is important to consider the wider
picture and if family members are going to support the young person, they too
will benefit from information and support.
13. Support Networks
It is always preferable to involve others who are close to the young person -
whanau, friends, teachers, etc. This needs to be done sensitively and with the
young person's permission. The involvement of some people will not be appropriate. Be guided by the
young person.
14. Mutual Support Groups
Organisations, including some Youth Mental Health Services operate these groups. They can be
accessed through your local community Mental Health Agency. Citizen's Advice Bureaux may also
have information about groups that are operating locally.
15. Spiritual Sustenance
How we view the world and where we see ourselves in relation to it, has a profound impact on our
mental health. (Disley, 1996) Some people gather strength from the solitude of a mountain, others from
organised religion, and others from family and community involvement.
CHURCHES YOUTH MINISTRY STUDIES 51 CHALLENGE OR OPPORTUNITY?
STEPS IN HELPING – USEFUL GUIDELINES
Here are a few simple guidelines contributed by people who have known severe depression.
(Coping with your Teenager's Depression - Youth Specialty Service, Healthlink South, 1996)
Don’ts
Don't tell me to pull myself together - I would if I could.
Don't tell me to count my blessings. I know they are there but I can't feel them as real.
Don't give me lots of advice I haven't the energy to follow - I already feel hopelessly inadequate.
Don't preach - I am already overwhelmed by guilt.
Don't give up on me - I am so near to giving up on myself.
Don't judge me - you are not in my skin.
Do’s
Do listen to me and patiently encourage me to talk or cry.
Do accept my feelings as I experience them, not as you imagine they are.
Do show me that you love me - not with too many words, but by warmth and companionship.
Do work with me as 1 make little changes.
Do help me to separate feelings from facts and to cheek them out.
Without becoming entangled in my negativity or mocking me with too much cheerfulness,
domaintain your own hope, optimism and calm.
Do reassure me that this darkness will pass in time. I need to know that.
Although I am so hard to convince, do try to affirm my strengths and the qualities you value in me.
I may find it hard to believe in the things you say, but they keep my hope alive.
Do reassure me that I'm not going mad because that fear is sometimes with me.
It is important for you to:
Recognise the symptoms
Support the person to get/receive help
Assure them of your support/love/caring
Recommend helping resources
If necessary, accompany them to appointments, and act as 'go betweens' for appointments
If the young person refuses help, seek advice from friends, family, school, church, Marae, - other
trusted adults.
Common Myths and Facts about Depression
Myth - Teenagers are supposed to be moody - it's not possible for teenagers to be depressed.
Fact - Depression can affect people of any age, race or economic group. Probably half of the people
who ever have depression will have a first episode before the age of 25 years. Depression in teenagers
can be missed because we assume it's normal teenage behaviour - this mistake can have serious
consequences for the young person
Myth – Every young person with depressive symptoms has a depressive disorder.
Fact - Depressive symptoms can occur for a variety of reasons - in young people it can be from alcohol
and drug abuse - this should be considered.
Myth - They just need to pull themselves together - we all have our ups and downs
Fact -. Depression is an illness not a weakness. Because there is a chemical imbalance in the brain, it is
very unlikely that things will improve without appropriate support/treatment options.
Myth - Young people will grow out of depression.
Fact - Many depressive episodes in young people will resolve without treatment. However, these
episodes may last months or years if left untreated. Remember that long spells of depression in young
people adversely affect their personal, social, academic and vocational development; not to mention
their risk of suicide.
CHURCHES YOUTH MINISTRY STUDIES 52 CHALLENGE OR OPPORTUNITY?
Myth – If the young person gets more involved in outside activities and gets out more things will
improve.
Fact – Most people with depression just can‟t enjoy the activities that used to make them happy.
Without treatment „getting out more‟ will have minimal effect on their state of mind
Myth – They have nothing to be depressed about - they come from a great family and have all they need.
Fact – Because depression is an illness, it can affect anyone.
Myth – Talking about depression only makes it worse
Fact – A supportive listener can be very helpful, and help the person recognise that they need help.
Myth – I know she/he is very depressed, but there is no way they would ne suicidal, it’s just not like
them.
Fact – Depression can make people unlike their usual selves. At all ages depressive disorders are linked
to suicidal ideation, attempts and to death by suicide. Many depressed youth who die by suicide have
given warnings to friends and family – always take these seriously.
