Young people’s experience of seeking and accessing mental health support in Wales 

One-size-fits-all methods left many young people with unmet needs. Rigid session structures, default delivery models, and a lack of multi-disciplinary working across service providers led individuals to seek support from multiple sources or to receive help that only partially met their needs. This was exacerbated for neurodivergent participants, who struggled to adapt to the providers’ approach. 
[“if there was a service that was more neurodivergent-friendly, we would be far more inclined to actually access the service when we need it.” – female, 18-20”]

Most participants had to seek support multiple times. Many felt they were “going in circles”, where they were passed between services without receiving meaningful support. 
[“60 visits before I got mental health support…I was having to go nearly every week for 18 months before [my GP] realised that I couldn’t wait for CAMHS support anymore.” – female, 21-25]

Young people with co-occurring needs often reported being turned away instead of receiving integrated support. Some were rejected by both autism and mental health services because their needs were considered ‘too high’. 
[“…there needs to be some sort of system in place for people with autism that are trying to access mental health support…why have I been referred to [autism services] if they very clearly don’t do mental health support.” – female, 21-25]

Poor signposting left participants feeling misunderstood and neglected, with many reporting a lack of clear guidance on available support.  
[“it felt like they were just saying things, trying to signpost me to things, and as a result…they didn’t do anything.” – male, 21-25]

Participants experienced challenges during transitions in their help-seeking journeys, describing the process as confusing, time-consuming, and full of administrative hurdles resulting in significant gaps in provision of care. 
[“…transition to adult services…is an absolute minefield to navigate. It takes so many hours of sending emails, reading letters, phoning people to get any information.” – female, 18-20] 

Unfavourable experiences make young people hesitant to seek support again, potentially worsening mental health issues over time. 
[“I haven’t seen support for anything…because the way they treated me is just not putting my faith in those kinds of services” – n/a, 18-20]

LGBTQ+ and neurodivergent participants felt existing systems failed to accommodate their needs, with a lack of awareness and flexibility from staff across different providers. 
[“I had counselling with someone who marketed herself as LGBT friendly…but she was actually quite transphobic” – male, 21-25]

Having continuous support in one setting (e.g., educational institution) allowed young people to build trust with providers, making them feel safe to open up. 
[“it was terrifying at first…I just need support where I feel comfortable and just have that friendly face…I feel like I’m talking to someone that I personally know and that I can trust.” – female, 18-20] 

Having supportive family and friends who shared advice or advocated for their needs made young people feel more comfortable and confident in seeking help. 
[“so [college] introduced me to their wellbeing hub…I really appreciate [my friend] for that, for seeing that I was struggling…when you’re anxious, you don’t realise how deep you’re digging yourself in.” – male, 18-20] 

Easily accessible local services in schools or the community played a crucial role in supporting young people during the early stages of seeking help. 
[“…school decided it would be appropriate to receive support from the counsellor…we discovered that there were underlying mental health conditions there, not just stuff that had been caused by stress” – n/a, 18-20]

Many participants felt that staff often dismissed their concerns. However, when staff listened and took them seriously, young people were more likely to trust them in return and benefit from the support provided. 
[“And he genuinely wanted to help. It’s not something I’ve experienced from many other people; it feels like they’re just doing a job. They tick a box. They’re trying to get someone off the waiting list” – male, 21-25]

When services were inclusive and had awareness of needs for LGBTQ+ and neurodivergent individuals, young people were likely to feel more comfortable seeking help. 
[“when I got my autism diagnosis, they actually had a specialist who was autistic themselves…I was able to feel more at home and they understood me more” – female, 21-25]

Being able to access private support would mean that young people could get diagnoses much quicker, and access individualised support that suited their needs. 
[“the service that I paid for, I was seen a lot quicker…I managed to get a lot of problems sorted…and get on the right treatment and find a treatment that was working for me” – female, 21-25]

lexibility meant providers took steps to make young people more comfortable accessing support. This could mean offering different times of the day, flexibility around remote/face-to-face appointments, or alternative methods of communication. 
[“just being able to fit it around life has been really good, and being online just means it’s more flexible” – male, 21-25] 

Young people emphasised that preventative measures, such as routinely offering mental health support in schools or reaching out to populations with higher risk (e.g., those with experience of care), could reduce the overall burden on mental health services.  
[“I’m quite idealistic, and I know that this is not practical at all. But I would say get help for everyone…even for those who don’t struggle, and don’t even ask for help.” – male, 21-25] 

Traditional phone and video calls can be anxiety-inducing, especially for neurodivergent individuals. Participants highlighted the need for text-based options, which allow more time to present their thoughts in a less spontaneous manner.

[“I think a GP should have the option [to] text how you’re feeling…I find it easier expressing how I’m feeling via text” – female, 21-25]

Young people felt NHS services needed to address low capacity, shortage of staff, and long waiting lists. Charity services provided a ‘release valve’ but often didn’t have the knowledge of co-occurring needs that some young people needed. 
[“If the NHS is lacking in therapists, then they need to put money in there and develop that and provide services.” – female, 21-25]

Young people emphasised a need to simplify the transition from CAMHS to AMHS, with a call for better co–ordination and communication between services to avoid gaps in care. 
[“I think that’s really important that services don’t [just] not give support just because [someone is] accessing support elsewhere. I think everyone needs to be open and honest about what can be accessed.” – female, 21-25]

The internet is the main avenue for seeking support, services should improve their online presence and use social media platforms to ensure young people know what support is available. 
[“Just keep promoting it, put it up in shops, put it up anywhere, make banners on Facebook, social media is a big thing, put it everywhere.” – female, 21-25]

Young people stressed the need for flexible support in remote/face-to-face appointments and the types of therapies that are available. Neurodivergent individuals need services that understand their needs and collaborate with autism and ADHD services. 
[“…most neurodivergent people have had really bad experiences and are very, very cautious of accessing services where they are ultimately misunderstood.” – female, 18-20]

More leniency with missed appointments. There is likely a reason why individuals are missing sessions, and providers can work with individuals to make the support more comfortable and accessible rather than dismissing them from the service early. 
[“There really does need to be more of a support network…even if people don’t answer honestly, the fact that you’re at least asking at least indicates that you actually do care, and you’re not just filling out a form.” – male, 21-25]