Despite decades of evidence showing that institutional and interpersonal racism serve as significant barriers to accessible healthcare for Aboriginal and Torres Strait Islander Peoples, attempts to address this systemic problem still fall short. The social determinants of health are particularly poignant given the socio-political-economic history of invasion, colonisation, and subsequent entrenchment of racialised practices in the Australian healthcare landscape. Embedded within Euro-centric, bio-medical discourses, Western dominated healthcare processes can erase significant cultural and historical contexts and unwittingly reproduce unsafe practices. Put simply, if Black lives matter in healthcare, why do Aboriginal and Torres Strait Islander Peoples die younger and experience ‘epidemic’ levels of chronic diseases as compared to white Australians? To answer this, we utilise critical race perspectives to theorise this gap and to de-center whiteness as the normalised position of ‘doing’ healthcare. We draw on our diverse knowledges through a decolonised approach to promote a theoretical discussion that we contend can inform alternative ways of knowing, being, and doing in healthcare practice in Australia.

Aboriginal and Torres Strait Islander Australians experience high rates of mental illness and psychological distress compared to their non-Indigenous counterparts. E-mental health tools offer an opportunity for accessible, effective, and acceptable treatment. The AIMhi Stay Strong app and the ibobbly suicide prevention app are treatment tools designed to combat the disproportionately high levels of mental illness and stress experienced within the Aboriginal and Torres Strait Islander community. This study aimed to explore Aboriginal and Torres Strait Islander community members' experiences of using two culturally responsive e-mental health apps and identify factors that influence the acceptability of these approaches. Using qualitative methods aligned with a phenomenological approach, we explored the acceptability of two culturally responsive e-mental health apps through a series of three 3-hour focus groups with nine Aboriginal and Torres Strait Islander community members. Thematic analysis was conducted and coresearcher and member checking were used to verify findings. Findings suggest strong support for the concept of e-mental health apps and optimism for their potential. Factors that influenced acceptability related to three key themes: personal factors (eg, motivation, severity and awareness of illness, technological competence, and literacy and language differences), environmental factors (eg, community awareness, stigma, and availability of support), and app characteristics (eg, ease of use, content, graphics, access, and security and information sharing). Specific adaptations, such as local production, culturally relevant content and graphics, a purposeful journey, clear navigation, meaningful language, options to assist people with language differences, offline use, and password protection may aid uptake. When designed to meet the needs of Aboriginal and Torres Strait Islander Australians, e-mental health tools add an important element to public health approaches for improving the well-being of Aboriginal and Torres Strait Islander people.

Background: Global research has found that prevalence rates of child sexual abuse suggest that this is a significant ongoing public health concern. A recent Australian study, for example, revealed that more than three girls and almost one in five boys reported experiencing sexual abuse before the age of 18. Self-reported rates of abuse, however, far exceed official figures, suggesting that large numbers of children who experience sexual abuse do not come to the attention of relevant authorities. Whether and how those children have tried to tell their stories remains unclear. Objective: The goal of the review was to explore scholarly literature to determine what was known about what enables or constrains children to disclose their experience of sexual abuse. Method: A systematic scoping review was undertaken to better understand the current state of knowledge in the scholarly literature on child sexual abuse disclosure. Thirty-two scholarly publications were included for analysis following a rigorous process of sourcing articles from five databases and systematically screening them based on transparent inclusion and exclusion criteria. Ecological systems and trauma-informed theoretical paradigms underpinned an inductive thematic analysis of the included manuscripts. Results: Three multi-dimensional themes were identified from the thirty-two publications. These themes were: factors enabling disclosure are multifaceted; barriers to disclosure include a complex interplay of individual, familial, contextual and cultural issues; and Indigenous victims and survivors, male survivors, and survivors with a minoritised cultural background may face additional barriers to disclosing their experiences of abuse. Conclusions: The literature suggests that a greater understanding of the barriers to disclosures exists. Further research that supports a deeper understanding of the complex interplay of enablers and the barriers to disclosure across diverse populations is needed. In particular, future research should privilege the voices of victims and survivors of child sexual abuse, mobilising their lived experiences to co-create improved practice and policy.

