Abstract
Piki is an innovative free primary mental health service for youth that has been piloted successfully across the Greater Wellington region of New Zealand. The overall aims for the pilot service were: • to improve access to mental health and wellbeing support for all young people aged 18-25 years with mild to moderate mental and/or substance misuse-related distress; • to increase equity via a strategic focus on priority (‘under-served’) groups; and • to trial an integrated psychological therapies model for youth. The embedded evaluation team used mixed methods within a modified action research framework to encourage ongoing review and adaptation. This was informed by principles of co-design combined with tools from complexity and implementation science. This approach is underpinned by a philosophy of ‘appreciative inquiry’ which seeks to identify opportunities, strengths, and the positive and aspirational features of innovation, whilst commenting constructively on emerging challenges and problems. Key recommendations were to:
• Continue the Piki service locally.
• Roll out similar free or low-cost initiatives more widely.
• Retain successful innovations (e.g., peer support, self-referral, integration).
• Strengthen focus on equity and targeting to priority groups.
• Commit to genuine co-design and engagement with tangata whenua, local communities.
• Offer a range of evidence-based talk therapy and digital options.
• Consider widening the age range (especially 16–18-year-olds).
• Systematically address workforce capacity and training issues.
• Routinely embed formative evaluation/CQI into new initiatives.