Measurement of social and emotional wellbeing and mental health outcomes in first nations children: A systematic review

Background There is a critical lack of reliable, high‐quality epidemiological data on mental health and/or social and emotional wellbeing (SEWB) outcomes for First Nations children, partly, due to the limited availability of culturally valid assessment tools. This review aims to assess the cultural validity of mental health and SEWB assessment tools used with First Nations children aged 4–12 years in Australia, and identify gaps, strengths, and opportunities for reform that enhance cultural safety, and self‐determination in assessment practices. Methods A systematic search of five electronic databases (Web of Science, PubMed, PsycINFO, Informit, and CINAHL) identified English‐language studies (1980–2025) assessing mental health or SEWB in Aboriginal and/or Torres Strait Islander children aged 4–12 years. Data on assessment tools were extracted and their cultural validity analysed using the First Nations Cultural Validity Assessment Tool. Tools were classified, as bespoke, culturally adapted or generic, using the CBSPATSISP definitions. Results This review examined the cultural validity across 10 studies, including 11 unique tools and 16 assessments of cultural validity. Three tools were bespoke, eight culturally adapted, and five generic. Over three quarters of tools used to assess SEWB or mental health in First Nations children had poor or limited cultural validity. Two bespoke SEWB tools were identified, although none specifically targeted mental health. Conclusion Culturally valid assessment tools for First Nations children remain limited, with research predominantly relying on inappropriate measures. Improving the measurement of mental health and SEWB outcomes requires a shift towards First Nations‐led, co‐designed tools grounded in Indigenous knowledges, strengths, and cultural frameworks. The evidence base was limited by reliance on published academic sources, which may have missed community‐used assessment tools, a focus on cultural validity rather than broader study quality, and limited psychometric reporting for some First Nations‐specific measures. Trial Registration PROSPERO (CRD42024542866). 13 May 2024. www.crd.york.ac.uk/PROSPERO/view/CRD42024542866 .