Abstract
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.