Community Is Medicine: Understanding Indigenous Youth-Led Peer Support in Mental Health and Suicide Prevention

Abstract

Indigenous youth in Canada face complex mental health challenges, including disproportionately high rates of suicide. Peer support separates itself from typical mental health care provision by centering the value of lived experience to provide hope, challenge stigma, and build a sense of community and self-efficacy for young people. Through peer support, Indigenous youth can share their experiences, offer one another support, and honor their cultural identities. The purpose of this study is to understand what culturally grounded strategies Indigenous youth peer support models use to promote Indigenous youth resilience, mental wellness, and suicide prevention. This study adopts a partnership-oriented, community-based research approach that centers Indigenous youth leadership and knowledge, grounded in the concept of “wise practices.” This study examines two Indigenous youth-led peer support programs: We Matter (operating nationally across Canada) and Yúusnewas (operating regionally in British Columbia, Canada) through interviews, program observation, and digital content analysis. Results indicate that We Matter and Yúusnewas both have four core culturally grounded program elements: cultural programming, intergenerational involvement, harm reduction education, and youth political advocacy and leadership development. Through centering Indigenous knowledges, these programs serve as an example of culturally relevant, sustainable, and effective Indigenous mental health promotion approaches.

Introduction

Indigenous youth in Canada face complex mental health challenges, including disproportionately high rates of suicide, the leading cause of death among Indigenous individuals under 45 (Statistics Canada, 2019). These outcomes reflect not only individual struggles but also systemic conditions shaped by intergenerational trauma, cultural dislocation, and inequities in care access (Ansloos, 2018; Inuit Tapiriit Kanatami, 2016; Statistics Canada, 2019). For Indigenous youth, navigating identity within the context of colonial and racialized inequities underscores the importance of culturally resonant, community-driven approaches to mental health.

Youth-led peer support programs may provide a culturally grounded response to mental health promotion and suicide prevention. Peer support focuses on connection, solidarity, and mutual care, distinguishing it from traditional services (de Beer et al., 2022). These programs can enable Indigenous youth to share their lived experiences, offering each other support in ways that honor cultural identities (Ansloos, et al., 2024; Barker et al., 2017; Graham et al., 2021; Peltier & Ansloos, 2025; Thorburn et al., 2023). Peer support does not replace broader systemic changes; it works alongside them, addressing the immediate needs of Indigenous youth while also challenging the stigma associated with mental health and suicidality (de Beer et al., 2022).

This study examines two Indigenous youth-led peer support programs: We Matter operating nationally across Canada and Yúusnewas operating regionally in British Columbia, Canada. Both programs share a commitment to Indigenous peer support by blending cultural practices with youth advocacy and community-building. We Matter, initially a digital campaign, now connects Indigenous youth across Canada through storytelling and peer-led initiatives, fostering hope and resilience. Yúusnewas, rooted in community organizing, focuses on life promotion, harm reduction, and cultural continuity through workshops and activities that directly engage Indigenous traditions. Together, these programs model peer support that is uniquely responsive to Indigenous youth, and grounded in Indigenous knowledge systems and traditions.

The purpose of this research is to understand what culturally grounded strategies are used to promote wellness in Indigenous youth peer support models. Interviews with youth peer organizers and participants, along with a review of program materials, reveal how these programs strengthen community bonds, reduce stigma, and provide Indigenous youth with tools to navigate mental health challenges in ways that align with Indigenous ways of knowing.

At the core of both We Matter and Yúusnewas are four culturally grounded strategies that structure their approaches to promoting Indigenous youth wellness: (a) cultural programming, including land-based practices, language revitalization, storytelling, and ceremony that affirm identity and foster healing; (b) intergenerational involvement, which centers mentorship and reciprocal knowledge exchange with elders and older allies to strengthen community connection; (c) harm reduction, grounded in non-judgmental, strengths-based approaches to substance use, sexual health, mental health, and suicide prevention that prioritize care and cultural safety; and (4) youth political advocacy and leadership development, which cultivates peer-led initiatives and supports collective self-determination. These strategies are explored in detail in the results that follow. By centering Indigenous knowledge systems and relational accountability, these programs offer a compelling model for culturally relevant, community-driven mental health promotion, and suicide prevention in Indigenous contexts.

