Get Real: Talking mental health & disability
Get Real presents frank and fearless conversations about mental health and disability, including people with lived experience, frontline workers in the sector, as well as policymakers and advocates. Get Real is produced and hosted by Emily Webb and co-hosted by Karenza Louis-Smith on behalf of ermha365 Complex Mental Health and Disability Services provider (https://www.ermha.org/).
Get Real: Talking mental health & disability
Creating stable bases for young people who commit serious youth-to-youth violence with Dr Lisa Warren
ermha365 CEO Karenza Louis-Smith has a thought-provoking conversation with Clinical Forensic Psychologist Dr Lisa Warren, Clinical Director of Code Black Psychology about the Stable Bases Model that the organisation developed to support young people involved in serious youth-to-youth violence to guide their developmental journey and foster long-term positive outcomes.
This episode was recorded at the Complex Needs Conference in Melbourne co-hosted by ermha365 and ACSO Australia with support from Swinburne University's Centre for Forensic Behavioural Science and funded by the Victoria State Government's Department of Families, Fairness and Housing.
ermha365 provides mental health and disability support for people in Victoria and the Northern Territory. Find out more about our services at our website.
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Speaker 2:Welcome to Get Real talking. Mental health and disability brought to you by the team at Burma 365.
Speaker 1:Join our hosts Emily Webb and.
Speaker 3:Carenza Louis-Smith, as we have frank and fearless conversations with special guests about all things mental health and complexity, with special guests about all things mental health and complexity.
Speaker 4:We recognise people with lived experience of mental ill health and disability, as well as their families and carers. We recognise their strength, courage and unique perspective as a vital contribution to this podcast so we can learn, grow and achieve better outcomes together.
Speaker 3:What does it mean to be a privileged young person? Back in the day, I thought privilege meant money.
Speaker 5:Yeah, I probably would have thought the same too.
Speaker 3:Man, have I got that wrong? What do you think it is today? A privileged young person is a young person who has adults who see them, hear them, value them and allow them to maintain really strong and secure attachments while they go out there in the world and be their authentic selves, including those moments where they get it wrong, those moments where they get it right, the moments where you can turn up to a school assembly and the moments where you've got to pick them up from their mate's house because they've just broken the window.
Speaker 6:This episode was recorded at the Complex Needs Conference in Melbourne last month that Irma365 co-hosted with AXO Australia with support from Swinburne University's Centre for Forensic Behavioural Science and funded by the Victoria State Government's Department of Families, fairness and Housing.
Speaker 6:Irma365 CEO, carenza Louis-Smith, has a thought-provoking conversation with clinical forensic psychologist, dr Lisa Warren, who is a clinical director of Code Black Psychology, and they're talking about the stable basis model that the organisation developed to support young people involved in serious youth-to-youth violence to guide their developmental journey and foster long-term positive outcomes. This model came from an intensive review and much stakeholder engagement on the drivers of violence between groups of diverse youth in the West Metro region of Melbourne. There is much more in this discussion that applies a nuanced lens to the issue of youth violence and offending. Lisa is a recognised expert in threat management, in particular her research on the risks associated with threats to kill. Lisa's clinical expertise is in the fields of complex patients, perpetrators and victims, survivors of family violence and coercive control, and those who cause repeated harms like stalkers and persistent, unreasonable complainants. We will definitely need to have lisa on the podcast to talk about more of her work, but for now, over to karenza and lisa I'm here with lisa warren, who is the Director of Code Black.
Speaker 5:Hello, Lisa, Hi Carenza, Welcome to Get Real. Thank you. Yeah, we're going to have some great conversations today. Now you're one of the presenters at the 2025 Complex Needs Conference. Now your conference presentation is creating stable bases for young people who have perpetrated serious youth-to-youth violence.
Speaker 3:Yes, stable bases is a model that came out of a project back in 2021 when we partnered with DJCS to try and disrupt the kind of the narrative that was being put forward about young people being something to be feared, people who were carrying knives and other weapons around with them and a group in our community that were almost a bit beyond hope, and when I partnered with Youth Justice, neither of our organisations believed that at all. However, we did understand that being able to genuinely see and value a young person when they are carrying a knife, when they are espousing ideas that tell them that violence is kind of something that's reasonable and needs to happen to keep you safe and is just part of being, you know, one of the group we realise that we need to be thinking about this differently.
