In their own words: young people's mental health in drought-affected rural and remote NSW.

OBJECTIVE: To record the drought-related experiences of young people and to contrast these with their teachers' and other adults' observations.
DESIGN: Content analysis of issues and priorities raised in semistructured school-based forums.
SETTING: Rural schools in NSW centres. PARTICIPANTS: Young people, their teachers and service providers. INTERVENTION: Six youth and community forums organised under the Rural Adversity Mental Health Program.
RESULTS: Participants welcomed increased community connectedness in response to prolonged drought but reported that drought's mental health impact was mainly negative. Adults observed children's distress, wondering if anyone else noticed it. They witnessed young people worrying about their families, increasingly isolated, at risk of harm, unable to obtain help and facing educational and employment limitations. Young people disclosed many mental health and relationship difficulties at school and at home. They worried about their families, communities and futures and about money and being isolated.
CONCLUSION: Adults and young people reported similar effects of prolonged drought on young people's mental health. But, while adults were more concerned with risks to young people (of harm, abuse, homelessness, problems with the law and constrained opportunities), young people were simply overwhelmed, wanting help for their immediate worries. They sought coordinated support within schools, schools working together, more information about mental health and where to seek help for them and their friends, and support people who understood drought and rural circumstances and on whose discretion they could rely. Mental health programs that are developed in and for metropolitan contexts need to be adapted before being deployed in rural settings.