Social And Emotional Wellbeing Research Articles

Thriving Beyond Adversity: A Prospective Longitudinal Cohort Study Using a Strength-Based Approach Depicts Indigenous Adolescents with Less Adverse Childhood Experiences (ACEs) Had Fewer Neurodevelopmental Disorders (NDDs)

Improving social and emotional well-being (SEWB) among Indigenous adolescents is crucial. Since neurodevelopmental disorders (NDDs) are common in Indigenous people and adverse childhood experiences (ACEs) are important contributors to negative health outcomes throughout the lifespan, we investigated whether limited ACE exposure is associated with reduced risk of NDDs in Australian Indigenous teens using the data from multiple waves (Wave 1 to Wave 9, and Wave 11) of the Longitudinal Study of Indigenous Children (LSIC). We also examined the role of other protective factors, such as Indigenous cultural identity and school connectedness, against NDDs. A strengths-based approach using mixed-effects logistic regression models examined the protective effect of limited ACE exposure (from LSIC waves 1–9) on NDDs (outcome from LSIC wave 11), adjusting for sociodemographic factors. The NDDs included autism, ADHD, intellectual, neurological, and specific learning disabilities. Of the 370 individuals analysed, 73.2% valued Indigenous cultural identity, and 70.5% were strongly connected at school. More than one-fourth (27.8%) reported limited ACE exposure, while the majority was not diagnosed with NDDs (93%). Longitudinal analysis revealed limited ACE exposure was 6.01 times (95% CI: 1.26–28.61; p = 0.024) more likely to be protective against NDDs compared to those exposed to multiple ACEs. Moreover, valuing cultural identity (aOR = 2.81; 95% CI: 1.06–7.39; p = 0.038) and girls (aOR = 13.88; 95% CI: 3.06–62.84; p = 0.001) were protective against NDDs compared to their respective counterparts. Our findings highlight the need to prevent ACE exposure and promote Indigenous cultural identity in preventing negative health outcomes and the exacerbation of health inequities to strengthen the SEWB of Indigenous communities.

Enhancing Equity in Clinical Social Work Education: Supporting Indigenous Queer and Gender Diverse Students and Researchers'

AbstractFor Indigenous Australian Queer and Gender Diverse (QGD) Peoples, being acknowledged, recognised, and considered in frameworks, policies, and within organisations in the broader Australian context is rare. This article will explore some of the structures, systems, and policies that impact on Indigenous QGD peoples in Higher Education (HE). We will speak on social and emotional wellbeing (SEWB) and how this knowledge may translate into clinical social work practice. We explore the ways in which HE can become conscious, motivated, and emboldened to enact clinical social workers of the future towards ultimately improving current recruitment, retention, which will contribute to individual and group change in Australia.

The interactive effects of Indigenous identity and lateral violence on youth adjustment in Aboriginal and Torres Strait Islander children

ABSTRACT Objectives Lateral violence is the potential for members of a group to engage in practices that are harmful to other members of their own group. Evidence indicates that lateral violence can affect Aboriginal children’s social and emotional wellbeing (SEWB); however, little is known about the potential for ethnic-racial identity (ERI) to protect against harmful effects of lateral violence. Methods We investigated whether ERI affirmation moderated the relationship between exposure to lateral violence and Aboriginal children’s SEWB. Children (n = 360) from the K-Cohort of the Longitudinal Study of Indigenous Children were included in this analysis. Children’s ERI was dichotomised into high versus low affirmation, and General Linear Models were used to examine the effects of lateral violence on SEWB and the potentially moderating effect of ERI on that relationship. Results Increased exposure to lateral violence was associated with increased difficulties in all Strengths and Difficulties Questionnaire domains. ERI was also shown to moderate the relationship between exposure to lateral violence and peer difficulties, with children in the high ERI affirmation group showing greater vulnerability than those in the low group. Conclusions The findings of this study are discussed in relation to their potential to inform policy and clinical practice.

