From vulnerability to risk: Consolidating state interventions towards Māori children and young people in New Zealand

2020 ◽  
Vol 40 (4) ◽  
pp. 526-545
Author(s):  
Elizabeth Stanley ◽  
Sarah Monod de Froideville

Vulnerability has been a guiding narrative to state interventions towards children and their families in New Zealand. This article shows how this progressive notion has been systematically managed to fit pre-established political and policy priorities. These processes have emphasised: (i) categorisations of risk to those who demonstrate vulnerabilities; (ii) pre-emptive, multi-agency involvement in the lives of those deemed potentially ‘vulnerable’; and (iii) a responsibilising expectation that children and families will avoid vulnerable situations and comply with interventions. This individualising logic of vulnerability has solidified policy interventions towards Māori, and re-emphasised colonial practices of viewing Māori children and young people as deficit-laden risks to be managed. With a late 2017 change in government, the political dalliance with vulnerability appears to be in decline. A new progressive policy discourse – of child ‘well-being’ and ‘best interests’ – is being engaged. Yet, the emphasis on risk, and its corresponding elements of pre-emption and responsibility, persist. These discursive and institutional arrangements will ensure that Māori remain perilously entrenched in welfare and justice systems.

2021 ◽  
Author(s):  
Hiran Thabrew ◽  
Christa Fouché ◽  
Laura Ann Chubb ◽  
Stacey Yates ◽  
Harshali Kumar ◽  
...  

BACKGROUND Hospitalized children and young people can feel disconnected from their peers and families, which can in turn predispose them to psychological problems including anxiety and depression. Immersive Reality Experiences (IRE) technology, recently developed by the New Zealand Patience Project Charitable Trust may help to overcome these issues. IRE technology uses immersive 360-degree live-streaming and a virtual reality (VR) headset to enable hospitalized children and young people to connect with cameras located in either their school or home environment. OBJECTIVE This trial was undertaken to 1) quantitatively evaluate the effectiveness of IRE technology in reducing social isolation and improving social connectedness and wellbeing using validated outcome measures and 2) expand qualitative findings from a previous smaller ‘proof of concept’ trial to ascertain the views of hospitalized New Zealand children and young people, their caregivers and teachers regarding IRE technology. METHODS An open trial of IRE technology was conducted between December 2019 and December 2020 and included 19 New Zealand children and young people aged 13-18, who had been hospitalized at Starship Hospital, a specialist pediatric hospital in Auckland, for at least 2-weeks. All participants completed the Short Warwick-Edinburgh Mental Well-Being Scale (SWEMWBS), an abbreviated version of the Social Connectedness Scale (SCS) and the Social Inclusion Scale (SIS) and at baseline. Ten participants used IRE technology as often as they wished over a 6-week period and completed post-intervention measures. Semi-structured interviews with a subset of participants, caregivers and teachers were conducted immediately post-intervention. RESULTS Participants reported improvements in social inclusion (mean change 3.9, SD 2.8, p 0.057), social connectedness (mean change 14.2, SD 10.0, p 0.002) and well-being (mean change 5.7, SD 4.0, p 0.003). Key themes from interviews with participants, caregivers and teachers were: the importance of support for using IRE technology, connecting vs connectedness, choice and connection, and the value of setting it up and getting it right. A number of recommendations for improving connectedness via IRE and related technology were also provided. CONCLUSIONS IRE technology can improve the social inclusion, social connectedness and well-being of hospitalized New Zealand children and young people. With some technological modifications and simplified implementation, IRE technology could become part of standard care and support hospitalized children and young people in New Zealand and elsewhere to sustain family and peer cohesion, experience fewer psychological problems and more easily return to normal life following completion of treatment. CLINICALTRIAL This study has been registered with the Australian New Zealand Clinical Trials Network Registry: ACTRN12619000252112p


2019 ◽  
Author(s):  
Elvira Perez Vallejos ◽  
Liz Dowthwaite ◽  
Helen Creswich ◽  
Virginia Portillo ◽  
Ansgar Koene ◽  
...  

BACKGROUND Algorithms rule the online environments and are essential for performing data processing, filtering, personalisation and other tasks. Research has shown that children and young people make up a significant proportion of Internet users, however little attention has been given to their experiences of algorithmically-mediated online platforms, or the impact of them on their mental health and well-being. The algorithms that govern online platforms are often obfuscated by a lack of transparency in their online Terms and Conditions and user agreements. This lack of transparency speaks to the need for protecting the most vulnerable users from potential online harms. OBJECTIVE To capture young people's experiences when being online and perceived impact on their well-being. METHODS In this paper, we draw on qualitative and quantitative data from a total of 260 children and young people who took part in a ‘Youth Jury’ to bring their opinions to the forefront, elicit discussion of their experiences of using online platforms, and perceived psychosocial impact on users. RESULTS The results of the study revealed the young people’s positive as well as negative experiences of using online platforms. Benefits such as being convenient and providing entertainment and personalised search results were identified. However, the data also reveals participants’ concerns for their privacy, safety and trust when online, which can have a significant impact on their well-being. CONCLUSIONS We conclude by making recommendations that online platforms acknowledge and enact on their responsibility to protect the privacy of their young users, recognising the significant developmental milestones that this group experience during these early years, and the impact that technology may have on them. We argue that governments need to incorporate policies that require technologists and others to embed the safeguarding of users’ well-being within the core of the design of Internet products and services to improve the user experiences and psychological well-being of all, but especially those of children and young people. CLINICALTRIAL N/A


2020 ◽  
Author(s):  
Hiran Thabrew ◽  
Karolina Stasiak ◽  
Harshali Kumar ◽  
Tarique Naseem ◽  
Christopher Frampton ◽  
...  

