non-Indigenous Young People Research Articles

Exploring the association of Indigeneity, social adversity status and externalizing symptoms in children and adolescents.

The relationship between Indigeneity, social adversity status and externalizing symptoms is complex and unclear. This study investigates how Indigeneity, social adversity status and externalizing symptoms are related in young people. A total of 132 Indigenous and 247 non-Indigenous young people aged 6-16 years were recruited from a hospital mental health outpatient service. Normality plots with statistics for social adversity status and parent-reported externalizing symptoms were completed for the two groups, matched for age, gender, mental disorder symptom severity, symptom-linked distress and impairment. Standard multiple regression was used to examine how Indigeneity moderates the relationship between social adversity status and parent-reported externalizing symptoms. A scatterplot investigated the association between Indigeneity and social adversity status in young people with parent-reported externalizing symptoms. The distributions of the two groups and (1) social adversity status and (2) parent -reported externalizing symptoms were non-normal but acceptable for a moderator analysis. Indigeneity and social adversity status made independent significant positive contributions to externalizing symptoms. In contrast the interaction between Indigeneity and social adversity status made a nonsignificant negative trend to externalizing symptoms. A scatterplot revealed Indigeneity moderated the link between social adversity status and externalizing symptoms. High social adversity status is linked to externalizing symptoms in non-Indigenous young people but despite higher social adversity, Indigenous young people don't necessarily externalize. Potential protective resilience factors for externalizing symptoms in the Indigenous young people need to be ascertained and nurtured. Future systematic investigations of the contribution of these protective factors to Indigenous referral pathways and management are needed. It is also crucial that increased social adversity status is addressed and managed in all young people, regardless of Indigeneity.

Aboriginal and Torres Strait Islander youth suicide mortality and previous mental health, suicidality and service use in Queensland, Australia, from 2001 to 2021

BackgroundThe current study aimed to compare current suicide rates, trends, previous treatment, suicidality and mental health diagnoses for First Nations and non-Indigenous young people who died by suicide. MethodsAge-specific suicide rates (ASSRs) were calculated per 100,000 persons/year using suicides aged 10–19 years in the Queensland Suicide Register. Rate Ratios (RRs) and 95 % CIs compared ASSRs for First Nations and non-Indigenous youth dying by suicide in Queensland, Australia, from 2001 to 2018. Risk ratios (RiskR) with 95 % CIs compared characteristics between First Nations and non-Indigenous youth suicides. Joinpoint regression was used to identify any changes in trends and annual percentage change (APC) in suicides with 95 % CIs. ResultsThe First Nations youth ASSR was 24.71 deaths per 100,000 persons/year, 4.5 times the non-Indigenous ASSR (95 % CI = 3.74–5.38, p < 0.001). Both non-Indigenous and First Nations suicide trends were stable with no joinpoints (APC: 0.3 %, 95 % CI: −1.6-2.2, p = 0.78; APC: 0.9 %, 95 % CI: −0.2-2.1, p = 0.11). Less than a quarter (23.9 %) of First Nations young people had ever received mental health treatment, significantly fewer than non-Indigenous youth (RiskR = 0.80, 95 % CI = 0.71–0.90, p < 0.001). Similarly, in the three months preceding their death, only 14.5 % of First Nations young people had received mental health treatment (RiskR = 0.89, 95 % CI = 0.83–97, p = 0.015). LimitationsReported mental illness, suicidality and help-seeking could be underreported due to concealment from family or police. ConclusionsThe current study finds no change in the gap between the First Nations and Non-Indigenous youth suicide rates nor evidence of decrease in the First Nations youth suicide rate. There is a need for alternative approaches to Indigenous youth suicide prevention, such as assertive outreach models outside of traditional triage and mental health systems to proactively build trusting relationships with young people in communities to identify young people needing support.

Country and community vs poverty and conflict: Teasing apart the key demographic and psychosocial resilience and risk factors for Indigenous clinic-referred children and adolescents.

Indigenous young people are known to have adverse demographic and psychosocial factors affecting worse mental health outcomes and some household factors aiding resilience. In Australia, there has been no exploration of these factors in clinically referred Indigenous young people assessed in a culturally appropriate way. A total of 113 Indigenous children and adolescents, 217 non-Indigenous young people, age, gender, mental disorder symptom severity, symptom-linked distress and impairment matched, and 112 typically developing participants, age- and gender-matched were recruited. Cultural validity and reliability of the impairing symptoms in Indigenous young people were determined. Key demographic and psychosocial factors were compared across the three groups. The Indigenous clinical group differed significantly from the other two groups that did not differ on three possibly protective measures examined. Key demographic and psychosocial risk factors in the Indigenous group differed significantly from the non-Indigenous clinical group which in turn differed from the typically developing participants. The three groups exhibited a progressively increased magnitude of difference. It remains imperative to nurture features that provide protection and enhance resilience for Indigenous young people and their communities. Indigenous status is linked to significant demographic and psychosocial disadvantage over and above that conferred by clinical impairment and its management. It is crucial that these features are managed and/or advocated for with those demographic and psychosocial factors of the greatest magnitude dealt with first. Future systematic investigations of the contribution of these key factors to mental health referral pathways, assessment and management are needed.

