Toolkit identification
Figure 1 details the process of identification and inclusion of toolkits for analysis. After initial identification of 38 toolkits, at the data extraction phase, one toolkit was excluded from analysis because it was no longer available online (a toolkit produced by Batyr Australia), and another five toolkits were excluded for analysis because, upon data extraction, it was apparent they did not meet the inclusion criteria. Of these, the TalkCampus “Your student mental health toolkit” was identified to be an international resource and was an article that had used the term “toolkit” as a metaphor, rather than acting as a toolkit resource per our definition.[26] The South Australia Public Sector Mentally Healthy Workplaces Toolkit and the iCare Social Connections Toolkit were excluded as they were identified to be toolkits for workplaces rather than workers.[27, 28] Similarly, the Lourdes Hill College toolkit for positive mental health was excluded as it was intended for parents rather than young people themselves.[29] The Village app was excluded because it was not downloadable on an Australian device.[30]
Summary of toolkits
Table 2 provides a summary of the location of toolkits (Australia or New Zealand), the intended audience, and the formats of the toolkits. Of the 32 toolkits analysed, most (24) were from Australia.
In terms of intended audience, 14 toolkits were designed for young people, three for first responders, and one for young people who were also first responders. Another 12 were for paid workers, one for unpaid workers, and three for sports club members. One toolkit, the Care4Guide, was identified as being for two audiences – young people who are also first responders.[31]
Toolkits came in a range of formats, most commonly static webpages (13) or Portable Document Format (pdf) (10). The toolkits accessible through multiple formats included the Emerging Minds Community Trauma Toolkit in which resources were available via podcasts, short articles, and videos.[32] Another multi-format toolkit was the Care4Guide, which was available as a static pdf, an interactive online training module, and as downloadable desktop computer software where each format included largely similar content, but could be accessed in accordance with user preference.[31]
Table 2
Summary data of toolkits analysed
Variable | n | % |
Total | 32 | 100 |
Location of Resource | | |
Australia | 24 | 75% |
New Zealand | 8 | 25% |
Intended audience | | |
Young people (not strictly age defined) | 14 | 44% |
First responders | 3 | 9% |
Unpaid workers | 1 | 3% |
Paid workers (who are not first responders) | 12 | 38% |
Sports club members | 3 | 9% |
Format | | |
Mobile apps (downloaded through Android Google Play or iOS App Store) | 3 | 9% |
Downloadable and printable PDFs | 10 | 31% |
Interactive webpages (require user input to progress through) | 2 | 6% |
Static webpages (are to be read through with limited/no interactivity) | 13 | 41% |
Multiple formats | 4 | 13% |
A summary of extracted toolkit data is included in Table 3, which includes each toolkit’s name, citation, topic, format, target audience, an overview of included content, and (where available) evidence underlying each toolkit.
Table 3
Toolkits included in survey and analysis intended for young people
Toolkit name | Reference | Topic | Format | Target audience | Content | Evidence underlying toolkit |
Mental wealth | Le Va, 2019 [33] | Mental wellbeing and mental illness for young people | Website - information, tips, exercises, and resources | Young people New Zealand | Resources under three main categories: Check in, Feel good, and Stay Connected. Check in includes facts about mental health, common mental health problems (depression, anxiety, alcohol, bullying, gaming, etc.) and how to check in on your own mental health 'Feel good' has info about taking care of your mind, body, and soul (including spirituality and cultural identity) 'Staying connected' has info on how to connect, intergenerational communication, and links to other resources. | None found |
Toolkit for Mentally Healthy Workplaces | Australian Services Union - Victoria and Tasmania, 2018 [34] | Rights around workplace safety as it pertains to mental health | Website - information and resources | Paid workers Australia | About mental health OHS and psychosocial health & safety Health & Safety union rep info | None found |
Architects mental wellbeing toolkit | The Architects Mental Wellbeing Forum, 2021 [35] | Promoting a mentally healthy architecture workplace | PDF - actionable tips and resources | Paid workers (architects) Australia | Office culture & overtime Support systems & staff education Caring for students, interns, & graduates in practice Contracts, clients, & managing deadlines Physical office environment Technology Promoting a healthy workplace Champion a mindful, active approach (extracurricular office activities like sports, plus taking lunch breaks, etc.) Further resources | This is an adapted version of the UK Toolkit, which was compiled by members of the Architects Mental Wellbeing Forum in the UK.[35] |