Indigenous Youth Mental Health in Canada

In Canada, Indigenous peoples are recognized as three distinct groups: First Nations, Métis, and Inuit (Government of Canada, 2017). Within these groups are numerous nations, each with their own languages, histories, and cultural practices. While this diversity is a strength, Indigenous youth across Canada disproportionately face significant mental health disparities compared to non-Indigenous Canadian youth, including higher rates of suicide (Statistics Canada, 2019). These disparities are rooted in the enduring effects of colonization and systemic oppression that continue to shape the lived realities of Indigenous communities (Ansloos, 2018; Barker et al., 2017; Inuit Tapiriit Kanatami, 2016; Statistics Canada, 2019).

It is essential to emphasize that Indigenous youth experiences are not monolithic. Suicide rates among Indigenous youth vary widely, with some communities experiencing crisis levels while others report rates lower than the general population (Statistics Canada, 2019). This variance underscores that Indigenous identity alone does not inherently predispose youth to mental health challenges. Rather, contextual factors such as community resilience, access to resources, and self-determination play pivotal roles in shaping mental health outcomes (Government of Canada, 2017; Heid et al., 2022). Research consistently points to connection to culture as a protective factor against the impacts of mental health challenges and suicidality (Blacklock et al., 2020; Gfellner, 2016; Gray & Cote, 2019; Snowshoe et al., 2017).

Traditional mental health and suicide prevention models often center on professional interventions, diagnosis, and treatment. These models may overlook the fundamental importance of cultural connection and self-determination for Indigenous youth, focusing instead on clinical symptoms rather than the structural and cultural contexts shaping mental health (Ansloos, 2018; Barker et al., 2017). For Indigenous youth, effective mental health interventions must be culturally grounded and community-led, with an emphasis on restoring cultural practices and strengthening collective self-determination. These approaches should not only address immediate mental health needs but also work toward healing from the historical and ongoing impacts of colonization (Ansloos, 2018; Barker et al., 2017; Liu et al., 2014).

Peer Support as a Mental Health Approach

Peer support has long been a part of mental health care, emerging as a response to the limitations of traditional services. It dates back at least to the 1920s in the United States, developed as a countermeasure to the negative experiences many people had with mainstream mental health systems – such as over-pathologizing, stigma, discrimination, and a lack of empathy or understanding from mental health professionals (Hardy et al., 2019). Today, peer support has grown significantly in popularity globally, including in Canada, and is recognized for its potential to transform mental health care by centering lived experience (de Beer et al., 2022).

Peer support workers are individuals with lived experience of mental health challenges who combine this experience with formal training to support others. They operate not from a clinical or professional standpoint, but from a place of shared understanding (Fortuna et al., 2022). Multiple peer support models exist, including self-help groups, hospital-based programs delivered by peers, and peer workers embedded within traditional health care teams (Fortuna et al., 2022). Research shows that peer support can lead to improvements in clinical symptoms, quality of life, and overall mental health outcomes, while also fostering hope, recovery, and empowerment (Fortuna et al., 2022). In some cases, peer support has been shown to reduce the need for hospitalization, highlighting its potential as a preventive measure (Fortuna et al., 2022). However, these studies mainly concern adult mental health services (de Beer et al., 2022). Emerging research in peer support for young people, primarily focused on peer support embedded in mental health care teams for youth ages 16 to 24, indicates that peer support in this population may increase treatment engagement and reduce stigma (de Beer et al., 2022; Gopalan et al., 2017; Vojtila et al., 2021).

Peer Support as a Conceptual Framework

At its core, peer support is built on the premise that people who have navigated similar challenges can provide more authentic and meaningful support than those who have not. It rejects the traditional medical model’s focus on pathology and instead centers on the experiences of recovery, mutual respect, and shared responsibility (Fortuna et al., 2022). Peer support fosters a culture of resilience and health by emphasizing strengths rather than deficits, encouraging individuals to see themselves as capable and whole, rather than defined by their diagnoses or symptoms (Fortuna et al., 2022).

