Ian Hickie – Promoting young people’s mental wealth in the digital age

Ian Hickie – Promoting young people’s mental wealth in the digital age


Yes, I do have a grandchild
just been born in Quebec, you know, and I’m very grateful
to the talks that Michael was giving earlier about actually why, actually why my son is in
Quebec, and his partner, is actually there’s a whole
lot of services in Quebec that we don’t have, in various ways. It’s kind of interesting, the
emphasis within that environment actually on early childhood
services in the areas that Michael was talking about. I want to use this
workshop kind of experience to share with you my own current thinking and experiences about what the situation actually will be for children
born in the 21st century and beyond and how, if I might
say somewhat controversially, most of the systems we work in, and most of my experience
is obviously in health, aren’t fit for purpose
in the 21st century. And so the challenge, when
you’re in one of these big areas of public policy,
as you are in education, as we are in health and other areas, is we’re working with 19th
and 20th century models in an environment in the 21st century that is fundamentally
disrupted in its nature and the children growing up in those areas live in very complex worlds. The most obvious of which
is that I’ve just got off the phone with my son and the situation is a digitally disrupted world. It’s a really different world. Some of you may have not heard the comment I was just making at the
end of the previous session. Most of the media
portrayal is actually about the evil that might arise in
association with technologies. I am fundamentally one of those people that belongs to the other
side of the thing is, what are the opportunities? But it is a large social experiment that we are actually already subject to. We’re already living it, I’m sure as most people are sitting there, they probably have been doing
other things this morning, as I have, along with being here. But also being connected
with things, like my son in Canada, like my workplace,
like three other things, in a highly enriched way. Where actually it’s not
actually disconnecting me it’s connecting me concurrently with a variety of different things. And that’s the world,
of course, that children are growing up in. So what I want to way, is
it’s real, Erin says, great, also to have strategies. I think the role of strategies
remains incredibly important. I think when we get to the implementation of those strategies, and
I must say as we go along, if anyone feels free to jump up and object to what I’m saying, go right
ahead, okay? (laughing) I tend to have opinions
about these things. It’s great to have strategies,
but my close friend and colleague Allan Fels,
previous ACCC Commissioner, he says, “Look, you people in health,” and in mine it says people in education, “you’re the funniest people in the world. “You’re really old Stalinists,
who think you can have “a strategy and implementation
thing and impose it “from above and you really
think it’s going to happen.” No one else in the rest of
the world and the economy ever thinks that’s the case. In fact, the challenge for
governments and for others and those in a sense trying
to act in public good needs to be clear about
what the strategy is, but when it comes to the implementation do you create the environment
– you should’ve seen the young people on stage
this morning – in which those people can thrive without tryin’ to actually control what they do in a very deliberate kind of way. And I think that for many of us who work in these sort of settings,
in public policy, that’s actually really challenging. To say we want implementation,
we want certain things to happen, but
it isn’t going to happen the way we think it’s going to happen. Are we creating environments
in which it is most likely to happen, and I would say on
the other side of the coin, are we evaluating whether the
activities we’re engaged in are actually having the
desirable effects or not? In health we would say
to be less preoccupied with 99% of what we
fund, which is activity, and only about 1% in terms of
the outcome of the activity. And are we prepared to change what we do in relation to the outcome? So what I wanted to say
was really about technology and give examples from
the world I’m involved in, is its capacity to be an instrument for social connection
and pre-implementation, but also it’s capacity to track outcomes concurrently in real time and feed back in to the systems you’re actually working in, in a way that data systems
in the 19th and 20th century were never able to. The biggest challenge,
and I won’t say anything rude about educators, I’ll
just say maybe they’re like health people, is
the groups that’ve been most resistant are actually
often the professionals in those areas, who have
long standing historic and cultural ideas and have been trained and work in systems that make
certain kind of assumptions. Most of which, I think, are up for grabs. So, I want to talk about the second bit. To say, look, it’s obviously going on. There’s obviously potential here, but it’s going to be
disruptive (chuckles), y’know? And basically, are we ready
for what’s going to happen, whether we like it or not? Whether the New South Wales government has an Anti-bullying strategy,
a digital strategy, whether our federal
government has a strategy in curriculum or not,
stuff’s going to happen. The children are growing and
growing up in a wider world. I should say that there’s
consequences of that. I’ll talk about the
CLC that I was part of, developed between, it’s
now a joint venture company between the University of Sydney and PwC to take these things internationally, and I was, up until just last month, a member of the National
Mental Health Commission, which sees, and I must
say importantly there, the thing about the National
Mental Health Commission under Allan Fels’s leadership
had been to try and say, look, it’s not all about health. In fact, when it comes
to prevention, promotion, early intervention, it’s
rarely about health (laughing). I don’t need to tell people in this room. Health’s rarely there to help. (laughing) We have been a long way away from where the action usually is in
families, in communities, and then, for a large number of children, obviously in education. I was saying to a few
principals this morning, the downside of it of