The relationship between justice system non-involvement and the social and emotional wellbeing of young Aboriginal and Torres Strait Islander people

Aboriginal and Torres Strait Islander young people are highly overrepresented within the Australian justice system. Despite an increase in research and policies, it is still unclear which interventions, programs and policies are most effective. The aim of the current study was to investigate the relationship between the Social and Emotional Wellbeing (SEWB) of Aboriginal young people and justice system non-involvement from a strengths-based perspective. The sample consisted of 725 Aboriginal adolescents aged 10–15 years who completed The Next Generation Project’s Youth Well-Being Study survey. Logistic regression was conducted to assess the SEWB factors associated with justice system non-involvement. It was found that self-rated good health, positive scores on the Prosocial Scale of the Strengths and Difficulties Questionnaire and younger age were significant predictors of justice system non-involvement. Policies and programs focusing on systems level approaches to support wellbeing in young Aboriginal people are likely to be beneficial.

Weaving Wayapa and cognitive behaviour therapy: applying research topic yarning to explore a cultural interface between Western and Indigenous psychology practice in Australia

ABSTRACT Background Indigenous Psychology within Australia reflects the traditional knowledges of Aboriginal and Torres Strait Islander Peoples and their understanding of the cultivation of relational social and emotional wellbeing (SEWB). However, these perspectives are poorly incorporated into dominant “Western” psychological theories and practice, such as Cognitive Behaviour Therapy (CBT). This represents a barrier to the cultural safety of current mental health practice and its decolonisation within Australia. Objectives This study brought together CBT Practitioners and Practitioners of an Aboriginal Wellbeing practice (“Wayapa”) to engage in a series of yarns (guided focus groups) to share perspectives, insights, and stories on their own and each other’s practices. Method Indigenous qualitative research approaches including Research Topic Yarning were engaged to decolonise the research environment and support dialogue at the cultural interface of the two practices. Results Through experiencing Wayapa, CBT practitioners reflected on gaps in their own practice, with an enthusiasm for the opportunities that Wayapa provided to decolonise their practice. Wayapa practitioners were able to celebrate the holistic nature of their practice and the possibility for it to inform dominant “Western” psychological theories and practice, such as CBT, and encourage a more connected and culturally safe way of working with First Nations peoples. Conclusions Creating safe cultural interfaces between “Western” and Indigenous Psychologies, and building awareness of the value of Aboriginal grounded wellbeing models, can help to promote and expand culturally safe practices within Australian psychological practice.

Getting creative: Using art-based techniques to identify how arts organizations enhance young people’s well-being

Mental health concerns present significant challenges for Australian youth. Arts organizations play a key role in promoting preventative mental health strategies through enhancing the social and emotional well-being (SEWB) of youth. However, little is known about how the arts promote SEWB and the processes and contexts through which this occurs. This article describes a 2021 workshop conducted on the lands of Whadyuk Noongar in Boorloo, Perth, Western Australia as phase 1 of a research project aimed to improve the capacity of arts organizations to promote SEWB. Utilizing tableau, lightbox activities, and focus groups, the workshop employed art-based data-collection to identify approaches used by arts organizations to promote the SEWB of youth. The approaches encompassed developing empowerment and agency, creating safe spaces, connecting, and collaborating and encouraging emotion awareness. Given the high engagement of participants in the data collection process, art-based activities will be used in future phases of the project.

Social and emotional well‐being and economic insecurity of Aboriginal and Torres Strait Islanders: A multidimensional approach

AbstractThis study examines the relative deprivation in the mental health, henceforth referred to as ‘social and emotional well‐being (SEWB)’, of Aboriginal and Torres Strait Islander people in relation to non‐Aboriginal and Torres Strait Islanders. The study uses the multidimensional deprivation methodology to quantify the deprivation in SEWB. The results show wide variation in the relative deprivation of the Aboriginal and Torres Strait Islanders people between the dimensions of SEWB. This study finds robust evidence that the Aboriginal and Torres Strait Islander people experience lower SEWB and higher economic insecurity than the rest and the gap refuses to narrow over time.

