Wellbeing and mental health interventions for Indigenous children and youth: A systematic scoping review.

• Published evidence about mental health interventions for Indigenous children and youth is limited. • There are few evaluations of interventions that show what works. • There was little explanation of leadership by Indigenous people and paradigms. • Strategies targeted intersectoral systems, workforce skills, program quality and client care. • Outcomes included improved appropriateness, quality and effectiveness. • More Indigenous-led investigations of wellbeing interventions are needed. Key policy directives from Canada, Australia, New Zealand, Norway and the United States (CANNZUS countries) highlight the importance of addressing the unique and complex wellbeing and mental health needs of Indigenous school-aged children and youth. This systematic scoping review of the peer reviewed and grey literature identifies the extant evidence about the conditions, strategies and impacts of wellbeing and mental health screening, management and referral pathways for Indigenous children and youth in CANNZUS countries. A search for peer reviewed and grey literature was conducted of 17 electronic databases and 13 clearinghouses and websites in each of the included countries. Search results were imported into Endnote X9 with titles and abstracts screened against inclusion criteria. The full texts of selected publications were screened by at least two blinded reviewers. Data extracted from the full texts included: authorship, year and publication type; country, target group, sample size and intervention setting, intervention type and study design, outcome measures and reported outcomes. The searches produced 3223 peer reviewed and 278 grey literature publications (after duplicates were removed) giving a total of 3501 references. Screening resulted in 15 papers arising from 14 intervention studies in primary health care services, education, juvenile justice and community settings. Only 9 of the 15 publications evaluated an intervention; 6 were program descriptions. The review identified four key approaches to improve wellbeing and mental health care for Indigenous children and youth – cross-service collaboration, professional education, intervention quality and appropriateness, and enhancing direct service provision pathways. Intervention outcomes included acceptability, appropriateness and effectiveness. The small number of studies found suggests that this research niche area is still in development, with few evaluations of interventions. Identification of interventions within the four broad strategy areas is useful, and the review has some value in guiding the tailored development of interventions in other sites. Further Indigenous-led investigations of wellbeing are needed to identify what works to improve wellbeing and mental healthcare for Indigenous children and youth. [ABSTRACT FROM AUTHOR]