INDIGENOUS HEALTH

The value of partnerships: lessons from a

multi-site evaluation of a national social and
emotional wellbeing program for Indigenous youth
Ilse Blignault,1 Melissa Haswell, 1 Lisa Jackson Pulver1

E
vidence of mental health issues and
loss of social and emotional wellbeing
among Australia’s Aboriginal and
Torres Strait Islander young people can
be found across most measures of health,
education, employment and involvement in
the justice system.1 Young people constitute
a considerably higher proportion of the
Indigenous population than the general
population,2 and they are an important
group in realising community visions and
strengthening community capacity. As the
next generation of parents and community
leaders, how they fare during their youth will
greatly influence the future of Aboriginal and
Torres Strait Islander society and culture.
Youth – the period from puberty to
adulthood – can be both an exciting and a
vulnerable time, as it involves entering the
age of identity formation, risk-taking and
sexual activity. It is also the period when
individuals begin to be heard and recognised
outside their family and to interact
independently with the broader community.
Positive experiences during this period will
contribute to positive physical, mental and
social outcomes in the long term.3
Although the amount of available data has
increased over the past decade, the evidence
base to inform initiatives to improve the social
and emotional wellbeing of Aboriginal and
Torres Strait Islander youth remains limited.4
A recent review found that successful
programs in this field shared a number of
common features. These included: addressing
upstream social determinants of wellbeing
as well as current issues; building on the
strengths of Indigenous culture, community
Abstract
Objective: To evaluate the first three years of a national program to improve the social and
emotional wellbeing of Indigenous youth in remote and regional Australia.
Methods: Combination of open inquiry and audit review involving investigation of process
and outcomes, with a broad national overview supplemented by five in-depth case studies in
diverse settings.
Results: Community development principles were applied at all 14 sites. There were many
examples of collaborative, community-driven health promotion initiatives, with most progress
observed where there were strong local partnerships. Within the range of activities, education
sessions on alcohol and other drugs, mental health and violence were facilitated by program
staff. There was a tension between community development and specific program delivery,
with the balance reflecting the needs and capacity of individual sites, program staff expertise
and contractual requirements.
Conclusions and implications: The main lessons concern program design and resourcing
and ways of working. Program staff at each site learned to be not too ambitious, but to work
consistently with the community, establishing partnerships and engaging and training
community members. Community and stakeholder capacity enhancement should be regarded
as core, and evaluation built in. Activities directed at youth must be engaging and effective,
and integrated with other programs and services.
Key words: Indigenous, youth, social and emotional wellbeing, program evaluation
and family; paying careful attention to both 16–26, with a particular focus on depression,
content and process; being led by local anxiety, violence and alcohol and other drug
people and exerting an impact at multiple problems, by engaging young people and
levels; and engaging the broader community. strengthening stakeholder and community
Mainstream models need to be appropriately responses to Aboriginal youth social and
adapted to the local context; for example, emotional wellbeing issues.
by working in partnership with the local The program model comprised a community
Indigenous community.4 development approach based on culturally
This article reports the general findings and respectful ways of working and partnerships
lessons learned from an external evaluation of with Aboriginal people and communities,
a new national program in this field, referred involving a range of culturally appropriate
to as SAM Our Way, for Australian Red Cross. early-intervention, prevention and education
The program’s broad aim was to improve the initiatives driven and owned by community
social and emotional wellbeing of Aboriginal members and tailored to community needs.
and Torres Strait Islander young people aged The program model also drew on the harm

1. School of Public Health and Community Medicine, University of New South Wales
Correspondence to: Dr Ilse Blignault, Level 3, Samuels Building, School of Public Health and Community Medicine, UNSW, Sydney, NSW 2052;
e-mail: i.blignault@unsw.edu.au
Submitted: September 2014; Revision requested: January 2015; Accepted: February 2015
This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License, which permits use and distribution in any
medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
The authors have stated they have no conflict of interest.
Aust NZ J Public Health. 2016; Special Issue: 53-8; doi: 10.1111/1753-6405.12403

