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There are significant disparities in mental health care between First Nations and non-Indigenous people in settler-colonial nations. This paper, authored by a crosscultural and interdisciplinary team, argues that settler-colonial legislation, the tools and technologies of architecture, and the clinical practice of psychiatry are all implicated. Taking inspiration from Tanganekald, Meintangk-Bunganditj legal scholar Irene Watson, who yearns for freedom to roam across Country and connect with the land of her ancestors, we propose tactics for 'roaming' from the conventions of architecture and psychiatry to decolonize our practices. These include yarning, walking Country, and representing these itinerant practices through wandering lines. The outcomes are processes for developing new therapeutic places and practices for mental health care. [ABSTRACT FROM AUTHOR]

Objective: 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. Methods: 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. Results: 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. Conclusions: 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. [ABSTRACT FROM AUTHOR]

The extant literature has scant detail about everyday spiritual practices that aid Indigenous young people. This paper systematically explores Indigenous Spirituality, health, and well-being through Elder-governed yarns conducted via Zoom with 44 Aboriginal Elders, Healers, and Senior and Junior people involved in health and well-being of the Victorian Aboriginal community. These yarns were analyzed through an innovative, constructivist, multi-perspectival discursive grounded theory method. Key findings are that Spirituality is crucial for health and well-being, leading to a clear mind and at-peace “center” in a person. Aboriginal spiritual practices reflect the unique characteristics and essential rhythms of Country. Spiritual development is incremental and increases the obligations and responsibilities a person has to community and Country and leads to increased caring for Country. This paper provides rich detail about practical spiritual techniques to aid Indigenous young people and their kinship networks. It has the potential to shape future policy. [ABSTRACT FROM AUTHOR]

A 10-year review of the 2008 Council of Australian Governments’ (COAG) Close the Gap Strategy identified the lack of involvement of Indigenous people in developing policies as a key reason health disparities persist. It also posits that disconnection from Country and culture have been crucial factors. Physical and mental health cannot be separated from spiritual health and well-being amongst Indigenous Australians. This article describes the co-development of a cultural enrichment research study with Indigenous Elders, health service leaders, and community members that places culture at the centre of care to augment traditional Western mental health management. The study has been overseen and nurtured from its inception by a governance board of Traditional Custodian Elders and an Advisory Group of Indigenous health workers. Qualitative data were collected through community ‘zoom-yarns’ between an Indigenous research assistant and 44 community members during COVID-19 lockdowns. These yarns were analysed through an innovative, constructivist, multi-perspectival discursive grounded theory method. Findings have led to an Elder-governed adjuvant cultural therapy which is currently being trialled and will be evaluated using the same multi-perspectival discursive grounded theory research methodology. One third of all Indigenous Australians now live in capital cities, so developing models to bring culture and Country into urban health facilities are becoming increasingly important. The Indigenous-led research approach outlined in this paper suggests a model for engaging Indigenous communities that mainly distrust Western research and have been failed by Western mental health care. It has the potential to shape future policy. [ABSTRACT FROM AUTHOR]

Objective: Recently, Indigenous academics have evolved an Indigenist discourse that centralises Indigenous 'ways of knowing, being and doing'. Through this dialogue, Indigenous 'ways of knowing and being' augment Western biopsychosocial treatments.Methods: This paper outlines the authors' clinical encounters with young people from the Koori community and ongoing consultation with Koori community Elders in Victoria that led to engaging young people and their families in an Indigenist dialogue.Results: The Indigenist dialogue facilitates deeper engagement in the therapeutic process, opportunities to mirror and reflect on young people's experiences, and drawing parallels between Western health interventions and Aboriginal cultural ways of doing health and being healthy.Conclusions: The young people and their families evince greater faith in the management process and a deeper focus, centred awareness and knowledge of their Cultural rights and responsibilities. Future developments should include a systematic database with qualitative and quantitative data to support its evaluation and iterative development and improved community engagement to ensure holistic health gains are maintained. [ABSTRACT FROM AUTHOR]