course, is the expectation that education will fix everything. The most disconnected
the society we live in, the more teachers and principals and local schools can fix it. And I’m part of that group that says that is really an unreasonable
set of explanations. Sure, it’s an opportunity, but schools are just one part of a
more complex community and we need the other
partners to play ball. In a workshop we were
having here yesterday the issue of partnerships
is a two-way street. To what extent are schools really partners in their local communities
and with parents and others? And to what extent are the other people, and I’d put in this case health, really partners along the way? I think the question
being asked earlier on, we’re going to see this
play out in the pre-school environment, in the early
developmental confines, but we’re going to see it
play out, great experiment. Hopefully in Australia we might end up something like Quebec,
where we’re actually really serious about
the national investment that is required in a sustained way, through health, through
education, through social welfare. The more agencies you get involved, the more likely they are to all have their own information
systems to be disconnected and to be controlled by anyone other than the person who is the subject of it. So you may have seen in
Australia the great experiment we call My Health Record. It’s actually not your health record, it’s their health record (laughing). Belongs to the health system,
it has no user interface, you can’t interface with it. And the notion has always been in health, they’re our records, we
share them, and then, but it’s your health
that’s getting controlled. There are now almost, I’m a strong supporter of the actual integration of that data. There’s about a million
and a half Australians have walked out on it already (chuckling), when they found out it’s
actually not theirs. When they’re using every
other technology system now, in relation to their
banks, their airlines, everything else, they
expect to interface with it. They expect to control the information, they expect to make
choices in relation to it, not for it to be controlled by others. In work I’m associated
with, it’s feeding that back into health systems now in real time, to change what happens in those services. So the point I was making at the end of the conversation this morning
again, in the other room, is expectations about the
personalization of services will just increase. Everyone will expect, at
a school, you will respond more and more to their individual kid. So while in one sense
all of our strategies will be universalist, to
try and lift everybody up, the expectation actually
will be the opposite. ‘Cause actually you’ll do
more for the individual. You’ll understand more
the individual needs. In fact, one of the great
challenges in education I’m associated with is
the cognitive development, for cognitive development
age is a very poor proxy. So if you’re just promoting
kids from class to class by their age and whatever else movement, in the pre-school environment
it’s basically hopeless. Y’know, there’s actually a very poor proxy for what’s going on in the kids’ emotional and social development. And yet we continue to
use systems like that, like just straight chronological age, to plan interventions
and to set expectations, like in that plan, as to
what you’ll have achieved at certain periods of time,
by your age and by your class, as if there is some equality. What we know more and
more about the individual is that that’s less and less the case. So to be able to track
that and partner with parents and children in
development is critical. On the services side, if you’re
going to get more personalised, you got to be able to actually
say what can you actually do. In situations I’m involved
in, about teenagers and young people, we used
this example, for example. We talk about a 25, if
we in health planning, if we got our act together,
maybe in 20, 25 years we’ll have a system that responds
to what we’ve never built; a system for kids with suicidal behaviour. In fact, in the digital world, y’know, five years is a really long time. In fact, if the thing hadn’t succeeded, the thing I’m associated
with at the moment, if it doesn’t succeed in two years, commercially, it’ll be dead. So there’s been really big disconnect between the responsive
technologies and the way they’re being developed and marketed, largely with private capital, right? They largely exist and are being developed outside of our well-centralized, well-organized people
systems and they’re being marketed to families and
other people directly. For example, the University
of California, San Diego, the Early Childhood
Team got bought by Apple and just moved (laughing)
lock, stock and barrel, into a private capital market, for development of early
childhood training tools. Which will be marketed to the
world, indirectly, y’know. Now, within that, there
are fabulous tools. How they’ll actually interface
with the childcare system in Quebec or the early childhood care, now early childhood education
policies we’re building in Australia, who knows? But I suggest that we all play a key role in that as we go on. But we want those things
to actually happen. I come from the world that says, look, we should really seriously try and work with the new opportunities
that these provide, rather than resist them
in particular ways, because they also are
empowering, fundamentally, to those affected, and
they’re most empowering to those most affected. The issue that I was trying to talk out with Michael this morning
about the disproportionate or the proportionate universalism, is how do you actually use technologies? How do you get them to the
most disadvantaged communities and disadvantaged individuals
to engage those people who have been reluctant, in fact, to engage with more traditional systems. They’re not the ones who. Technology, given price
and availability and costs, and there are educational
issues about using technologies, of course, that actually come into play, I would suggest create
fabulous opportunities. This is a concept, I’m a
bit sad in the last month, six weeks or so, ’cause
some of you may know that we had a Prime Minister that we just traded in a little while
ago, who we had convinced, ’cause he had grandchildren,
and I must say his wife was very enamoured with
their grandchildren, that the future mental