Workforce training needs to address social and emotional wellbeing in home-based Aboriginal and Torres Strait Islander aged care.

Objective To explore the training needs of the home care workforce in supporting the social and emotional wellbeing (SEWB) of Aboriginal and Torres Strait Islander peoples receiving aged care services through the Home Care Package (HCP) Program. Methods A mixed-methods design including (1) a focus group and interview with coordinators of HCP Program services for Aboriginal and Torres Strait Islander peoples across metropolitan and rural South Australia in April and June 2022, and (2) a desktop review of training, professional development opportunities and resources for existing and pre-entry workforce addressing the SEWB of Aboriginal and Torres Strait Islander peoples in aged care across the Vocational Education Training and higher education sectors in South Australia, the Australian Indigenous HealthInfoNet, the Department of Health and Aged Care website and aged care email alerts between December 2021 and September 2022. Results Five themes representing workforce training needs were identified: cultural safety, trauma-informed care, case management, compliance with funding rules and preferred formats for training. The desktop review identified a paucity of formal training, professional development and resources within the context of addressing the SEWB of Aboriginal and Torres Strait Islander peoples in aged care. Conclusions These findings suggest that ongoing practice-based professional development learning opportunities are needed within organisations to enhance peer-learning and support. These need to be available together with dedicated formal training programs and practical resources on meeting Aboriginal and Torres Strait Islander peoples' SEWB in aged care.

A Silver Fluoride Intervention to Improve Oral Health Trajectories of Young Indigenous Australians: Protocol for a Cluster Randomized Controlled Trial

Background Indigenous Australian children and adolescents experience profound levels of preventable dental disease. The application of silver fluoride (AgF) to active dental caries is a noninvasive alternative to traditional dental treatment approaches. There is particular utility among Indigenous children and young people with dental fear, who may not have access to timely or culturally safe dental service provisions. Objective The aims of this study are to: (1) assess levels of active dental caries among Indigenous children and young people in 6 Australian states and territories; (2) determine if an AgF intervention reduces levels of active disease over 12-24 months; (3) measure the impact of improved oral health on social and emotional well-being (SEWB) and oral health-related quality of life; and (4) calculate the cost-effectiveness of implementing such an initiative. Methods The study will use a 2-arm, parallel cluster randomized controlled trial design. Approximately 1140 Indigenous children and youth aged between 2 and 18 years will be recruited. Each state or territory will have 2 clusters. The intervention group will receive the AgF intervention at the start of the study, with the delayed intervention group receiving the AgF intervention 12 months after study commencement. The primary outcome will be the arrest of active carious lesions, with arrested caries defined as nonpenetration by a dental probe. Secondary outcomes will include SEWB, oral health-related quality of life, and dental anxiety, with covariates including dental behaviors (brushing and dental visits). Effectiveness measures for the economic evaluation will include the number of children and young people managed in primary oral health care without the need for specialist referral, changes in SEWB, the numbers and types of treatments provided, and caries increments. Results Participant recruitment will commence in May 2023. The first results are expected to be submitted for publication 1 year after a 24-month follow-up. Conclusions Our findings have the potential to change the way in which active dental disease among Indigenous children and young people can be managed through the inclusion of specifically tailored AgF applications to improve dental health and SEWB delivered by Indigenous health care workers. Desired impacts include cost savings on expensive dental treatments; improved SEWB, nutrition, social, and learning outcomes; and improved quality of life for both children and young people and their caregivers and the broader Indigenous community. The AgF application could be easily implemented into the training program of Indigenous health workers and yield critical information in the management armamentarium of health and well-being recommendations for Australia’s First Peoples. International Registered Report Identifier (IRRID) PRR1-10.2196/48558

Reconnecting with the Warrior Within: Australian Indigenous perspectives on the development of a social and emotional wellbeing program.

