Modifiable psychosocial factors associated with psychological distress, depression, anxiety and self-rated health among Aboriginal and Torres Strait Islander populations

Aims To examine mediators and modifiable psychosocial factors associated with psychological distress, depression, anxiety and self-rated health among Aboriginal and Torres Strait Islander peoples (hereafter respectfully referred to as ‘Indigenous Australians’) aged ≥18 years. Methods This was a cross-sectional study based on the analysis of the 2018–19 National Aboriginal and Torres Strait Islander Health Survey dataset (N = 3942). Odds ratios (OR) and 95% confidence intervals (CI) for associations and indirect effects for mediation analyses were computed. Results Our results showed that Indigenous Australians with higher levels of perceived social support were less likely to have psychological distress (OR = 0.36, 95% CI: 0.23, 0.56), depression (OR = 0.44, 95% CI: 0.29, 0.67), anxiety (OR = 0.43, 95% CI: 0.28, 0.65) and low self-rated health (OR = 0.52, 95% CI: 0.33, 0.82). Similarly, those with a high level of mastery were less likely to have psychological distress (OR = 0.14, 95% CI: 0.11, 0.19), depression (OR = 0.20, 95% CI: 0.15, 0.28), anxiety (OR = 0.26, 95% CI: 0.20, 0.36), and low self-rated health (OR = 0.37, 95% CI: 0.28, 0.50). Perceived social support mediated 33.7% of the association between removal from the natural family and psychological distress, 14.6% of the association between discrimination and psychological distress, 20.3% of the association between discrimination and depression, 14.8% of the association between discrimination and anxiety and 16.6% of the association between discrimination and low self-rated health. Both perceived social support and mastery mediated the association between physical harm and psychological distress, depression and anxiety. Conclusions We believe that community-driven psychosocial programs that enhance social support, self-efficacy and cultural connection may significantly improve the mental health and psychosocial well-being of Indigenous Australians.