Report: Improving the Transition

[Full report: Sir_Peter_Gluckman_embargoed_report_Improving_the_Transition_for_Adolescents.pdf]

Improving the Transition

Reducing Social and Psychological Morbidity During Adolescence

A report from the Prime Minister’s Chief Science Advisor

May 2011

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Synthesis Report

A Consensus Statement from the Taskforce

Executive summary

• Adolescents in New Zealand relative to those in other developed countries have a high rate of social morbidity. While most adolescents are resilient to the complexities of the social milieu in which they live, at least 20% of young New Zealanders will exhibit behaviours and emotions or have experiences that lead to long-term consequences affecting the rest of their lives.

• An extensive and unbiased review of the relevant scientific literature has been undertaken by a multidisciplinary panel of experts. The key points are summarised in this introductory Synthesis Report, and the main part of the report contains the detailed and domain-specific reviews.

• One dominant message comes through – that application of the international and domestic evidence base to policy formation and programme development in this area will lead to better outcomes for our young people. However, to do so will require a prolonged effort over several electoral cycles and cannot be held hostage to adversarial politics. Our research suggests that many programmes have been introduced, albeit with good intent, that are unlikely to succeed as they are not supported by the evidence base, whereas other approaches likely to be effective have not been implemented. A key challenge is to ensure that all programmes are appropriately monitored to ensure that they are effective and cost effective within the New Zealand context, allowing better use of scarce public resources to support our young people.

• Adolescence is now a prolonged period in the human life course. Its length is influenced by the declining age of puberty as child health has improved and by the rising age at which young people are accepted as adults. This has both societal and biological elements, the latter reflecting recent findings that brain maturation is not complete until well into the third decade of life and that the last functions to mature are those of impulse control and judgement. It is therefore inevitable that adolescence is a period of risk-taking and impulsivity. For many children these are basically healthy and transient behaviours, but for too many there are long-term negative consequences. The key issue is what can be done to change the nature of, and reduce the impact of, these behaviours.

• The evidence shows that the risk of impulsive and antisocial behaviour is greatly increased by experiences earlier in life. It is now clear that early childhood is the critical period in which executive functions such as the fundamentals of self-control are established. Children who do not adequately develop these executive functions in early life are more likely to make poor decisions during adolescence, given the inevitable exposures to risk in the teenage years. It is very clear from our review of the literature that more can be done to improve socialisation and executive function development by reorientation of early childhood programmes. Further, while all children will benefit from these programmes, the evidence is compelling that targeting intensive but costly interventions towards the higher-risk sections of the community has a high rate of social and economic return. Hence the critical importance of adopting a life-course approach to prevention.

• Remediation in adolescence is not likely to be as effective as prevention. Although there are some remediation programmes that are partially effective, others clearly are not. Public and voluntary investment in programmes directed towards at-risk adolescents needs to be re-orientated towards those interventions that can be shown by high quality research to have real impact within the New Zealand context.

• The adolescent brain is clearly more sensitive to both alcohol and cannabis, with long-lasting adverse consequences for far too many. Stronger measures are needed to restrict access of young people to these drugs.

• One cannot overestimate the changed nature of the social environment in which young people find themselves compared with that of previous generations. The nature of peer pressure and role models has been radically altered by exposure to electronically connected social networks and to very different media content. Young people have far greater freedom, engendered by more ready access to funds. While the exact impact of these changes is difficult to ascertain, it is clear that they have radically affected the social pressures that influence adolescent behaviour. This creates challenges for parents and society in establishing boundaries and acceptable behaviours.

• A significant proportion of young people suffer from depression and other mental health disorders, yet the range of services available to them is inadequate. Given New Zealand’s high rate of adolescent suicide and psychological morbidity we suggest that priority be given to addressing this capacity gap and to raising public awareness of the particularities of adolescent depression.

• In general, most of the risky and impulsive behaviours of adolescence reflect incomplete maturation of self-control and judgement. Accordingly, punitive approaches are less likely to be effective than well-established and validated approaches that attempt to remedy these deficits. There is an inherent conflict between the practical focus on using chronological age to determine rights and obligations and the highly individualistic processes of maturation.

• The young people of New Zealand reflect the changing ethnic mix of our population. While the issues and their solutions are generic across all of our population, programmes must be developed and delivered in culturally appropriate ways to the very different communities that now make up young New Zealand. Targeted investments in the ‘long tail’ of educational underachievement and social disengagement will be needed. It is clear that while adolescent morbidity is observed across the whole of our communities, it is disproportionately found within sectors where there is intergenerational disadvantage.

• Social investment in New Zealand should take more account of the growing evidence that prevention and intervention strategies applied early in life are more effective in altering outcomes and reap more economic returns over the life course than do strategies applied later. This will require long-term commitment to appropriate policies and programmes.

• The report identifies a number of knowledge gaps that should be addressed.

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[Full report: Sir_Peter_Gluckman_embargoed_report_Improving_the_Transition_for_Adolescents.pdf]

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