Australian Indigenous youth are at high risk of developing mental health problems. Historical determinants and socioeconomic disadvantage continue to impact their social and emotional wellbeing (SEWB) and sense of identity. Previous literature suggests connecting to culture significantly impacts SEWB in Indigenous youth. Given the diversity of Indigenous culture, collaboration and consultation with specific cultural groups is required to develop appropriate and relevant psychological treatments for SEWB. The Warrior Within Program was developed to improve SEWB in Indigenous youth by assisting them to better understand their identity through participation in group-based cultural activities. This research aimed to understand Central Queensland Indigenous Development staff perspectives around (1) the process of developing the program and (2) how group-based cultural activities contributed to staff perceived improvements in SEWB of program participants. In this qualitative study, semi-structured individual interviews of 60-90 min were conducted with four Warrior Within Program staff of Central Queensland Indigenous Development. Transcripts were thematically analysed and the subthemes identified were categorised into main themes. The process of developing the Warrior Within Program, cultural and Indigenous identity, reconnecting and knowledge emerged as the four main themes. This study makes a unique and important contribution to the Australian Indigenous literature regarding the role and nature of culture in group-based programs and the importance of collaborating with Indigenous groups to increase our understanding of their usefulness and efficacy. This study also helps to bridge the gap between Indigenous ways of knowing in program development and non-Indigenous methods of evaluation. SO WHAT?: Acknowledging Australian Indigenous methods and ways of knowing are essential to the development and delivery of culturally appropriate group problems for addressing the psychological needs of this population. The methods used in this study could be used by others seeking to legitimise cultural ways of knowing.

Social and emotional wellbeing of Aboriginal and Torres Strait Islander peoples in Aboriginal controlled social housing

BackgroundLittle is known about the wellbeing and aspirations of Aboriginal and Torres Strait Islander peoples living in social housing. Aboriginal and Torres Strait Islander peoples living in social housing face common social housing challenges of low income, higher incidence of mental health issues and poorer health along with specific challenges due to the impacts of colonisation and its ongoing manifestations in racism and inequity. A greater understanding of social and emotional wellbeing needs and aspirations is essential in informing the provision of appropriate support.MethodsSurveys of social and emotional wellbeing (SEWB) were completed by 95 Aboriginal people aged 16 years and older living in Aboriginal Housing Victoria social housing in 2021. The survey addressed a range of domains reflecting social and emotional wellbeing, as defined by Aboriginal and Torres Strait Islander peoples.ResultsMost respondents demonstrated a strong sense of identity and connection to family however 26% reported having 6 or more health conditions. Ill health and disability were reported to be employment barriers for almost a third of people (32%). Improving health and wellbeing (78%) was the most cited aspiration. Experiences of racism and ill health influenced engagement with organisations and correspondingly education and employment.ConclusionStrong connections to identity, family and culture in Aboriginal peoples living in social housing coexist along with disrupted connections to mind, body and community. Culturally safe and appropriate pathways to community services and facilities can enhance these connections. Research aimed at evaluating the impact of strengths-based interventions that focus on existing strong connections will be important in understanding whether this approach is effective in improving SEWB in this population.Trial Registration: This trial was retrospectively registered with the ISRCTN Register on the 12/7/21 with the study ID:ISRCTN33665735.

Social and Emotional Wellbeing of Aboriginal Community Controlled Health Services Staff during the COVID-19 Pandemic.