Special Issue Australian and New Zealand Journal of Public Health 53

© 2015 The Authors
Blignault, Haswell and Jackson Pulver

reduction principles of the save-a-mate at different levels, with a broad national
(SAM) Alcohol and Other Drug Emergencies overview and five in-depth case studies.
education program developed by Red Cross. Data collection methods included document
The SAM Our Way program, which analysis, in-depth semi-structured interviews
commenced in 2009, was co-funded by and focus groups in the form of ‘yarning
Australian Red Cross and beyondblue for a circles’, and participant observation. Findings
fixed period of three years. Red Cross has were analysed and grouped together
made a commitment to remain in all program according to the evaluation requirements,
communities for the longer term (7–10 years) and supplemented by drawing on relevant
and has actively pursued further funding literature.
while resourcing the program from internal
funds in the interim. Stakeholder engagement and case
The original project proposal was ambitious, study selection
given the time and resources available. The preparatory stage involved several
Following a mid-term review in 2010, it was meetings/teleconferences with the Red
decided to consolidate the work at existing Cross project team, two teleconferences
sites rather than increase the number of sites with the evaluation reference group and
as planned. In 2012, when this evaluation was a presentation to SAM Our Way program
conducted, the program was operating at officers (referred to as Community
14 sites in the Northern Territory (two sites), Development Officers or CDOs) and Red Cross
Queensland (two sites), South Australia (five national and state/territory managers at the
sites) and Western Australia (five sites). The SAM Our Way national forum in Adelaide in
evaluation sought to assess to what degree March 2012. Activities included: relationship
and with what effect SAM Our Way’s aim building; gaining an understanding of
and objectives had been met across the 14 the program’s operation at different sites;
program sites, utilising the criteria of impact, clarifying expectations of the evaluation;
effectiveness, relevance and appropriateness, agreeing on data collection methods; drafting
and sustainability. It also aimed to extract information sheets and tools (later tailored
broad lessons for future activities and similar for informants and sites); and negotiating the
efforts elsewhere. case study sites with Red Cross managers,
CDOs and communities.
Due to time and budget constraints, it
Methods
was not possible for the evaluators to
The evaluation combined elements of visit all 14 sites. Five case study sites,
improvement-oriented open inquiry (drawing considered illustrative of the program’s
out lessons for the local communities as well diverse operations and achievements,
as Red Cross) and audit review.5 It involved were chosen on the basis of community
investigation of both process and outcomes interest, geographic coverage (ensuring
representation from each state and territory
and different categories of remoteness)
and Indigenous profile (percentage of total
population) – see Table 1.
Instruments
From the evaluation questions provided
by Red Cross, topic lists were developed to
guide the key informant interviews in the
national overview and case studies and
the focus groups. These were introduced in
conversational style to adhere to culturally
respectful protocols and allow flexibility
to pursue new lines of questioning to
understand how a program’s success is
affected by practical circumstances. Wording
was tailored for each site as advised by the
CDO and others. This approach enabled
respondents to describe the program in a
way that was authentic to their individual
experience, while reflecting on the broader
strengths and challenges of the program and
its delivery.
We employed the Growth and Empowerment
Measure (GEM)6 in interviews with young
program participants at two of the sites.
The GEM is a strengths-focused measure
of emotional wellbeing and social
connectedness that seeks to reflect the
changes that people experience as they gain
confidence and capacity in their lives. We
used it here to enable program participants
to identify where they felt they were in
relation to core components of psychosocial
wellbeing and empowerment and to
articulate the ways in which involvement in
SAM Our Way activities had assisted them to
move forward.

Data collection and analysis

Table 1: SAM Our Way case study sites.a,b
National overview
State/territory Site Accessibility and indigeneity Data sources
Northern Territory Site N1 • Very remote, discrete Aboriginal community Interviews with Red Cross staff and 5 other More than 20 documents relating to SAM Our
• 95% Indigenous service managers and providers. Way and the Red Cross Aboriginal and Torres
Queensland Site Q1 • Very remote Interviews with Red Cross staff, 3 other service Strait Islander Strategy were reviewed. These
• 6.4% Indigenous providers, 3 youth and 1 parent. provided a background for the interviews
Focus group with 7 others: youth, parents, with Red Cross/SAM Our Way staff. Twenty-
community members and an Elder. five telephone interviews were conducted
South Australia Site S1 • Accessible Interviews with Red Cross staff and 5 other between late March and early July 2012: six
• 17.8% Indigenous service providers. with national managers, nine with state/
Focus group with 4 youth. territory/regional managers and 10 with CDOs.
Site S2 • Accessible, discrete Aboriginal community Interviews with Red Cross staff and 1 other The CIPP Evaluation Model7 – Context, Input,
• 95% Indigenous (estimate) service manager.
Process and Product – was used to organise
Focus group with 8 Elders and community
information collected about each site.
members.
Western Australia Site W1 • Remote Interviews with Red Cross staff, 3 other service
managers, 7 other service providers,
Case studies
• 48.5% Indigenous
4 community members and 2 parents. The case studies were designed to provide an
a: Location classified according to Accessibility/Remoteness Index of Australia (ARIA+). in-depth understanding about which aspects
b: Percentage Indigenous population taken from 2006 Census with the exception of Site S2.
of the program design and implementation

