“I wish they heard my story rather than my conditions.” –A qualitative exploration of young people’s experiences during mental health assessment in the UK

Poor mental health can present a significant impact on young people's quality of life. Mental health assessment may detect issues early and select appropriate treatments to prevent a worsening of symptoms. However, current research suggests that rates of non-attendance for mental health services are high amongst young people, possibly due to negative assessment experiences. Despite their potential importance, little research has explored the experiences of young people during mental health assessments. We recruited 12 culturally diverse young people who have had a mental health assessment within the last 18 months. They participated in semi-structured online interviews exploring their experiences during assessment. We analysed the data using reflexive thematic analysis. Young people with lived experience helped identify the themes for data analysis. Three themes were identified: importance of person-centred care, systematic barriers and safe space. Overall, participants reported an unfulfilled desire for holistic and personalized care that prioritises their needs over meeting systematic requirements. Assessment was frequently characterised by a lack of agency and dismissal of experiences, generating disengagement. Young people who reported a more positive experience of assessment identified factors including a warm environment that facilitated engagement and prepared participants for upcoming support. The results suggest that, although mental health assessments have the potential to detect mental health issues early and facilitate subsequent treatment engagement, young people often experience them negatively. Frequently, they are perceived as impersonal and rigid, presenting a barrier to help-seeking. In light of these issues, there is a need to prioritise the implementation of person-centred care in assessment practices.