Searching for evidence: what works in Indigenous mental health promotion?

Issue addressed The high rates of mental health issues confronting Indigenous populations make it imperative that action to promote mental health and prevent the development of mental health problems is effective. An accumulating evidence base for mental health promotion now exists; however, it remains significantly underdeveloped for Indigenous groups. Methods This paper outlines the key findings of a systematic review of the literature undertaken to identify attributes of effective Indigenous mental health promotion interventions. Results Conclusive evidence of the efficacy of Indigenous mental health promotion interventions could not be determined because the evidence base is limited. However, this review did highlight several important findings. First, there were few well-conducted intervention evaluations; in many, the design was weak and insufficient information was supplied to assess effectiveness. Second, Indigenous mental health promotion initiatives commonly focused on individual behaviour change, rather than the broader social, ecological or policy determinants. Third, many interventions involved extensive Indigenous participation, thus supporting cultural relevance and community involvement, essential for the future of Indigenous mental health promotion. Conclusions There is insufficient evidence about effective mental health promotion and prevention interventions for Indigenous populations. So what? This paper will assist policy makers, practitioners and researchers to plan more effective mental health promotion interventions for Indigenous people. Future developments should ensure meaningful Indigenous participation and focus on the implementation and evaluation of comprehensive interventions, together with appropriate dissemination of findings.