Wellbeing Toolkit | Australian Red Cross, 2022 [36] | Combatting stress and burnout | PDF - information, questionnaires, and activities | Unpaid workers Australia | Definition of wellbeing (from the WHO), and of stress and stress symptoms. Tips to combat stress. Self-questionnaire assessing your level of stress. Burnout checklist Advice to recover from stress/burnout (concept of the "recovery rocket"), including a self-assessment for recovery level Self-care plan (for readers to fill out) Information about positive psychology and exercise to reflect on what activities make you feel good/help you to flourish, and ideas to try. | None found |
Community Trauma Toolkit | Emerging Minds, 2019 [32] | How first responders can support the mental health of young people who have experienced a traumatic event. | Multiple - hosted on a website with podcasts, short articles, videos, fact sheets. | First responders (who work with children and young people) Australia | Incident preparedness Immediate aftermath of incidents Short-term/long-term/ongoing coping with trauma | A co-design and consultative process with intended audience members, disaster recovery and resilience groups and experts, as well as children and families who have lives experience of traumatic incidents.[37] |
Smiling Mind | Smiling Mind, 2023 [2012] [38] | Supporting sleep, meditation, and mindfulness; stress reduction. | App - User answers some questions about their interests and mental state and the app suggests some interactive mental health programs. | Young people (aged 3 to 18) Australia | A range of programs you can complete, divided up by age category, group (like families, classrooms, at work), topic, and language. For example: "An introduction to mindfulness", "supporting students' wellbeing through challenging times", "planning for the future", "getting a better night's sleep". | Topics covered are based on evidence (e.g. on the effectiveness of meditation broadly).[38] Research evaluations and collaborations are undertaken. E.g. [39–41] |
My Toolkit - Build Your Space | headspace, 2022 [42] | Learning about mental health, improving your own mental health, identifying mental illness, and helping out others | Interactive website - users choose modules relevant to them. | Young people Australia | Can select from a huge range of resources, both in terms of looking after your own or another's mental health and life stressors. Users choose from a list what is relevant to them and 'build' their own space with relevant modules. Some modules have self-tests, or walk-throughs to tackle problems. | Headspace does undertake research and evaluation,[43] but no relevant evidence for this toolkit was found. |
Healthy headspace Action Plan | headspace, 2019 [44] | Developing a plan to improve one's own mental health | PDF − 2-page worksheet and reference | Young people Australia | 2 page resource framed around self-care and getting users to reflect on looking after their own mental health. It includes an action plan to increase activities to promote mental health which the user fills out, and 7 tips to promote mental health. | Headspace does undertake research and evaluation,[43] but no relevant evidence for this toolkit was found. |
Students - mental health and wellbeing toolkit | State Government of Victoria, 2022 [45] | Improving one's own mental health and addressing distress/mental illness | Website - reference and advice | Young people (school-aged) Australia | Mental health tips Connecting with specific communities (Koori, LGBTI, people with disability, CALD communities) Where to find help for you or a friend Information about common mental health concerns for young people (e.g. anxiety, depression, bullying). | None found |
The Mental Health Toolkit for Young People | Kindred, 2022 [46] | Introduction to mental ill-health and distress. | PDF - information and activities | Young people Australia | Defines mental health as well as mental health conditions Explains different available mental health services (crisis lines, chats, counsellors, peer coaches, etc.) Understanding emotions (with an activity) Explainers on common conditions (anxiety, depression, stress and burnout) with personal stories; and brief info on other conditions Tips on coping in uncertain times (e.g. lockdown, natural disasters) | Young people and psychologists contributed to building this toolkit.[46] |
Niggle app | Kids Helpline, 2019 [47], Zelenko, Cheers, 2019 [48] | Dealing with worry | App - forms a 'to do' list for the user to complete, based in their inputs | Young people (aged 5 to 25) Australia | User identifies how they are feeling and what's bothering them (e.g. cyberbullying, the news, work/school stress, sex/relationships, mental health issues, physical health, family issues, identity, and more). The app suggests related tools (tipsheets, apps, videos, audio, and others' stories) and activities that might help. The tools and activities then make up a 'to do' list. The worries are visualised as "niggles" - a shape that you can update as things change. | Queensland University of Technology partnered up with Kids Helpline, over 30 young people and Kids Helpline counsellors to create Niggle.[48] |