Speaker 5:It's a really interesting and probably quite a hot topic actually at the moment in Victoria, isn't it Youth crime? I mean, I think people are frightened. I think you know genuinely. You listen to the radio, you read the print media. There's a lot of rhetoric in here, isn't there? About crime, gangs, kids running wild knives. We're going to ban the sale of machetes and knives under a certain size. I guess my question is is that actually real, is that happening, or is that kind of whipped up a bit as well? What's your thoughts on that?
Speaker 3:The media is, I think, distracted by how serious some of these events actually are, and even one event feels like a lot when you have one young person killing another young person. It feels like a lot. So that want to be able to understand why would young people do this Like, why would they hurt each other like this? That, I think, is a kind of the reasonable question that the media are exploring. Unfortunately, the media, in my experience, can get distracted by the loudest voices, and sometimes those loudest voices are the ones that are promoting the most downstream interventions that we are putting forward, like tougher bail laws.
Speaker 5:Yeah, because that's a big hot one right now, isn't it? You know we're going to have the toughest bail laws in Victoria now in the country.
Speaker 3:Having seen Professor Tonya Nicholls present this morning some extraordinary statistics, it really worries me that, with downstream interventions that are actually counter-indicated, that what we're going to do is be distracted by these loud voices and invest in methods that are simply not. Are they not going to work? They're probably going to make the problem worse.
Speaker 5:So let's touch on that a minute. So I think one of the things that I've always thought a lot about and hypothesised is, when you send a young person to prison, we're actually sending them on an apprenticeship, right? You know, here's your apprenticeship. You're going to learn to become a career criminal because you've got a whole bunch of you know new role models and mentors. You're probably not going to get a job at the end of this experience. So what does the kind of future look like for you? And isn't it? One of the single biggest indicators of how long somebody might spend in the criminal justice system is the age of their earliest offence.
Speaker 3:Absolutely and the way that we try and understand what are the kind of the levels of responsibility and culpability for someone who has a brain that isn't anywhere near developed yet. We've debated in Victoria what the age of criminal responsibility should be just recently and we've moved from 10 to 12, rather than what other states are doing, which is moving it from 10 to 14. We decided not to do that.
Speaker 5:So if I'm, you know, a member of the public and I'm listening to this conversation, I would be saying well, what are the alternatives then? Because we've got youth crime, we've got these things happening, like you say. We've got kids in schools and shopping centres harming other kids. That's a horrific thing. What can we do differently? If we're not going to have tougher bail laws or not going to send these kids to young offender institutions, slash jail, what do we do differently?
Speaker 3:We invest in upstreaming. I think that's perhaps the simplest answer is where do we identify vulnerable young people at those earliest opportunities where they are not investing in their own selves? Part of the work that we've been doing with djcs has really got me rethinking about. What does it mean to be a privileged young person? Back in the day, I thought privilege meant money.
Speaker 5:Yeah, I probably would have thought the same too.
Speaker 3:Man have I got that wrong what do you think it is today? A privileged young person is a young person who has adults who see them, hear them, value them and allow them to maintain really strong and secure attachments while they go out there in the world and be their authentic selves, including those moments where they get it wrong, those moments where they get it right, the moments where you can turn up to a school assembly and the moments where you've got to pick them up from their mate's house because they've just broken the window.
Speaker 5:Yeah, that's true, that's true. And so what do you think the difference is? Do you think that these are kids that don't have that privilege?
Speaker 3:What it means to have to survive a day rather than be able to be held in your day and valued in your day enough that you can focus on your own development is a big part of the issue. So if you see a young person who's wandering the streets at two o'clock in the morning and they're 10 and 11, what are we not doing to really hold and support that family so they are able to show up? And it's really easy to blame parents and blame families, but that and certainly the research bears this out as well is also a mistake. How do we show up as a community? And I was again fascinated to hear the presentation about colonialism and how we've really got to take some responsibility around some of the damage that's done. And I recently had the privilege of seeing Gabo Mate when he was here and it really struck me as a physician. He said, in fact, that we should actually be going back to the Indigenous ways if we're really going to make a difference.
Speaker 5:That's interesting, isn't it? Because that kind of comes back to I remember as a kid growing up like you know, if you did something naughty, like if you were out of order, my word your mum and dad knew probably before you got home. And you know I don't know if this is necessarily this was the right thing, but you get a clip around the ear and you probably wouldn't do it again because the community, like this kind of extended family and this whole you know thing around the community caring, was very strong. It's different today, isn't it? I think the world's changed, you know, I look at my kids. I think it's quite different.