"Ngany Kamam, I Speak Truly": First-Person Accounts of Aboriginal Youth Voices in Mental Health Service Reform.

Aboriginal young people are experts in their own experience and are best placed to identify the solutions to their mental health and wellbeing needs. Given that Aboriginal young people experience high rates of mental health concerns and are less likely than non-Indigenous young people to access mental health services, co-design and evaluation of appropriate mental health care is a priority. Increasing Aboriginal young people's participation in mental health service reform is key to ensuring services are culturally secure, relevant and accessible. This paper presents first-person accounts from three Aboriginal young people who worked alongside their Elders and in a positive and constructive partnership with mainstream mental health services on a three-year participatory action research project in Perth, Western Australia, in Whadjuk Nyoongar boodja (Country). The young people recount their experiences as participants and co-researchers on a systems change mental health research project and share their views on the importance of privileging Aboriginal youth voices. Their accounts highlight that Aboriginal young people's participation and leadership must be understood through a decolonising lens and that working in genuine partnership with the community is key to increasing their contact and engagement with mental health care and improving mental health and wellbeing outcomes.

Suicide rates for young Aboriginal and Torres Strait Islander people: the influence of community level cultural connectedness.

To examine associations between community cultural connectedness indicators and suicide mortality rates for young Aboriginal and Torres Strait Islander people. Retrospective mortality study. Suicide deaths of people aged 10-19 years recorded by the Queensland Suicide Register, 2001-2015. Age-standardised suicide death rates, by Indigenous status, sex, and age group; age-standardised suicide death rates for young First Nations people by area level remoteness and Index of Relative Socioeconomic Advantage and Disadvantage, and by cultural connectedness indicators (at statistical area level 2): cultural social capital index score, community Indigenous language use, and reported discrimination. The age-specific suicide rate was 21.1 deaths per 100 000 persons/year for First Nations young people and 5.0 deaths per 100000 persons/year for non-Indigenous young people (rate ratio [RR], 4.3; 95% CI, 3.5-5.1). The rate for Aboriginal and Torres Strait Islander young people was higher in areas with low levels of cultural social capital (greater participation of community members in cultural events, ceremonies, organisations, and community activities) than in areas classified as having high levels (RR, 1.8; 95% CI, 1.2-2.7), and also in communities with high levels of reported discrimination (RR, 2.7; 95% CI, 1.7-4.3). Associations with proportions of Indigenous language speakers and area level socio-economic resource levels were not statistically significant. We found that suicide mortality rates for Aboriginal and Torres Strait Islander young people in Queensland were influenced by community level culturally specific risk and protective factors. Our findings suggest that strategies for increasing community cultural connectedness at the community level and reducing institutional and personal discrimination could reduce suicide rates.

Restorative Justice Conferencing: Not a Panacea for the Overrepresentation of Australia's Indigenous Youth in the Criminal Justice System.

Restorative justice conferencing is a police diversionary strategy used extensively in Australian jurisdictions to channel young offenders away from formal court processing. Advocates view conferencing as culturally appropriate and a means to reduce the overrepresentation of Indigenous young people because it is rooted in Indigenous justice traditions. However, whether conferencing is effective at reducing recidivism by Indigenous young people compared with non-Indigenous young people remains unknown. We examine this using a longitudinal cohort of youth offenders from Australia. Propensity score matching was used to match Indigenous and non-Indigenous young people at their first conference and examined reoffending outcomes to explore its efficacy at reducing recidivism ( n = 394). Results indicate that, despite statistically controlling for factors related to reoffending, recidivism levels postconference were significantly higher for Indigenous young people. These results suggest that conferencing is unlikely to address the problem of Indigenous overrepresentation within Australia's youth justice system.

