Does youth-friendly mental health care improve therapeutic engagement and psychosocial outcomes?

Objectives: We discuss the paradox of young people dropping out of the Australian Government national youth psychotherapy programme (headspace), which is co-designed by youth people. Conclusions: A very large percentage of young people drop out of psychotherapy before completing evidence-based treatment. Youth-friendly psychotherapy services are hypothesised to improve therapeutic engagement and psychosocial outcomes. However, empowered young people may not choose greater engagement with psychotherapy. For example, the Australian Government recognises the right to youth-friendly services and headspace emphasises providing young people with access to support where, when, and how they want. Most appear to want very short courses of psychotherapy (1–3 sessions), which are associated with lower than expected psychosocial outcomes compared to other real-world services. Only the 20% who engage in 6 or more sessions have outcomes comparable to other psychotherapies. These findings have international significance because similar youth-friendly psychotherapy programmes are being established around the world.