Globally, young people are at high risk of mental health problems, but have poor engagement with services. Several international models have emerged seeking to address this gap by providing youth-specific care designed in collaboration with young people. In this study, 94 young people in New Zealand participated in collaborative workshops exploring their vision of an ideal mental health service. Participants were aged 16–25. Reflexive thematic analysis was used to identify seven themes. These describe the ideal mental health service for these young people as comfortable, accessible, welcoming, embedded in the community, holistic, adaptable, and youth-focused. In addition to describing how services might better serve the needs of youth, this article outlines a method for adapting international principles for youth-friendly care to the specific needs of a population of young people. This article provides supporting evidence that services should consider how to improve their engagement with youth through collaboration with local populations of young people.

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Introduction The inclusion of suicide gestures in modern nomenclatures for self‐injurious thoughts and behaviors (SITB) is contentious due to their history of pejorative connotations and inconsistent operationalization and measurement. Here we sought to investigate the extent to which participants who endorse this behavior on a standardized SITB measure: (1) describe their behavior in a way that is consistent with contemporary definitions for suicide gestures; (2) accurately classify their behavior when presented with multiple SITB response options; and (3) consistently report their level of intent to die across survey items. Methods Participants were 83 adults from a community‐based sample who endorsed lifetime suicide gesture(s) in an online survey containing self‐report measures assessing their prior SITB engagement, followed by open‐ended questions eliciting narrative descriptions of their behaviors. Results Approximately 13% of participants who endorsed lifetime suicide gestures provided narrative descriptions that met criteria for the behavior, and around one‐third consistently reported zero intent to die in their explicit ratings. Additionally, some participants reported non‐zero intent to die from behaviors without direct potential for physical injury. Conclusions Overall, this study highlights substantial issues with the validity of current approaches to measuring suicide gestures. Implications for the classification of suicide gestures in clinical and research settings are discussed.

Evidence from around the world consistently indicates young people experience high rates of mental ill-health, but frequently have limited engagement with treatment. One powerful influence on young people’s engagement with mental health care is their relationships with treatment providers. A strong relationship with clinicians may be key to sustaining engagement, reducing dropout rates, and improving outcomes from treatment. However, research into young people’s perspectives on qualities they value in their clinicians has often been limited by traditional methodologies which explore young people’s attitudes to clinicians they have already worked with. This limits young people’s responses and, therefore, our understanding of who an effective ‘youth mental health clinician’ could be. In this study, 94 young people from New Zealand participated in innovative research workshops in which they described their ideal mental health clinician. Thematic analysis identified five themes which summarized these young peoples’ priorities for an ideal mental health clinician: Someone Like Me, Someone I Connect With, Someone Who Protects My Space, Someone Who Treats Me as an Equal, and Someone Who Works in the Right Way for Me. The presence and demonstration of these qualities may support both initial and sustained engagement with treatment, with the potential to improve outcomes for young people. Importantly, the connections between these themes highlight that young people are less likely to value ‘relatability’ as an isolated quality in their clinicians and most desire to work with clinicians who balance a warm and comfortable personal style with professional expertise and boundaries. These findings provide guidance for clinicians from a range of orientations who wish to work effectively with young people as to how they can adapt their approaches and seek feedback to improve their work with young people.

Objective: Suicide is a major public health concern in the United States, but few effective and scalable interventions exist to help those with suicidal thoughts. We hypothesized that reading first-person narratives about working through suicidal thoughts would reduce the desire to die among adults and that this effect would be mediated by increased perceived shared experience and optimism. Method: Using a randomized waitlist-controlled trial, we tested the effect of digital narrative-based bibliotherapy among 528 adults visiting a social media platform dedicated to providing mental health support. Participants were randomized to either a treatment condition (n = 266), in which they read one suicide narrative per day for 14 days or to a waitlist control condition (n = 262). The primary outcome was a measure of desire to die assessed daily for the 14-day trial period and at 2-week follow-up. Results: Participants in the treatment condition reported lower desire to die than participants in the control condition during the 14-day trial period (β = −0.26, p = .001) and at 2-week follow-up (t = −2.82, p = .005). Increased perceived shared experience (indirect effect b = −0.55, p < .001) and optimism (indirect effect b = −0.85, p < .001) mediated the effect of treatment on desire to die. Conclusions: Digital narrative-based bibliotherapy may be an effective intervention for those at risk for suicide, and may work in part by increasing feelings of perceived shared experience and optimism. Future research is needed to test the generalizability of these results to other platforms, groups, and conditions.