Russell Wills – ALCOHOL ACTION NZ 3rd Annual Conference

Mickey new ikea ikea koto hallmark so I’m Russell Wells I’m a pediatrician in Hawke’s Bay and I’ve been Children’s Commissioner since the first of July and it’s my pleasure to to give this opening keynote and on behalf of the office of the Children’s Commissioner know my heart and life like a timeline I’m absolutely delighted to be co-presenting this opening presentation with four members of the young people’s reference group and with me today will be pressure on Cassandra Jessica pillar a alex crotch and Kieran Denton and prashant going to help with the introduction as well curato good morning everyone first of all we would like to thank alcohol action New Zealand and its supporters for making this conference happen as well as other contributors today for lending their voice to this topic and advocating for children and young people we would also like to thank dr. wells for the chance he has given us to speak today so that as this issue affecting children and young people is discussed children and young people can share their views and finally we thank you for attending and wanting to make difference in the way alcohol affects babies and children in New Zealand so as I said I’m a pediatrician and my experience and using a child rights approach is really a largely at a local level I’m still getting the hang of what it means to do this at a national level and so for this talk my colleagues and I going to discuss the broader context of alcohol-related harm to children and young people their views on the issue and we’re going to focus on local solutions to alcohol-related harm to children young people using a rights-based approach so this is Mandy she’s 17 and she’s estranged from her abusive parents since she left home at 15 now this is based on a real case with some details changed she’s on the independent youth benefit she dreams heavily and she uses drugs when she came she is transient and she’s pregnant she has just been arrested for willful damage after breaking a window while drunk most likely as part of the cry for help so what’s the likely outcome for Mandy and her baby in 2012 how did this happen and what can we do to improve us so as a clinician specializing in severe behavior I’m seeing children with fetal alcohol effects increasingly in my practice and it worries me enormously these children do remarkably badly now they manifest much like children with ADHD but they’re learning difficulties are often more severe the dose of stimulants they need to gain any semblance of control is often considerably higher and of course they have the side effects of that we’re also seeing increasing numbers of what initially presented a sudden unexplained death an infancy which we re categorizing really as overlying an alcohol clearly has an important part to play in that a neck Baker who’s talking after us will be talking about that I’m sure pediatricians also see abuse and neglect of children and young people and commonly we see the behavioral and developmental consequences of parents who have alcohol and other drug addictions as well as mental illness there’s no doubt that alcohol affects parenting capacity and it means that they aren’t able to respond to the emotional and developmental needs of children and that has profound consequences particularly as we’re learning more about attachment disorder and trauma as that manifests as behavioral problems that are increasingly presenting to us and china de lism into health and in pediatrics so of course it’s during term for the drinker we’re aware of that mostly for adults and young people that’s around injury but it clearly makes mental illness worse as well so what is the cost of alcohol to

society other speakers are going to talk about this later today why is it that we allow new alcohol outlets to sit up in poor suburbs that already have two or three or four of them why is there while there wasn’t much for us in alcohol law reform one thing there is is an increased ability for local government to decline new applications for alcohol outlets and to respond to two public feelings about that and thank goodness for that at last a piece of scenes and lock government legislation is going to help the local democratic process the Pickers we have from Caswell suggests that alcohol as a burden of disease contributes to around one percent of gross domestic product I’m sure that’s an underestimate I’m Connor and Casswell have talked about a burden of around five or six hundred million dollars in terms of alcohol-related harm a year in New Zealand that’s going to be close to the truth but again as you’ll know estimating the cost of harm is hard that’s like cooking under estimate so when we’re considering policy options and anything we need to consider the broader context and there are other detrimental effects on families and these issues are not rare for those of us in clinical practice we see these things often daily and as you all know they often congregate and families so it’s common to see all of these issues here and one family and each of them needs to be identified assist well and included in a comprehensive management plan if we’re talking about policy change we also need to be clear about the influences on governments governments don’t work in a green fields playing situation the world financial crisis is real it’s affecting us right now district health boards and services like mine are having to pull out real dollars from services right now and that will effective to use so if we ask government to spend money on a thing there has to come from somewhere and we need to be clear about whether it’s going to come from we have an increasingly informed public and media that creates demands on politicians and it creates demands on health services we’ve got rising acute demand particularly from the increasing elderly population and the costs of care are going up remarkably for me we have widespread torrents of all of these issues which means that attitudinal change has got to be part of the solution we have public resistance to intrusion and private lives and what mr pushback from the section 59 heading children law reforms and I’m sure that contributed to to the previous governments lots of power so that is very real and governments have to take that into account and in families will see shortly the alcohol industry is very powerful and very clever and pushing back at us so this picture you see here a schoolboy apt to get a sense of how early the influence of the alcohol industry has an influence on children and young people all of these issues are relevant to the effects of alcohol on children and young people the marketing is very sophisticated we have absurdly cheap alcohol and absurdly easily available alcohol in New Zealand drink-driving countermeasures are limited by the amount of resource we can put into them and as adults we’re role modeling drinking behaviors for the next generation and sometimes my peers are not modeling the kinds of behaviors that we would expect from young people and yet we blame them so the alcohol industry it’s really clear is using