wealth of countries, this is actually from the
UK, not the mental health, but the mental wealth of nations, depends actually on our
investment over the childhood and developmental sets of periods. So it’s not just about treating kids with mental health problems,
we need to actually in advance, if we want to be, if you can read that, economically and socially to
prosper and to be cohesive. Mental wealth really matters. Investing in what’s inside of kids heads. So we did have Malcolm Turnbull saying the most important resource in Australia was inside kids’ heads,
not under the ground in Western Australia,
for the 21st century. We had lived off the back
of what was underground in Western Australia and
elsewhere in 20th century, really coal’s not the future. There’s other stuff inside people’s heads we need to be training for
that particular kind of world. Oops, go forward. And within that, just to say
in terms of what we do know, in terms of interventions
that people were asking this morning, actually the
thing for which there’s the strongest scientific
evidence base at the moment is from early interventions. So you want to get ’em in early. So the discussion
Michael was leading about forget school, let’s get to pre-school, and conversation we’re involved
in in Central Australia with Aboriginal Communities Congress, it’s readiness for school from minus nine months to five years. Minus nine months, in fact,
of two years or three years. Y’know, if it goes wrong at that point, the chance that you’re
ever going to progress in those systems is
greatly reduced, of course. So the identification
of particular issues, and then this real challenge about the personalisation within that. That simple, brief and
a lot of my learnings and things I’m associated with,
simple, brief interventions for complex problems don’t go very far. And the sustained nature
of the interventions to achieve long term outcomes,
as much of the childhood literature is clear, if
they’re brief, short, they have brief, short
effects and go away again. So, you know, the sort of
things we’re talking about require an engagement with
the person and family affected over a long period. We’ve never had systems which
actually are up for that. They’ve never collected,
held and taken forward the information, or taken
forward the information that’s available in health,
available in education, available in social welfare in any way, coordinate or organise that around the person affected and their family. We just don’t. We just haven’t operated
that way, fundamentally. So when you look at the
costs, and disability costs associated with these
things, they play out hugely in adolescence, but a lot
of them have their onset in the childhood kind
of years and therefore I often spend a lot of
time talking about ageing, but you know, really, if you
want to invest a lot of money effectively, the challenge
is is the money we invest, is it going to make a difference? So I was on, briefly, a
Prime Ministerial taskforce, of the previous Prime
Minister, about the policy transformation from if
we’re going to pay for early childhood care
universally to support female participation in the workforce for its economic gain,
then really what it needs to be about is early childhood education. We should stop saying it’s about care and say it’s about education and we need the tools and the supports to do that. How’re we going to do that? When we largely have a
workforce that’s largely predicated around providing care, with fairly low levels of
qualifications and skill. Y’know, what’s going to
support that development? What’s going to pick up
kids from very early ages, through parental report
and other sorts of things, and track them in terms
of their development and provide the right kind of intervention and then see, at the individual level, whether that intervention’s
actually making a difference or not? Got into a debate with some
large statistical bodies in Canberra, ah well, we’ll just do NAPLAN and we’ll do the Child Development Indices and these cross-sectional things and somehow we’ll know something. (laughing) We won’t know anything! You’ll be trying from very indirect data to draw inference about what’s working. More importantly, what’s happening
in different communities? What’s working regionally,
what’s working locally in a particular way? You’ll have no idea. Just talking to Michael and
some of the other principals. You’re going to be dealing
with groups that are equally disadvantaged from a local
socioeconomic point of view or a geographical point of view and see quite different outcomes
in communities that appear to share the same rate of risk factors. Something good’s happening
in some communities and not in others. Some good communities or
good schools and things go bad over time, something
changes in terms of the rate of that thing
at a particular time. So in terms of real time responses
in those particular areas you need systems that actually can monitor individually and then locally, what is actually happening
to judge the value of the investment that you intend to make. What I’d suggest is, actually, the people who understand this are rarely in the big organised systems
called Education or Health. They’re out there in the wider economies, they’ve done it in other industries in particular kind of ways. And there’s a certain set of principles as to why private capital will actually probably take over the area
and it’s got to do with, and this is true in a lot of
early childhood education, it’s going to be true in mental health, basically people want more. And why wouldn’t they, y’know? I want more for my children
and now I want more for my grandchildren on
an ongoing kind of basis. Y’know, we want to create a better world. And the evidence about
earlier intervention, more productive intervention,
richer environments and in tracking, and also
responding if there are problems at the earliest possible
intervention, is a key issue. And people now can start to
access information about that. They don’t necessarily access
really critical information about how to apply that
to their own situation, but they are increasingly
aware there’s a lot more information available than
what they are being told at their local school
level, or their local child development clinic
or at their local hospital or at their local paediatrician. And, in fact, the local may not be that well informed, y’know, depending. So the variation between information to an extent is huge in particular areas. So demand is out there, people
