Interview with ABC South East SA


Mornings with Stan Thomson, ABC South East SA, 13 April 2011. Topic – thinking outside the 12-25 age group when addressing the challenges in mental health.

STAN THOMSON:        The quest for a workable mental health solution may be a mirage unless we stop breaking it down into politically-digestible bites and start looking at the problem as just one problem. Some of the thoughts of our next guest. And, again, we would like your comments on that. 87241000 is the number.

        [Unrelated items]

STAN THOMSON:        Well, no doubt, like me, you've heard about the great thinkers in the world - Socrates to Stephen Hawking. But until now, I had not heard of the use of the metaphors hedgehogs and foxes to describe the types of high level thinking that we experience. More on the fauna connection, shortly. But it's one that our next guest has used to discuss today's mental health policy. He's Andrew Leigh, who's the ALP Federal Member for Fraser. And writing in The Financial Review this week talks about the youth-centred approach to mental health, the fact that policy makers should be perhaps broadening their approach to the 35 to 44 year age group, in part because that's where the suicide rate seems to peak. Andrew Leigh, good morning and welcome to the program.

ANDREW LEIGH:        Thanks very much, Stan.

STAN THOMSON:        Now, there is a belief, is there not, that the earlier we start with educational guidance on just about any topic, the more likely a child will become a healthier adult?

ANDREW LEIGH:        That's absolutely right. So certainly in principle with any health issue, you would want to start as early as you could. So if we could head off young people from taking up smoking, then that would have gains through the life cycle. If we could start people on healthy eating at the earliest ages, then that should be great through the rest of your life.

STAN THOMSON:        So reading your article, are you not a fan of early intervention?

ANDREW LEIGH:        Look, I am. But I think it's important to recognise it's not the only game in town, that we, of course, have quit smoking programmes for people in their fifties, recognising that while we want to encourage young people not to take up smoking, we don't always succeed in that. And we have all - treatments throughout the life cycle. Intervening early is good, but we don't always solve all of the problems.

STAN THOMSON:        There are two programmes that you've been talking about in this article and that's headspace and EPPIC, is it?

ANDREW LEIGH:        EPPIC, yeah.

STAN THOMSON:        What is it about those programmes that you find - well, you are critical of?

ANDREW LEIGH:        Well, look, those programmes themselves have been successful, as I understand it. There's evaluations of both. Headspace is sort of for more moderate mental illness and EPPIC is for serious mental illnesses, such as psychotic episodes. And both of them have been effective, but they focus on an age range of 12 to 25 and…

STAN THOMSON:        And we should be starting earlier, you feel?

ANDREW LEIGH:        There is - there's certainly some emerging research suggesting that we could get gains out of programmes that start even earlier. One of the most frightening studies I came across in researching the piece was one that suggested that observations of toddlers correlated with suicide attempts when those same children were in their twenties.

STAN THOMSON:        Yes, I saw that in your article. That sort of staggered me a little bit. Where has this come from, Andrew?

ANDREW LEIGH:        So it's a study, I think, in the UK, which was following right through - I mean, obviously, very long-run follow ups but suggesting that there are little clues in the behaviour of toddlers, and we should be sensitive to that and have a system that is able to quickly respond and provide the extra assistance to toddlers that are obviously having some trouble adjusting.

STAN THOMSON:        The problem is, I suppose, as parents anyway, we don't have the skills to detect that sort of behaviour, do we?

ANDREW LEIGH:        That's right. And so the early childhood professionals say, well, all families come in contact, say, for example, with a community nurse system, most come in contact with day care and certainly then with preschool. And those workers need to be trained to pick up problems early on and make sure that the experts are dealing with them quickly, with, you know, appropriate treatments. We're not talking about drugging little kids, but simply just, you know, making sure that they're in counselling, and if there's other issues going on, like family violence, that that's brought up as early as possible.