This form of support is a dynamic, reciprocal process – both peer supporters and those receiving support benefit from sharing experiences and building community. It is meant to counter the isolation, rejection, and frustration often experienced by individuals facing mental health challenges, instead creating spaces of belonging and understanding (Fortuna et al., 2022). Initially, peer support was provided primarily through self-help groups, with the aim of challenging societal stereotypes and offering empathetic, non-judgmental support. Today, peer support has been integrated into many health care teams, where it plays a crucial role in modeling recovery, reducing stigma, and inspiring behavioral change (de Beer et al., 2022; Fortuna et al., 2022). Peer support models highlight the importance of relationship-building and mutual care, offering a profound challenge to the depersonalizing tendencies of institutional health systems.

Peer Support Strategies, Implementation, and Impact

The diverse philosophies and conceptual underpinnings of peer support are reflected in the wide range of strategies and implementations that exist today. A systematic review of peer support for mental health across a variety of settings for youth ages 8 to 26 found that peer support workers embody multiple roles that are vital to their success (de Beer et al., 2022). By sharing their own lived experiences, peer support workers help reduce isolation, foster mutual understanding, and create spaces where mental health struggles can be discussed openly (de Beer et al., 2022). Their lived experience also enables them to validate, confront, and empathize with the issues peers face, in ways that traditional health care providers may struggle to achieve (de Beer et al., 2022).

Peer support workers also act as advocates, pushing for more recovery-oriented and culturally responsive care. They bridge the gap between peers and health care professionals, ensuring that peers’ voices and experiences are centered in their care (de Beer et al., 2022). These workers often help reduce stigma and promote a sense of agency among peers, challenging the depersonalization and hierarchies embedded in clinical care. Across different contexts, peer support models offer not only care but also a challenge to the assumptions and stereotypes that limit the potential of individuals navigating mental health challenges.

Peer Support and Suicide Prevention

The application of peer support to suicide prevention is an area of increasing interest, though empirical research remains limited, and mostly focused on adult populations (Schlichthorst et al., 2020). Peer support models for suicide prevention share many of the same foundational principles as those in mental health care, with a focus on mutual empathy, emotional connection, and shared lived experiences. These models exist in various forms, including group and one-on-one support, and operate in diverse settings such as schools, clinics, online platforms, and community programs.

Across settings and age groups, peer support workers help suicidal peers feel heard, reduce their reluctance to talk about suicide, and provide constructive advice on alternatives to suicide (Schlichthorst et al., 2020). Peer support workers in this field may face challenges, including managing their own mental health while supporting others, and confronting reluctance from traditional healthcare providers who may be resistant to peer-led suicide prevention strategies (Huisman & van Bergen, 2019). However, early evidence suggests that peer support for suicide prevention can increase feelings of community, enhance understanding of suicidal thoughts, and reduce suicidality (Schlichthorst et al., 2020). In studies examining the impact of online peer support messaging boards for suicide in which 88% of participants were under 30, online suicide forums were found to decrease intensity of suicidal thoughts, and increase support and constructive help (Eichenberg, 2008). Motivations for engaging in these message boards included a desire for emotional support, connection, and understanding (Eichenberg, 2008).

Peer Support, Cultural Congruence, and Self-Determination

Notably, research in peer support for youth ages 16 to 24 in culturally diverse mental health settings has highlighted that for some youth, it is essential for peer support workers to reflect the backgrounds and experiences of the people they serve, further underlining the importance of culturally attuned peer support (Hiller-Venegas et al., 2022). This may be particularly important for Indigenous youth, whose conceptualizations of well-being may differ significantly from non-Indigenous youth, and for whom cultural connectedness is an integral part of achieving well-being (Clark et al., 2013; Hatala et al., 2020; Isaak et al., 2020; Kooiman et al., 2012; Lines et al., 2019; Petrasek MacDonald, 2015).