want to invest worldwide in better education and
better health for children. I once had the beauty
of meeting a previous Chinese Minister for
Health and we were whinging and carrying on about all the
problems we face in Australia and he goes, “Look, in China
we went from life expectancy “of just over 30 to life expectancy “of over 70 in one generation.” (laughing) When you have a life expectancy of 30, you don’t need an education
system or a health system. (laughing) People survive, then they die. You know, if you live to
70, people, the first things they want to have are
education and health. They want to create better worlds. So worldwide in the
developing world and elsewhere this is the bigger kind of issue. Y’know, the other issue’s about choice. The more and more of this
we have, the more and more we want it to be personalised. Now people see that as
selfish on the one hand. Why won’t people just
accept, the same as everyone? Well, we don’t accept
the same as everyone else for anything (laughing) and of course, if it’s available we’re
going to do different things. The availability of
service, being able to bring expertise to areas where
there’s no expertise or there’s limited
expertise, where we have manpower and workforce shortages, I say to people in this
room, this is where expertise actually becomes more
valuable, not less valuable. So the capacity to combine
expertise and take it places, through technology that
was not possible before, I would suggest in the educational sector as much as the health sector is out there. That’s a really interesting
issue about scalability, ’cause actually we find
with a very small number of committed professionals we can reach a really much higher number with expertise through technology than we ever could in a man-to-man type way. And the marrying of local,
on the ground availability of the relevant people,
with available expertise that may be available remotely
and support on the ground, really big set issues. What you got to have to do
that is shared data systems. You have to be lookin’ at the same thing. You have to understand
what’s actually going on. Obviously from a cost point of view this produces particular advantages. One of the issues that I
am personally tied up with the most has got to do with quality. In healthcare, and I
think this is in the sense like education, we have
a strong universalist kind of approach. Okay, okay, if we touch
everyone lightly, that’s good. So we have a so-called –
it isn’t really – we have a so-called universal
health system in Australia, but in truth, in terms of the
quality of services provided within it, it’s highly variable
in curtain kind of areas. So we have a universal education system, but in truth it’s highly
variable in terms of the quality. In fact, to outsiders
who come and look at our complexity of our health
and education systems, we just had another
Canadian visitor last week who came in to go, “You
know, you’re not really “like the UK or Canada, are you?” I go, no (laughing). In truth, we’re much closer to the US. We’re much more mixed economy
in the education sector and health sector than we like to pretend. So the variability is huge
in that particular way. Consequence of that, the
quality within systems and over time is highly variable. But people don’t know that. And as administrators of
systems, are you looking at that? Are you actually looking at
the quality of service delivery at regional and service kind of levels? And over time, ’cause
it changes over time. Got to do with making things accountable in particular kind of areas. Right, so, I’ve asked the
question of these kind of things, is if this stuff is happening,
it’s going to happen in your world and it’s
going to be controlled by others whether you like it or not. People you’re dealing
with are going to be using all sorts of issues
whether you like it or not. I’m sure with teachers you’ve already got the issue of technology’s already just taken over the classroom,
it’s taken over education, kids are exposed to it. You know, the attempt to
regulate it just doesn’t work in that particular way. You know, obviously,
most of us, and most kids and whatever else, actually are now, from very young ages,
hilariously funny about people trying to control digital
use of people under 12 and whatever else, I don’t
know if any of you have seen? Have you seen, sort of, 18 month old kids actually using technology in
particular ways for things. The most remarkable thing
I saw is a kid with autism who is completely
averbal, with no language, very limited skills, actually
playing with his siblings in fact through a set of
games and demonstrating a cognitive capability that
was, he was not known to have. But it was actually through
the game environment that he’d been able to
express that and been able to form a kind of language
interaction with his siblings actually through the game, by using things related to the particular
gaming kind of environment. So the interaction between the technology and developing brains is
going to be a fascinating kind of thing, it’s a new
kind of literacy, if you like. But it’s also a new availability, with different kinds of social contacts in addition to the traditional
ones which are developing. The danger for it in many ways, of course, is those with the most
financial capacity will get the most use out of these things. Out of the technologies,
out of the tracking systems, they will bring, in education, y’know, here’s my kid’s cognitive development, what do you intend to do about it? (laughing) I’m here to help,
blah, blah, blah, blah. I think I’ve got to go
to a parent teacher night on Thursday night (laughing). In the future I’m sure
it’ll be us turning up with now, how does your record
match my record, you know? Kind of, what is the particular issue where parents actually
have a capacity to track their own kid’s cognitive
and educational development and have a different kind
of style of relationship with educators on an ongoing basis. So that’s, y’know, and if that’s on the user end, tremendous enthusiasm. Interestingly, in our interaction with, and here I use largely
the health providers, a lot really don’t like it. You know, there’s something, and I suggest this may be true in
the school environment. There’s something so