54 Australian and New Zealand Journal of Public Health Special Issue

© 2015 The Authors

worked well and which worked less well
and, through within-case and cross-case
analysis, to capture both essential program
elements and unique variations in approach,
leadership, participant groups and settings.8
Site visits were conducted between July and
early September, 2012. Each two-person
evaluation team comprised an Aboriginal
and a non-Indigenous evaluator and was
introduced by a Red Cross national manager
who did not participate in data collection.
Informants at the community level included
program participants and their parents,
knowledgeable community leaders/Elders
and other community members, as well
as personnel from related services and
programs. Written consent was provided by
all participants and from parents/guardians
of youth under 18 years. Extensive notes
were taken during interviews and focus
groups, which were also digitally recorded.
The audio files were later fully or partially
transcribed and the resulting data analysed
both in terms of emerging themes and the
stated evaluation questions. Each case study
was written up as a short community report
and sent to the CDO and their manager for
verification with informants.
Ethics approval
Primary ethics approval for both the national
overview and the case studies was given by
the University of New South Wales Human
Research Ethics Committee, pending
letters of support/collaboration that were
subsequently obtained from the Aboriginal
communities involved in the case studies.
We obtained additional approval at the
state/territory level for each of the case
studies from the South Australian Aboriginal
Health Research Ethics Committee, the
Central Queensland Health Service District
Human Research Ethics Committee, the
Western Australian Aboriginal Health Ethics
Committee and the Aboriginal Medical
Services Alliance of the Northern Territory.
Limitations
The evaluation was subject to several
limitations. Specific measurable targets
related to youth social and emotional
wellbeing were not included in the initial
project development and the absence
of baseline data precluded pre/post
comparisons. Interview and focus group
questions were not standardised but,
necessarily, had to be tailored in content
and language. In order to conduct effective
Special Issue Australian and New Zealand Journal of Public Health 55
Evaluation of a national Indigenous youth program
and culturally appropriate evaluations in
Aboriginal communities, a high level of trust
must be gained;9 therefore, the evaluation
team relied on Red Cross to assist with this.
The relatively short field visits (2–4 days)
limited community input. At one site, where
the visit coincided with funerals and sorry
business, we were unable to meet with any of
the program participants or their parents.
Capturing the impact of community
strengthening initiatives is not easy. A
long-term view is required, especially
in disadvantaged communities where
circumstances can change rapidly. While
the visits provided valuable qualitative
information, they were essentially ‘snapshots’
– providing a partial picture at a particular
point in time. Moreover, SAM Our Way was
often only one of several initiatives taking
place, e.g. the Northern Territory National
Emergency Response formed an important
backdrop for two of the sites. Even where
change can be documented, attribution
of causality is not straightforward in such
situations.
Results
Overall operating context, enabling
factors and constraints
SAM Our Way was introduced following the
Red Cross services renewal process, and
reflected the increased focus on development
and delivery of programs to Aboriginal and
Torres Strait Islander communities.10-12 The
program mid-term review led to greater
support for program implementation at
existing sites, with additional assistance
from national office accompanied by
increased clarity around program purpose,
objectives, requirements and ways of
working. By the third year, earlier problems
with recruitment and staff turnover had been
largely overcome. Implementation was also
influenced by factors external to the program.
Across the sites, there was considerable
variation in remoteness, infrastructure and
services, population size and composition,
and history. The challenges were much
greater in distant or satellite communities
than in the communities where program staff
were based.
Scope and nature of activities
Program activities were diverse, with
program staff drawing on local knowledge
and networks to identify and address
priority issues by working in partnership
© 2015 The Authors
with community and other organisations
(see Table 2). Collaboration with secondary
schools and, occasionally, tertiary education
institutions was a common feature. At two
regional centres, the CDOs worked with
young men in prison. Art, music and sports
were frequently used ‘hooks’ that worked
well to attract the youth. Bush camps with
input from Aboriginal Elders provided
opportunities to promote culture and
identity – a major issue for all adolescents
and particularly salient for descendants of the
Stolen Generations.
There was a shift over time from short, one-off
activities to longer, more-intensive activities
and multifaceted events, such as festivals,
or a series of linked activities designed
to build individual and – in some cases –
organisational and community capacity.
Relevance and appropriateness
Elders and other community informants
who were interviewed welcomed the
focus on early intervention, prevention
and community education. It was clear at
all case study sites that SAM Our Way had
contributed to improved coordination among
stakeholders and assisted communities
to develop greater capacity to meet the
needs of their young people. Some activities
were specifically designed for youth while
others embraced their families or the whole
community. Gender and other cultural issues
were taken into account where relevant.
Effectiveness
There was a tension across the program
between community development and
program delivery, with the balance reflecting
both the needs and capacity of the individual
sites and the expertise and family and
community networks of the CDOs and their
managers, as well as the requirements of
the external funding body. Nevertheless,
community development principles were
applied at all sites and, as illustrated in
Table 2, there were many examples of
collaborative, community-driven initiatives.
Greater engagement and participation in
the planning stages resulted in a greater
level of community ownership. Program staff
facilitated education sessions on alcohol and
other drugs, mental health and violence,
drawing on content from save-a-mate and
other evaluated programs, and beyondblue
fact sheets on depression and anxiety.
Different strategies were used to engage and
address the needs of marginalised groups,
Blignault, Haswell and Jackson Pulver