Examining Injury Among Indigenous Young People: A Narrative Scoping Review

Indigenous young people of circumpolar developed countries experience a disproportionate incidence of injury compared with non-Indigenous young people. Much has been published about the experience of injury within the general Indigenous population, but literature is limited with regard to Indigenous young people. Trauma nurses, who are important members of the multidisciplinary team that provides injury intervention to Indigenous populations, need to be aware of this literature, as well as subsequent research gaps, to provide effective care to Indigenous young people experiencing injury. The purpose of this study was to provide an updated comprehensive review of the research-based evidence related to all-cause injury for Indigenous young people. An exploratory scoping review was conducted with a narrative synthesis. To locate literature, 7 electronic databases were searched from 2003 to 2017. Criteria were applied to all located articles to determine inclusion and then data were extracted from each study's findings. A total of 15 studies were included in this review that met the inclusion criteria. Themes derived from the knowledge synthesis process are as follows: incidence rates, mechanisms of injury, risk factors, and gaps in research. A strong epidemiological focus has emerged from the research found in this review of injury among Indigenous young people. The results of this review serve as a starting point for trauma nurses to successfully assess, build trusting relationships with, and further research injury among Indigenous young people.

Social media and digital technology use among Indigenous young people in Australia: a literature review.

IntroductionThe use of social media and digital technologies has grown rapidly in Australia and around the world, including among Indigenous young people who face social disadvantage. Given the potential to use social media for communication, providing information and as part of creating and responding to social change, this paper explores published literature to understand how Indigenous Australian youth use digital technologies and social media, and its positive and negative impacts.MethodsOnline literature searches were conducted in three databases: PubMed, Google Scholar and Informit in August 2014; with further searches of additional relevant databases (Engineering Village; Communication & mass media complete; Computers & applied sciences complete; Web of Science) undertaken in May 2015. In addition, relevant literature was gathered using citation snowballing so that additional peer-reviewed and grey literature was included. Articles were deemed relevant if they discussed social media and/or digital technologies and Indigenous Australians. After reading and reviewing all relevant articles, a thematic analysis was used to identify overall themes and identify specific examples.ResultsA total of 22 papers were included in the review. Several major themes were identified about how and why Indigenous young people use social media: identity, power and control, cultural compatibility and community and family connections. Examples of marketing for health and health promotion approaches that utilize social media and digital technologies were identified. Negative uses of social media such as cyber bullying, cyber racism and the exchange of sexually explicit content between minors are common with limited approaches to dealing with this at the community level.DiscussionStrong cultural identity and community and family connections, which can be enhanced through social media, are linked to improved educational and health outcomes. The confidence that Indigenous young people demonstrate when approaching the use of social media invites its further use, including in arenas where this group may not usually participate, such as in research.ConclusionsFuture research could examine ways to minimise the misuse of social media while maximising its positive potential in the lives of Indigenous young people. Future research should also focus on the positive application of social media and showing evidence in health promotion interventions in order to reduce health inequities between Indigenous and non-Indigenous young people.

Tertiary education and its association with mental health indicators and educational factors among Arctic young adults: the NAAHS cohort study

BackgroundCompleted tertiary education is closely associated with employment and influences income, health and personal well-being.ObjectiveThe purpose of the study is to explore predictors for completed tertiary education among indigenous Sami and non-indigenous young people in relation to mental health indicators and educational factors in sociocultural rural and urban contexts across the Arctic part of Norway.DesignThe Norwegian Arctic Adolescent Health Study (NAAHS) is a cross-sectional, school-based survey that was conducted in 2003–2005. Of all 5,877 10th graders (aged 15–16 years) in north Norway, 83% from all 87 municipalities participated; 450 (9.2%) reported indigenous Sami ethnicity, and 304 (6.2%) reported Laestadian affiliation. Data from NAAHS were merged with registry data from the National Education Database and Norwegian Patient Register for 3,987 adolescents who gave their consent for follow-up studies.ResultsCompletion of upper secondary school is the only common predictor of a completed tertiary education degree for both genders. Among females, conduct problems was a significant predictor of lower level education, typically vocational professions, while among males severe mental health problems requiring treatment by the specialist health care system reduced the opportunity to complete tertiary education at intermediate and higher level. Parental higher educational level was associated with less lower education among females and less higher education among males. Men residing in the northernmost and remote areas were less likely to complete education on higher level. Males’ completion of higher level education was strongly but not significantly associated (p=0.057) with higher average marks in lower secondary school.ConclusionsThe gender differences found in this study emphasize the need for gender-specific interventions to encourage, support and empower young people to attend and complete tertiary education. Young females with conduct problems choose lower or intermediate education, and males in need of specialist mental health care have half the chance to complete intermediate tertiary education compared with males not in contact with the mental health service. Closer cooperation between low threshold social services, general practitioners, mental health services and higher study institutions can help young male adults complete tertiary education.