Myth – What about the causes of the depression – there is no point just treating the symptoms.
Fact – It‟s true that the causes need to be dealt with, but we must also deal with the immediate situation
– because of the nature of depression the young person does not always have the energy or motivation to
work on the causes, until the symptoms are treated.
CHURCHES YOUTH MINISTRY STUDIES 53 CHALLENGE OR OPPORTUNITY?
Suicide Risk for Young People with Depression
'The high and increasing rate of suicide among New Zealanders aged 15 to 24 years is a major public
health concern. Suicide is the second most frequent cause of death among this age group, after death
from injuries resulting from motor vehicle crashes.' Youth Mental Health Promotion, (Ministry of
Health, 1996) „In 1992,129 young people between ages ]5 and 24 died as the result of suicide. Eighty
seven percent of these were young men. In the same year, 1120 young people were admitted to hospital
for the treatment of self- inflicted injuries. Sixty percent of these were young women. This figure does
not include those suicide attempts that did not result in hospital admissions. Suicide attempt rates are
very difficult to determine as there is no central register' (Rivers, 1995)
SUICIDE WARNING SIGNS
Any one of the following signs does not necessarily indicate a risk of suicide. But a combination of
attitudes and actions may indicate the person is undergoing serious problems which could lead to a
suicide attempt.
Any incident or thought of self harm requires serious attention
Pre-occupation with themes of death or expressing suicidal thoughts.
Giving away prized possessions, making a Will or other „final arrangements".
Changes in sleeping patterns - too much or too little.
Sudden and extreme changes in eating habits, losing or gaining weight
Withdrawal from friends or family or other major behavioural changes.
Break up of a relationship
Changes in school performance, lowered grades, cutting classes, dropping out of activities.
Personality changes, such as nervousness, outbursts of anger, impulsive or reckless behaviour or
apathy about appearance or health.
Use of drugs or alcohol.
Recent suicide of friend or relative.
Previous suicide attempts.
Frequent irritability or unexplained crying.
Lingering feelings of unworthiness or failure.
No plans for the future
HOW YOU CAN HELP
Believe the person - take seriously the person's claims.
Be alert to veiled references and check them out. "Are you going to suicide?" Ask up front. "How
long has this been going on? " - the longer the time the higher the risk.
Find out method - more lethal, more risk.
Find out family history - cheek for modelling. Don't leave them alone!
Try to sound calm and understanding. Don't sound shocked by anything the person tells YOU.
Try to take a positive approach by always emphasising the person's most desirable alternatives.
Use constructive questions to help to separate and define the person's problem and to remove some
of the confusion.
To help the person understand the situation, rephrase important thoughts and restate them by saying
"In other words, you feel ......
Emphasise how problems must be tackled one at a time.
Make a contract with the person that they will not harm themselves until further help can be
obtained
If you can't help, be prepared to refer the person to someone who can - recognise your limits..
CHURCHES YOUTH MINISTRY STUDIES 54 CHALLENGE OR OPPORTUNITY?
Suppose you hear a family member or friend say "I can't handle life like this - may be I need a one-way
ticket to paradise".
Responses such as the following are NOT appropriate, they are "shut up responses" and they don't
encourage the person to tell you more.
"I remember when I broke up with my girlfriend ... I got over it”
"Don't be so serious all the time"
"You are just having a bad day",
“Maybe you should take some vitamins",
"Don't let your father hear you talk like that, he's had a bad day at work”.
These are not the ways to respond. You need to help such people to talk more about how they feel and
what they are thinking of doing.
Instead of giving "shut up" responses you need to try to hear with understanding and to give
responses which encourage the person to talk to you. For example: "A one way ticket to paradise?
That sounds scary - what do you mean?”
"I've noticed you seem pretty low, how bad are you feeling?"
These responses show your interest and concern and will encourage further communication.
HOW SERIOUS IS THIS?
Find out first if life itself is at stake. If the person is about to commit suicide the causes for their
behaviour are of secondary importance when faced with the initial crisis of saving their life. Avoid
questions like "What's the matter?" These confuse the person. They don't know if you are asking about
suicide or the problems causing their distress. Instead ask, "Do you mean you are thinking of killing
yourself?" This is not easy for someone to ask, but is of vital importance. It lets the person know how
deeply you care and that you realise how serious the situation is.