similar tactics to that used by their cigarette industry to promote alcohol and to undermine the health promotion tactics that we use so we’re going to be very clever to have an effective response to that public health respect to how public health risk so as dr. wells mentioned we are part of the Y prg the young people’s reference group and as the Y prg as well as advising dr. wells we advocate for the rights of children and young people in New Zealand in different ways I was actually lucky enough to attend this conference last year learned a great deal and it is with pleasure that I’m able to return today Jason Alex will be discussing alcohol in relation to the media and violence and Kieran will be offering some recommendations but first I would like to direct you to the quote that is on the screen what’s never focused on is the fact that children and young people are the victims there’s a quote from a young person which we received from a survey we sent out earlier this year there’s a term called the second-hand effects of alcohol which relates to what others suffer as a consequence of those abusing alcohol others in this case being children and young people alcohol can take away a child’s right to safety a clean environment food and water protection from things that can harm them and ultimately life and it is the second hand effects of alcohol on babies children and young people that should be the focus when making decisions about how to improve New Zealand’s drinking culture and the second issue that really stems from the drinking culture is a teen drinking culture and I say teen loosely because the normal age to start drinking is getting lower and lower there’s a simple response to that unless New Zealand’s drinking culture as a whole is targeted first including how much power the alcohol industry has over individuals our teen drinking culture is not going to change young people’s role models are dots the people who are supposed to be responsible for young people who freely let them go off and get drunk adults the people who are often the suppliers of the alcohol adults so therefore we cannot to target teen drinking first and expect to make a difference the factors children and young people have no political power we need adults to fight and advocate for us on our Passover to juice when thinking about what the most important message that I could give to all of you today could be I really thought the idea of expectations that we get from the media was the most important one because it’s no news that we have this drinking culture is prashanth is talked about but what does need to be used is that this is all not just young people’s fault but in fact it’s the fault of the media or sensationalizing alcohol and giving drunk because what the adults will say is that as teenagers we can drink responsibly when in fact the expectation that’s put on us by the media and that’s become for social norm is there s teenagers we should not drink responsibly growing up in the 21st century means that we are constantly exposed to the media which and controls the way in which we look at things and when we have got we’ve got twitter we’ve got facebook we’ve got music videos and the messages that get from our music I’ve got celebrities are meant to be our role models and we’ve got TV shows and movies entha list of where we get our influences from in the 21st century just goes on and on and on and the messages that we get from all of these things is there it’s a 16 year old girl and New Zealand I should be rebellious against my parents I should be getting drunk I should be taking drugs it’s normalized in all of these things that i’ve been told about but at the same time I’m being told that in fact they’re just normal and as usual a teenager I should be doing all of these things cuz then I look at their I listen to my music I see aired on TV watch TV shows and think what does that make me if I’m not what I meant to be doesn’t make me add normal does that mean that I need to conform to peer pressure to be normal does it mean that I’m not a real New

