This lecture will focus on how health services and clinicians can help set expectations for parents and young people alike. An important aspect of ensuring that health services are appropriate and acceptable for young people as well as for their parents. Parents of young children carry a heavy responsibility for their children's health and well being as I've tried to illustrate here on the yellow icon on the left. But as we've discussed in the earlier lectures around family in particular, an important role for parents is that they help set expectations for their children about what happens as they get older. This includes parents helping to set expectations with their children about education, about gender norms and roles, about friendships and relationships, about employment and finances, and around young people forming their own families. This is as true for these young girls in South Asia as it is for the young people on the right from Norway or for my own family members here in Australia. The same applies to health care. The United Nations Convention on the Rights of the Child recognises the growing maturity of adolescents to make independent choices and judgements about matters affecting them and their future, including their health. In the earlier lectures we discussed that at times there we can teach in between the special rights that legal minors have for protection versus their growing maturity to make decisions about their lives. The convention on the rights of the child empowers children and young people in the context of their evolving capacities to make autonomous decisions. As we've discussed previously, [INAUDIBLE] for example, the British common law concept of the mature minor doctrine. However, we cannot expect parents to appreciate the details of the United Nations Convention on the Rights of the Child. It's the role of communities and especially of health care professionals to assist parents appreciate this growing autonomy and independence that young people have to make independent decisions about their health and well being. Hopefully, supported by their families. The United Nation Convention does not describe the specific age that young people become competent to make important decisions about their health. However, I thought these data might be of interest as they are a reminder that even young adolescents typically make similar decisions to young adults around in this case a series of hypothetical, complex ethical health scenarios. As clinicians in health services that consult with adolescents we retain responsibilities to parents as I've attempted to articulate in the first column here. And as already stated we have responsibilities to support parents to assist children take on growing responsibilities for their health as they mature. And to help parents understand the changing patterns of health in young people and the changing responsibilities that health services have to address these. Not just the problems that young people present to health services with. Showing in the middle column are the responsibilities we have as health services to ensure that both parents and adolescents are informed about the specific legal context of health consultations. We want parents and young people to understand that in addition to consultations with parents, that consultations with young people alone can enhance young people's capacity to engage in their own healthcare, to become involved and to gain greater responsibility. And as shown in the last column, health services also have responsibilities to support young people themselves to engage more with their healthcare. And to help them anticipate the changing nature of health issues that may affect them with increasing age, what this might mean for them and the responsibilities that health services have to address these together with the problem that they actually presented with. Sounds complicated. Well it is and it isn't. The main thing to understand is that health professionals must balance both parents and young people's issues and concerns. Often this can be straight forward. It might simply involve pointing out to parents that it is for these reasons that you are going to be starting to address questions to the young person directly rather than to have the parent speak on behalf of the adolescent. It includes point out to the adolescent, that it is due to health needs changing with age and young people gaining greater sensitivity about these, that you will be starting to ask them a number of wider questions, not just about what they came to see you for. And that you will be doing this confidentially without their parent present and that this is part of your clinical role. At other times though, I think we can appreciate, it can be more challenging to balance both of these perspectives. In addition to what clinicians might say, there are other ways that they can help set expectations such as through the health information, health promotional material displayed on the walls of clinics, all through community services or school based approaches. You can appreciate that health services for infants and younger children will have a heavy focus on health promotional material that are relevant to to their age group such as posters around the importance of breast feeding or immunisation for infants. But adolescent friendly health services can also help set expectations about what clinicians might discuss in consultations with the young by displaying materials that address relevant health issues for adolescents. This might include posters on human papillomavirus immunisation, about the importance of contraception or of the dangers of smoking, alcohol or other drugs. Importantly, schools are a setting that can also help set expectations around a variety of health issues. This includes the traditional areas that schools have in terms of delivering comprehensive sexuality education including gender norms but can also be wider in terms of promoting health literacy. For example, around the importance in changing nature of mental health and well being and interpersonal violence. Schools can also be reassuring to young people about the confidentiality and sensitivity, hopefully of local health services. And posters such as the one on the right that we developed locally can be a resource in schools, health services and the community to help for example, in this case, increase health literacy about the range of emotional responses that can be experienced at any time. Setting expectations is also about ensuring that young people with chronic physical health and mental health conditions learn about the importance of remaining actively engaged in health services as they mature. And that they equip young people to have the skills to do so. This is referred to as transition to adult health care and is recognised increasingly as a challenge across the world not just in high-income settings which have, for the last two decades focused in this space. On the left is a copy of some of the documentation that my own hospital has developed to support parents and their adolescents maintain their involvement in healthcare as the adolescent matures. Many, many health services globally have developed information of particular relevance to young people in their local communities. This is important that communities do this work and make sure they bring them to the attention of their young patients.