Mental fitness toolkit | Peak Fortem, 2021 [49] | Improving "mental fitness" | Interactive website - resources are available in audio, video, and text. | First responders Australia | Introductory video on mental fitness (analogised to physical fitness) Program is divided into 4 categories (Control, Motivate, Boost, Balance) each with a range of practical exercises and tools such as breathing techniques, problem solving skills, positive self-talk, visualisation, goal setting, and gratitude. | Based on research about the Cognitive Behaviour Model and the Emotional Regulation Model.[50] |
Community Responders project | The Australian Centre for Social Innovation, 2019 [51] | How to have a positive, community response to mental ill-health and mental wellbeing | PDF - worksheets and information | Young people Australia | Two toolkits: One for roles people need to take to support the mental health of their community, the second to have safe and productive conversations about mental health. | The toolkits have been developed with a significant community consultation process led by young people with lived experience of mental ill-health.[51] |
Club Toolkit | Outside the Locker Room, 2020 [52] | Responding to one's own or another's mental health challenges | PDF - reference information | Sports clubs Australia | Information about what to look out for (signs and symptoms of mental health challenges), how to talk about mental health, how to respond to someone in need of support, and information about support services. | None found |
Care4Guide | Bushfire and Natural Hazards CRC, 2021 [31] | Mental wellbeing as a first responder | Multiple - a PDF workbook, an interactive course, and downloadable software | Young people First responders Australia | What is mental health Building blocks of wellbeing (e.g. social connections, sense of achievement, gratitude) Protecting your mental health (reducing the impact of traumatic incidents/dangerous situations) Mindfulness - info and practical exercises Self-compassion Coping skills for difficult situations Checking in with your mental health Making a list of people you can go to if you need support List of help resources | This project was a partnership between the CRC, AFAC, the University of Adelaide, the University of Western Australia, Flinders University, the University of British Columbia, the Hospital Research Foundation, Military and Emergency Services Health Australia and key fire and emergency services, as well as the young adult members of AFAC’s Young Volunteers Advisory Committee, who informed the development of all resources.[31] |
AFL Club mental health & wellbeing | AFL, 2023 [53] | Information about mental illness and mental health safety in clubs | Multiple - website with webinars, tools, and information. | Sports clubs (AFL players) Australia | Mental health webinar viewable online Ahead of the Game - "teaches players, parents, coaches, umpires and volunteers to understand mental health, build mental fitness, and strengthen resilience to deal with challenges in sport and life." How to seek help tool How to respond to a critical incident How to respond to a suicide Safe storytelling guide (how to communicate about mental health in a way that prioritises the safety of the person with lived experience) Club resources: choosing a mental health program for your club, promoting a culture of safety and inclusion | None found |
Workplace Mental Health Toolkit | Black Dog Institute, 2017 [54] | Handling mental illness at work | PDF - information and guidance | Paid workers Australia | Context about mental health/mental illness, its impact on workplaces Fact vs fiction on mental illness Info about stress, depression, and anxiety Information about supports available Rights and responsibilities at work (protections against discrimination, reasonable adjustments), and information about disclosing/talking about mental health at work Tips for staying well Links to help resources | The Black Dog Institute is a research institute and they report that their workplace training generally is evidence-based on their website,[55] but no specific evidence found for this toolkit. |
Workplace Mental Health Toolkit (variation) | Black Dog Institute and Healthy Heads, 2021 [56] | Handing mental illness in the truck driving, warehouse, logistics industries | PDF - information and guidance | Paid workers (truck driving, warehouse, logistics) Australia | Same as above plus information on the impact of mental health in these specific industries | As above |
Work and Mental Health | Beyond Blue, 2022 [57] | Mental wellbeing and mental illness at work | Website - information | Paid workers Australia | Self-care Mental health conditions (anxiety and depression, plus links to info about other conditions) Staying at or returning to work in/after a mental health episode Working with a mental health condition Bullying Deciding about disclosure Helping a workmate Suicide prevention Resource library Personal stories | Beyond Blue has dedicated research and policy staff, however no evidence is available for this specific toolkit. |
