Kiwi youth unhealthy but help tenuous, says report

BY REBECCA TODD

Kiwi youth suffer some of the worst health outcomes in the developed world, but funding for their health services is "tenuous", a new report says.

The Ministry of Health-commissioned report said New Zealand youth had higher rates of mental illness, suicide, teen pregnancy and suffered more injuries than young people in other OECD countries.

However, fragmented and tenuous funding models for dedicated youth health facilities meant they were struggling to meet demand and provide adequate services for their clients.

Christchurch youth health specialist Dr Sue Bagshaw said youth were almost invisible in terms of attracting health funding despite their continually bad health status when compared with other countries.

A "good minority" of young people were entering adulthood as obese or depressed and would become a drain on the health system, she said.

The report said youth – 12 to 24-year-olds – make up nearly one-fifth of New Zealand's population.

In the 2008-09 financial year, funding for the country's 14 dedicated youth health facilities was less than $7 million of which just $4.7m was health funding.

The national budget for health services tops $12 billion.

It found that youth one-stop-shops were providing a high level of service to a vulnerable group, but relied heavily on goodwill rather than any policy or legislative requirements.

A youth one-stop shop is a community-based facility that offers a range of services such as counselling and family planning in youth-friendly settings.

The facilities had difficulty attracting and retaining staff because of low pay and many relied on part-time staff and volunteers, the report said.

"A general lack of stability in funding limits the ability of many youth one-stop shops to plan ahead and provide efficient, stable services for their clients."

It said several of these youth clinics were at capacity and unable to register more patients.

Barriers to youth accessing other services included issues around confidentiality, trust and that they would rather go without care than "access services which do not address their needs in an acceptable way.

"The way in which youth one-stop shops provide services is unique and highly valued by other providers in the sector," the report said.

"While the youth one-stop shops do not provide any services that are not available elsewhere, the integrated and youth-specific model of care increases access by youth, particularly those who have higher need."

The report said the capitation funding model that many district health boards were adopting – including Canterbury – would make funding issues worse as it required young people to register with youth health centres as their primary provider.

Young people were known to "graze" services according to their situation and needs, but funding models did not acknowledge that.

It recommended a whole-of-Government approach be used to address the health and social needs of youth.

Bagshaw said she was pleased with the recommendations in the report, but concerned it was not publicly announced or published by the Ministry of Health.

"It was just quietly put on the ministry's website, no fanfare because they don't want to put money into it," she said.

"That's really sad. They have put money into all sorts of other things, but not young people.

"It's not just about giving us more money, we need to be seen as a mainstream service providing all-round primary health care to young people," she said.

Capitation funding would have spelt the end for Christchurch's free youth health centre, 198 Hereford, by February next year.

However, she went to the Canterbury District Health Board governance board with her concerns two weeks ago and it had agreed to continue funding the service.Bagshaw said research showed the first three years of life and around puberty were hugely important in terms of brain development.

The pressures of modern-day life could be overwhelming for teenagers' brains, meaning they did not develop as they should do and were more likely to engage in risky behaviours.

"What we need is health services that acknowledge and cater for that," she said.

- © Fairfax NZ News