Young People’s Experiences of Assessment in a Mental Health Setting

Abstract

The high dropout rate of young people in the early stages of engagement with mental health services suggests it is important to better understand how they perceive their initial encounters with the service which usually occur through the assessment process. Given Māori young people are over-represented in mental health statistics, this research explored their experiences of the mental health assessment process, what they learned from this encounter and their views about how cultural aspects dealt with during the assessment. Young people between the ages of 13 and 18 who had undergone an assessment in a child and adolescent mental health centre took part in an hour-long, in-depth narrative-style interview. Sixteen interviews were collected from seven who had been referred via community services and nine who had been referred for a mental health assessment through youth forensic services. Findings reflected young people’s concerns and varied expectations before attending the assessment. Their responses showed how they found ‘opening up’ to an unknown clinician was complex and challenging and how trust was only established gradually, through the clinicians’ personal warmth, consideration, and information sharing. Themes also highlighted aspects of the clinician’s manner that potentially threatened young people’s engagement including formal practices that made clinicians seem they were just doing their jobs, the way questions were framed, and not being informative about the assessment processes. The analysis also suggested that some young people described positive gains from the assessment including better family interaction, increased self-knowledge and feelings of hopefulness. While some participants appreciated including Māori cultural practices in the assessment, preference for a Māori clinician was varied. The study proposes ways clinicians could enquire about young people’s preferences and fears relating to the assessment process and then make adjustments to meet these needs. Keywords: mental health assessment, young people, Māori, perspectives