Each Indigenous community has its own diverse values, and these values often differ significantly from mainstream ideas about mental health. For example, Indigenous youth commonly cite land as an important determinant of wellness. Hatala et al. (2020) found four processes that Cree and Metis youth in Saskatchewan engage in to find healing within nature: Hugging trees for comfort and acknowledging them as family; giving offerings to the land to maintain, reinforce, and support their relationship to the earth; acknowledging nature as a source of knowledge and land-based teachings; and embracing natural areas as soothing places for regulating emotions. These processes are connected to the Cree philosophy of miyo-wicehtowin, which directs Cree peoples to establish positive relationships with all beings around them, including human–nature relations (Hatala et al., 2020). Although each community has its own philosophies, many communities have values and practices that reflect a view of wellness more holistic and relational than those typically espoused by traditional systems of mental health care (Clark et al., 2013; Hatala et al., 2020; Isaak et al., 2020; Kooiman et al., 2012; Lines et al., 2019; Petrasek MacDonald, 2015). As a result, Indigenous youth are less likely to be able to access culturally congruent forms of care within these systems. Peer support represents a promising avenue for Indigenous youth to provide one another with forms of care that resonate with their beliefs and values.

Additionally, Indigenous scholars have increasingly drawn attention to the link between well-being and self-determination for Indigenous young people and their communities (Ansloos & Peltier, 2021; Liu et al., 2014; Simpson, 2017; Thorburn et al., 2023). According to these scholars, colonial violence undermining Indigenous self-determination is at the heart of Indigenous suffering, and promoting self-determination and cultural resurgence, both at the individual and community level, is essential for healing (Ansloos & Peltier, 2021; Liu et al., 2014; Simpson, 2017; Thorburn et al., 2023). This resurgence has been conceptualized as both community-level strategies such as advancing political autonomy, and individual-level recovery of traditional cultural practices (Simpson, 2017). Peer support may be a valuable potential tool for advancing Indigenous self-determination because of its founding principles of autonomy, reciprocity, and client-centered care (de Beer et al., 2022). Additionally, elements of peer support such as sharing lived experiences may align with some Indigenous cultural practices such as storytelling. Overall, peer support appears to be well-positioned to advance Indigenous wellness through centering shared cultural values and practices to guide the recovery process, rooted in the principles of autonomy and self-determination.

Peer Support and Indigenous Youth

Although research on peer support specifically for Indigenous youth remains limited, emerging findings suggest that such programs can have transformative effects. A systematic review of Indigenous youth-led peer health promotion programs for youth ages 13 to 29 found evidence of improved health knowledge, attitudes, and behaviors among participants, though methodological limitations in existing studies were noted (Vujcich et al., 2018). In Canada, Indigenous youth peer health promotion programs for adolescents ages 13 to 19 have been linked to positive outcomes in areas such as mental health, HIV/AIDS prevention, and diabetes management (Vujcich et al., 2018).

A recent study on a 2-year school-based mentoring program for Indigenous young people ages 11 to 14 in Canada reported promising results. The program, which focused on promoting mental well-being and cultural identity, showed improved mental health outcomes and enhanced participants’ knowledge of their culture and relationships (Crooks et al., 2017). Qualitatively, Indigenous youth wellness leaders ages 15 to 35 working in peer support roles related to mental health emphasize the importance of sharing cultural traditions and lived experiences as key components of their success (Thorburn et al., 2023). These early findings suggest that peer support is uniquely positioned to address the specific needs of Indigenous youth by centering cultural connection, self-determination, and community-led approaches to mental health care. However, further research is necessary to fully explore what culturally grounded strategies are used in Indigenous youth peer support, particularly in relation to suicide prevention and mental health promotion.

Methodology and Methods

Research Design

This study adopts a partnership-oriented, community-based research approach that centers Indigenous youth leadership and knowledge. Grounded in the concept of “wise practices” (Wise Practices, 2019), we reject deficit-driven models common in Indigenous health research, focusing instead on community-led and life-affirming strategies that foster hope, belonging, and purpose. Wise practices in Indigenous suicide prevention highlight community-driven approaches that strengthen cultural resilience and community bonds. These strategies, rooted in Indigenous knowledge, spirituality, and land-based connections, not only address the ongoing impacts of colonialism but also advocate for culturally grounded transformations that affirm life.