fundamentally interfering with the normal human relationship bit, the social context in which
we’re used to operating, to have these technologies
as part of that. So the tendency to see it is as an add-on or intrusion, maybe it’d be useful, maybe at the peripheral
it’s kind of helpful. Rather than actually,
I suggest, it’s y’know, it’s going to be no more
peripheral in our environments than it is in the rest of our lives. The rest of these
technologies in our lives are no longer peripheral. They’re actually central
to the way we organise a lot of other things. Whether it’s good or bad, I’m
not really commenting on it. As I say, I think it’s a
large social experiment as to the actual outcome of
all of this, but it’s there. I’m part of the group that
says we should sort of try and actually work out the best ways to do these things as
the situation develops. A lot of money’s going to go in and it’s very attractive to Government. It’s very attractive to
Government on a number of levels, ’cause actually, not just on a cost basis, but actually the issues
of monitoring quality and monitoring services
et cetera and being able to compare much, much more real time. I must say the education
and early childhood debate, the reason I got involved
in this, was part of the Prime Ministerial taskforce
on this, was exactly that. To try and work out which
programmes to actually invest in. And know that, at an individual
level, longitudinally. So the point that Michael
was making this morning about trajectories, not
sure if everyone got it, is so important. Y’know, whether any of the
investments that we make ever actually alter those trajectories. Do they reach those most at risk? And do they actually make a difference? And the accountability for
that at the moment’s very low. Government tends to come
back with one simple universalist approach, okay? Here’s this extra money for childcare, or here’s this extra money
for some other particular bit, with the assumption that it’s going to change those trajectories. The more we know about
that, I think the more challenged it is that
actually you’ll be able to change those trajectories
without more sustained and more personalised
sets of interventions to actually achieve
those particular outcomes on an ongoing basis. So I like to show this picture,
no so much ’cause of him, but because of her (laughing). She’s actually a Colombian psychiatrist, Doctor Lara Spinapolinos,
and she’s actually a child psychiatrist,
works in a particular area, actually comes from Bogota in Colombia. She was providing services to
a young man in Broken Hill, who’d never seen a child developmentalist, never done anything else,
and in fact she continued to provide services when her
dad sadly died in Bogota. So she was, in a great piece
of reverse imperialism, she’s sittin’ in Bogota
in a developing country, providing services to
Broken Hill (laughing). This issue of taking
expertise in the appropriate kind of ways, somewhere, to back up, not to compete with local
services but to work with. In fact the project we
were doing in Broken Hill had really strong support from education. In fact, the strong supporter,
health was sort of a mess. And a variety of
non-government organisations. The stable influences
were actually in education and in schools and in
most of our discussion, bit like those kids this morning, was with kids and
schools, how to better use the technology they already had. Like why was, and one of the
big issues in the country is cost of technology and the
reliability of WiFi et cetera, so the kids were saying
why isn’t the school WiFi just available all the time, to everybody? Like, it’s available
there, rather than having a debate, which we were, with Susan Lee, who was the Member at the
time, about how to improve and the cost, the kids
were saying why can’t we use the school one all the time? In fact, why can’t everyone else? It’s a public infrastructure. It’s got a quality of WiFi connection that we can’t, you can get
five metres out of the school and it immediately disappears
around that place et cetera. You know, there are sort of
solutions that are out there, but there’s also sort of make
the point about expertise. About workforces, that
where there is expertise and you need personalised
sets of interventions, this might be a way of overcoming some of those difficulties. So, to pick up the
Allan Fels kind of thing I was saying before
about, I would say about not just healthcare,
but education, they are part of the real economy, okay? We exist in systems where
we pretend that we’re not, particularly in the bigger
public sector organised bits. We just see us as being publicly funded, but actually there’s a
whole lot of stuff going on in those particular areas. And that really what we
need is regular reporting. We need ways of reporting
back what’s really going on. We need the regulation that sits around to be smart, not dumb. I was involved in a
discussion, a public discussion some years ago in the seat of Wentworth, about, you know, should governments try and regulate these things? (laughing) As if they could. Y’know, as if they’re
going to regulate kids’ use and make everyone do things to stop particular kind of
things, as distinct from create an environment where
there’s the maximum degree of innovation in the area,
individualization, and free up. So in the public health sector, the endless debate is
that people are forbidden in one way other, if
they’re working with one of the public sector agencies,
from using these things to actually support the
healthcare they provide. ‘Cause it’s not a New
South Wales Health endorsed X, Y, Z, blah, blah, blah, blah. Myself, I’m just in a slightly
different part of the system, although I also sit in that system. Everyday of my life I’m
in contact with people and I’m always somewhere
else in the world. About changing their healthcare, monitoring their
healthcare, making decisions about what goes on on a regular basis, a highly interactive
way that is empowering for those affected and leads to them being more engaged in those
areas of people who don’t want to be engaged, necessarily, in a lot of aspects of their care. So for those who are most
disadvantaged and most disconnected or disengaged,
if that’s the right way of putting it,
actually there are really interesting sets of issues ’cause they’re in control of things that they were never in control of before. – [Woman] If they can
