Fears "we are failing our youth" come after new research reveals one in five high school students haven't been able to see a health professional when they needed to.
The Government-funded Youth19 survey also found thousands of pupils weren't assured of their confidentiality and were unable to talk with a health professional in private.
It comes after another Youth19 report in August showed signs of depression and suicidal attempts had increased among secondary school students, while substance use had dropped.
"We are failing our young people by not providing a safe context for them to be able to have good health consultations ... we really are missing opportunities to help our young people," one of the investigators of the study, Associate Professor Terryann Clark said.
Clark - who is also a Māori health nurse - and fellow researcher Roshini Peiris-John - who is also a public health doctor - said the findings hadn't improved in 20 years and the gap between rich and poor had widened.
"Poverty is becoming more of an issue and it's a huge concern for our young people being able to accessing health," Clark said.
"Young people who have mental health or sexual health issues are not going to disclose them if there is a caregiver present and if health professionals aren't reassuring young people of their confidentiality they don't know if they can trust them," she said.
The survey involved more than 7700 students from high-schools randomly selected across Waikato, Northland and Auckland.
Clark said they made sure there was a diverse group of students that they believed represented the whole country.
The survey found while more than two-thirds of students reported good wellbeing, 23
per cent said they had significant symptoms of depression. This has almost doubled for many groups since 2012.
Suicide attempts amongst this age group had also increased, particularly for males. Around one-fifth of students reported that they had difficulty getting help.
Researchers said models of care were "too mainstream" and "Pākehā-focused" meaning they did not cater for diverse communities.
Another issue they said was the rollout of the Government's Nurses in Schools programme varied in quality.
Some schools had visiting nurses while others had multiple permanent health professionals on site, Clark said.
She said health professionals were not being taught how to treat youth and it was causing young people to feel misunderstood.
As part of the Youth19 survey, students were encouraged to give their voice. Comments included:
"Listen to them. Respect as people not just useless kids," European male, decile 7, age >17.
"Make it normal and comfortable to talk to people and not make it like people who talk about their feeling are weird and needy people who are just looking for attention because that's how young people in this day and age think," Māori female, decile 2, age 15.
They were also asked what could help. Responses included:
"Trained professionals wandering around schools just talking to students
without having an appointment," Māori male, decile 9, age 15.
"More counsellors around our age that can understand our feelings better and so
we can have a chill conversation rather than a nervy one, "Asian female, decile 9, age 14.
Researchers suggest five priorities for improvement:
1. Provide healthcare services that are appropriate to youth and get input from youth.
2. Ensure health professionals are well-trained and know how to engage with young people and provide conditions for them to have proper consultations in ways that make sense to them.
3. Look at a multitude of ways to support access into health services whether that be through schools, Youth One Stop Shop, GPs. Young people need lots of different ways to access healthcare.
4. Minimise the impact of poverty on health access, for example free healthcare, like that for under 13-year-olds.
5. Increase the information available to young people, particularly in schools, about accessing healthcare - especially for minority groups.
Health Minister Chris Hipkins said improving access to quality health services was a priority for the Government – particularly for young people and vulnerable communities.
In the past three years a lot of work had been done to address this issue, including extending the nurses in schools programme and delivering free support to 18 to 24-year-olds in Wellington and Wairarapa under the Piki programme, Hipkins said.
A ministry of health spokesperson said work was underway to boost school-based health services (SBHS), which was already being provided to students in 300 Decile 1 to 5 public secondary schools, Teen Parent Units and Alternative Education sites. It aimed to help link young people with primary health care providers to improve access.
"We'll continue to make it easier for youth to get the support and care they need by funding 20 new mobile dental clinics to ensure that those in more hard-to-reach communities can get access to the free care they are entitled to," Hipkins said.
National's health spokesperson Shane Reti said health inequality was "not acceptable" and he planned to bring back health targets at all publicly funded health services to make sure there was greater accountability.
He said the findings showing an increase of depression and suicidal attempts among young people was a problem that had been further exacerbated by coronavirus.
"National has announced a mental health strategy with many layers of care targeting youth. Our methamphetamine policy is also the only comprehensive new drug addiction policy on offer in this election bundling together actions at the border with an inpatient detox bed safety net for every DHB and the best practice Matrix programme in the community."
Ruaputahanga Takiari says not feeling listened to was the story of her life, at high school anyway.
The 19-year-old, who finished secondary school last year, was diagnosed with a condition called cataplexy, which is a sudden and uncontrollable muscle weakness, or full paralysis, triggered by strong emotion, such as excitement.
For Takiari it meant laughing would end in her falling off her chair. She also developed a condition called narcolepsy which meant an excessive amount of daytime sleeping.
At the age of 15, Takiari had diagnosed herself but for at least a year it wasn't official.
"Doctors swept it under the rug and teachers just thought I was attention seeking."
She now takes daily medication and sees a neurologist through the hospital.
But seeking help at school was tough, Takiari said.
The school had a counsellor but the teen said their books were often full and many students found it difficult to talk to them.
There was a part-time nurse, but again the relationship and understanding was lacking so there was often no point going there, Takiari said.
"If we went to the sick bay we would probably be given Panadol and then get sent back to class."
Takiari said her condition started to affect her mentally but she didn't feel comfortable speaking to the counsellor so she would talk to teachers she trusted.
"I feel like that wasn't fair on the teachers as well, it's not their job to take on our burden."
She said there needed to be better communication between hospitals and schools.
"The school wouldn't have known about my condition unless I told them and I feel like this is a barrier because lots of kids feel shy or embarrassed to do that."
Now, Takiari is studying a Bachelor of Health at the University of Victoria where she hopes to help change the system.
"I want young people to know there is light. Even at university the health system is so much better, mental health especially is prioritised and understood, I just wish it was the same for high schools."
More about the Youth19 survey:
• The Youth19 survey is the latest in the Youth2000 series, which has been running since 1999, and aims to measure the health and wellbeing of secondary school students.
• More than 7700 students from randomly selected schools in Waikato, Northland and Auckland were surveyed as part of Youth19.
• Previous Youth2000 surveys have included teens from schools across the country, but after losing Government funding the number of schools and students involved decreased.
• The Youth19 survey was funded by Health Research Council of New Zealand, which is a Crown agency of the New Zealand Government. It is responsible for managing health research to help advise policy decisions.
• The average time taken to complete the survey was 46 minutes.
Where to get help:
• Lifeline: 0800 543 354 (available 24/7)
• Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
• Youth services: (06) 3555 906
• Youthline: 0800 376 633
• Kidsline: 0800 543 754 (available 24/7)
• Whatsup: 0800 942 8787 (1pm to 11pm)
• Depression helpline: 0800 111 757 (available 24/7)
• Rainbow Youth: (09) 376 4155
• Helpline: 1737
If it is an emergency and you feel like you or someone else is at risk, call 111.