'Woefully deficient' youth services

New Zealand has a woefully deficient number of mental health services that are aimed specifically at young people, according to a new report. File photo / NZ Herald

New Zealand has a "woefully deficient" number of mental health services aimed specifically at young people, a report released today has found.

The report, Improving the Transition for Adolescents, was requested by Prime Minister John Key in 2009 and was undertaken by a taskforce co-chaired by Professor Peter Gluckman and Professor Harlene Hayne.

It arose from concern adolescents in New Zealand have a high rate of social morbidity compared to other developed countries, with at least 20 per cent of young New Zealanders exhibiting behaviours and emotions or having experiences that lead to long-term consequences affecting the rest of their lives.

Among its findings, the report said New Zealand "has a woefully deficient number of mental health services that are aimed specifically at young people".

"Furthermore, doctors, teachers, and parents are poorly trained to identify those young people who might be at risk," the report said.

"Given that the opportunity for successful intervention is greatest when the intervention occurs early, it is economically sensible to increase the mental health work force in New Zealand, particularly those who are specifically trained to work with children and adolescents."

It found there are capacity deficits for both mental health screening and treatment, although acknowledged in the current economic climate more cost effective ways need to be found to identify and treat adolescents who are at risk.

"Preliminary work, for example, has shown that therapy provided on-line, or e-therapy, holds some promise for treating adolescents with anxiety and depression. The other advantage of e-therapy is that the cost is low and there is little or no barrier to access."

Better screening to detect those with mental health issues, and improved access to therapy are also recommended.

"Given the concerns about the possibility that antidepressants can increase the risk of self-harm, increasing access to psychological therapies for young people would be important."

The report, which was based on domestic and international peer-reviewed research, also outlined the risks drugs and alcohol pose to the wellbeing of adolescents, and recommended policies be developed that restrict the access teenagers have to alcohol and drugs.

"There is also a sound case for reviewing New Zealand's legislation on the possession of cannabis to obtain a better balance between criminalisation and harm avoidance."

It recommended the increase of the purchase price and reduced marketing and availability of alcohol to curb excessive consumption and subsequent harm to young people.

"The key task for lawmakers is to strike a balance between protecting young people from harm and allowing them enough freedom to learn from their mistakes."

The report also found "there is no evidence to support the recent suggestion that increased coverage of suicide in the media will reduce youth suicide, and much evidence that it would actually do harm".

Key recommendations of the report:

• A recommendation that a primary prevention or 'life-course' approach is taken to reduce the morbidity associated with adolescence.

• Targeted investment in evidence-based education, prevention and treatment programmes directed towards at-risk children and their families is particularly cost effective.

• Targeted investment is also needed to address the long tail of educational underachievement.

• Efforts should be prioritised to address significant gaps in New Zealand's knowledge of what influences the transition through adolescence.

• Additional capacity is required in the mental health work force in New Zealand, particularly those who are specifically trained to work with children and adolescents, so as to provide effective screening and treatment for the substantial group of young people whose transition to adulthood is marred by mental health issues.

• A strategic national approach to reducing depression in adolescence.

• Measures to increase the purchase price of alcohol, to restrict its marketing and availability, and to more tightly regulate drink-driving, would reduce the considerable harm that excessive alcohol consumption does to New Zealand's young people.

• A major focus should be the development of policies and practices that address the issues that place Maori and Pasifika young people at greater risk of morbidity during adolescence.

• There needs to be an acceptance that programmes aimed at improving outcomes must meet criteria of effectiveness based on evidence rather than advocacy.

• Government should be cognisant of the social and economic importance of a smooth transition from childhood to adulthood, and of the importance of the family/whanau and broader social context to this transition. Consequently, during policy development, the public service needs to consider the potential impacts on adolescent well-being, even when the policy might not be obviously related to that group.