Speaker 3:It's a more disconnected world, in part because our cities are bigger and they're busier and there's more happening. You can connect without leaving your room. You know using social media, the responses to COVID and you know Melbourne was one of the most locked down cities in the world, so we learned how to be disconnected. I have two children that did Year 12 from their bedrooms and it kind of qualitatively changed their ability to know what it means to really connect in with another person. I've been watching at this conference with 700 delegates, the number of people that say oh wow, you're an actual human. I've never actually met you before, I've just seen your head.
Speaker 5:I've seen your head and shoulders.
Speaker 3:And we've been working together for three years.
Speaker 5:Yeah, it's incredible, isn't it?
Speaker 3:So a big part of the work that we put forward is back in 2021, we did a worldwide literature review around youth-to-youth crime so-called gang crime, knife crime and we did some focus groups with about 60 stakeholders in West Metro Melbourne and mapped that literature to what was happening in that area West Metro Melbourne and mapped that literature to what was happening in that area. And what we found is and it's really striking and clear that privileged young people are young people who have got the space and the safety to focus on their own personal development and they need adults who value them. They need to experience things like trust and not just having someone to trust, but someone trusting them.
Speaker 5:Yeah, I can understand that, I can see that, and so I suppose the challenge then because this conference is all about what works, you know, when we take that learning, that research, that evidence base, how do we change that? What does change look like and where does it begin?
Speaker 3:Part of what I think would make an enormous difference is the way that the sector shows up to collaborate.
Speaker 3:The first admission that we all need to make when we really look at ourselves in terms of how do we show up as a sector, is to really recognise there is no one solution, there is no one service, there is no one sector that's going to be able to get it right or be able to solve the problems of what it means to be ostracised in your community, to have to manage things like systemic racism, to deal with disability, when your disability makes you vulnerable to people who want to use you for things like the mewling type offences. These are not, you know, people who are, we talk about criminal masterminds. In fact, when you look at the vulnerabilities, all of a sudden the logic of what somebody did starts to become so much more apparent. So what we've been really looking at is, if we were to create a stable base around a young person, what would it mean for them to be able to really focus on their own personal development? And the analogy that we used was walking a tightrope that to move from being a child to being an adult.
Speaker 5:Which is hard.
Speaker 3:For everybody, Even the really really privileged kids that have got lots and lots of adults who are really tuned into them. Yeah, it's still tough, it's embarrassing and it's awkward and you get it wrong and you know, as somebody who has six children themselves, I've seen it play out a number of different times. But in walking the tightrope, the one of the reasons that we use that analogy is that nobody can do it for you.
Speaker 5:That's true.
Speaker 3:But what we can do, though, is really stabilise that journey and make that journey more rewarding and easier, and we found that there is six ways. There's six really key, evidence-based methods to stabilise the immediate environments of young people, and the work that we're doing at the moment is creating a tool and a protocol to help services audit are you actually doing those things that work? Is a mental health service really supporting things like the development of self-identity? How do I become kind of my best unique self? Is, for example, a community-based service or a sporting team or the kind of local police youth officer really creating opportunities for self-growth? So we've got these six bases where we all work together and say how well are we actually stabilising the world around the young person? We can do what young people really need from adults, which is to be seen, to be heard and to be valued. So what are your six?
Speaker 5:bases. What are they?
Speaker 3:So base number one is trust.
Speaker 5:Yeah, okay.
Speaker 3:And that's not just experiencing trust and kindness, but it's actually being able to have someone value that from you. And when you look sort of developmentally at, say, a five and six-year-old child and you see them doing a simple chore around the house and a parent says, wow, you did that really well, thank you so much, that was really effective or that was really helpful, you watch them be really proud of themselves.
Speaker 5:Yeah, they're just puff out, don't they?
Speaker 3:They're just smile 100%.
Speaker 5:Yeah, it's an important thing, isn't it? It's that kind of recognition.
Speaker 3:What am I good at and what would this person trust me with? So that's one. Another is being valued, so genuinely being heard and being validated. Another is self-identity, which is the big task of adolescence is what kind of adult do I want to become and how do I bring some sort of consistency to that? And we see in our deeply, deeply traumatised people that stability, kind of a permanence in their identity, is something that's very disrupted. There's another base around self-growth and I suppose the most practical of all of the bases is security. There's a very good reason why young people walk around with knives is they are genuinely trying to keep themselves safe and to borrow from our legal colleagues when they talk about defensive carrying as think of the knife as the shield, not the sword.