such as youth considered at-risk or living with and from family members and others who themselves. At Site Q2, a young woman who
a disability. knew the participants, were overwhelmingly started as a volunteer later took on the job of
positive. At Site Q1, two girls in their early CDO. At Site Q1, the young CDO told us how
Impact teens and an older boy who were interviewed she had grown enormously as a result of her
It was evident from the SAM Our Way project using the GEM described a range of personal involvement – learning from her own on-
documents and evaluation interviews that outcomes: increased self-esteem and the-job experiences, from the people around
the more established programs – where there ability to speak up, learning how to deal her, and from the CDOs at other sites she has
were strong local partnerships and had been with painful emotions without resorting to met at the quarterly national forums. The
less staff turnover – had made more progress alcohol and drugs, making friends, improved role has given her many new skills, built her
towards the intended outcomes of increased relationships, increased confidence at school confidence and opened up new possibilities
knowledge, improved health promotion skills, and in life generally, and a new sense of for her own future.
additional resources, greater community and Aboriginal identity. At most of the sites, the save-a-mate
stakeholder capacity, and increased avenues SAM Our Way’s impact in enhancing Alcohol and Other Drugs Emergencies
for Aboriginal young people to exercise their community capacity was evident in the new- program and other training was provided
autonomy and power. During site visits, found knowledge, skills and confidence of to service providers in addition to youth
reports from young participants who had the local Aboriginal staff. All had benefited, and community, thus enhancing workforce
been heavily engaged in program activities, especially those who were young people capacity in partner organisations and
community service networks generally.
Table 2: Examples of SAM Our Way program initiatives and activities. At Sites S1 and S2, the older and more
Site Projects and partners experienced CDOs provided both social and
emotional support and coaching to youth
N1 Mental Health Week activities included a Women’s Bush Tucker Tent and a Celebration Day at the secondary school, with a
mental health quiz ‘What Keeps Us Strong?’ as well as painting, basketball and a healthy BBQ. The preceding week was used workers in partner organisations. In addition
to generate community awareness about social and emotional wellbeing through a mural project, in partnership with Red to formal instruction, the youth workers were
Dust Role Models and drawing on the theme of the ‘Stay Strong Tree’. often stimulated by the role modelling and
N2 Horticultural project linked to the Community Development Employment Project (CDEP) and University Horticultural mentoring that occurred naturally during the
Department and Remote Indigenous Gardens Network, and led by an experienced Elder. The project boosted the youths’ delivery of save-a-mate and other activities.
capacity, connected them with external education opportunities and enhanced their employment prospects, while
At Site S1, this powerful combination of
simultaneously nurturing their ability to engage in a meaningful activity channelled through existing cultural knowledge.
processes was particularly evident among
Q1 Regular school holiday programs incorporating sports nights, cultural activities, cooking workshops and save-a-mate, in
collaboration with Anglicare, Youth Connections and Red Cross FOODcents (nutrition program). Art workshops where youth the young female leaders of the Aboriginal
were encouraged to identify a stressor and create a piece of art that expressed their feelings followed by discussion about Youth Advisory Council, which also served
managing difficult emotions and situations, in partnership with Queensland Health. as the youth governing board for the youth
Q2 Support for potential young leaders, encouraging them to support and mentor other young people, by developing a youth centre. As a result of their participation,
