'It's mean!' The views of young people alienated from mainstream education on depression, help seeking and computerised therapy

Background: Adolescents alienated from mainstream education before they reach the minimum school leaving age have high rates of depression and seldom receive evidence-based mental health treatment. We set out to investigate their views on depression, help seeking and computerised therapy. Method: Focus groups with 39 young people (74% males, 49% Maori, 38% Pacifi c Island, all aged 13-16 years) in alternative schooling programmes for students excluded or alienated from mainstream education. Findings: Participants generally thought that depression was real and that people their age suffered from it. The main responses to feeling depressed were self-harm, fighting and substance use. Most were very reluctant to talk to health providers about depression. Some would be distressed or might hurt themselves if referred to mental health services. There was a high level of interest in computer programmes to assist with depression irrespective of the gender or ethnicity of the students or whether they felt down in the past. Barriers to using computerised therapies included lack of help seeking, potential embarrassment and access to computers. Conclusions: Approaches that allow young people to receive help, without having to actively seek assistance from health professionals may be needed to address depression among this vulnerable group. The use of computer programmes that are appealing and can be provided in non-stigmatising ways appears to be one promising approach.