Adolescent / Young Adult Health
- the forgotten patient group in the Health Sector-

Currently young people aged 15 years and above, and some as young as 13 and 14 years of age, who are newly diagnosed with serious, degenerative and life threatening diseases are declined admission to children's wards, given “adult status”, and placed in adult wards. Their needs are frequently ignored because the staff are not trained to cater for the unique needs of these young people.

While it may be tolerable in surgical wards, for instance, to have a mixing of patients of all age groups in any particular ward - when the length of stay is very short, it is most inappropriate care psychologically for Adolescent / Young Adult patients to be placed in the adult wards when there are serious long term health issues for the following reasons:

a) the needs of Adolescent / Young Adult patients are very different from
those of the older patients who are often old enough to be their grand parents or great grand parents for that matter. Although these patient groups maybe suffering similar illnesses (e.g. cancer of one form or another) their psychosocial needs are hugely different. While they are no longer young children, they are still vulnerable. Their needs are much more complex than at any other time of their lives and that is without adding a chronic illness and expecting them to cope, without sufficient caring support and understanding.

(b) staff are rarely trained to understand and care for this particular age group and therefore usually lack the necessary empathy and understanding. Consequently, these patients (and their families) often have to cope on their own with serious diseases and disabilities, due to a lack of medical support services.

(c) the adult wards tend to be negative places where the environment is not conducive to a positive mental outlook for patient survival. The statistics for childhood cancer patients, indicate clearly an increasingly larger number of survivors which must be catered to. In the adult wards patients are sometimes at death's door and some die there. Many ‘tomb stones’ flank the corridors i.e. gifts from appreciative families of deceased patients, with signs, “In memory of....”

(d) the atmosphere is old and there is no spark of youth or the usual lively
things adolescent / young adults enjoy. They are in essence like fish out of water and are often in a state of crisis in their own way as they bravely face and try to cope with the horrendous threat to their lives while they undergo difficult and painful treatments which also have a high risk factor.

(e) since there are few patients of this age group in any particular ward for life threatening diseases and chronic disabilities they do not have the support in hospital of other adolescent / young adult patients who are also facing similar kinds of fears, worries and concerns, over and above all the usual concerns of this age group.

(2) Modify and create policy at Government level to help protect the interests and needs of this particularly vulnerable patient group, both within the hospital system and the wider community, and home based care, and to help ensure young people receive timely and appropriate support, to help them achieve and maintain a sense of independence, a sense of having control over their own lives and thus to help reduce their feeling of causing added strain on their families.

(3) Establish adolescent/youth wards that are able to cater to the developmental and psychosocial needs of young people without reservation, in an environment conducive to a positive mental attitude, and to ensure that they are informed of and initiated into all appropriate medical and financial support systems peculiar to their needs and those of their family. 

In regard to the Elizabeth Ewing Fund in Youth Health, Auckland District Health Board wrote (April 1999), that it is "the beginning of a long term solution to raising the standard of care for adolescents and young adults." They go on to say that, "We know very well that the health needs of adolescents and young people are sorely neglected." 

This Award promotes, encourages, and assists health providers to acquire the necessary attributes for the appropriate care of our young people. This will increase the professional workforce in adolescent health and simultaneously increase the research resources about our own youth.Once the workforce reaches a certain pre-optimum trigger level, it will have a helpful 'snow ball' effect on several key areas, such as, appropriate legislation amendments and creations that work together to help our young people; hospital and community support services work to provide a seamless service to young people; staff trained in adolescent health to assist them in understanding and being able to relate to young people; and funding which will become more comparable with the size of this group as society becomes more aware of the plight of young people and the waste of young lives that we are currently seeing which is often due to the stresses faced by young people in the world today. Unfortunately, their risk taking behaviours are far more seriously dangerous than that for any earlier generation. 

These improvements and opportunity for earlier diagnosis and intervention will lead to happier more resilient, sustained, productive and Alive young people.

Your donation or bequest will be gratefully received in helping to bring about the necessary changes in the standard of health for the adolescent/young adult patient group.  

Please make these payable to: The Elizabeth Ewing Fund at  the University of Auckland School of Medicine Foundation and 
and send to:

School of Medicine Foundation,
Faculty of Medicine and Health Science,
University of Auckland,
Private Bag 92 019,
Auckland,
New Zealand.

(All donations over $5 are tax deductable
Thankyou for your contribution.)

Author of this Article : Jane Ewing, written as a result of her experience.

See her article, Our Adolescents - forgotten in the health system, Published in the New Zealand Family Physician, which is the Journal of the Royal New Zealand College of General Practitioners,  volume 27 Number 1, Feb 2000.

Email Contact : jane.ewing@uts.edu.au

or jane.ewing@stat.auckland.ac.nz