Through examining two youth-led peer support programs, We Matter and Yúusnewas this study explores the culturally grounded strategies these programs use in order to promote Indigenous youth resilience, mental wellness, and suicide prevention.

Program Details

This study examines two Indigenous youth-led peer support programs operating in different regions of Canada: We Matter and Yúusnewas. While both programs center Indigenous youth peer support, they differ in scale, delivery methods, participant demographics, and community engagement contexts. These distinctions informed the varied approaches to data collection in this study.

We Matter is a nationally registered Indigenous youth-led organization dedicated to supporting Indigenous youth ages 12 to 30 in mental health and suicide prevention. It originated as a social media campaign and has since developed into a broader peer support network operating primarily in digital spaces, although it also offers occasional in-person trainings, conferences, and community events. We Matter engages Indigenous youth from urban, rural, and remote communities across Canada and is community-led.

We Matter prioritizes accessibility by providing a flexible, low-barrier engagement model where youth can participate at their own pace, whether through virtual storytelling, social media-based advocacy, or structured live gatherings. Youth become involved with We Matter through various outreach strategies, including social media, school and community partnerships, and word of mouth. The program offers both online and in-person programming, including scheduled events such as storytelling sessions, mental health workshops, leadership trainings, and live panel discussions. These gatherings are highly interactive and youth-driven, relying on active participation and the co-construction of knowledge between participants and facilitators. Whether virtual or in-person, youth are invited to contribute their experiences, ask questions, and support one another in real time, reinforcing the program’s emphasis on community-building and relational accountability. Youth leaders within We Matter are often previous participants who transition into leadership roles. These leaders receive informal, mentorship-based training through elders, program staff, and mental health professionals in peer support skills, crisis intervention, and leadership development. Unlike traditional mental health services, this training is non-clinical and culturally grounded, emphasizing lived experience as expertise rather than professional credentials. Given We Matter’s emphasis on online engagement, data collection focused on digital content analysis and semi-structured interviews (conducted both in-person and remotely) with program organizers, facilitators, and participants to assess how the program fosters community, reduces stigma, and provides mental health support in virtual spaces.

Yúusnewas is a regionally based, community-driven Indigenous youth-led organization operating in British Columbia. It creates in-person spaces for Indigenous youth ages 12 to 30 to connect, build knowledge and skills, and provide peer support in areas such as mental health, harm reduction, and racial equity. Unlike We Matter’s digital model, Yúusnewas operates exclusively in-person, offering regular, structured programming in both urban and rural settings.

The program’s urban gatherings take place in drop-in centers, whereas its rural sessions are held in community centers on First Nations reserves. Yúusnewas follows a monthly schedule of peer-led gatherings, alongside specialized workshops on harm reduction, land-based healing, and Indigenous cultural teachings. These sessions are designed to be highly interactive and participatory, centering peer facilitation and mutual learning. While elders often participate, they are typically engaged as community members with lived experience, contributing in ways that emphasize intergenerational exchange without reinforcing hierarchical structures. This relational model reflects the program’s commitment to culturally grounded, non-clinical approaches to wellness.

Like We Matter, Yúusnewas is community-led rather than school-based, with youth leaders – often former participants – serving as facilitators. They receive mentorship-based training from elders, staff, and harm reduction specialists in cultural teachings, mental health first aid, crisis de-escalation, and peer support strategies rooted in Indigenous knowledge systems.

Given its in-person, community-based format, data collection for Yúusnewas included ethnographic observation of workshops and peer-led events, as well as semi-structured interviews to capture the dynamics of peer support, cultural healing, and intergenerational mentorship. Both programs are inclusive of diverse gender identities, with intentional supports for Two-Spirit, non-binary, and gender-diverse youth.

Importantly, these programs were not originally researched for direct comparison but rather as distinct examples of wise practices in Indigenous youth-led peer support. However, analyzing them together highlights the ways Indigenous youth are enacting culturally grounded peer support, demonstrating how different models share features that support mental health and suicide prevention.