council. The youth council developed an informal peer-support program with another youth group in a nearby town that the four young women in the focus group
included cultural-exchange excursions and opportunities to discuss issues of concern to them. appeared to have learned how to use their
S1 Support for a range of health promoting activities at the youth centre, Including Red Cross FOOD cents, RespectED (violence voices, how to personally overcome barriers,
prevention and healthy relationships) and save-a-mate, plus support for management when required. Support to the
and how to help other young people to do so.
Aboriginal Youth Advisory Council, a group of young and emerging female leaders who meet at the youth centre.
This experience led to exciting jobs for some
S2 Supported the local youth centre with basketball and youth camps, sending teams to the National Aboriginal and Indigenous
former leaders.
Basketball Championship. Red Cross also acted as a clearinghouse on behalf of the Aboriginal Community Council for funds
from the Commonwealth Government to build basketball courts adjacent to the new community healing garden. For Red Cross, the addition of SAM Our
S3 In partnership with the Department of Correctional Services, engaged a group of young men in low-security prison in Way to its suite of Aboriginal and Torres
planning for their release. The group worked on developing a shared story that highlighted their journey before, during and Strait Islander programs broadened the
after their incarceration and that could be used as a tool for yarning and promoting positive behaviour change in other young populations, settings and organisations with
people in community.
which it worked. It also raised the profile of
S4 Regular yarning sessions at secondary schools in conjunction with the South Australian Aboriginal Sports Training Academy youth and social and emotional wellbeing
&5 (SAASTA). Topics included the impact of identifying as an Aboriginal person; pride in self, culture, tradition and family;
community issues such as alcohol and other drug use, intergenerational unemployment, loss of language, identity and – part of the bigger health and wellbeing
culture; and planning for the future including utilising personal and community strengths and general life skills. picture that includes food security, violence
W1 Co-facilitation of the Family Violence Program (organised by Department for Corrective Services and Juvenile Justice) with prevention and caring for people with mental
Kinway (Anglicare), Kimberley Aboriginal Medical Service and the Department for Child Protection. Topics included drug and and/or physical disability.
alcohol misuse, money management, violence and anger management, extended family relationships and bush activities/
getting back to country. Music featured strongly – guitar, didgeridoo and clap sticks.
Sustainability
W2 Bush camp for young people who had caring responsibilities for a family member, with activities designed to support
Three years is a relatively short time in the
personal skills development, problem solving, self-discovery and team work.
context of remote and regional Aboriginal
W3 Assisted other agencies to run bush camps designed to engage youth around social and emotional wellbeing messages,
&4 establish mentoring relationships and introduce local service providers. Activities included making fishing spears, cooking
Australia. For all programs, a skilled,
damper and gathering bush tucker fruit, as well as team-building and yarning sessions. Co-facilitation of DRUMBEAT motivated and stable workforce is vital for
(Discovering Relationships Using Music – Beliefs, Emotions, Attitudes & Thoughts) at a remote Aboriginal school. continued growth and development and
W5 Partnered with the City Council to deliver programs and run an after-school drop-in-centre at the new purpose-built and an important indicator of sustainability.
well-equipped youth space. The CDOs presence, working alongside other youth workers, makes the mainstream facility more By employing, training and mentoring
attractive and safe for Aboriginal youth who seek them out. local Aboriginal staff, delivering programs