Speaker 5:That's a powerful statement, because I don't think people see it in that way. I think you know people are fearful and then you have a knife you're here to harm. I think that's probably what's seen.
Speaker 3:When we did the work with the focus groups. It was a comment by one of the school principals that really struck me. They had a young person sent to their office who had a knife on them at school. The principal confiscated the knife and said what are you doing bringing that to school? Why have you got that on you? And his answer was well, miss, someone's going to get me.
Speaker 5:Wow.
Speaker 3:So that's the title of our stable basis report is well miss, someone's going to get me.
Speaker 5:That's scary. It would be frightening to be that kid.
Speaker 3:Absolutely so. In addressing that base, we very much take a trauma-informed approach that young people need to be safe, not only feel safe, and when you look at some of the neighbourhoods and some of the local issues that are occurring, it makes sense that a young person feels unsafe.
Speaker 5:And I think when you touch on schools, that's a really important place, isn't it? I mean, that's you know. Hopefully, most young people are going to school. You know that's where some of these things happen and play out. And yet you know schools aren't necessarily funded or resourced or have the staff or the capability to manage some of these complexities, and so the easier option is to say, well, sorry, it's going to expel you and exclude you from school because it's too hard. We've got, you know, a thousand other students and the five of you. You can just go because, yeah, it's which. What do we do? Do we support the 995 or the five?
Speaker 3:that's a beautiful segue to the last base. Oh there you go, which is belonging. Yeah, okay, that feeling included and connected is an evidence-based way to have a young person really connected to the institutions that they're involved in. And expelling them from school is systemic ostracism and it's done under the guise of keeping people safe, and it's done under the guise of keeping people safe, but it is such a last resort approach where there are other ways to ensure that there is safety and that there's opportunity for a young person who's really struggling to genuinely belong at school.
Speaker 5:So if a school's listening to this podcast, their school teacher and school principal that's easy to say, but far that is bloody hard to do. How can schools kind of change that then? Because I imagine that's difficult.
Speaker 3:Absolutely, and my first statement to them is that they're right. It is hard. If it was easy we'd have solved it by now, but we can't also have compassion fatigue. There's always going to be the next cohort of young people and the problems that they're facing are going to be as complex, if not more complex, than the cohort that preceded them. And that safety is one among six considerations. And I think when I've been involved in care teams with complex young people, when we've got teachers and principals showing up to our care team, we create these far better solutions.
Speaker 3:My organisation, code Black, we're partnering with a school at the moment who is really struggling with a young person who behaves in a way that puts themselves and others at risk quite frequently, and we absolutely acknowledge that being at school is distressing for this young person.
Speaker 3:Not being at school is even more distressing for this young person. So how do we gather around the school as professionals to say you've got child safety obligations and you can't have all your resources channelled into one student, but excluding the difficult ones is also not an option. So we've got an entire plan around this young person where we can connect together the family, the school, the clinical team and really understand what is the function of this young person's distress? What does it mean when they're trying to escape or avoid something that just feels too big or too overwhelming? What does it mean when we all start to worry that avoiding is becoming a coping method of choice? And how do you challenge in a productive and safe way, that young person to be able to say you know what. I can actually trust that I can cope with a bit of distress here. I know I'm supported in this. I've got my identity that's developing here is that I don't have to walk away from everything. That's tough.
Speaker 5:That's powerful. I'd like to talk a bit about Code Black as well and your work, because I think people listening are going. I want to talk to her. I want to talk to Lisa. I want to hear more. So you established and set up Code Black I did in 2009. Why, what was the driving force or the reason why you decided to go out on your own and do something like this?
Speaker 3:I liked the agility of the private sector, and the longer I've worked in the complex space, the more I've realised that it is actually the joining together of the public sector who has to take the bulk of the work. I mean, the government is responsible for a whole lot of making sure that standard practice is embedded in everything that we do, but my work has always been around. But what happens when standard practice doesn't work? And one of the psychological variables I've always had an interest in is this concept of persistence, and why would someone continue to do something that, on the surface of it, makes no sense? And as somebody who's a clinical forensic psychologist, and I work with an incredible team of psychologists, behaviour support practitioners and we've got a whole team of coordinators. They're actually like the case manager of the care team and we love the work that they do, because their job all day, every day, is to just bring everybody together and not only create a shared understanding but create sustainable models of care for these exceptional cases.
Speaker 5:And you often get called in, don't you into into situations where, like this, is a really wicked difficult kind of problem to solve? Perhaps you could tell our listeners a little bit about some of that work as well.
