Objective: To describe Aboriginal community members' perspectives on the outcomes and origins of resilience among Aboriginal children. Methods: Face-to-face interviews were conducted with 36 Aboriginal adults (15 health service professionals, 8 youth workers and 13 community members) at two urban and one regional Aboriginal Community Controlled Health Service in New South Wales. Interviews were transcribed and analysed thematically. Results: We identified six themes: withstanding risk (displaying normative development, possessing inner fortitude); adapting to adversity (necessary endurance, masking inner vulnerabilities); positive social influences (secure family environments, role modelling healthy behaviours and relationships); instilling cultural identity (investing in Aboriginal knowledge, building a strong cultural self-concept); community safeguards (offering strategic sustainable services, holistic support, shared responsibility, providing enriching opportunities); and personal empowerment (awareness of positive pathways, developing self-respect, fostering positive decision making). Conclusions: Community members believed that resilient Aboriginal children possessed knowledge and self-belief that encouraged positive decision making despite challenging circumstances. A strong sense of cultural identity and safe, stable and supportive family environments were thought to promote resilient behaviours. Implications for public health: Many Aboriginal children continue to face significant adversity. More sustainable, Aboriginal-led programs are needed to augment positive family dynamics, identify at-risk children and provide safeguards during periods of familial adversity.

Objectives: To estimate the prevalence and determine protective factors for resilience in urban Aboriginal adolescents. Methods: Cross‐sectional survey data was collected from 119 Aboriginal adolescents participating in the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Resilience was defined as having ‘low‐risk’ Strengths and Difficulties Questionnaire scores on the total difficulties (range: 0–40) or the prosocial scale (range: 0–10). Results: Most adolescents scored in the low‐risk range of the total difficulties (n=85, 73%) and prosocial scales (101, 86%). Family encouragement to attend school was associated with a 4.3‐point reduction in total difficulties scores (95%CI, 0.22–8.3). Having someone to talk to if there was a problem and regular strenuous exercise were associated with higher scores on the prosocial behaviour scale, increasing scores by 1.2 (95%CI, 0.45–2.0) and 1.3 (95%CI, 0.26–2.3) points, respectively. Conclusions: Most adolescents in SEARCH displayed resilience. Resilience was associated with nurturing family environments, social support and regular exercise. Implications for public health: Our data accords with previous research that demonstrates resilience, but also a higher prevalence of emotional and behaviour problems among Aboriginal youth. Supporting Aboriginal young people to build resilience may promote better mental health outcomes leading to important public health benefits.

Indigenous children living in high income countries have a consistently high prevalence of mental health problems. We aimed to identify psychosocial risk and protective factors for mental health in this setting. A systematic review of studies published between 1996 and 2016 that quantitatively evaluated the association between psychosocial variables and mental health among Indigenous children living in high income countries was conducted. Psychosocial variables were grouped into commonly occurring domains. Individual studies were judged to provide evidence for an association between a domain and either good mental health, poor mental health, or a negligible or inconsistent association. The overall quality of evidence across all studies for each domain was assessed using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) guidelines. Forty-seven papers were eligible (mainland US 30 [64%], Canada 8 [17%], Australia 7 [15%], Hawaii 4 [9%]), including 58,218 participants aged 4–20 years. Most papers were cross-sectional (39, 83%) and measured negative mental health outcomes (41, 87%). Children’s negative cohesion with their families and the presence of adverse events appeared the most reliable predictors of increased negative mental health outcomes. Children’s substance use, experiences of discrimination, comorbid internalising symptoms, and negative parental behaviour also provided evidence of associations with negative mental health outcomes. Positive family and peer relationships, high self-esteem and optimism were associated with increased positive mental health outcomes. Quantitative research investigating Indigenous children’s mental health is largely cross-sectional and focused upon negative outcomes. Indigenous children living in high income countries share many of the same risk and protective factors associated with mental health. The evidence linking children’s familial environment, psychological traits, substance use and experiences of discrimination with mental health outcomes highlights key targets for more concerted efforts to develop initiatives to improve the mental health of Indigenous children.

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.