56 Australian and New Zealand Journal of Public Health Special Issue

© 2015 The Authors

and providing role models, SAM Our Way
had, in turn, increased both individual and
community capacity. Ensuring ongoing
funding to support the Red Cross long-term
commitment to these communities by
consolidating work at the existing program
sites and building on achievements was
an important issue for SAM Our Way staff,
community and stakeholders.
Discussion
This evaluation of a new national program
to improve the social and emotional
wellbeing of Aboriginal and Torres Strait
Islander youth for Australian Red Cross
considered both process and outcomes. It
was designed to inform the future work in
remote and regional Aboriginal communities
by identifying the aspects of program design
and implementation that worked well, and
those that worked less well, and providing
recommendations for improvement.
The term ‘social and emotional wellbeing’
has a very specific set of meanings to
Aboriginal and Torres Strait Islander peoples.
It is of crucial importance to health and
is embedded, with culture, in a holistic
definition of health that encompasses:
“Not just the physical well-being of the
individual but the social, emotional and
cultural well-being of the whole community.
This is a whole-of-life view and it also includes
the cyclical concept of life-death-life”.13(px)
According to the South Australian Aboriginal
Health Partnership, “Enjoying a high level
of social and emotional wellbeing can be
described as living in a community where
everyone feels good about the way they live
and the way they feel. Key factors in achieving
this include connectedness to family and
community, control over one’s environment
and exercising power of choice”.14(p6) For
many Indigenous Australians, the connection
to land is also critical: “a connection that
constitutes one’s sense of individual and
social identity and responsibility”.15
Improving social and emotional wellbeing
is essential to developing healthy, resilient
individuals who contribute to building strong
communities that, in turn, are imbued with
a strong cultural, spiritual and community
identity that supports all members to reach
their full potential. Social and emotional
wellbeing programs play a critical role in
securing the sustainability of gains achieved
through Closing the Gap and other specific
policy efforts.4
Special Issue Australian and New Zealand Journal of Public Health 57
Evaluation of a national Indigenous youth program
The fact that SAM Our Way was embedded
in an Indigenous community development
framework made it a very different program
to the save-a-mate program from which
it derives.16-18 Traditionally, save-a-mate
is delivered as a one-off education and
skills development program and does not
attempt to respond holistically to issues
affecting young people. SAM Our Way had a
much grander brief – delivering community
education and prevention through early
intervention while working to address some
of the broader issues that influence Aboriginal
and Torres Strait Islander youth wellbeing. The
evaluation team found considerable diversity
in the approach being taken and activities
facilitated at the different sites, and it was
far from a standardised program. To some
extent, this may reflect different stages in the
project cycle (with relatively well-established
programs in South Australia, Queensland and
the Northern Territory compared to those in
Western Australia), and differences in staff
skills and capacity of the local Red Cross
Office. However, it also reflected differences
in community context and aspirations, and
factors outside program control.
A ‘one-size-fits-all’ approach, in addition
to being antithetical to a community
development approach, is clearly not
workable in such circumstances. Program
activities need to be tailored to local context
and needs and the program logic developed
with input from community and stakeholders
– not imposed from outside. It would better
to consider SAM Our Way as suite of programs
working to achieve similar goals under one
overarching umbrella, rather than as a single
program to be implemented in multiple
locations. Local program models will – and
should – vary, reflecting local needs and
capacity and other contextual factors. The
development of such models would also
assist in the development of public policy in
this area.19
There is more work to be done at all 14 sites,
and it is significant that Red Cross has made a
long-term commitment to the communities.
A number of new SAM Our Way resources
have been – or are being – developed,
though these have yet to be evaluated and
consolidated. Thought needs to be given to
the shape of the final product, including how
these resources might be shared or applied
elsewhere.
© 2015 The Authors
Working partnerships were essential for
achieving the program’s positive outcomes.
This requires the meaningful engagement
with a variety of partners at each location,
including other service providers, local
Aboriginal organisations, Elders and
Traditional Owners and public authorities.
Naturally, these partnerships will vary in
type and range from informal to formal
arrangements; nevertheless, they are vital
in ensuring the SAM Our Way program is
embedded in the communities’ broader plans
and activities. Where this broad base of links
and connections does not exist, they need to
be established, nurtured and maintained.
It is important, at both the organisational
and individual level, to take time to develop
the trust and relationships that are the
foundation for working together for positive
change.4
All Indigenous social and emotional
wellbeing programs need strong and
consistent policy, management and resource
support over the long-term to ensure
effectiveness, sustainability and growth.20,4
Providing opportunity for creative,
enjoyable and inspiring interactions that
generate positive feelings, celebrating small
achievements and positive changes, and
facilitating connecting to culture are among
the features of successful programs for
youth.4
Making teenagers and young adults aware
of future possibilities and pathways and
encouraging them on a positive track would
be a significant outcome for any program
directed at youth. Establishing connections
and working with schools is essential –
education is a major social determinant of
health and a fundamental building block
for individuals. Training and employment
opportunities are important too.
From a program delivery point of view, and
taking into account other opportunities that
exist for young people in the communities,
thought needs to be given as to how one
activity might lead to another (entry, exit
and second opportunities) so that young
participants move forward with improved
life skills and a better sense of wellbeing.
Programs would benefit from greater
structure around the outcomes and outputs
desired by the local community, with
monitoring through existing data collection
systems as well as any program-specific tools.
Blignault, Haswell and Jackson Pulver

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