1. Dr Terry (Theresa) Fleming Senior lecturer Dept of Psychological Medicine & Dept of Paediatrics University of Auckland \ Welcome

3. Story telling Play-based learning Social learning Purpose Bicentric frame of reference

5. 26 not randomized Severe dep/high risk n =17 No depression n=6 Receiving treatment n=3 Merry et al, BMJ, 2012

6. Interviewer rated depression - CDRS-R Intention to treat analysis

8. SPARX in AE n = 32; 34% Maori; 38% Pacific; 56% male Fleming, Dixon, Frampton, & Merry, BCP, 2011 CDRS-R score

9. I didn’t think I would enjoy it but actually I did... The guide was on to it.... I liked choosing the character... thoughts, feelings, actions I liked that. What the guide said was really useful. The Bird of Hope is encouraging, it’s like having someone next to you, by your side, it will be in my memory. I was not really depressed at the beginning I was just angry, but it was still useful. I am not angry now... It has changed me, I don’t hate now. Oh yeah, I used to get some of those Gnats– but now I am all positive. I am thinking positive, thinking of all the good stuff that has happened to me. It changed how frustrated I was, so I could understand what was going on. I was understanding what it was saying to me and I was solving problems.

10. ‘This makes you more likely to ask for help, it gives you more confidence’ ‘Maybe less ‘cause it helps’ Do you think SPARX makes people more/less likely to ask for help?Alt Ed Students

11. Now nationally available, with youthline/lifeline back up www.sparx.org.nz Merry et al, BMJ, 2012

12. Supporting SPARX as a clinican Try it out yourself Consider asking young person if they are willing to check it out, encourage, reward? Keep up the caring Complete Goodfellow training: http://www.goodfellowunit.org/courses/e-therapy-youth- depression http://www.goodfellowunit.org/courses/e-therapy-youth- depression Not keen? Not improving? Try something else Safety issues or not sure? – get professional help

13. GFU Training Good fellow

14. Future directions US survey data: 46 % healthcare professionals say that they will introduce mobile apps to their practice in the next five years – http://www.healthcare-informatics.com/news-item/survey- doctors-and-patients-see-benefits-mobile-apps http://www.healthcare-informatics.com/news-item/survey- doctors-and-patients-see-benefits-mobile-apps 71 percent of millennials would be interested in a doctor/provider giving them a mobile app on their smartphone/tablet to actively manage their well-being – http://www.healthcare-informatics.com/news-item/survey- patients-open-tech-few-use-health-it-tools-now

15. www.thelowdown.co.nz

16. www.depression.org.nz

17. http://www.beatingtheblues.co.nz Access via GP (free to you) or purchase online

20. Whaanau & self Often first place to start Examples: – Sleep – Exercise – Activity scheduling – Solving specific problems – Building strengths & interests – Connecting, listening & having fun – Spend time with close whaanau Health provider or other professional can support We don’t know your needs: severe, possible safety issues, or not improving = get help

21. Community options Hapu and iwi services School supports Counselling via text, email, phone Counselling, face to face at school or in community Others e.g. support via church, police, youth services We don’t know your needs: severe, possible safety issues, or not improving = get help

22. Health provider options Primary health care – GP, family doctor, school or student health, sometimes Maori health services, Public Health Nurse Specialist mental health services Emergency services We don’t know your young persons needs: severe, possible safety issues, or not improving = get help

23. Thank you Nou te rourou, naku te rourou, ka ai te tangata. With your basket and mine, together we will flourish.

24. www.sparx.org.nz http://www.goodfellowunit.org/courses/e- therapy-youth-depression http://www.goodfellowunit.org/courses/e- therapy-youth-depression www.thelowdown.co.nz Depression.org.nz