This study explores the impact of the COVID-19 pandemic on the work and social and emotional well-being (SEWB) of staff at Aboriginal Community Controlled Health Services (ACCHS) in Australia. Between September and November 2021, staff from three ACCHSs in New South Wales completed an online survey to report changes to their roles, concerns about becoming infected with the COVID-19 virus, and job satisfaction in the last month. The survey measured emotional exhaustion and psychological distress by using the Maslach Burnout Inventory-Human Services Survey and Kessler-5 scale, respectively. The survey determined staff's access to SEWB support. Descriptive statistics were calculated for each variable. Among 92 staff from three ACCHSs, 36% reported a COVID-19-related change in their role and 64% were concerned about becoming infected. In spite of the pandemic, most staff (69%) were satisfied with their job. While most staff were not burnt out or psychologically distressed, 25% had high emotional exhaustion and 30% had high to very high psychological distress. Relatedly, 37% had accessed SEWB support at least once in their lifetime and 24% had accessed support in the last month. As the pandemic continues, it is important to identify factors influencing burnout or psychological distress among ACCHS staff and implement evidence-based solutions.

‘Healing through culture’: Aboriginal young people's experiences of social and emotional wellbeing impacts of cultural strengthening programs

BackgroundCultural connection for Aboriginal young people promotes wellbeing, resilience and healing. There is little research on the social and emotional wellbeing (SEWB) impacts of cultural strengthening programs for Aboriginal young people, especially research that includes the perspectives of young people. There is even less research that includes the experiences of Aboriginal young people who have been in out-of-home care. ObjectiveThe current study sought to address these research gaps by exploring the SEWB impacts of cultural strengthening programs by amplifying the voice of Aboriginal young people, including those who have been in out-of-home care. Participants and settingAboriginal young people involved in an innovative cultural strengthening program, the Narrun Yana art collective, established by the Victorian Aboriginal Child Care Agency (VACCA). Also participating was VACCA's Team Leader of Children and Youth Programs, thus providing both experiences of participating in and of organising cultural programs. MethodA qualitative phenomenological approach was taken. Data consisted of semi-structured interviews with the team leader and two young people and written responses to the interview questions from one young person. ResultsLived experience provided evidence that cultural strengthening programs; help strengthen SEWB, including connection to self, relationships, community and culture; contribute to building resilience in the context of intergenerational trauma, cultural loss and racism; and encourage help-seeking, both informal support and accessing mental health services. Young people also viewed participating in the research as worthwhile. ConclusionsFindings highlighted the importance of Aboriginal young people having opportunities to; connect to culture through participation in cultural strengthening programs, and engage in the design of these programs.

Impact on stakeholders of a cultural adaptation of a social and emotional well-being intervention in an Aboriginal community.

Australian Indigenous people conceptualise health broadly as situated within a social and emotional well-being (SEWB) framework. A consultation process with an Aboriginal community revealed that the fundamental principles of the population wide, community-based Act-Belong-Commit mental health promotion Campaign were consistent with Aboriginal people's understanding of SEWB and that a cultural adaptation of the Campaign would be welcomed in the community. The purpose of this paper is to present key stakeholders' feedback on the Campaign adaptation. Two years after implementation of the Campaign, individual in-depth interviews were conducted with a purposeful sample of n = 18 Indigenous and non-Indigenous stakeholders to identify ongoing issues in the community and assess their reactions to the Campaign implementation and perceptions of the effects of the Campaign on the community. The two primary factors influencing stakeholder acceptance of the Campaign in the community were (i) the nature of the consultation process that clearly acknowledged that it was for the community to decide whether or not to adopt the Campaign and (ii) the ability of the Aboriginal Project Manager to gain the trust of the community, bring stakeholders together and illustrate the Act-Belong-Commit principles in her actions in the community. Stakeholders reported observing social and emotional well-being benefits for individuals, their families and the whole community. Overall, the results suggest that the Act-Belong-Commit mental health promotion Campaign can be successfully culturally adapted as a community-based, social and emotional well-being Campaign in Aboriginal and Torres Strait communities. SO WHAT?: The Act-Belong-Commit cultural adaptation in Roebourne provides an evidence-based best practice model for the development of culturally appropriate mental health promotion campaigns in Indigenous communities around Australia.

