How New Zealand Is Confronting Its Youth Mental Health Crisis Head-On

Even in the years leading up to the COVID-19 pandemic, a large share of U.S. high school students had been experiencing mental health issues. But months of isolation from peers and support systems and disruptions to daily activities made things far worse. By 2021, more than a third (37%) of high schoolers were reporting poor mental health and almost half (44%) were dealing with persistent feelings of sadness and hopelessness.

U.S. teens are not the only ones in crisis, however. Suicide is one of the leading causes of death for youths between ages 15 and 19 globally, and the World Health Organization estimates that one in seven (14%) between ages 10 and 19 experience mental health disorders, the majority of which go undiagnosed and untreated. During the pandemic, rates of depression and anxiety in children and adolescents nearly doubled.

But while problems like COVID-19, poverty, and housing insecurity affect young people around the globe, the mental health supports available to them vary considerably among countries. New Zealand has one of the highest youth suicide rates in the developed world, but it is also leading the way in prioritizing investment in mental health services for this particularly vulnerable group.

How Is New Zealand Investing in Youth Mental Health?

In 2018, years before the U.S. Surgeon General issued the first advisory on youth mental health, the Aotearoa New Zealand government (Aotearoa is the Māori name for New Zealand) commissioned an inquiry into mental health and addiction amid widespread concerns in the community. The panel, which included a youth representative, released a seminal report recommending specific changes to improve the country’s approach to mental health, with a particular focus on Māori and other disproportionally impacted people.

The report found children and young people to be in high levels of distress, with many engaging in frequent self-harm and other risk-taking behaviors. It also identified unmet needs — often resulting from delayed or inappropriate interventions — that were leading to high rates of suicide. Among rangatahi Māori (Māori youth), cultural alienation and generational deprivation, among other factors, were noted as major causes of poor mental health outcomes.

The report triggered an influx of government funding for a variety of initiatives across ministries and public agencies. One major regional effort is Mana Ake — Stronger for Tomorrow, which targets the mental health and well-being of Canterbury-area children in elementary and middle school (years 1–8). Class programs and sessions for caregivers are designed to help children manage issues like bullying, parental separation, grief, and loss. Another initiative, the Piki Pilot Project, provides free primary mental health services for 18-to-25-year-olds in the greater Wellington area. Designed with input from young people, it features 24/7 phone and web support as well as Peer Zone, a program offering workshops and one-on-one or group peer support.

The Aotearoa New Zealand government has continued to increase funding for youth mental health services in the years since, setting aside $90 million in 2022 to expand programs like Mana Ake.

Many programs in New Zealand struggled to transition to a virtual setting during the country’s strict COVID-19 lockdowns. While the Piki Pilot Project and Mana Ake were ultimately able to adapt through virtual technology, the former’s equity targets lagged in 2020, highlighting the need to invest in programs created by, with, and for Māori communities.

Despite the slowed progress, both programs have reduced critical barriers to accessing mental health care like cost and availability. Over the past 24 months, Mana Ake has reached an estimated 3,800 children in 132 class programs and held 696 sessions with caregivers; it also achieved a 19 percent reduction in the number of children entering the program considered to be of “significant cause of concern.” The Piki Pilot Project, meanwhile, delivered roughly 21,000 therapy or peer support sessions to 5,307 clients over a 24-month period that largely coincided with the pandemic.

A Wake-Up Call for All

Globally, we are at a critical juncture in addressing the youth mental health crisis. Many states in the U.S. are deploying a variety of programs to meet young people’s mental health needs, including collaborative care models, school-based interventions, and efforts to leverage Medicaid resources. But there is an opportunity for more federal coordination and funding to ensure actors at the federal, state, and local levels are working as effectively as possible. The U.S. could take a page out of New Zealand’s book and invest in more early intervention and mental health support for young people through services that are culturally competent and designed in partnership with youth. This would require health care providers, payers, and policymakers to work in tandem.

The author would like to thank Jane Kinsey , a 2021–22 New Zealand Harkness Fellow, for her input on this International Insight.