Improving sexual health for young people: making sexuality education a priority

How well do young people understand their developing sexuality and what this means? This paper reports on findings from the Our Lives: Culture, Context and Risk project, which investigated sexual behaviour and decision-making in the context of the everyday life experience and aspirations of Indigenous and non-Indigenous young people (16–25 years) in the Northern Territory, Western Australia and in South Australia. Using qualitative data, this paper focuses on what participating young people thought was necessary to improve the quality of sexuality education. Participants suggest that current forms of sexuality education are too clinical, didactic and unengaging, and are missing in relevant content. Young people requested more information on relationships, first sexual experiences and negotiating condom use. These requests indicate that young people realise that they need more knowledge in order to have healthy relationships, which conflicts with the popular belief that providing young people with open, honest information around sex will encourage them to have sex or increase sexual risk taking. Making sexuality education more of a priority and listening to the needs of young people could be a positive step towards improving sexual health and well-being.

Health needs of Australian Indigenous young people entering detention

To determine whether there are different health needs associated with differences between Indigenous and non-Indigenous youth in detention in Brisbane, Queensland, Australia. All records of young people (aged 10 to 21 years) taken into detention in Brisbane Queensland over the period 1 July 2001 to 30 June 2009 were reviewed, and data were extracted documenting the mental health and related behaviours of those referred to the Mental Health, Alcohol, Tobacco and Other Drugs Service. International Statistical Classification of Diseases and Related Health Problems - Tenth Revision (ICD-10) criteria were applied to a clinical interview. ICD-10 diagnostic outcomes and reason for referral are presented by Indigenous status and age. Young male (under 14 years of age) Indigenous respondents are substantially over-represented in youth in detention. Indigenous youth in detention are disproportionately referred and diagnosed with a substance use problem. Referral and diagnosis of substance use problems was not as commonly found for non-Indigenous youth. Young Indigenous persons are substantially over-represented in those taken into detention in Queensland. This study shows significant differences in relation to mental health and substance use assessment outcomes for Indigenous and non-Indigenous young people in youth detention in Queensland. Further research focusing on service delivery for Indigenous young people should focus on their specific needs.

Type 2 diabetes in young Indigenous Australians in rural and remote areas: diagnosis, screening, management and prevention

The burden of type 2 diabetes mellitus (T2DM) among Indigenous children and adolescents is much greater than in non-Indigenous young people and appears to be rising, although data on epidemiology and complications are limited. Young Indigenous people living in remote areas appear to be at excess risk of T2DM. Most young Indigenous people with T2DM are asymptomatic at diagnosis and typically have a family history of T2DM, are overweight or obese and may have signs of hyperinsulinism such as acanthosis nigricans. Onset is usually during early adolescence. Barriers to addressing T2DM in young Indigenous people living in rural and remote settings relate to health service access, demographics, socioeconomic factors, cultural factors, and limited resources at individual and health service levels. We recommend screening for T2DM for any Aboriginal or Torres Strait Islander person aged > 10 years (or past the onset of puberty) who is overweight or obese, has a positive family history of diabetes, has signs of insulin resistance, has dyslipidaemia, has received psychotropic therapy, or has been exposed to diabetes in utero. Individualised management plans should include identification of risk factors, complications, behavioural factors and treatment targets, and should take into account psychosocial factors which may influence health care interaction, treatment success and clinical outcomes. Preventive strategies, including lifestyle modification, need to play a dominant role in tackling T2DM in young Indigenous people.

Youth justice conferencing and indigenous over-representation in the Queensland juvenile justice system: a micro-simulation case study

Restorative justice conferencing for young offenders is firmly established in Australian juvenile justice, and legislated conferencing schemes are operating in all Australian states and territories. While there is some variation in the terms used to describe restorative justice conferences (e.g., family group conferencing, family conferencing, or youth justice conferencing), there is much more consistency in how the conferencing process is managed across Australian jurisdictions. In Queensland youth justice conferencing is a process that brings together an offender, the victim and their supporters to discuss the harm caused by the offending behaviour and provide the young person with an opportunity to take responsibility for his or her behaviour and make amends. This paper begins by briefly sketching the development of restorative justice conferencing in Queensland and describes the Juvenile Justice Simulation Model (JJSM), a micro-simulation model developed for criminal justice policy analysis in Queensland, Australia. We use this micro-simulation model to conduct an experimental exploration of the effects that youth justice conferencing has on system-wide outcomes for indigenous young people. The model simulates the impact of interventions up until 2011 on the number of finalised youth justice court appearances. Our results indicate that youth justice conferencing is unlikely to reduce the over-representation of indigenous young people in the juvenile justice system. The simulations demonstrated that, by the 2011, youth justice conferencing would result in a 12.5% decrease in finalised court appearances. Unfortunately, this decrease was more apparent for non-indigenous young people (13.7% decrease in court appearances) than for indigenous young people, who had a 10.5% decrease in court appearances. This differential impact of conferencing is due to the different court appearance profiles between indigenous and non-indigenous young offenders, with indigenous young people initiating offending at an earlier age and offending more frequently than non-indigenous young offenders.