The Prime Minister
Rt Hon. John Key
9 May 2011
Dear Prime Minister
Improving the transition: reducing social and psychological morbidity during adolescence
In October 2009 you requested me to provide a report focused on how we may improve the outcomes for young people in their transition from childhood to adulthood. Your request arose from the concern that young New Zealanders have relatively high morbidity relative to other developed countries. That report is attached.
I established a Taskforce co-chaired by myself and Professor Harlene Hayne ONZM FRSNZ, an eminent academic from the University of Otago with expertise in developmental psychology. Professor Hayne and myself invited a number of distinguished academics and clinical practitioners from a variety of relevant disciplines to join the Taskforce, and as the work has progressed we have co-opted additional members as gaps were identified in our skill set. These people are named in the Appendix to this report.
As we agreed, the purpose of the Taskforce was to review the peer-reviewed scientific literature, both international and domestic, so as to understand the issues and to identify ways in which we could do better for young people. The exercise has been a major task and has involved enormous dedication from the Taskforce members, who have served without recompense and put in extensive individual effort to review the literature and debate its implications. Despite the broad range of backgrounds and disciplines on the Taskforce, the conclusions were reached with strong consensus and the Synthesis Report is endorsed by all members of the group. I acknowledge all their contributions, and particularly those of Professor Hayne and of Dr Alan Beedle from my Office, who have committed an enormous effort to this project.
An interim report was provided to you in June 2010 and since then the committee has worked intensively to complete the final report. The Synthesis Report has been subject to external review by international experts to ensure that there have not been any significant
omissions or exaggerations and that the balance of interpretation of the literature is based on evidence rather than opinion.
The report consists of the Synthesis Report followed by 22 substantive chapters written by named members of the Taskforce and their associates. They were requested to rigorously review the evidence base and their contributions are extensively referenced. We are not aware of a comparable comprehensive review, although we have made extensive use of more limited analyses available within the scientific literature.
In research relating to human development and behaviour, the importance of experimental design, population selection and methodology is often underappreciated. Considerable expertise is needed to interpret the extensive literature. It is also easy to insert bias into the reading of the literature, and the Taskforce has been very aware of not falling into this trap. We are fortunate that we have a number of outstanding researchers in the areas of human development in New Zealand, many of whom were on the Taskforce.
The science of human development is complex – we have had to consider biological, cultural, social and behavioural domains. Even so, a comprehensive understanding of the factors that put an individual young person at risk is not possible. However, this does not mean that we lack a strong evidence base of what would reduce risk across our population of young people – indeed, there is substantive documented evidence to suggest that we can do much better for them.
On the other hand it is clear that an evidential approach is not being systematically used in deciding what programmes to offer and which to maintain. Too many programmes appear to have been started on the basis of advocacy rather than evidence or have characteristics which cannot scale. As a result opportunities are being lost and funds are being wasted on programmes that will not achieve their objectives. This reflects a general lack of critical decision-making in developing, applying and monitoring programmes in the social domains. Just because an intervention appears promising in the short term, or is promoted by anecdote, does not mean that it is effective over the long term.
It is also important to note that social, socioeconomic and cultural factors mean that there is marked heterogeneity in the risks facing young people across New Zealand. There is a need to distinguish programmes that are appropriate for all young people from those that should be targeted at individuals or families who are particularly at risk. Economic modelling in other countries has demonstrated the long term benefits of targeted programmes for high-risk families provided that those programmes meet certain criteria. It is also clear that programmes initiated early in life to reduce later risk are generally more effective – and more cost-effective – than attempts at remediation.
As the report makes clear, to improve outcomes for New Zealand’s young people will require sustained effort over multiple electoral cycles. It will require many agencies to consider their priorities and approaches. It will require greater integration of actions across ministries. The report also identifies knowledge gaps where research is needed.
While many of the concerns discussed by the Taskforce are not unique to New Zealand, I believe that this country, because of its small size, excellent social science research base, committed professional workforce and a community determined to address the issue, is uniquely placed to lead the world in developing a more integrated and effective approach to ‘improving the transition’.
In accord with the role of my Office, the report reaches a number of general conclusions to inform policy formation but does not attempt a list of specific action points. This approach reflects my brief that the role of scientific advice is to elucidate the evidence, recognising that policy formation must involve other considerations which were not part of our remit.
I thank you for the opportunity to address this critical matter and to demonstrate the value of an evidence-based approach to complex issues.
Sir Peter Gluckman KNZM FRSNZ FMedSci FRS
Chief Science Advisor