Speaker 3:So one of the, I suppose, services that we've really worked to create something different is in our workplace consultancies, and that's about supporting the organisations who are really struggling because standard practice doesn't work.
Speaker 3:As an example, we have a case where we have a man who has a psychosis, who has been treated with a range of medications, and when you talk to the doctors about their selection of which medicines and which doses, at what time of day and in what combination gosh, there's a lot of thought being put into how do I give this person as much relief as we possibly can from their symptoms, and there's this sadness that you see in the doctors that none of it's worked.
Speaker 3:This poor person is still tortured by their symptoms, no matter what has happened. We, then, have worked with the allied health services and psychologists and looked at all of the ways that the system has tried to stabilise the world. For this person to say, even though those symptoms are not abating as much as we would like them to, we can still create immediate environments for you that are tuned into you, and the environment can do the therapeutic work and give you a place that is safe enough that you can relax and think about something other than your symptoms. So that's, I think, been a really helpful part of my work. I will just share, if it's all right, a little story of a collaboration that we had.
Speaker 5:We've been partnering with an architect for the last couple of years, as in an architect, like someone that designs buildings, uh-huh.
Speaker 3:Okay, and he has been discovered by the University of Columbia in America, and their school of architecture has just sent 12 architecture students to Melbourne to visit a number of places, including Code Black, where there's an emerging speciality for creating design built spaces for people with complex disabilities.
Speaker 5:Yeah, okay, so cool, very, I can imagine, because that's built environments are a huge game changer, right?
Speaker 3:if you have the right kind of bricks and mortar setting and it works, that's a good thing absolutely, and I think my favorite question that I posed to them was how do you create a built space that endures over time? Because that's been one of the challenges of architecture that you can create a therapeutic space for the right here right now. But people change. Their disabilities can change in terms of their capacity, their own sense of self, how a person would like to approach their day-to-day life. So how do you have a space to reflect that and evolve with people as we develop? What do they say? We really dug down into that concept of a flexible space. So what does it mean to be able to move things in an environment including walls? So having things like concertina doors, Wow.
Speaker 3:Yeah, it's really interesting, I know, and as a psychologist it kind of blew my mind because it's so far out of scope and that's an interesting collaboration because I'd be interested.
Speaker 5:I don't know if anyone in this kind of conference over the next two days is going to talk about partnerships with architects.
Speaker 3:I hope they do, but I bet they don't.
Speaker 5:So there are going to be people listening to the podcast. They're going to be fascinated in the tool that you're talking about and the six I'm going to say domains, but I think that's the wrong word.
Speaker 1:Bases Bases Thank you Six bases.
Speaker 5:How do people get in touch with Code Black, and you know they want to hear more about your work. What's the best way?
Speaker 3:I suppose, like lots of people, we have a website. I'm slightly addicted to LinkedIn, so please feel free to reach out to me there. I think there's just such brilliant thought exchanges going on in that environment. We've got a little form on our website, so there's that. There's certainly that there's info at codeblackpsychologyau.
Speaker 5:That's our kind of general email that you can get in touch with us and the final question that we're asking people, too, is you know, emily likes this if you had a magic wand, you know, and there was one thing that you could wave this magic wand and change, and it would really change how we approach and work with complexity. And whether it's about you know, young people, or it's about something else, what would your magic wand be? You know, if you could do that, your fairy godmother's sitting on your shoulder. Here you go.
Speaker 3:I think that's alarmingly easy to answer. Okay, it's about the person. What does it mean to really see and hear and support someone to be authentic, and what does it authentically mean? And a number of the presentations they talked about really specific goals. So this person I loved the story of Rebecca that she wanted to earn money and buy herself Tommy Hilfinger shoes. I mean perfect. Every human being on this planet has has just such beautiful value if you care to look yeah, I agree.
Speaker 5:Thank you so much for your time today. Are there any last um pearls of wisdom that you want to impart to our listeners before we wrap up?
Speaker 3:I suppose just a reminder to say that the complexity is sometimes not in the person, it's around the person yeah, I think that's very, very wise counsel.
Speaker 5:Thank you so much, lisa Warren, director at Code Black, for your time here today at the Complex Needs Conference.
Speaker 3:Thanks, Corenza.
Speaker 2:You've been listening to Get Real talking mental health and disability, brought to you by the team at Irma 365. Get Real is produced and presented by Emily Webb, with Corenza Louis-Smith and special guests. Thanks for listening and we'll see you next time.
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