Development of a youth version of the Here and Now Aboriginal Assessment (HANAA-Y) tool

IntroductionAssessment of social and emotional wellbeing (SEWB) of Aboriginal people is challenging. A The culturally appropriate screening instrument for SEWB in Aboriginal adults entitled Here and Now Aboriginal Assessment (HANAA), has been developed and evaluated. The HANAA explores ten key domains and adopts a yarning process to initiate a semi-structured interview that covers each domain. This is recorded in narrative form and each domain rated as ‘problem’ or ‘no problem’ and a ‘recommended action’ is determined. The HANAA is widely used by Aboriginal mental health service providers around Australia.ObjectivesThere have been multiple requests by service providers for a similar instrument to be developed for young Aboriginal people. This study aims to develop a youth version of the instrument abbreviated as HANAA-Y.MethodsA Working Group comprised of Aboriginal and non-Aboriginal psychiatrists and mental health professionals with expertise of SEWB in Aboriginal youth was established and a draft version of the HANAA-Y has been produced. Evaluation od cultural applicability, reliability and validity of HANAA-Y is underway in metropolitan, rural and remote locations across Australia.ResultsThe original HANAA structure, yarning style, and rating has been retained. However, new domains and probe words relevant to young people have been selected. The new domains are as follows: somatic complaints; emotional issues; suicide risk and self-harm; alcohol and drug use; cognition and activity; behavioural and legal issues; strange thoughts and unusual experiences; functioning; stressful life events; and resilience and healing. The HANAA-Y administration guidelines have also been amended to be of relevance to Aboriginal youth.ConclusionsIt is expected that HANAA-Y will be a culturally appropriate and useful instrument which can be used by a range of service providers with differing levels of mental health training to screen for SEWB among young Aboriginal people.Disclosure of InterestNone Declared

Lessons Learned during a Rapidly Evolving COVID-19 Pandemic: Aboriginal and Torres Strait Islander-Led Mental Health and Wellbeing Responses Are Key.

As the world journeys towards the endemic phase that follows a pandemic, public health authorities are reviewing the efficacy of COVID-19 pandemic responses. The responses by Aboriginal and Torres Strait Islander communities in Australia have been heralded across the globe as an exemplary demonstration of how self-determination can achieve optimal health outcomes for Indigenous peoples. Despite this success, the impacts of pandemic stressors and public health responses on immediate and long-term mental health and wellbeing require examination. In December 2021, Aboriginal and Torres Strait Islander mental health and wellbeing leaders and allies (N = 50) attended a virtual roundtable to determine the key issues facing Aboriginal and Torres Strait Islander peoples and communities, and the actions required to address these issues. Roundtable attendees critically reviewed how the rapidly evolving pandemic context has impacted Aboriginal and Torres Strait Islander mental health and social and emotional wellbeing (SEWB). This paper presents an overview of this national collaborative consultation process, and a summary of the key issues and actions identified. These results build on evidence from other roundtables held in Australia during 2020, and the emerging consensus across the globe that Indigenous self-determination remains essential to Indigenous SEWB, especially during and following a pandemic.

Aboriginal Young People's Experiences of Accessibility in Mental Health Services in Two Regions of New South Wales, Australia.

This article assesses the accessibility of mainstream mental health services (MMHSs) in two regions of New South Wales (NSW), Australia, based on experiences and perspectives of Aboriginal young people aged 16-25. Semi-structured yarning interviews were conducted with thirteen Aboriginal young people in two regions of NSW. Thematic analysis was undertaken by all research team members to identify major themes from the data and conceptual connections between them. The identified themes from individual analysis and coding were triangulated during several analysis meetings to finalise the key themes and findings. Aboriginal young people had no experience of engaging with early-intervention MMHSs. MMHSs were identified as inaccessible, with most participants unaware that MMHSs existed in each region. Due to MMHSs being inaccessible, many Aboriginal young people presented to emergency departments (EDs) during a crisis. Aboriginal Community Controlled Health Services (ACCHSs) were identified as key providers of accessible, culturally meaningful, and effective social and emotional wellbeing (SEWB) service support for Aboriginal young people in NSW. If health and wellbeing outcomes are to improve for Aboriginal young people in NSW, MMHSs must increase accessibility for Aboriginal young people requiring SEWB support.