This paper describes the first six years of a government-initiated project to train Indigenous health professionals in digital mental health (d-MH). It illustrates how community-based participatory research (CBPR) methods were used to enable this “top-down” project to be transformed into a ‘ground-up’ community-guided process; and how, in turn, the guidance from the local Indigenous community partners went on to influence the national government’s d-MH agenda. The CBPR partnership between five community partners and a university rural health department is described, with illustrations of how CBPR harnessed the community’s voice in making the project relevant to their wellbeing needs. The local Indigenous community’s involvement led to a number of unexpected outcomes, which impacted locally and nationally. At an early stage, the conceptual framework of the project was changed from d-MH to the culturally-relevant Indigenous framework of digital social and emotional wellbeing (d-SEWB). This led to a significant expansion of the range and type of digital resources; and to other notable outcomes such as successful advocacy for an Aboriginal-specific online therapy program and for a dedicated “one-stop-shop” d-SEWB website, Wellmob, which was funded by the Australian government in 2019–2021. Some of the implications of this project for future Indigenous CBPR projects are discussed.

Child sexual abuse is a pervasive social and public health concern with high social and economic costs. Children and young people who experience this form of abuse are in danger of serious, ongoing impacts on their development, functioning and overall life trajectory as a result of the lasting influence of complex trauma. The recent research, drawing from young adult self‐reports, has found that more than one in three girls and almost one in five boys have experienced child sexual abuse. These alarming figures are not, however, matched by official data reporting rates of substantiated child sexual abuse cases. It is possible that a sizeable proportion of children who have experienced sexual abuse may not be coming to the attention of authorities and, consequently, may not have their needs being met in a timely way, including their need for safety. A question about the disclosure of child sexual abuse emerges, specifically whether, how and to whom children can tell about what has happened or is happening to them. This paper reports on a study focussing on the disclosure of child sexual abuse, based on in‐depth individual interviews with 51 adult victim survivors of child sexual abuse. Findings revealed that most interview participants disclosed a multitude of times before being heard and having their disclosures acted upon. Some were never heard. A thematic inductive analysis is presented and discussed, and recommendations are made for policy and practice reform.

Background: In Australia, mental health services are undergoing major systemic reform with eMental Health (eMH) embedded in proposed service models for all but those with severe mental illness. Aboriginal and Torres Strait Islander service providers have been targeted as a national priority for training and implementation of eMH into service delivery. Implementation studies on technology uptake in health workforces identify complex and interconnected variables that influence how individual practitioners integrate new technologies into their practice. To date there are only two implementation studies that focus on eMH and Aboriginal and Torres Strait Islander service providers. They suggest that the implementation of eMH in the context of Aboriginal and Torres Strait Islander populations may be different from the implementation of eMH with allied health professionals and mainstream health services. Objective: The objective of this study is to investigate how Aboriginal and Torres Strait Islander service providers in one regional area of Australia used eMH resources in their practice following an eMH training program and to determine what types of eMH resources they used. Methods: Individual semistructured qualitative interviews were conducted with a purposive sample of 16 Aboriginal and Torres Strait Islander service providers. Interviews were co-conducted by one indigenous and one non-indigenous interviewer. A sample of transcripts were coded and thematically analyzed by each interviewer and then peer reviewed. Consensus codes were then applied to all transcripts and themes identified. Results: It was found that 9 of the 16 service providers were implementing eMH resources into their routine practice. The findings demonstrate that participants used eMH resources for supporting social inclusion, informing and educating, assessment, case planning and management, referral, responding to crises, and self and family care. They chose a variety of types of eMH resources to use with their clients, both culturally specific and mainstream. While they referred clients to online treatment programs, they used only eMH resources designed for mobile devices in their face-to-face contact with clients. Conclusions: This paper provides Aboriginal and Torres Strait islander service providers and the eMH field with findings that may inform and guide the implementation of eMH resources. It may help policy developers locate this workforce within broader service provision planning for eMH. The findings could, with adaptation, have wider application to other workforces who work with Aboriginal and Torres Strait Islander clients. The findings highlight the importance of identifying and addressing the particular needs of minority groups for eMH services and resources.