get to people like you through their systems,
because the health system– – So the comment is, can
they get to people, yeah? – [Woman] If they can
get to people like you. – Right, so here’s the dumb bit – [Woman] The health
system isn’t linked up. – Right, so if your system,
if your top-down system locks it up and says we don’t do that, which is what New South Wales
Health does, historically. And it’s not Robinson Crusoe on that. – [Woman] We don’t work with them– – Yeah, they don’t. You don’t work with them (laughing), no. So systems, this is a
regulatory kind of issue, right? This is where we got to
get smart from a regulatory point of view, in fact, under the previous Prime Minister, there
was a discussion going on around technology that what was required was actually deregulation
to empower people in certain situations
to behave responsibly. So that you need a set
of ethics, you need a set of best practice, you
need a set of values, but to think you can regulate
that to prevent bad things, all it ever does is
actually cut people out. You know, you want to
make use of what we mostly do with these things,
which is fundamentally connect with others in real
time, in personalised ways that’s highly responsive. So that’s one of the
really big challenges, I think, is how do people
in charge of these systems think about these things,
in particular ways? – [Woman] And if it could
be used for those reasons, I think the majority of the time that what we’ve seen with young people, and that’s what I thought
most of this talk was about, it’s used to bring them
down because their access to the technology in their developmental– – So just to make sure I
accurately say what you’re saying. – [Woman] Sorry, the
access to the technology at their developmental
level, it’s cats and dogs and they get into the
negative and they bring themselves down, they’re not higher order thinking enough, I suppose. – Well, let’s contest the first bit. – [Woman] There’s positives. – So the comment is, does most interaction at particular certain
developmental ages with technology bring kids down. Well, what do you all think about that? Is that a strongly held view? When you go and look at the evidence about this kind of stuff. – [Woman] They are working with it. They’re working, Wellington,
they’re working– – To bring them, yeah, yeah. – They’re working–
– To bring them down? – [Woman] Yes. – Well, when you go and look at. This is one of the really
interesting things, as I say, at one level I think it’s a big social experiment, right? So actually, before arguing
the merits of the various surveys or not, I’d say
that actually tracking what is going on, which is
kind of like the last thing we said down here as well, tracking. Tryin’ to understand
what is really going on in a world where this stuff
is changing so rapidly and use of these things
changes even more rapidly, so what’s happening in
the gaming environment now and other sets of things, and the social messaging environments, is really, really tricky. So I think there are a
lot of strongly held views about the negative side of things. I’ve been involved in
surveys and other things actually about, in a sense just
to skip along to show a bit. – [Woman] If they would access
the more positive stuff– – Right.
– That they’re talking about. – Right, why the if? I say the challenge is the how. So I’ve been involved
for the last 10 years, a thing led by Jane
Burns, originally about the Centre for Technology,
People and Wellbeing, blah, blah, blah, which is now the basis of this ongoing sort of company work. It’s that actually, I
guess the big caveat, if facilitated right, right? And this is in education
settings, in health settings, in childcare, in other
settings, a lot of the evidence is very positive, it’s
about connecting people who are disconnected. It’s about supporting
people who are in trouble. It’s about not reifying
glorified images et cetera. It’s about normalising, in
fact, normal development. It’s about supporting kids
with abnormal development. So the challenge here is,
I think, and I was, sorry? – [Woman] It’s a double-edged sword. – Well, like all things
that happen technically, I think, I would say though,
a lot of the evidence of when, so put the when in, when facilitated, when done smart, when
used in appropriate ways, which is of course what
tends to happen in the more researchy kind of settings, okay? Where people are thinking about it. But also, also monitoring
for inadvertent harm. You know, unintended harm, so looking at what can go wrong as well. The balance of that is strongly
in favour of the positive. Because of the social
connectedness kind of element. Just come back to, if you
look to what really seems to drive that in the right
environment is not disconnection, but reinforcement of
positive social connection through the right sort of
technologies in a particular way. So take the example of kids
in the country et cetera. Same sex attracted kids,
kids who are different, kids who can’t connect in their local community, can connect. Kids who’ve got, sort of, social anxiety, autistic behaviours, don’t
have a lot of social skills. Kids who can’t find
other things in their own particular environment
are no longer isolated by being in Bourke or
Broken Hill or whatever, they can actually be
part of other communities in a wider world. The big challenge I’d
say to face at the moment is the gaming one, right? ‘Cause the gamers have
all tracked onto the thing about the best game to play
is not one on your own, it’s one in which all
sorts of other people are joining in, so it’s
actually drawing on the social connectedness
of game environments to keep you on the game, which has a lot of other potential downsides. If you look at the, as I said, the evidence about people’s
then use of those things, most kids are not overusing them and most, there are
considerable benefits for a lot of kids who are previously marginalised in various ways by various attributes, who actually do become part of more socially connected
environments as a consequence. So I think, as a parent
and now grandparent, not the first time I’ve
been a grandparent, but as a grandparent, I do share your, if it’s anxiety, I share
your anxiety about it, but I’m not sure that
from the data, it’s right. – [Woman] Biologically, as an organism, can we actually move that fast in the amount of time that we have? I mean, in my lifetime, I’m 50, – Very young.