If a distressed person says they can control themselves and that they wish to overcome their problems it
suggests that the current crisis may be contained - but remember, the unexpected can happen. If the
response is reassuring, move on to exploring stress but continue monitoring the risk in the days ahead.
Next, ask: "You say you wouldn't really kill yourself - that's good to know because I'd be lost without
you - now tell me what's getting you down so much?" Bear in mind your interest and concern may be
highly reassuring.
FAMILY PROBLEMS IN THE REAL WORLD
Suicide usually, though not always, occurs in the context of relationship problems. You may be part of
that problem. How do you respond to "Yes I do want to die; it beats hanging around with you!"? Now is
the time to hold steady. The situation is too serious for you to respond with anger. Keep the person
talking and try to keep control of your emotions. In 5-1 0 minutes of conversation you will have a better
idea of how you stand - whether you need to arrange professional help or can handle things by being
more available to talk on a day to day basis.
"OK you are really angry with me - right now I'd like to listen".
If the situation looks risky - arrange help
Most suicides can be prevented but often skilled help is needed. In addition to life problems, depression,
alcohol and drugs can make suicide more likely. In fact over 90% of suicides are associated with such
disorders. People considering suicide need to be encouraged to seek help. Offer to go with them to help.
After all, they are feeling destructive. Who you turn to will vary according to whom is available in your
locality. Likely appropriate helpers include:
A trusted helpful family member, friend, teacher, minister, parent etc. - they may help with
emotional first aid.
Your family doctor (GP).
CHURCHES YOUTH MINISTRY STUDIES 55 CHALLENGE OR OPPORTUNITY?
The local general hospital emergency department.
Lifeline and Youthline have trained telephone counsellors available 24 hours to help you. Lifeline
can provide emotional first aid and put you in touch with appropriate professionals.
The community mental health service.
A psychiatrist
If the person considering suicide will not go with you to see someone, you should go along personally to
discuss the situation to see what options for assistance may be available to you. If your early efforts to
obtain help are not quickly successful, do not be deterred. Be assertive and persist till you get help.
IF THE SITUATION IS CRITICAL
If the person has taken an overdose they need to be taken to hospital immediately. If you can't take them
yourself, call an ambulance, having explained the nature of the emergency. If the situation is not that
easy, and the person is pacing the house with a gun and talking of suicide, you have to act quickly! Call
the police. Phone 111. Let the police know:
There is an imminent risk of suicide - so urgent that there is no time to get a doctor.
You are requesting their assistance to take the person to hospital.
If a weapon is involved they and, maybe you, could be at risk.
SUMMARY
Listen - really listen! Aim at getting the person to talk in depth regarding their feelings.
Hear - hear how they are perceiving things.
Distinguish between situations where there seems to be significant risk of suicide and those where it
might be reasonable to arrange to talk supportively more regularly.
If there is significant risk, seek professional help
REFERENCES
Marsh, A. (1996). “Young people with drug problems: Why some and not others?” In C Wilkinson & B
Saunders (Eds.), Perspectives on addiction: Making sense of the issues. (pp 55-64). Perth: William
Montgomery Pty.
Wyllie, A., Millard, M., & Zhang, J. (1996). Drinking in New Zealand: A national survey 1995.
Auckland: Alcohol and Public Health Research Unit
O‟Hagan, J., Robinson, G. & Whiteside, E. (1993). Alcohol & Drug Problems. Wellington:
Alcohol Advisory Council of New Zealand.
Field, A., & Casswell, S. (1999) Drugs in New Zealand. Alcohol & Public Health Research Unit:
University of Auckland.
Together we can stop family violence. Police Managers‟ Guild
Alcohol and Drugs - Safer Communities Together Police Managers Guild
Young people and depression, Mental health Foundation of New Zealand 1997
Thorpe, G. & Swift, D. (1996) Beyond Violence: Women working with women
Cannabis: What’s the real deal? (1998) Foundation for Alcohol & Drug Education: Auckland
Cannabis: The Public Health Issues 1995-6 (1996). Ministry of Health. Public Health Group:
Wellington
CHURCHES YOUTH MINISTRY STUDIES 56 CHALLENGE OR OPPORTUNITY?