Workplace Mental Health Month Toolkit | WayAhead, 2022 [58] | Activities to promote mental wellbeing in the workplace | Multiple - activities to do on one's own and collectively, and information | Paid workers Australia | Morning tea guide Mental health month trivia Calendar of mental health tips for the workplace Conversation cards Colouring in pages (for mindfulness) Looking after your mental health at work tips Tips on being a mental health ally | None found |
Fighting Fit | Australian Government - Defence, 2023 [59] | Mental health resources for the Australian Defence Force | Website - list of resources and information | Paid workers Australia | Help phone numbers specifically for ADF members and families. List of health resources (including suicide prevention and mental health as well as physical health). Health updates. | None found |
Workplace Resources for asking "Are you OK?" | R U OK?, 2018 [60] | Activities to promote mental wellbeing in the workplace | Website - guides, posters, presentations, and information about hosting RUOK. | Paid workers Australia | Downloadable Conversation Guide, 4 Steps Poster, Conversation Framework Poster, Support services poster, workplace presentation template, industry-specific resources, resources on hosting RUOK Day. | None found |
Recovery at Work Toolkit | NSW Government - State Insurance Regulatory Agency, 2023 [61] | Mental health recovery at work | Website - information and resources | Paid workers Australia | What is recovery at work? (in terms of mental health practical actions to maintain positive mental health How to talk about supporting recovery at work (for people with mental illness, leaders, managers; developing a recovery at work plan) Mental health continuum - mental health not as a static state, but something that needs constant checking in Making changes (reasonable adjustments, staying connected, building mentally healthy/safe culture at work) Further resources | None found |
Mental health and wellbeing | CPA Australia, 2021 [62] | Avoiding burnout at work | Website - tips and resources | Paid workers (accountants) Australia | Strategies for avoiding burnout List of supports provided through CPA or externally (e.g. online course, mental health first aid course) Links to Beyondblue resources and training program | None found |
5 ways to wellbeing | Next Gear, 2017 [63] | Mental wellbeing in the construction industry | PDF - activities, information, and resources | Paid workers (construction) Australia | Set of factsheets: why is mental health important, particularly in this industry (construction) Laing O’Rourke's relationships with help organisations, internal support services, mental health champions/first aid through the organisation The role of leadership Discussion resources on: the five ways to mental wellbeing, ten things you can do to improve mental health, one-minute stress strategies, gratitude, recalibration after a stressful life event, mindfulness. An activity guide Goal setting template (worksheet) Action plan template Links to external help resources. | None found |
School Leavers’ Toolkit | New Zealand Government - Ministry of Education, 2020 [64] | Caring for your mental health as a school leaver | Website - information and resources | Young people (late-teens) New Zealand | A range of info, one section of which is caring for your own and others' mental health. Mental health section includes info on: Where can I get help when things get bad? What can I do to help someone who is feeling low? How can I keep mentally well? Mental illness A guide to help you stay healthy Key websites | None found |
Staying On Track | Just a Thought, 2020 [65] | How to support your mental health during COVID (and beyond) | Website - online course | Young people New Zealand | An online course "to support your wellbeing during COVID-19 and beyond" - available as an interactive or audio course (Just a Thought also has other courses for specific diagnoses). This course includes some Cognitive Behavioural Therapy (CBT) information, info on staying connected, mindfulness, etc. A range of web, audio, and PDF guides on relaxation, mindfulness techniques, sleeping, CBT-related exercises (re-framing worries), solving problems, etc. | Adapted from resources developed by a team of clinicians and researchers from St Vincent's Hospital, Sydney, and the University of New South Wales to improve personal wellbeing and for the treatment of anxiety and depressive disorders.[66] |
Melon App | Melon Health, 2021 [67] | Mental wellbeing for young people | App - interactive modules and information in audio, video, and text formats | Young people New Zealand | Health Journal (tracking sleep, activity and mood and how they affect you) Resources are presented as a "program", which is similar to a set of online training modules. Questions to reflect on and assess your progress Coping tools (Podcasts, videos and articles on mindfulness, nutrition, creating habits, relationships, etc.) | Melon Health offers a range of health apps, and their diabetes app has been evaluated in a randomised control trial.[68] However, no evidence found for this mental health app. |