STAN THOMSON:        Now, they may be slowly improving in regional areas, in terms of mental health services, but it's often felt that not enough is available for the younger person. And it comes in a little bit to what you're talking about here, particularly the under 12s. You know, what do you do if you're in what could be considered an isolated area and your under 12 is showing signs?

ANDREW LEIGH:        Well, certainly the Lifeline number is one that people should be calling if they need immediate counselling assistance. That's 131114. And Lifeline is a good service that also then passes people on to other contacts. There's websites such as the BeyondBlue website or the SANE website and they have information about those counselling services and ways of dealing with anxieties.

STAN THOMSON:        Are there signs, do you think, of the suicide rate falling?

ANDREW LEIGH:        Yes, there are. I mean, this is the best news out of mental health, that our suicide rate is now lower than at any time since World War Two. And so, we're winning that battle, to some extent, but of course while there are still young people taking their own lives and older people taking their own lives, we haven't gotten there yet.

STAN THOMSON:        And, Andrew, how much of a role does disadvantage play in the state of our mental health?

ANDREW LEIGH:        Look, I think it's a really important part of it, there. I mean, certainly people's feeling of not being part of a society, often having experienced job loss or family breakdown, some sort of a stressful event - these things are often correlated with mental health issues. And so it's important the more we can deal with those root issues of disadvantage, the better we can do, in terms of addressing mental health overall.

        We won't do it perfectly, and that's why we'll need mental health services to pick up the pieces.

STAN THOMSON:        I'm talking to Andrew Leigh, this morning, who is the Federal Member for Fraser. And, certainly, you are a politician and you represent the current sitting Government. But I was just attracted by some of the comments in this article in The Financial Review. And if people would like to check it out for themselves, it was Tuesday's, Tuesday April 12. You can grab a copy of it.

        Let's talk about this metaphor, the hedgehog and the fox. Where did you get that from and what is it?

ANDREW LEIGH:        So this is a wonderful metaphor by Sir Isaiah Berlin, who was one of the sort of great - well, I think the greatest philosopher of the twentieth century. And he has a notion of hedgehogs, who view the world through one single, defining idea. So, you know, he thinks of people like Plato or Nietzsche. And then foxes who draw on a whole lot of experience, who basically build up a picture, bit by bit, and are kind of distrustful of grand theories. And so, you know, you think of - classic foxes are people like Shakespeare or Joyce, people who regard the world as being more of a patchwork than being driven by one idea.

STAN THOMSON:        They know many little things, as you say.

ANDREW LEIGH:        Exactly, yes.

STAN THOMSON:        And a hedgehog?

ANDREW LEIGH:        And so then the hedgehog knows one grand thing. And so, you know, I think the great innovators, as you said in your introduction, people like Stephen Hawking or our own Howard Florey, who was crucial in discovering penicillin, they're people who are very much hedgehogs. You've got to have that single-minded focus if you're going to make a world-changing breakthrough. But it doesn't necessarily mean that that's the way to build policy. Policy is always trying to do lots of things in different contexts. So, you know, something like climate change, we're trying to help the environment, but also make sure people aren't disadvantaged. Mental health, we're trying to ensure that money is spent well across the country and that we're also helping people across the age range.

STAN THOMSON:        So how would you describe your Government - foxes or hedgehogs?

ANDREW LEIGH:        Look, Stan - I mean, think any government really needs to be foxes in some sense. You can't see Australia through one single idea. There's just too much going on. There's too many different needs to address to boil that down to a single idea. And very much in mental health, that's how I'd view it. There         are important ideas in the youth space, but we don't want to forget toddlers and we don't want to forget people in middle age.

STAN THOMSON:        It's a big job, isn't it?

ANDREW LEIGH:        It certainly is, yeah, yeah.

STAN THOMSON:        Thanks very much for joining us.

ANDREW LEIGH:        My pleasure.

STAN THOMSON:        Andrew Leigh, who is the Federal Member for Fraser, which is a Canberra-based seat.

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