Abstract
•Common mental health concerns have increased dramatically among young people over the last decade. Offering treatments for mental health needs is important but is akin to responding to the tip of the iceberg and does not prevent problems developing.•Population health strategies including systematically addressing determinants of mental health and providing early access to care offer critical opportunities for preventing mental health problems. These require multisectoral action, effective leadership, human rights and culturally safe, tailored approaches and research and evaluation.•Risk factors for mental health and barriers to care disproportionately impact Indigenous, ethnic minority, sexual and gender minority and disabled communities (together, ‘Indigenous and minoritized populations’). We assert that effective population youth mental health strategies should prioritise these groups, centring their needs and building outwards to include the whole population.•We propose a framework for action which utilises global prevention models and centres te Tiriti o Waitangi and young people's views to address disparities and to improve mental health for all.•While focused on Aotearoa New Zealand, this offers insights for other nations with persistent mental health inequities.
Symptoms of depression and anxiety have increased dramatically among Aotearoa New Zealand (Aotearoa) youth over the last decade, with widening inequities for Māori (Indigenous population). Increased access to quality timely treatment is essential, but not sufficient to reduce population rates of mental distress. Social determinants and other risk factors which increase the chances of mental health problems are cumulative, interact and are unequally distributed. Most of these risk factors are preventable. In this paper we present a framework for improving youth mental health in Aotearoa building on global evidence, ‘Te Mauri’ (an Aotearoa prevention model) and young people's perspectives. This centres equity in order to address disparities and to improve mental health for all. The six key elements for action are: embedding and enacting te Tiriti o Waitangi (founding treaty of New Zealand which protects the rights of Māori and all peoples); ensuring human rights-based, consumer-driven, and culturally safe approaches; fostering leadership and multisectoral collaboration; addressing modifiable determinants of mental health; ensuring early access to services; and embedding research and evaluation. This evidence-based framework is responsive to the unique needs of youth in Aotearoa and can inform efforts in other colonial and diverse nations to improve youth mental health and reduce the lifelong human and economic impacts of mental ill-health.
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