O-45 Implementation of a Multisectoral Programme to improve Indigenous AdolesCenT mental health (IMPACT) in Brazil and Dominica: co-development with Kalinago adolescents and multisector stakeholders i

Methods: We conducted readiness assessments at 3 PHCs and 4 schools in the Kalinago Territory and border areas, a focus group with 14 Kalinago school children (10-13 years), and 2 half-day World Café workshops with stakeholders (n=31) including teachers, parents, government actors, primary care clinicians, MH specialists and community leaders. Adapted readiness questionnaires incorporated the WHO Building Blocks and Mental Health GAP - Community Toolkit. Collaborative sense-making with stakeholders triangulated quantitative and qualitative findings.

Results: There was strong alignment across all stakeholder groups on the importance of protecting adolescent Kalinago MH, programme engagement with the Kalinago socioeconomic and cultural contexts, and for capacity building of practitioners and communities in adolescent MH prevention. Primary care MH services were minimal, with a paucity of trained on-site practitioners in MH. Protocols for referring children to the primary health care clinics (PHCs) are absent. Students reported a positive outlook on life, particularly in relation to future aspirations but there were concerns, which aligned with the narratives from teachers and community leaders, about bullying, family dynamics and loneliness.

Conclusion: This formative phase co-identified key considerations to increase the likelihood of IMPACT’s effectiveness, sustainability, and scalability. These included the importance of multisector governance anchored by adolescent voices, capacity building, co-development of protocols, and using art-based and digital technologies for implementation, evaluation, and advocacy.