All right? | Canterbury District Health Board and Mental Health Foundation of New Zealand, 2013 [69] | Mental wellbeing and connection for young people | Website - tools, resources, and products (some available for purchase) | Young people New Zealand | Connecting with culture Tips for daily wellbeing Tips for being your best (finding your strengths, making new habits, etc.) Tips for parents/family/whānau Workplace wellbeing Identity and culture Sparklers (resources for primary school students) Coping in tough times | All Right? says that it undertakes consultation with different target audiences (e.g. LGBTQIA, parents, workers, CALD communities, mental health service users, and others) to understand what issues are pressing for them and to evaluate the effectiveness of their resources.[70] |
CALM - Computer Assisted Learning for the Mind | The University of Auckland Faculty of Medical and Health Sciences, 2009 [71] | Managing mental health challenges for young people | Website - information and resources | Young people New Zealand | Mental resilience Managing stress, anxiety and depression Healthy relationships Finding meaning in life Guided meditations Further help resources | Research was conducted on CALM users among university medical students. The research found that users had higher anxiety levels at baseline than the population average, indicating effective self-selection of users.[72] |
Mind. Set. Engage. | New Zealand Rugby Union, 2018 [73] | Mental fitness and managing mental illness for rugby players | Website - information | Sports clubs (rugby players) New Zealand | Resources in 3 categories: Want to be mentally fit? Advice for daily wellbeing Feeling off? Info about depression, anxiety, injury, and other issues that may affect rugby players. Worried about someone else? Information for different figures (coaches, caregivers, and mates) | None found |
Five Ways to Wellbeing at Work Toolkit | Mental Health Foundation of New Zealand, 2021 [74] | Mental wellbeing at work | PDF - information and worksheets | Paid workers New Zealand | An outline of the 5 ways to wellbeing, a business case for them, role of leadership, creating supportive environment, implementing, talking openly about mental health at work, and evaluating/celebrating impact at work. There's also a lot of supportive tools like promotional materials, wellbeing bingo, action plan template, etc. Links to other resources. | None found |
Toolkit Analysis
The randomised 32 toolkits were independently reviewed by 68 survey respondents who have expertise in a range of domains, as summarised in Table 4. Due to the length of the survey and the ability to review as many as they were able, only seventeen respondents (25%) completed 99 or 100% of the survey and there was an average completion rate of 33%, constituting an average of around 10–11 toolkit reviews per participant. Each toolkit was reviewed by a mean number 13.76 reviewers (SD = 1.72), as calculated from the supplementary table provided in the Appendix (Table 2). The survey took a median time of 102 minutes to complete for the seventeen respondents who completed 100 or 99% of the survey.
Table 4
Domain expertise of respondents1
Domain | n | % |
Researchers: | 11 | 16% |
Human Geography2 | 2 | 3% |
Injury/drowning prevention | 2 | 3% |
Mental health/Psychology | 2 | 3% |
Public health | 3 | 4% |
Other | 2 | 3% |
Psychologists | 2 | 3% |
SLSA (and state body) – paid workers | 20 | 29% |
SLSA – unpaid workers | 30 | 44% |
Social workers | 4 | 6% |
Other first responders (e.g. police officer, paramedic) | 3 | 4% |
Quantitative Analysis
Table 5 shows the mean value of each of the toolkits on each of the variables of usefulness, relevance, appropriateness, and accessibility; its helpfulness in managing the impacts of SLSA work; and its general helpfulness in stress management (with the highest possible score of 5 and the lowest possible score of 1 on each measure). Table 5 also shows the highest and lowest mean scores of each variable scored by an individual toolkit. Overall scores were lowest on toolkits’ capacity to manage SLS-specific trauma (with a mean score of 2.62, a maximum mean of 4.05, and a minimum mean of 1.48). These results are indicative of a potential gap in the ability of existing toolkits to manage the impact of performing rescues and other high-risk situations – such as responding to suicides and self-harm – that arise in Australian waterways. Toolkits, on average, were given higher ratings on other variables. Appendix 2 includes a supplementary table of the mean scores of each toolkit on the same measures as in Table 5.
Table 5
Summary statistics of usefulness, relevance, appropriateness, accessibility, capacity to help manage SLS-specific trauma, and capacity to help manage general trauma across toolkits.
Variable | Mean (SD) | Max mean | Min mean |
Usefulness | 3.13 (0.54) | 4.17 | 2.08 |
Relevance | 3.01 (0.54) | 4.17 | 1.92 |
Appropriateness | 3.07 (0.53) | 4.25 | 2.14 |
Accessibility | 3.16 (0.50) | 4.25 | 2.29 |
Specific trauma | 2.62 (0.50) | 4.05 | 1.48 |
General trauma | 3.07 (0.56) | 4.36 | 2.08 |
An analysis was undertaken to find the mean scores of toolkits, divided by intended audience category, as per Table 6. Overall, toolkits intended for first responders and young people were highest rated, while toolkits intended for workers were lowest rated, on average.