Zealand teenager and I think that that there is a key problem with this whole alcohol problem and the effect that it has another young people because it’s teaching us to conform to this really bad new zealand drinking culture because apparently this is what it’s you know being a teenager is all about getting drunk it’s what we meant to do to have a good time in the media targets as young people they put millions of dollars each year and advertising that means that ass young people are told that yeah we meet to get drunk so if you want to stop the drunken culture in New Zealand I really believe that you have to stop the media giving this really bad image to young kids and use the herbs me that means that young kids won’t grow up with this expectation like me and my friends have been there in order to have a good time you need to get drug a major way in which alcohol causes harm to young people as violence fueled by drunken behavior in many situations of physical abuse alcohol consumption makes problem much worse violent people are more aggressive when intoxicated people can often become aggressive and abusive when drunk especially those that a violent normally as well as us intoxicated young people may be more likely to be the victims of violence because they show more risk-taking behavior physical abuse and Families is usually directed towards children a statistic from the New Zealand police shows alcohol is an effect of around twenty nine percent of family violence issues and instance they have investigated women violent parents are drunk that just makes things worse the abuse and its consequences just get much more serious a quote from my groups recent survey on secondhand effects of alcohol stated that an families were physical violence issues alcohol escalates the problem badly violence between young people is more prevalent when alcohol is involved there is a strong link between high alcohol use and violence between young people fourteen percent of young people and the youth 2000 survey said they have been in the fight whilst drunk it isn’t hard to see the alcohol can fuel aggressive behavior especially in young people children will feel unsafe and scared in their homes and communities of alcohol-fuelled violence is present young people are shaped by the communities and families that they grow up in so it’s important that they feel safe and secure in these environments often when alcohol is being abused there are people being hurt and those people are all too often children yet what’s never focused on is fact that young people are the victims as a group we sort of green paper on Bonneville children is a great opportunity to make government aware of the negative consequences for children and young people growing up around alcohol and bringing their struggles to the forefront of the decision making the Y prg surveyed young people from around New Zealand their answers were relevant high level pieces of information as a conference we need to set a precedent children and young people want and need to be engaged in the decision-making process and their views be taken into consideration children have no political power they rely on adults both in and out of government to approach consider discuss our views and opinions which allows us to be positive change makers and active contributors to policy as we mentioned in our green paper submission and these steps will help them to improve the situation for children and young people and new zealand remove alcohol advertising from from spots alcohol advertising and sponsorship from sports and other cultural activities the second-hand effects of alcohol needs to be openly condemned by government and an awareness campaign funded by government and facilitated by government organizations you can read us the mission at occ onz this is not my issue that smokes your issue it’s our issue every single person in New Zealand needs to make a sacrifice which allows forgot

to change government needs to place public well-being above and beyond the profit from the liquor industry there is no silver bullet there is no one person who can change culture but together everyone can make their sacrifice so children and young people and not so where’s the convention come in on this those of you who know the UN Convention on the Rights of the Child would know it’s a comprehensive statement of how the world should be for children and young people and we ratified the 54 articles of the UN Convention some 20 years ago now so the Convention requires us as a country to do some things and you can read those for you now p it for yourselves up there when I’m teaching on the convention what I invite people often to do is to hold that slide in their head when you’re thinking about what you just heard from the young people on the way prg and ask yourself to what degree does alcohol prescribe these rights that we signed up to 20 years ago but the convention is also a useful way of thinking about how we implement policies and programs at a local level as they affect children and young people so when I’m beginning a project for example on before school check or advanced intervention program I find it helpful to start by have an explicit discussion about and agreeing our values the values that underlie that project for that program I’m writing them down the speaker is very helpful when difficult decisions come up later as they often do and we have a benchmark test values again and I like to ask people what will we actually do that demonstrates these failures so when we say that all children have these right but does that mean that before school check program we are very clear that we will do everything we can will move heaven and earth to see every child is entitled to that program we use a database to know where the children do with they received a check to find them of their message to follow matter in a local alcohol program this could mean active case finding of pregnant women who are drinking and not giving up when they say that they don’t want to what discrimination means it means we’re focused is particularly on our come equities so Mario Pacific access rates the force will choose well child immunizations are actively monitored and everything is done that’s possible to lift those access rates real goal little time it could be monitoring access alcohol treatment services and what schools and communities we have programs in and how effective that paramountcy means we prioritize children young people for prevention and treatment services of my drinking got out of hand and I needed help and a young person needed help at the same time they should be prioritized for survival and development means we ensure our acute services are properly equipped and start our child development centene have the skills and resources they need the alcohol it means we have the skills to realize severe addiction and respect and we’ve got the skills to address this that might be appropriate use of detox or compulsory treatment where necessary we automatically refer all babies in Hawke’s Bay to mothers who drink heavily to our child development service and we make sure those staff are trained to recognize fetal alcohol effects and to match those standards means we do things properly our policy derivatives based our training standards are high our interventions are effective and are supported by robust thought initiatives and children’s voices means we ask them we seek their input and we’re designing services and the feedback our child with clients of those services note that none

of this costs anything more this is just about using the resource we have in a more clever and effective way to make sure that the needs of children and young people the United Nations Convention on the Rights of the Child are extremely useful it describes how well should be for children it gives values that we all should follow and it’s extremely helpful when we approach this with an policy and designing new policy and there are there are um hand sorry there are situations in our hands to choose to take them often these steps do not need more money it just needs small leadership you