BACKGROUND individuals experiencing their first psychiatric symptoms can be difficult to engage in treatment, for reasons including developmental stage and social environment. Early and consistent treatment, thus engagement in treatment, is critical to improved long-term outcomes. OBJECTIVE to identify better methods of engaging youths in mental health services by asking experienced mental health consumers for suggestions for clinicians. METHODS 177 members of an integrated health plan, ranging in age from 16–84 years and diagnosed with schizophrenia, schizoaffective disorder, bipolar disorder or affective psychosis, completed four in-depth semi-structured interviews over 24 months as part of a study of recovery from serious mental illness. We transcribed and coded interviews, extracted a set of common themes addressing consumer recommendations to clinicians, and compared these themes across age groups. RESULTS five primary themes emerged in participants’ recommendations: (1) use an age-appropriate approach that reflects youth culture and lifestyles; (2) foster development of autonomy; (3) take a personal, rather than diagnostic, approach; (4) be empathetic and authentic; and (5) create a safe and supportive environment. Consumers age 30 and older described three additional areas in which clinicians could contribute to youths’ well being: (1) help find the right diagnosis and the right medication, (2) counsel youths to avoid using alcohol and drugs, and (3) take steps to help prevent social isolation. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE findings suggest that many strategies recommended for working with adults may benefit young people, but that developmentally-appropriate modifications to these approaches are needed to foster treatment engagement among youths.

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