Table 6
Usefulness, relevance, appropriateness, and accessibility of toolkits by intended audience
Intended Audience | Variable | Mean (SD) |
Young People |
| Usefulness | 3.45 (0.38) |
| Relevance | 3.35 (0.36) |
| Appropriateness | 3.41 (0.37) |
| Accessibility | 3.42 (0.42) |
| Specific trauma | 2.78 (0.47) |
| General trauma | 3.33 (0.51) |
First Responders |
| Usefulness | 3.83 (0.30) |
| Relevance | 3.82 (0.31) |
| Appropriateness | 3.81 (0.39) |
| Accessibility | 3.83 (0.37) |
| Specific trauma | 3.56 (0.46) |
| General trauma | 3.81 (0.48) |
Unpaid workers3 (who are not first responders) |
| Usefulness | 3.27 (n/a) |
| Relevance | 3.13 (n/a) |
| Appropriateness | 3.29 (n/a) |
| Accessibility | 3.27 (n/a) |
| Specific trauma | 2.61 (n/a) |
| General trauma | 3.47 (n/a) |
Paid workers (who are not first responders) |
| Usefulness | 2.64 (0.41) |
| Relevance | 2.51 (0.43) |
| Appropriateness | 2.55 (0.37) |
| Accessibility | 2.76 (0.43) |
| Specific trauma | 2.27 (0.40) |
| General trauma | 2.63 (0.45) |
Sports club members |
| Usefulness | 3.18 (0.25) |
| Relevance | 3.00 (0.13) |
| Appropriateness | 3.16 (0.08) |
| Accessibility | 3.24 (0.14) |
| Specific trauma | 2.76 (0.18) |
| General trauma | 3.13 (0.18) |
Top toolkits
An analysis was undertaken to determine the highest scoring toolkits across all variables. The toolkits with the five highest mean scores for each variable were listed and consistently high scoring toolkits are collated in Table 7. The Care4Guide[31] had the highest mean scores across all variables and was the only toolkit to have a mean score over 4 for any and all variables. Headspace’s Build Your Space[42] ranked within the top five toolkits across variables except “accessibility” and the Smiling Mind app[38] were ranked among the top five toolkits in all categories except “specific trauma”. Emerging Mind’s Community Trauma Toolkit[32] ranked in the top five of all variables except “usefulness” and “general trauma”. Table 7 also includes representative comments regarding these top toolkits pertaining to their strengths and weaknesses for the young SLSA member target demographic.
Table 7
Four top-scoring toolkits
Toolkit name | Variable | Mean | Representative comments regarding toolkit |
Care4Guide [31] | | | • “Useful, mostly engaging exercises. Lots of activities… This resource really feels like it "gets" what it's like to be a young first responder.” • “Would be good as a baseline with some additional modules focused on the marine / SLSA environment.” • “This seems to be really helpful, being geared specifically to young first responders and teaching resilience strategies, coping mechanisms etc.” |
Usefulness | 4.17 |
Relevance | 4.17 |
Appropriateness | 4.25 |
Accessibility | 4.25 |
Specific trauma | 4.05 |
General trauma | 4.36 |
Build Your Space[42] | | | • “Specifically aimed at young people. Well known and highly regarded organisation providing the information which gives it credibility.” • “A barrier would be needing to sign up (although, it would be impossible to otherwise make it so individualised) and I'm not sure how applicable it would be in a first response sense, but otherwise it would probably be very helpful.” • “Even though there were many, many topics available, I was surprised to see very little relating to trauma specifically.” |
Usefulness | 3.91 |
Relevance | 3.73 |
Appropriateness | 3.82 |
Accessibility | 3.55 |
Specific trauma | 3.07 |
General trauma | 3.90 |
Smiling Mind[38] | | | • “Would aid in mindfulness post critical incident which for some young people would find helpful.” • “More accessible than the other resources and information is easier to digest.” • “Good as a follow up to any training but not [as a] stand alone [resource].” |
Usefulness | 3.88 |
Relevance | 3.75 |
Appropriateness | 3.81 |
Accessibility | 3.61 |
Specific trauma | 2.90 |
General trauma | 3.73 |
Community Trauma Toolkit[32] | | | • “Focussing on young people and on traumatic events is obviously relevant. Although it’s not geared towards supporting first responders and their specific [needs], it is important to know for engaging with the community after these events and I would think knowing the information would have some benefits for the first responders.” |
Usefulness | 3.60 |
Relevance | 3.73 |
Appropriateness | 3.67 |
Accessibility | 3.67 |
Specific trauma | 3.48 |
General trauma | 3.46 |
Thematic Analysis
Free text responses were coded by theme: delivery, content, relevance, and application to SLSA contexts. A 10% check was undertaken to determine inter-coder reliability, which revealed an agreement of 76%, and a Cohen’s kappa of 0.41, indicating moderate agreement.[25] Disagreements were straightforwardly resolvable through an additional review of the data, as is commonly the case in qualitative, subjective research.[25] No major differences in the interpretation of the meaning of individual comments were evident.
Although unpaid SLSA members were well-represented among respondents, they were less likely to leave free text responses compared to researchers, as is reflected in the quotes extracted for thematic analysis.