Data Collection

Data for this study was collected between 2019 and 2022 through multiple methods, allowing for a thorough examination of both the digital and in-person dimensions of the peer support programs. These methods include:

1. Interviews: A total of 15 semi-structured interviews were conducted with program organizers, peer support facilitators, and participants from both We Matter and Yúusnewas. Of these, nine interviews were conducted in Yúusnewas and six in We Matter. Of the 15 total interviews, the vast majority were conducted with Indigenous youth who had directly participated in the programs. In Yúusnewas, eight of the nine interviewees were current or former youth participants; among them, four were active peer facilitators and three were former attendees who had not taken on facilitation roles. The remaining Yúusnewas interviewee was an elder involved in the program’s cultural mentorship and harm reduction education. In We Matter, all six interviewees were youth participants, including two who also served as peer facilitators. This overlap between participant and facilitator roles reflects the programs’ emphasis on youth-led leadership, where many participants transition into facilitation or ambassador roles over time. The interviews, ranging from 1 to 2.5 hr in length, were designed to gather detailed insights into how these programs were developed, the strategies they employ, and their contributions to Indigenous youth mental health and suicide prevention. Participants received an honorarium of $100 per interview as recognition of their time and contributions. Additionally, in accordance with cultural protocols for knowledge exchange common among many Indigenous communities, participants were gifted culturally significant medicine bundles. These forms of recognition were made possible through funding provided by the Principal Investigator (Author 2) through a Social Sciences and Humanities Research Council of Canada Partnership Development Grant supporting this project. These gifts reflect the program’s commitment to relational accountability and respect for Indigenous ways of sharing knowledge. A total of 30 individuals were invited to participate in interviews, with 15 agreeing to participate, resulting in a response rate of 50%.

Interviews were conducted both in-person and online, allowing participation from individuals across various geographic locations. Participants were recruited through program networks and community outreach efforts. Informed consent was obtained from all participants before the interviews, which were audio-recorded with their permission and subsequently transcribed verbatim to ensure accuracy and preserve the richness of their narratives.

The interviewees represented different roles within the programs. Organizers were responsible for designing programming, securing funding, training youth leaders, and liaising with elders and mental health professionals. Peer support facilitators – often former participants – led programming, provided mentorship, and facilitated direct peer support through workshops and gatherings. Participants contributed valuable perspectives on the lived experiences of Indigenous youth engaging with peer support in both digital and in-person contexts.

• 2. Program Observation: Observations were carried out during 13 in-person workshops and cultural events organized by Yúusnewas. These included harm reduction workshops, the Culture is Healing offerings, and the First Direction gathering. Each observation session ranged from 1 to 5 hr and focused on peer dynamics, facilitator–participant interactions, and the integration of cultural practices within the workshops. These observations were instrumental in understanding the real-time dynamics of the programs and the ways in which cultural and peer support practices intersect. Program observations were conducted by Author 2 with experience in community-based research who attended Yúusnewas’s in-person events between 2019 and 2020. Observation was not conducted for We Matter as its peer support model primarily operates in digital spaces, making direct in-person observation impractical. Instead, digital content analysis was used to understand program engagement and community-building in virtual settings.

• 3. Digital Content Analysis: We analyzed 80 pieces of digital content from We Matter, including social media posts, video stories, written testimonials, program reports, and online workshops. These materials, created primarily by organizers and participants, spanned various platforms such as Facebook, Twitter, and TikTok. However, because content was not always explicitly linked to specific individuals, a precise breakdown of contributions by role was unavailable.

The analysis focused on the reach and engagement of this content, as well as how it extended peer support and suicide prevention efforts to geographically dispersed Indigenous youth. It provided insight into how youth engaged with the program, the themes that resonated with them, and the ways digital platforms facilitated peer support, advocacy, and knowledge sharing. This digital examination complemented our broader investigation by capturing the program’s online presence and its role in promoting mental wellness across different contexts.

