Anonymous self-report health and wellbeing surveys were completed by alternative education (AE) students in the Auckland and Northland regions of New Zealand, and 11 semi structured interviews were conducted with key informants about their perceptions of health issues for AE students. Both groups reported concerning health-risk behaviours among AE students, including drug and alcohol abuse, depressive symptoms and dangerous driving. Health services have consistently failed to engage AE students in effective primary and preventative care that includes their whanau/family. Significant changes to the current New Zealand health system are required to provide appropriate and effective health care for students attending AE facilities. (Contains 1 table.)