We heard that children and young people are exhibiting high levels of distress leading to deliberate self-harm, risk-taking, anxiety disorders and other troubling behaviours.
Parents spoke of their deep concerns about bullying and alcohol abuse, which link to youth suicide, about the misuse of the internet, including pornography and harmful sexual images, and about social media, also linked to bullying and poor social skills development. We heard about high levels of mental distress among children, resulting in cutting, other forms of self-harm and eating disorders, which can be devastating and life-threatening.
Students talked about young New Zealanders needing guidance on mental health – how to look after oneself and to look after friends. School counsellors and teachers told us they are overwhelmed by the number of students in distress, the complexity of their issues and the incidence of acting out via problem behaviours in class.
Children and young people who represented their peers in state care asked that there be deeper training for foster parents around mental health challenges.
We heard of a tidal wave of increased referrals to Child and Adolescent Mental Health Services and Behaviour Support Teams, which make it difficult to respond to the early signs of mental distress. Childhood trauma was reported to be a major issue.
Paediatricians and other professionals working with children and young people described a ‘patch-up’ mentality in state-funded services, with pressure to record ‘outcomes’ in terms of case closures. In their view, complex health, developmental and familial challenges meant that engagement throughout a child’s early life course, from the womb to early adulthood, is necessary. People said a short-term fix mentality is inappropriate and harmful, and that what is required is an opportunity to resource a long-term, consistent engagement and create a trusting and respectful relationship between a child or young person, their family, and a therapeutic team. Continuity of care is important, but it can be disrupted by setting a rigid age limit that requires moving to an adult service.
We also heard about high levels of concern about the impact of poverty, student debt 31 and deprivation on children and young people and about their regular exposure to alcohol and other drug abuse, violence (against themselves or between adults in the household), not having enough food and a warm home, and family turmoil (for example, frequent changes of address leading to disrupted schooling and opportunities for socialisation).
A strong theme from submissions was that prevention must engage more fully with life-course theory and that child-centred, early intervention service delivery is insufficiently embedded into current mental health and addiction services. The role trauma plays in mental health and addiction challenges and the need for adequate and appropriate responses were emphasised.
Submitters highlighted the toxic environment in which many children and young people live, affected by multigenerational trauma, family violence, poverty, abuse and neglect. Reversing this situation – intervening to prevent adverse childhood experiences among today’s infants, children and young people and supporting whānau to nurture them – was described as the best medium- to long-term investment in mental wellbeing.
Many people described the high rate of youth suicide in New Zealand as a national shame and said that the number one priority is to prevent so many young people from taking their own lives. We heard heart-breaking accounts from family and whānau who had undergone the trauma of losing loved ones to suicide, sometimes several members of the extended family. Many people expressed anger at the inadequacy of mental health services to act on early indications of suicidality and despair at the ongoing ripple effects of such traumatic loss on families, whānau and friends.
Workers reinforced the message that our current responses are inadequate. They said that despite the complexity of the causes of suicidality, we can do better to prevent suicide and support family and friends through the aftermath of suicide, when they are at increased risk themselves. People spoke about some impressive multi-agency teams working through schools and youth programmes and a growing number of peer-support organisations.
Students and teachers highlighted the importance of learning about mental health as part of the health curriculum in schools and of helping young children develop resilience and learn how to regulate their emotions.
A survey of 1,000 young people and rangatahi (run by Action Station and Ara Taiohi as an input to the Inquiry) highlighted multiple sources of stress and anxiety for youth, including:
These findings align with what we heard from tertiary students across Aotearoa. A 2018 report by the New Zealand Union of Students’ Associations identified adjusting to tertiary study, feelings of loneliness and academic anxiety as major triggering factors of depression, stress and anxiety amongst students.32 We heard that students find it hard to access adequate support and face lengthy wait times to see a counsellor. They described needing to work too many hours to make ends meet and a lack of campus community, leaving many struggling with their mental health challenges alone and considering dropping out of tertiary study because they felt overwhelmed and unable to cope.
Young people in prison said youth development approaches and access to therapy and counselling are essential. It is vital to their mental health, wellbeing and rehabilitation to have greater access to their family, whānau, cultural and spiritual support. Young people commented that the social determinants of health are often the root cause of their offending.
They also shared about the impact of the stigma of their offending, which can affect the success of their transition to the community and diminish their mental wellbeing.
31 S Nissen. 2018. Student Debt and Political Participation (chapters 3–4). London: Palgrave.