Delivery
As reflected in Table 3, toolkits were presented in a range of different formats. Reviewers spoke to the advantages and disadvantages of those formats in presenting information, particularly for communicating with a younger audience. Several reviewers expressed a preference for having multiple format types available for users, and for users to be able to choose how they interact with the content. On the Community Trauma Toolkit,[32] a geography researcher commented that rather than being forced to read long swathes of text, young SLSA members “can instead listen to it on a podcast.” Choices that make it “easier to digest information” was considered “an effective strategy in encouraging engagement with the material.” Other comments further emphasised keeping text to a minimum, and integrating self-tests, case studies, pictures, video, and audio.
Moreover, the ability to extend choice to building your own relevant resource (as per headspace’s Build Your Space toolkit[42] and the Niggle app[47]) was considered innovative and valuable.
Some concern was raised over printable resources and their likelihood of being used. A public health researcher pointed out that it was unlikely that younger people owned printers, while a paid SLSA worker and injury prevention researcher worried that printed resources “will just gather dust”.
Several reviewers also expressed concern about the journal format of the Melon app,[67] which asks users to input text over time, saying that they did not imagine many young SLSA members being interested in habitually engaging with this format.
Multiple reviewers also pointed out that it would be advantageous for toolkits to work well on mobile devices commonly used by younger people. Some toolkits (especially older ones) were found not to be mobile friendly.
There were relatively few comments relating to the visual design of toolkits, but reviewers generally indicated a preference for “simple”, “minimalistic”, and “modern” layouts that are easy to navigate. Resources that appeared to be “dated” or “corporate” were suggested to be disengaging for younger demographics.
Reviewers were further mindful of the ways language use and the logical presentation of content would appeal to young SLSA members. They were critical of content that came across as “boring”, “dry”, “dense”, or overly “corporate”, “clinical”, or “academic”. On the other hand, “authenticity” and “relatability” were valued.
The toolkits included in the analysis had different means of structuring their information. Toolkits were generally complimented for being “well curated” or “brief”. Where toolkits included a lot of content, reviewers suggested that a clear structural break-down of that content was desirable.
Reviewers left varied comments in relation to the ease of accessing and engaging with the toolkits for young people. Multiple access barriers were identified, such as need for login, having too many links to click through, exercises akin to “homework”, and documents being overly long. Giving over app permissions and personal data was also felt to potentially undermine confidentiality.
Content
Reviewers emphasised the importance of a toolkit that would appeal to the 13–25 age demographic specifically. Toolkits whose intended audience were young people were assessed as being overall age appropriate for young SLSA members.
While there was also caution around toolkits that felt too “corporate” or difficult to use, there was also caution around toolkits feeling “too young” as well. One response suggested that the Niggle app,[47] produced by the Kid’s Helpline, may not be age appropriate as this age demographic would find identification as a “kid” to be off-putting. A different reviewer suggested that this app could, however, be a useful resource for “nippers” (an SLSA junior development program for children aged 5–14). Some toolkits (such as Mental Wealth[33] and Niggle[47]) were identified as appropriate for younger people within the target age group, but potentially not relevant for those in their older teens and twenties.
An identified component of age-appropriateness is recognising that younger people may not have had much previous psychoeducation. This was identified a challenge for adapting resources originally intended for adults. A psychology researcher, for example, was critical of the Outside the Locker Room[52] resource for assuming “a level of basic mental health literacy that young people often do not have.”
Interactivity, group activities, visualisation (such as visualising a mental health “niggle” in the Niggle app[47]), and gamification were identified as good strategies for engagement. Two reviewers suggested that the links between mental and physical fitness expressed by the Peak Fortem toolkit[49] (alongside Mind. Set. Engage.[73]) provides a novel means of engaging young SLSA members. A public health researcher said, “The emphasis on the link between physical and mental health may appeal to SLSA volunteers as people who undertake physically demanding work.” Similarly, a geography researcher pointed out that fitness is seen as a “positive” trait in general, and echoing that positivity in “mental fitness” may be effective.
Reviewers assessed the creators of each resource and made several comments in regard to the overall credibility. Organisations judged to have credibility included headspace,[42, 44] R U OK?,[60] and the Black Dog Institute.[54, 56] Some resources were complimented for being evidently “well researched”.
In terms of specific topics for inclusion, many responses pointed out that more general mental health guidance (for example, around dealing with stress, practising mindfulness, or building resilience) are of relevance to potentially traumatic situations encountered by young SLSA members, but would not be sufficient on their own without further specific guidance pertaining to trauma, especially “high acuity” presentations and critical incident preparation and response.
