King's College London

1. To engage Indigenous community stakeholders, including Indigenous adolescents, teachers, community health workers (ICHWs), nurses, social workers, village leaders, community champions, and policy actors in a collaborative process to maximise the effectiveness of a culturally adapted evidence-based adolescent mental health (MH) programme;
2. To build the capacity of Indigenous community stakeholders to promote culturally adapted MH messages to raise awareness of the importance of good MH, prevention, and treatment; and teachers, social workers, ICHWs and primary health care (PHC) nurses to identify and manage common adolescent MH problems, using culturally adapted WHO mental health Gap Action Programme – Implementation Guide (mhGAP-IG);
3. To understand how the Indigenous contexts influence implementation strategies and outcomes;
4.  To disseminate findings at community, national, regional and policy levels in collaboration with Indigenous adolescents and older youths.

Our study includes 4 Work Packages (WP):

WP1 - Partnership and co-development: establish an Indigenous Adolescent Stakeholder Group (ASG) and a Stakeholder Implementation Group (SIG) at each site; co-develop culturally adapted evidence-based positive messages to be promoted during school and village activities; co-adapt the WHO’s Mental Health Gap Action Plan – Intervention Guides (mhGAP-IG) integrating culturally centred knowledge and customs.

WP2 - Training implementors: train teachers, Indigenous community health workers (ICHWs) and community champions to embed the MH promotion messages, co-developed in
WP1, in community activities; use the adapted mhGAP-IG to train ICHWs and primary health care (PHC) practitioners to identify and manage common adolescent MH problems.

WP3 - Programme evaluation: include ~1400 pupils aged 10-18 yrs in schools, local community clubs and PHC Centres and conduct mixed-method case studies to gain in-depth understanding of context and linkages affecting processes and outcomes (including MH, risk behaviours, general health); conduct site-specific programme economic evaluations.

WP4 - Knowledge exchange and impact: support Indigenous adolescents to contribute to multi-media dissemination; support ASG and SIG on using findings for strengthening the responsiveness of their schools and PHC.

We focus on the prevention of MH disorders at a critical stage of the life course among Indigenous adolescents. Addressing health equity is also key . Nowhere is this more pertinent than for Indigenous adolescents who face the challenge of a legacy of social injustices and poor health. We are deeply aware that there has been a historic imposition of western-based research agendas on Indigenous communities. Our participatory methodologies and knowledge co-production are based on Indigenous worldviews. Longstanding partnerships between our research team and Indigenous communities allow us to explore an ambitious programme that spans education, health and community sectors.