Appendix 2: What young people want in mental health services

Meeting the mental health needs of young New Zealanders.

The definition of "meeting need" we used in this work is based on the themes and findings in the table below. This is drawn from our discussions with youth advisory groups, previous consultations on similar topics that presented young peoples' views, and our review of the extensive published research on youth mental health services including young peoples' views and perspectives.

Theme What all young people want What rangatahi Māori and other priority groups of young people want
Youth-specific care Services and models of care that are for young people. Not expecting young people to fit into services designed for adults.
Rapid, barrier-free access to support Access to support when young people need it, without the need for a referral or a waiting list.

Young people may be on low income or financially dependent on whānau, so services need to be free or low cost to be accessible.

Flexible ways to access support, such as through services offering drop-in sessions, making appointments available outside of working hours, and offering a variety of channels (such as text or webchat) for young people to engage with mental health practitioners.
Physical accessibility of services and, where appropriate, assistance to travel to services is particularly critical for disabled young people.
Services in places where young people commonly spend time Services located in locations where many young people are such as schools, tertiary institutions, or accessible community locations.

Mobile services are a youth-friendly option for bringing services to young people.

Internet-based services are an attractive option for many young people. However, not all young people can or want to access services online, and it is important for services to offer face-to-face alternatives.
Youth-friendly environments The physical space in which mental health services are delivered is extremely important to young people and can be a deciding factor in whether young people choose to use or stay with a service.

Young people want to access services in environments that are safe, welcoming, and where they want to spend time. They may find clinical or hospital-like settings stigmatising and offputting.

Young people may feel stigma about accessing a mental health service. Young people also worry about the confidentiality of the information they share with professionals. For these reasons, settings which allow their need for privacy are extremely important.
For rangatahi Māori, creating time and space for meaningful connections to grow, in contexts that nurture their wellbeing (such as in te taiao – the natural environment) is particularly important.

Rainbow young people told us that service environments need to be explicitly inclusive and welcoming of Rainbow young people for them to feel comfortable.
Youth voice and participation Young people want services to listen to them and empower them. They want services that recognise their inherent value and potential and treat them as partners in their own care.

Young people want to be involved in all stages and levels of services, from their design to their delivery, governance, and ongoing monitoring and evaluation.

We heard that including young people in service delivery, such as through employing them as peer support staff, can help make services more relatable for other young people.
Rangatahi Māori want services to uphold and enhance their mana and tino rangatiratanga.
Relationships Young people value the ability to develop ongoing relationships with trusted adults who can relate to young people and are non-judgemental.

It is important that services allow young people the time and space for relationships to develop.
The importance of relationships characterised by mutual trust and reciprocity are encapsulated in the Māori value of whanaungatanga.105

It may require extra time for rangatahi and whānau who have experienced discrimination or other negative experiences with government services to build up trust in professionals.
Whānau-centred care Involving whānau (however a young person chooses to define their natural supports) in decision-making over their care is important to young people.

However, some young people seek privacy and autonomy from whānau and it is important for services to respect young peoples' preferences, so far as is possible within the constraints of safety and consent.
Connectedness to whānau and where they're from is important to rangatahi Māori well-being.

Connection to culture and identity is also particularly important to Pacific young people.
Services and a workforce that reflect diverse young people Young people are diverse, and services and the workforce need to accommodate and celebrate this diversity.

Young people do not want a single universal service. Rather, they want services that understand and reflect their diverse "identities, world views, and needs".
Rangatahi Māori and Pacific young people may be reluctant to engage with or remain in a service if mental health practitioners do not understand their culture or if the models of care do not align with their worldview. Examples of this could be lack of accommodation for whānau or services not following tikanga.

In practical terms, responding to young peoples' diverse needs is likely to involve offering the choice of separate services or care models for some groups of young people, such as rangatahi Māori and Pacific young people, and improving the inclusiveness of "mainstream" services for groups such as disabled and Rainbow young people.

105: Hamley, L et al (2023), "Te Tapatoru: a model of whanaungatanga to support rangatahi wellbeing", Kōtuitui: New Zealand Journal of Social Sciences Online, Vol. 18, no. 2.