Other topics suggested for inclusion in toolkits included information about “burn out” to assist young people juggling multiple commitments (such as the demands of SLSA membership with school or university), “success stories”, a mix of information about how to seek help for oneself as well as helping others, and links to other services (particularly free services). Resources on relationships, bullying, and climate anxiety were all suggested as relevant.
There was an overarching attitude that an ideal resource would be comprehensive, as reflected in a comment from a psychology researcher that, based on their research, young people desire “self-contained” resources “that they don't have to leave to go and find information and strategies.”
Relevance
Very few of the toolkits deal specifically with exposure to trauma, which reviewers identified as a shortfall. The Care4Guide[31] and the Peak Fortem[49] mental fitness toolkit were both highlighted as being relevant for trauma preparation and recovery for first responders including young SLSA members. A paid SLSA worker surmised that “any of the toolkits that target first responders seem far more helpful than the ones that target general mental health.”
Reviewers responded to values they found expressed by several toolkits, as well as values which would be important to incorporate in a fit-for-purpose toolkit for young SLSA members.
Several reviewers pointed to inclusion as a key value for mental health toolkits. A social worker, for instance, praised the Australian Centre for Social Innovation (TACSI) toolkit[51] as it “demonstrated a commitment to diversity.” An injury prevention researcher similarly thought the Victorian Government toolkit[45] was strong in its coverage of “a range of minority communities”.
Toxic positivity”, or failures to represent the complex realities of young SLSA members were identified as being important to avoid. Instead, reviewers valued realism and frankness when discussing mental health. Reviewers were supportive of toolkits that were realistic about the experience of mental ill-health, the impact of systemic issues like challenging working conditions, and power dynamics. As a social worker surmised of the Next Gear toolkit,[63] “The "let’s make the most of every day" on every page is really off-putting and patronising at best. Toxic positivity helps no one. I think many would see that and would close down the document – I wanted to.
It was important to multiple reviewers that the onus of improving mental health was not seen as a purely individual task, but instead one that the SLSA community as a whole takes ownership of. Reviewers highlighted the role of a supportive community and organisation, and building connections.
Another value running implicitly through reviewers’ responses is pragmatism. Although high-level, conceptual information about mental health was viewed as having a place, reviewers looked favourably on “actionable”, “active” (as opposed to “passive), “practical” resources that showed readers/users what to do when facing distress, and guided them through activities.
Application
Reviewers acknowledged that a toolkit is not sufficient on its own as a mental health strategy for improving the mental health of young SLSA members. Reviewers suggest access to psychological support, support from team leaders, support from peers, mental health training and “face-to-face sessions”, and even “providing practical support such as meal planning, [and] meditation” (SLST state paid worker) is critical for the success of SLSA’s mental health strategy. As a geography researcher succinctly put it: “Dealing with body retrieval and other highly traumatic events shouldn't be left to an app”.
Yet, although very few toolkits dealt directly with trauma and the nature of first response work, most other toolkits were seen to hold some benefit for this target audience, but would require varying levels of adaptation to be appropriate for an SLSA environment. A typical comment to this effect, made by an unpaid SLSA worker and paramedic on the Niggle app,[47] was: “This would be good supplementary information to back up the specific first responder information.”
As toolkits were selected from a wide-ranging search, several were identified as being completely remote from SLSA contexts. For instance, toolkits for specific professional groups (such as CPA accountants,[62] architects,[35] transport and logistics workers,[56] construction workers,[63] etc.) were difficult for reviewers to see how they could be relevant to a young SLSA cohort. Toolkits intended for sports club settings also tended to be dismissed as irrelevant, with some exceptions. For example, multiple reviewers indicated that the Critical Incident Response Guide included in the AFL toolkit[53] would be useful for SLSA clubs, albeit likely not to young members themselves.
At the same time, reviewers imagined how various resources could be applied to SLSA scenarios, even though they were initially created for different contexts:
Young members can use the App post incident and use that as a way to journal, keep track of daily activities etc. (Social worker, Melon app[67])
Promote how many of us use and are using this, so people see it more as a trend / a popular coping strategy. (SLSA unpaid worker, Smiling Mind app[38])
[This] Information… could be a reference for the Peer support officers. (SLSA unpaid worker, Emerging Minds Community Trauma toolkit[32])
I believe if used correctly would provide resilience prior to and incident and additional support post the incident. Peer support could provide some direction to the app. (SLSA unpaid worker, CALM[71])
Would give clubs some good ideas for events to put on after an incident so everyone can debrief… (SLSA paid worker, WayAhead workplace mental health toolkit[58])