Today, punitive systems criminalize substance use and impose biomedical models without acknowledging cultural context. Addiction in Indigenous communities stems from trauma, not individual failure. A comprehensive shift is possible if we embrace the Indigenous Determinants of Health (IDH) as a holistic approach to Indigenous health. Mental health justice must be more than inclusive. When Western systems fail to see this, they don’t just offer inadequate care.

To the best of our knowledge, most of the studies did not report a plan to follow-up with the community after the intervention, ways to disseminate findings, or plans to apply findings to future program or policy. The observations in our review support the establishment and uptake of reporting guidelines for Indigenous health research to improve both the implementation and description of research. Also, ‘mental health and mental disorder’, keywords in our search strategy, were keywords in articles on SEWB (Calma et al., 2017; Gee et al., 2014). As our search terms did not include ‘social and emotional wellbeing’, relevant studies from Australia may have been missed.

How can policy changes address Indigenous mental health disparities?

• A 2020 study outlined the complicated link between contributing factors and depression and anxiety among AIANs.
• Six were rated moderate, meaning a 60–79% follow-up rate or non-applicability due to study design, and the remaining 12 were weak as they provided no reasons for their withdrawals and dropouts or because follow-up rates were less than 60%.
• When contemplating strategies and actions that a community-led health promotion initiative could design and ultimately provide, a true measure of success can only be determined when an initiative, in its entirety, is viewed through an Indigenous framework to health and mental wellness.
• Active participation in caring for Country was found to improve social and emotional wellbeing6 through revitalisation and healing,48,59,63,64 and environmental stewardship or land management,28,29,40,57,58,65, 66, 67, 68 such as park ranger programs.69,70 Redvers41 notes the positive impact of a land-based healing camp in Canada for those facing substance abuse and homelessness.
• The IHS is housed within the Department of Health and Human Services and tasked with upholding federal responsibility and providing health care services to tribal communities (IHS, 2018a).

Achieving person-centred positive outcomes can be enhanced by framing health promotion through a lens of IK and ways of sustainment (Walters et al., 2020). The rationale for this is that Indigenous Peoples have had their cultural ways of being eroded and dismantled by their lived experience under generations of colonial assimilation (Walter et al., 2020). Although a substantial foundation of health promotion research and intervention programming is available to reference and build upon, this research and program development has classically been framed using a non-Indigenous lens, leading to suboptimal outcomes (Walter et al., 2020). This concept helps us understand where the community has come from, which is an essential step in understanding where it will endeavour to go. It is important to recognize that mental illness is a barometer or litmus test that directly demonstrates the outcome of stress and distress on an individual’s or a community’s current level of coping and resilience. Cultural and ethnic erosion has also been strongly connected to an increased risk of suicide among Indigenous youth as they have migrated away from traditional lands and practices into forced settlements and artificial social structures (Cianconi et al., 2019).

Enhancing decision-making in suicide risk assessment through the application of the Narrative Crisis …

The Division of Behavioral Health, within the Office of Clinical and Preventive Services, provides integrated health and wellness services that are holistic and culturally appropriate. The last 30 years have seen the development of innovative approaches to addressing alcohol/substance use, social services, and mental health issues. But there are contributing factors — such as historical trauma, racism, and disparities in healthcare access — that make them more likely to experience mental health conditions.

Assessment criteria were selection bias, study design, confounding, blinding, data collection, and withdrawal and dropouts. The studies were appraised using the Effective Public Health Practice Project (EPHPP) quality assessment tool (Armijo-Olivo et al., 2012) by two independent reviewers, and conflicts were resolved with a third reviewer and through discussions (Supplemental Table S2). Bibliographic information, study design, setting and study period, recruitment, eligibility criteria, sample size, and response and follow-up rates were collected.

In addition, some AIAN researchers note that the very understanding of mental health must be reevaluated when applied to these individuals and communities. A 2016 study found that 70% of AIAN men and 63% of AIAN women will meet the diagnostic criteria for at least one mental health condition over the course of their lifetime. Native American and Indigenous peoples face unique mental health challenges, but they also have unique protective factors preventing https://www.bet.com/article/n1rvpe/suicide-and-young-black-men-why-the-brothers-feel-alone them from developing certain symptoms. Therefore, interventions and policy changes for improving Indigenous mental health should aim to promote cultural continuity, self-determination and self-governance. Funding and resources are integral to supporting self-determination and cultural continuity in many Indigenous communities (Auger et al., 2016; First Nations Health Authority, 2018).