– I’ve seen it gone from a transistor radio to a microchip to– – Can we move? – To automation and artificial intelligence.
– Right, okay, okay. (audience muttering) I’m from the, anyone
else think they can move? I can’t move so physically
so fast these days, I’m a bit orthopedically challenged, but cognitively, yeah,
I’m from the human is a highly adaptive organism group, right? I would say yes, the thing is, do our educational structures,
do our assumptions, do all our things in
health move as quickly? No, no, and that’s a problem. ‘Cause are our workforces,
I hate to say this, I was talking about our
systems being fit for practise, are our workforces fit for practise? Do their sets of assumptions, what Michael was alluding to this morning
about the rapidly changing science of early development. I just love seeing what
kids can actually do, that we assumed they
couldn’t do at all (laughing) because we relied on certain other verbal and other developmental phases to begin. – [Woman] It does seem to matter. I work with kids all day every day and they’re stressed from just being not able to deal with the
emotional impacts of things. – Right, so the, oh, five minutes. So, is it, now the causation issue, if we just take up the causation issue, just in another aside,
suicide rates in teenagers were much higher in Australia in the 1990s than they are now, right? Actually, adolescent
stress, if you like to use an adolescent marker which
we have good data about, was much higher before social technology was ever invented, pre-Facebook. Now we have a thing which
says that it’s the cause. A causal inference has
come in, as distinct from the developmental tasks
for teenagers, sorry? – [Woman] I’m not saying it’s the cause. It’s like what the first
bit was talking about, not all kids come in equal. – No. – [Woman] Or not all
organisms come in equal. So yes, there’s going to be benefits, but there’s also pockets
in largely isolated places that don’t get to see and
access people like you. – Right, but do they, we
had the other question about bullying in the earlier conference, about 1% being cyber-bullying and 30, 29% being regular, right? When you say access, right, I guess the optimist point of
view that I’m putting, or the positive point of view I’m putting, is that a lot of the
access problems we have, personalization problems,
not responding earlier, whatever else, are features
of the current system. And so the open question is,
is it part of the solution? I’m arguing it’s a big part. But, but it requires
an environment, right? And I’d say it requires the big systems, and yours being one of them, education, particularly across the
developmental periods, another one being health and particularly in the pre-school and then school period, to actually make use of that technology. Does anyone else, other than me, have a positive view in the room? – [Man] Can I just ask if we
can hold anymore conversation and we’ve got five
minutes left and I thought maybe we could have a chat
during the lunch break – But these are the
fundamentals, yeah, Lou? – [Lou] I share that really
positive view as well, and I think what’s been
missing in this conversation so far today is the
role that parents play. – Yeah. – [Lou] In generating positive use and access around technology. – Right, yeah, so, those
of us who were not born with these things in our hands, right? You know, I’m tryin’ to
understand on a daily basis, I have a 13 year old where
I’m tryin’ to understand on a daily basis what
the hell he’s doin’ now and with whom and in what setting, the parental engagement thing’s critical. So in the systems we’re
building, which have input, not just from the individual,
strongly encouraging others, carers, parents
and the neurodevelopmental bits we’re working with with children, is actually for parents
to become very active in the provision of information. Now, my question to you would
be, are you up to, part, parenting, (splutters)
partnering with parents in a really serious longitudinal way and the way they input it,
’cause they only put in about their kid and then
providing information ongoing, through sharing kind of
information, through one of these examples here of sharing, whoops, dashboards, care plans,
all sorts of other things. We’re actually, these are sort of sharings about where things are going,
creating information systems, we have ones now for cognitive development for kids et cetera. Are you up to it? You know, are you really? It’s fine to say that parents
should be more involved, but how up to it are you
actually working with them on a regular basis, sharing information? I will turn up at this parent
teacher night on Thursday, it’ll be the first time this year, or probably first time in two years, there’ll be some piece of
information which I know has got barely anything
to do with my daughter’s actual progress (laughing), in real terms, in a particular kind of way. We’re not sharing information every week, every day, we’re not really
tracking the particular things, fortunately she does
very well in education, I don’t really worry about it, but you know, if she was in
trouble, I’d get about the same amount of information, which
is not much (laughing). Would I be up to working
in that kind of way? And it’s really challenging,
because it requires a sort of scalability,
it requires a degree of input into the system
to be able to do that. So the other thing I
just dwell on is to say the automation that sits behind this, the scalability about
having expertise is also, you can, degrees of that
expertise you can automate, you’ve got to be able to do it at scale, in particular kinds of
ways, and the more you learn in these particular areas. So these bigger data systems are also learning machines themselves. They’re influenced by the
assumptions that people like yourself put in,
but you can automate them to respond at scale. So I think the question
is, in the positivist bit is also are parents up for partnering? Forget it, they’re going
to be more and more on your doorstep, and they’re
going to be more and more turning up with, whether
you like it or not, actually what are you doing with my kid, ’cause I’m trackin’ it in