BACKGROUND Approximately 10% to 12% of New Zealand children and young people have long-term physical conditions (also known as chronic illnesses) and are more likely to develop psychological problems, particularly anxiety and depression. Delayed treatment leads to worse physical and mental healthcare, school absence, and poorer long-term outcomes. Recently, electronic health (eHealth) interventions, especially those based on the principles of Cognitive Behavior Therapy (CBT), have been shown to be as good as face-to-face therapy. Biofeedback techniques have also been shown to enhance relaxation during the treatment of anxiety. However, these modalities have rarely been combined. Young people with long-term physical conditions have expressed a preference for well-designed and technologically-based support to deal with psychological issues, especially anxiety. OBJECTIVE This study aimed to co-design and evaluate the (i) acceptability and (ii) usability of a CBT and biofeedback-based, 5-module eHealth game called ‘Starship Rescue’ and (iii) to provide preliminary evidence regarding its effectiveness in addressing anxiety and quality of life in young people with long-term physical conditions. METHODS Starship Rescue was co-designed with children and young people from a tertiary hospital in Auckland, New Zealand. Following this, 24 young people aged 10 to 17 years were enrolled in an open trial, during which they were asked to use the game for an 8-week period. Acceptability of the game to all participants was assessed using a brief, open-ended questionnaire, and more detailed feedback was obtained from a subset of 10 participants via semi-structured interviews. Usability was evaluated via the System Usability Scale (SUS) and device-recorded frequency and duration of access on completion of the game. Anxiety levels were measured prior to commencement, on completion of the game, and 3 months later using the Generalized Anxiety Disorder 7-item scale (GAD-7) and Spence Child Anxiety Scales (SCAS), and at the start of each module and at the end of the game using an embedded Likert/visual analog scale. Quality of life was measured prior to commencement and on completion of the game using the Pediatric Quality of Life Scale (PEDS-QL). RESULTS Users gave Starship Rescue an overall rating of 5.9 out of 10 (range 3-10 and a mean score of 71 out of 100 (SD 11.7; min 47.5; max 90) on the System Usability Scale (SUS). The mean time period for use of the game was just over 11-weeks (78.8 days, 13.5 hours, 40 minutes). Significant reductions in anxiety were noted between the start and end of the game on the GAD-7 (-4.6 (p=0.000)), SCAS (-9.6 (p=0.005)), and the Likert/visual analogue scales (-2.4 (p=0.001)). Quality of life also improved on the PedsQL scale (+4.3 (p=0.042)). All changes were sustained at 3-month follow-up. CONCLUSIONS This study provides preliminary evidence for Starship Rescue being an acceptable, usable and effective eHealth intervention for addressing anxiety in young people with long-term physical conditions. Further evaluation is planned via a more formal randomized controlled trial. CLINICALTRIAL Australian New Zealand Clinical Trials Network Registry (ANZCTR): ACTRN12616001253493p;https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371443 (Archived by WebCite at http://www.webcitation.org/6sYB716lf)


2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Darren Sharpe ◽  
Mohsen Rajabi ◽  
Clement Chileshe ◽  
Sitali Mayamba Joseph ◽  
Ibrahim Sesay ◽  
...  

Abstract Background The mental health impact of the COVID-19 pandemic and quarantining on children and young people (CYP) living in low- and middle-income countries (LMICs) has yet to be fully comprehended. CYP in LMICs are at utmost risk, given the COVID-19-related restrictions and social distancing measures, resulting in reduced access to school-based services for nutritional and mental health needs. This study examined mental health of CYP during the first COVID-19 lockdown in Zambia and Sierra Leone. Method A total of 468 disabled and disadvantaged CYP aged 12 to 25 completed a planning tool that comprised the short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), as well as open-ended questions covering social connectedness, physical distancing and educational challenges during the lockdown. The community coaches screened individuals and families who could be eligible to receive emergency aid, and based on a convenience sample following distribution of aid, recipients were invited to complete the planning tool. Results The data showed that participants in the global south have increasing anxieties and fears centred on accessing offline educational resources and income loss in the family effecting food security and their ability to return to education. Mean (SD) SWEMWBS scores for all participants in Zambia and Sierra Leone, were 19.61 (3.45) and 21.65 (2.84), respectively. Mental well-being scores were lower in females, children aged 12–14 and participants with two or more disabilities. Factors significantly associated with poor mental wellbeing in the sample were: type of disability, nationality, peer relationships, connection to others during the pandemic, knowledge about COVID-19, worry about the long-term impact of COVID-19, and the types of self-isolating. Conclusion The study shows that participants who self-reported low levels of COVID-19 health literacy also scored low on the mental wellbeing self-assessment. Yet, despite undoubted limited resources, these CYP are doing well in identifying their needs and maintaining hope in the face of the problems associated with COVID-19 in countries where stigma persists around mental ill-health.


2021 ◽  
Vol 5 (1) ◽  
pp. e000981
Author(s):  
Tapomay Banerjee ◽  
Amjad Khan ◽  
Piriyanga Kesavan

Special schools play a significant role in the daily lives of children and young people with special educational needs and disabilities. We explored the impact of the COVID-19-related first lockdown and resulting school closure by surveying parents whose children attended three special schools in Bedford, UK. We asked about anxiety and impact on emotional well-being and education. We received 53 responses from parents: 31 felt their child was more anxious during the lockdown period/school closure compared with beforehand and 42 felt their child’s emotional well-being had been affected. Children and young people attending special schools may have struggled both academically and emotionally during the COVID-19 pandemic.


2018 ◽  

Psychotherapies are commonly used therapies for children and young people. They can help children and families understand and resolve problems, change their behaviour and change the way they think and feel about their experiences.


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