Purpose
The review draws on a range of mental health and wellbeing insights for tamariki and rangatahi. The following focus areas were adapted into research questions to guide the review, and this report is structured chronologically inresponse to each question:
- How is assessment and identification made for children and young people receiving assistance, or in care and protection or youth justice systems?
- For children and young people receiving assistance, or in care and protection or youth justice systems, what are typical approaches to addressing complexities and concerns related to the child (e.g., family), especially in instances where multiple agencies are involved?
- What system frameworks, services, and supports are found in OECD countries that experience similar challenges?
- In this context, what insights can be drawn for best practice from other jurisdictions with comparable Indigenous populations?
Please note, as questions two and three thematically overlap, they have been combined into a single section. Questions 1 and 4 remain standalone sections.
Methodology
Following discussions with Oranga Tamariki, our team undertook a scan and analysis of relevant literature across academic and general research platforms, based on agreed search terms (see Table 1).
The title and abstracts of initial returns were reviewed for relevance to the key research areas. The references used in articles or reports that passed this initial review, as well as lists of documents that had cited these articles or reports (generated by the databases searched), were also checked for any further relevant information sources.
A total of 62 documents – including research articles, government strategies, and reports – were reviewed, forming the basis of this report.
Key Results
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.