different sorts of ways. ‘Cause that would be readily available and commercial in big systems. So the challenge for us, I think, who work in the system area,
and I’m no advocate for these things operating
entirely independently of education and health and whatever, it’s how are we going to work with them in effective ways to make use of the power of those technologies. Anyone else have a view about that? ‘Cause this idea that
people are just stressed out and it’s just a problem, I think it’s– – [Woman] That’s not what I
said, that, continue, sorry. – It’s stressful, is it? – [Woman] Keep going, sorry. – Okay, but in terms of,
it’s a commonly sort of understood kind of view that we’ve created simply a new additional thing. In terms of your own systems,
how ready do you think your own systems are? To give you an example
for it, we don’t have an IT system at all. You’ve paid a billion
dollars in Australia for My Health Record and
whatever, it currently has no capability to actually work with such personally held systems. So the question, say, in
our education systems, you know, in our other big systems, in our child development systems, discussion yesterday, we
still have the Blue Book, for every baby born in New South Wales. I got asked recently by my 17 year old, where was her Blue Book. I said, “blue what?” (laughing) I’m sure I’ve moved houses
five times since then, or some other particular
thing, you’ve got to be joking. Where is actually, you
know, the set of records, where’s the particular thing? So that the tracking systems that we have are themselves needing to
undergo rapid transformation. The question would be, and
I said it’s the question I’d like to leave you
with is whether we are really up to being the
active participants. My appeal to a group like
this is to be very activist, is to actually take up the
opportunity that might provide for innovation, for partnerships,
for local accountability, rather than waiting for, in a
sense, some top down decision which probably is never
going to arrive in time. – [Moderator] Okay, two questions. One down the back. – [Woman] Just a question
in whether or not what you think of as being
positive is an artefact, is actually an artefact
of the data collection. Because basically if
you’re not engaged in that method of connection, and
that method of connection is not working for you, then you’re not going to be involved in it. So I suppose what I’m wondering is, in terms of mental health
support for adolescents that are using it, yes it may be positive, but is that just an artefact
of using the method? – We hope not.
– Because if it’s not positive for you, you stop using it, or you can’t access it.
– Well, we hope not. To protect against that possibility, ’cause that’s certainly a possibility, most of the evaluations are
not simply based on data that comes out of the
machine, it’s based on working with populations
and I make particularly the comment about rural
and regional populations, Aboriginal populations, low
socioeconomic populations, then developmentally things
like autistic populations and other groups, it’s based on actually the population evaluation of those things, in those settings. Now there is a big issue of moving outside research settings to
the wider scalability, so the next phase of that,
the thing the Australian government partly supports
us to do at the moment, is get outside the specific
testings we’ve done, which have not relied
on data, they’ve been evaluations of those whole communities, to actually what happens
when you go to scale? When you go to scale you’re
back in regular, other settings. Now we have tried to work
with communities et cetera, not by selecting those who
would be likely to succeed. We’ve tried to work in
communities in which we think it would be most relevant, who would be most likely to be left behind in the so-called digital divide. But I think, you know,
that’s a fair enough question to see, I don’t think it is an artefact, that’s the bottom line. – [Moderator] Okay, next question. – [Woman] Thank you, Ian, that was great. My question to you is
are you an advocate for an ID at birth, to track us through life. – For a, what at birth? – [Woman] An ID at birth
to track us through life. – You don’t think there already are them? (laughing) Well, I think in the Australian setting, I mean, in a sense, I think
the issue of data linkage and tracking is fundamental, yes. And there’s silly
attempts like a Blue Book and this and that, which are
all disconnected attempts to hold critical bits of
information about the individual. The question in the
whole wider world though is a much more profound
one, is who’s really in control of those systems? So what people don’t trust anywhere, not just in Australia, in the world, is some central agency to action it. So the bigger issue is an
ethical and governance one. In all the systems I’m associated with the person themselves determines
their participation in that and can withdraw from
that whenever they like, in a particular way. So I think the issue in the future is we’re used to big
centralised things, you know, the Australia Card, the
number, the welfare number, whatever, and increasingly
people hate those and they will not participate,
so it’s not a number, it’s a system that allows it. But the issue of personal
control over that system is still being really figured out. It’s really an open book as
to how that’s going to happen. – [Woman] I’m looking at
Finland, because I believe they have an ID system. – Well those countries that
have been happy (laughing) ’cause that’s the way they do things, well, I suggest that
people in those countries will also become more
unhappy with those systems. Because the data is not in the end, with all the systems you then use, limited to Finland or
Scandinavia or whatever. And as what happens in these systems, ’cause no system is 100%
secure in a particular way, the universal issue of
control over the system and who does that. So if you want participation
you’ve got to have a system that genuinely
empowers the principal user to be in control of
their own data for good. – [Moderator] Okay, thanks
Ian, can you put your. (audience clapping) Is anyone else.

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