Jasper Garay

Background: As the first peoples of Australia, Aboriginal and Torres Strait Islander peoples have continuing cultures that are essential to wellbeing. Complex sociocultural, health, and wellbeing inequities stemming from colonization, settler-colonialism, and mental health system challenges have led to high rates of negative mental health and wellbeing for Aboriginal and Torres Strait Islander peoples. Improving Aboriginal and Torres Strait Islander mental health and wellbeing outcomes is a national public health priority. Social and emotional wellbeing (SEWB) and the cultural determinants of health (CDH) provide evidence-based approaches for providing culturally centered wellbeing support. There is a need to increase the availability, accessibility, and effectiveness of culturally relevant, holistic, and strengths-based wellbeing supports. It is essential that Aboriginal communities have self-determined opportunities to develop and implement culturally centered wellbeing supports informed by SEWB and the CDH. Aboriginal digital health and wellbeing support research is an emerging field offering potential to help improve wellbeing outcomes. This study aims to explore how virtual reality (VR) could be used to provide SEWB and CDH support for Aboriginal and Torres Strait Islander peoples. Objective: This study protocol outlines a 3-phase mixed-methods approach that will inform the co-design and codevelopment of a VR application that aims to provide SEWB and CDH support. In partnership with Tribal Warrior, an Aboriginal Community Controlled Organization, Studio Gilay, an Aboriginal-led animation and storytelling studio, and Phoria, an Australian immersive storytelling technology company, this study will assess cultural relevance, acceptability, and feasibility of the VR application. Methods: Using Indigenist and Participatory Action Research methodologies, purposive sampling will be used to recruit 35 Tribal Warrior staff and Aboriginal community members to participate in each phase of research. Qualitative data collection will occur in each phase through yarning circles. Reflexive thematic analysis will guide qualitative analysis. Phase 3 will involve a quantitative survey, generating cultural relevance, acceptability, and feasibility evidence. Descriptive statistics analysis will be used to report results. Results: As of April 2026, data collection and analysis for phases 1 and 2 are complete. This study will culminate in the development and assessment of a co-designed and codeveloped VR application that aims to provide SEWB and CDH support for Aboriginal peoples. Findings from each phase will be published in academic papers and nonacademic outputs. The VR application will be implemented by Tribal Warrior into existing community programs and supports. Conclusions: Findings from this study have potential implications for improving availability and accessibility to culturally centered wellbeing supports for Aboriginal and Torres Strait Islander peoples. Assessing the cultural relevance, acceptability, and feasibility of using VR technology to provide culturally centered wellbeing support will contribute novel evidence to the fields of public health, digital health, and design-based research.

BACKGROUND Aboriginal and Torres Strait Islander peoples are the first peoples of Australia, with continuing cultures that are fundamental to health and wellbeing. Complex socio-cultural, health, and wellbeing inequities stemming from colonization, colonialism, and urbanization have led to high rates of negative mental health and wellbeing for Aboriginal and Torres Strait Islander peoples. Improving Aboriginal and Torres Strait Islander mental health and wellbeing outcomes is a national public health priority. The culturally specific concepts of health and wellbeing, Social and Emotional Wellbeing (SEWB) and the Cultural Determinants of Health (CDH), provide evidence-based domains that support good health and wellbeing. There is a need to increase the availability and accessibility of culturally relevant, strengths-based, self-determined, and community-tailored mental health and wellbeing supports informed by SEWB and the CDH. Utilizing Virtual Reality (VR) as a digital health tool to support Aboriginal and Torres Strait Islander mental health and wellbeing is an under researched and emerging field. This study aims to explore how VR could be utilized to enhance SEWB and CDH outcomes for Aboriginal and Torres Strait Islander peoples. OBJECTIVE This study protocol overviews a 3-phase mixed-methods co-design approach, outlining the research design that will enable the exploration of how VR could be utilized to enhance SEWB and CDH outcomes for Aboriginal people of Sydney, New South Wales (NSW), Australia. In partnership with Tribal Warrior, an Aboriginal Community Controlled Organization, Studio Gilay, an Aboriginal led animation and storytelling studio, and Phoria, an Australian immersive-storytelling technology company, this study will facilitate the co-design, development, implementation, and evaluation of a VR application designed to enhance SEWB and CDH outcomes for Aboriginal peoples in Sydney, NSW, Australia. METHODS Using Indigenist and Participatory Action Research methodologies, purposive sampling will be used to recruit 35 Aboriginal community members to participate in each phase of research. Qualitative data collection will occur in each phase through Yarning Circles. Reflexive thematic analysis will guide qualitative analysis. Phase 3 will involve a quantitative survey, generating evaluation insights into SEWB and CDH outcomes from engagement with the VR application. RESULTS This study will culminate in the development, implementation, and evaluation of a co-designed culturally tailored VR application. Findings from each phase will be published in academic papers, exploring and evaluating how the VR application could be utilized to enhance SEWB and CDH outcomes for Aboriginal peoples. CONCLUSIONS Findings from this study have potential implications for improving availability and accessibility to mental health and wellbeing supports for Aboriginal and Torres Strait Islander peoples. Utilizing VR technology for culturally specific wellbeing support contributes valuable evidence to the fields of Aboriginal and Torres Strait Islander health and wellbeing, public health, digital health, and design-based research.