‘It’s Us, Or Maybe No One’: Yarning With Aboriginal Social and Emotional Wellbeing Workers From the Kimberley Region of Western Australia

Objective Social and Emotional Wellbeing (SEWB) describes the holistic model of health and wellbeing advocated for by Aboriginal and Torres Strait Islander peoples. This research explored the experiences of Aboriginal peoples employed in SEWB service delivery to identify enablers, challenges, and requirements of growing a sustainable, and empowered SEWB workforce. Methods We used a yarning methodology with seven Aboriginal SEWB workers located at Aboriginal Community Controlled Health Organisations across the Kimberley region of Western Australia. Results Three key SEWB service delivery themes were identified: 1) Role of cultural identity; 2) Barriers and enablers of SEWB service provision; 3) Building the future of the SEWB workforce. Lessons Learned SEWB services, as delivered by Aboriginal peoples within Aboriginal Community Controlled Health Organisations, have great potential to comprehensively meet the health and wellbeing needs of Aboriginal peoples and communities. To optimally undertake their role, Aboriginal SEWB staff need to: have a clear understanding of their role; good relationships within their workplace; relevant sector knowledge; a strong sense of cultural safety within the workplace; and access to meaningful professional development. Understanding the barriers and enablers experienced by SEWB staff provides a platform to meaningfully develop the future Aboriginal SEWB workforce, and delivery of SEWB services.

SUPPORTING OUR SISTAS INSIDE: ANFPP WORKING WITH WOMEN IN CUSTODY

The current statistics of the incarceration of Aboriginal and Torres Strait Islander women and the subsequent impact on their health and well-being are appalling. When referring to the health and wellbeing of our mob it must be recognised and understood that connection to land, culture, ancestry, kinship and community play a vital role in our physical, social and emotional health and wellbeing. This calls for culturally-safe models of care to support and advocate for these women in custody in collaboration with Aboriginal Community Controlled Health Organisations (ACCHOs) to address health and social and emotional wellbeing (SEWB), and to break the cycle of incarceration.1

YArnhem: Co-designing a model of social and emotional wellbeing stepped care for young people of the north east Arnhem region: A development study protocol.

More Aboriginal and Torres Strait Islander young people experience high or very high levels of psychological distress compared to their non-Indigenous counterparts. This may be partly attributed to systemic barriers resulting in lower rates of help-seeking, sub-optimal identification of psychological challenges, and undertreatment. Reducing these barriers within health systems is an important factor in reducing the Social and Emotional Wellbeing (SEWB) health burden on young Aboriginal and Torres Strait Islander people. In partnership with Miwatj Health Aboriginal Corporation (Miwatj), this project will co-design an integrated youth Social and Emotional Wellbeing (SEWB) and mental health stepped care model for remote Aboriginal communities in the north east Arnhem region of the Northern Territory. A collaborative research approach using co-design methods will underpin a community-centric stepped care allocation method, to which culturally appropriate SEWB and mental health interventions and treatments are assigned. These components of the project will inform a digital platform which will facilitate access to SEWB care for young people in north east Arnhem land. This concept was co-developed in a partnership between researchers and Miwatj and builds on Miwatj's previous work to map the stepped needs of young people. The co-design of the content and features of these outputs will be facilitated through community participation and overseen by community, health, and cultural governance structures. This will ensure the solutions developed by the project are culturally responsive, fit for purpose, and will enhance self-determination while reducing systemic barriers to care.