Children and adolescent mental health services

The evidence brief provides insights on:

• assessment and identification
• addressing complexities and concerns
• indigenous research.

Mental and emotional distress amongst children in care is widespread. Children and young people in care can have complex and multiple social care, educational and developmental needs.

This evidence review aims to: 

• inform strategic discussions about how to better provide for the mental health and wellbeing needs of children and young people in a care and protection or youth justice environment
• explore how other international agencies have addressed the issue.

Assessment and identification

These are typically formal processes that develop management plans based on personal history, mental state, recorded problems and symptoms. Their effectiveness is unclear, and such processes are not always timely. Issues can be exacerbated for disabled youth in care and, in general, young people and their carers do not actively seek mental health support. However, some newer models of assessment are emerging, especially in Aotearoa.  

Addressing complexities and concerns

Tamariki and rangatahi centered models which coordinate responses and services are increasingly common. Early intervention and continuity of care are paramount and increasingly youth-specific services are emerging in Europe, the United Kingdom, North America, and Aotearoa. 

Best practice approaches include:  

• wraparound and early intervention initiatives
• ongoing professional development and support for carers.
• multi-agency collaboration
• locating health clinicians at care facilities
• children and young people being actively involved in decisions about their own mental health needs.

Insights from Indigenous research

Research emphasises the need to integrate culturally safe concepts and models of health into service provision. Best practice approaches include:  

• services that enhance Māori identity and are linked to cultural- and clinical-based CAMHS support
• working in partnership with parents, whānau, and community leaders
• models of care co-designed or co-constructed with Indigenous communities
• strengthened support for Indigenous families dealing with ongoing impacts of colonisation, language and culture loss, and removal from land practitioners/clinicians with an operational understanding of Indigenous practices, customs and ceremonies.