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Objective: Statements such as the Bridgetown Declaration 1 serve as a wake-up call for action to address the significant mental health needs in small island developing states. Overarching frameworks and action plans have been developed to support nations to promote mental health and build resilience for their populations in the region, and while these frameworks and action plans provide direction, translating them into grassroots change can be a challenge. At the Creating Futures 23 conference, delegates from the Oceania region were invited to participate in a plenary workshop entitled Framing the Future. Three questions were posed for workshop participants to respond to in relation to their perceived priorities, opportunities and innovations to support mental health in their local communities. This paper provides a summary of the workshop participants' responses., Conclusion: Community-led innovations, with programs tailored for small island communities, were seen as grassroots solutions in the Oceania region. Engagement with small island communities by policy makers and leaders was considered essential for effective, sustainable and community-led mental health initiatives to realise the objectives of high-level, overarching frameworks and action plans., Competing Interests: DisclosureThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.