Adolescent-Led Mental Health Promotion in the IMPACT Programme: Vignette Development with Indigenous Youth

IntroductionIndigenous adolescents experience unique biopsychosocial challenges compounded by cultural disruption, territorial displacement, and systematic marginalization. These factors contribute to elevated rates of psychological distress and suicide among Indigenous adolescent, necessitating culturally responsive mental health programmes that center youth voice and cultural values.ObjectiveTo develop and evaluate adolescent-led art-based vignettes as a culturally sensitive methodology for promoting mental health discussions among Kaingang Indigenous adolescents in the IMPACT study (Implementation of a multi-sectoral programme to improve Indigenous adolescent mental health in Brazil and Dominica)MethodWe conducted an exploratory qualitative study using participatory action research principles. Twenty-four Kaingang adolescents (ages 10-18) from two Indigenous schools participated in 12 workshops over six months. Participants created vignettes across multiple artistic formats (videos, drawings, songs) addressing school, family, and community contexts. Data collection included 10 group dynamics with adolescents, teachers, health professionals, and community leaders. Thematic analysis following Braun and Clarke's framework was conducted with cultural validation from community members.ResultsParticipants created 29 vignettes addressing key themes including cultural discrimination, substance use, environmental degradation, family dynamics, and spiritual practices. Protective factors identified included family support, sports participation, and community connections. Risk factors encompassed increased substance use, family conflict, discrimination, and environmental destruction. Vignettes effectively facilitated dialogue about sensitive topics including psychological distress, cultural identity, and belonging while creating safe spaces for collective reflection.ConclusionAdolescent-led vignette creation represents a promising, culturally grounded approach to Indigenous adolescent mental health promotion. This methodology successfully fostered meaningful dialogue, adolescent agency, and reflective engagement while honoring cultural values and community knowledge systems. Despite limitations in sample size, findings support expanding this participatory approach across diverse Indigenous contexts to strengthen intercultural mental health programmes.