Film-based cultural narrative intervention to enhance mental health literacy and resilience in indigenous adolescents: a mixed-methods co-design study

Background Indigenous adolescents in low- and middle-income countries experience heightened mental health risks while having limited access to culturally appropriate interventions. Mental health literacy, stigma, and resilience are critical determinants of help-seeking and long-term well-being, yet culturally grounded interventions addressing these factors remain scarce. Objective This study aimed to co-design and evaluate a culturally sensitive, film-based intervention to improve mental health literacy, reduce stigma, and enhance resilience among Indigenous adolescents in Indonesia. Methods This study employed a mixed-methods sequential exploratory design. A 20-minute short film co-created with Indigenous youth and grounded in local narratives was delivered alongside a facilitated group discussion. Seventy-two Indigenous adolescents (mean age 15.4 years; 52.8% female) were assigned to an intervention group ( n = 36) or a control group ( n = 36). Post-intervention outcomes were analyzed using ANCOVA, and qualitative feedback was analyzed thematically. Results The intervention group showed significant improvements in mental health literacy, substantial reductions in stigma, and moderate gains in resilience compared with controls ( p < 0.01). Large effect sizes were observed for literacy and stigma, and a moderate effect was found for resilience. Qualitative findings revealed four themes: cultural resonance and identity affirmation, emotional insight and relatability, empowerment and help-seeking motivation, and collective reflection and peer solidarity. Conclusions A co-designed, film-based intervention effectively improved mental health literacy, reduced stigma, and enhanced resilience among Indigenous adolescents. This culturally grounded and scalable approach offers a promising strategy for mental health promotion in marginalized communities, warranting further evaluation with larger samples and longer follow-up.