Most public health practitioners and researchers in Australia acknowledge the poorer health and wellbeing of Aboriginal and Torres Strait Islanders peoples relative to non-Indigenous Australians; some work with Aboriginal and Torres Strait Islander communities; however, few acknowledge the role that public health itself has played in the plight of Aboriginal and Torres Strait Islanders peoples throughout Australia’s colonial history. In this essay, we – Aboriginal, Torres Strait Islander, and non-Indigenous scholars at the Sydney School of Public Health (SSPH) – argue that truth-telling, which is critical for reconciliation, can only truly begin in Australian public health circles when we listen to the stories and truths of Aboriginal and Torres Strait Islander peoples as it relates to the colonial history of public health in Australia. Herein we give a brief outline of that history and provide some recommendations on ways forward; we also describe the successes and failures at SSPH in hopes that our story can help the broader Australian public health community on their truth-telling journeys. Although our story is about public health in Australia, we believe that its resonance lies everywhere public health has been explicit or implicit in its colonialism toward Indigenous peoples.

This article assesses the Cultural Safety of mainstream mental health services in two regions of New South Wales, Australia, based on the experiences and perspectives of Aboriginal young people aged 16 – 25. Yarning semi-structured in-depth interviews were conducted with thirteen Aboriginal young people in two regions of New South Wales. Thematic analysis was undertaken by all research members to identify themes from the data and conceptual connections between them. Identified themes from individual analysis and coding were triangulated during several analysis meetings to finalize key themes and findings. Aboriginal young people identified that Aboriginal Community Controlled Health Services offered culturally safe Social and Emotional Wellbeing service supports, whereas mainstream mental health services did not. Aboriginal young people proposed that institutional reforms such as increasing engagement with cultural competency programs, employing more Aboriginal staff, and implementing culturally meaningful services, would increase Cultural Safety in mainstream mental health services. Cultural Safety within mainstream mental health services should be enhanced to ensure the subjective Social and Emotional Wellbeing support needs of Aboriginal young people are understood, addressed, and supported. Without Aboriginal young people having confidence that mainstream mental health services and systems are prioritising Cultural Safety when providing supports, mainstream mental health systems risk failing to reduce mental health and Social and Emotional Wellbeing disparities unjustly experienced by Aboriginal young people in New South Wales.

Aboriginal and Torres Strait Islander peoples are facing growing levels of scrutiny to prove their identity to access Indigenous-specific government services designed to mitigate the impacts of past government policies. Yet, it is those who have been most severely impacted by past government policies of forcible removal from Country and separation of families who often face challenges obtaining evidence to prove their Indigeneity. Employing narrative inquiry and collaborative autoethnography, this article draws on the personal reflections and experiences of the Aboriginal authors to explore the health and wellbeing impacts of deficit discourses, perceptions, and judgements about Indigeneity in Australia. Our personal stories are shared to enliven discussion on how proof of Indigeneity requirements may systemically compound ongoing intergenerational trauma. These stories and perspectives are shared to stimulate review of proof of Indigeneity policies and procedures by government agencies and education institutions across Australia.

Solastalgia is a term used to describe the pain and distress experienced by those witnessing their home environments destroyed or changed in unwelcome ways. Solastalgia is expected to become more prominent as climate change worsens and transforms landscapes. This scoping review examines and maps the existing literature on solastalgia in Australia, particularly focusing on Aboriginal and Torres Strait Islander experiences. Four focus questions guided the review to explore how solastalgia is conceptualized, highlight risk and protective factors, and identify strategies for addressing solastalgia. Eighteen papers met the criteria for inclusion. Overall, our results show a minimal evidence base on solastalgia in Australia with an even greater gap in exploring solastalgia from Aboriginal and Torres Strait Islander perspectives. A strong connection to home environments was suggested as both a risk and protective factor for experiencing solastalgia. Aboriginal and Torres Strait Islander peoples are considered at risk due to intimate connections to home environments, and since the invasion, have experienced mental distress resulting from significant, damaging changes to landscapes and home environments. We recommend further exploration of lived experiences of solastalgia across a greater diversity of Australian contexts, particularly amongst Aboriginal and Torres Strait Islander peoples, including a focus on practical implications.

This article assesses the accessibility of mainstream mental health services (MMHSs) in two regions of New South Wales (NSW), Australia, based on experiences and perspectives of Aboriginal young people aged 16–25. Semi-structured yarning interviews were conducted with thirteen Aboriginal young people in two regions of NSW. Thematic analysis was undertaken by all research team members to identify major themes from the data and conceptual connections between them. The identified themes from individual analysis and coding were triangulated during several analysis meetings to finalise the key themes and findings. Aboriginal young people had no experience of engaging with early-intervention MMHSs. MMHSs were identified as inaccessible, with most participants unaware that MMHSs existed in each region. Due to MMHSs being inaccessible, many Aboriginal young people presented to emergency departments (EDs) during a crisis. Aboriginal Community Controlled Health Services (ACCHSs) were identified as key providers of accessible, culturally meaningful, and effective social and emotional wellbeing (SEWB) service support for Aboriginal young people in NSW. If health and wellbeing outcomes are to improve for Aboriginal young people in NSW, MMHSs must increase accessibility for Aboriginal young people requiring SEWB support.