Data Analysis

Our data analysis focused on identifying strategies that shape Indigenous youth peer support, centering on how Indigenous youth themselves define and enact peer support within their programs. While peer support models broadly emphasize emotional validation, shared experiences, and non-hierarchical relationships (Fortuna et al., 2022), Indigenous youth-led models of peer support are deeply shaped by cultural and contextual factors. This study examines how Indigenous youth articulate, practice, and sustain peer support within their communities, rather than simply mapping onto generalized peer support frameworks.

Informed by a structured qualitative framework (Saldaña, 2009), we employed thematic coding to systematically identify patterns across participant narratives and program materials. Our approach was inductive, ensuring that themes emerged directly from participant narratives rather than being pre-determined by the researchers. To facilitate this, semi-structured interviews were designed to be open-ended and exploratory, inviting participants to define the most important aspects of their programs, how they support Indigenous youth wellness, and the roles of culture, community, and advocacy. This approach ensured that the analysis remained participant-driven and responsive to their lived experiences.

Our research team consisted of three researchers: a senior supervising researcher (Author 2), and two graduate student researchers (Author 1 and a graduate student not involved in this manuscript’s development). Two of the three researchers are First Nations peoples, ensuring that Indigenous perspectives were embedded throughout the research process. All team members contributed to different stages of analysis, including data coding, thematic identification, and interpretation.

To enhance rigor and reliability, at least two researchers independently coded each transcript before reconciling differences through discussion. This collaborative coding process minimized individual researcher bias while ensuring interpretations remained data-driven. Any coding discrepancies were resolved through consensus, reinforcing trustworthiness and transparency.

To further validate findings, we engaged in member checking by sharing emergent themes with community partners and program leaders. This step ensured that findings were accountable to Indigenous youth perspectives and remained culturally responsive. Additionally, triangulation – integrating interviews, program observations, and digital content analysis – helped confirm patterns across different contexts while allowing for variations in program structure and implementation.

Reflexive engagement was central to our analytic process. We regularly examined our own positionalities as researchers, recognizing that while complete objectivity is unattainable, systematic analysis and accountability to participants enhance the robustness of qualitative findings. This commitment to reflexivity and Indigenous epistemologies ensured that findings were firmly rooted in Indigenous ways of knowing.

The themes – cultural programming, intergenerational involvement, harm reduction, and youth advocacy – were not imposed by the research framework but instead arose organically from participant narratives, reinforcing their relevance to Indigenous youth peer support. Through these systematic yet flexible analytic strategies, we ensured that the study remained rigorous while honoring the lived experiences, priorities, and cultural knowledge of Indigenous youth.

Researcher Positionality and Influence on Engagement

This project was carried out by a team that includes both Indigenous and non-Indigenous researchers, whose involvement was shaped by our backgrounds in peer support, as well as the authority that comes with being researchers. Our experiences working in peer contexts bring an additional layer of insight and responsibility to how we approach this work. These prior experiences allow us to engage with the data and the programs in ways that are attuned to the relational dynamics, challenges, and transformative potential of peer support.

Both authors come with distinct intersections of privilege and marginalization that shape our collaborative research engagement. The first author, a queer white settler and long-time youth mental health activist-scholar, holds privilege associated with whiteness and settler colonial systems, which afford access to resources, networks, and academic spaces. Their experience as a peer in mental health advocacy not only informs a deep commitment to challenging systemic inequities but also demands continuous reflection on how that privilege can replicate power dynamics that may marginalize Indigenous voices in both research and practice.

The second author, a queer Indigenous psychologist, brings the complexity of navigating both an Indigenous identity and institutional authority. While they continue to experience the impacts of colonialism as an Indigenous person, they also hold the power that comes with institutional legitimacy as a researcher and psychologist. Their experience as a peer in Indigenous-led wellness initiatives provides critical insights into the lived realities of Indigenous youth, which informs a nuanced and culturally responsive approach to the research and analysis. This dual positionality also requires a careful balance between advancing Indigenous self-determination and navigating the privileges responsibilities that come with holding academic and professional power.

Both authors’ peer experiences have deeply shaped our collaboration and analysis, helping us remain grounded in the importance of mutual respect, shared knowledge, and accountability to the communities we work with. Our positionalities – whether as Settlers or Indigenous individuals – intersect with issues of privilege, power, and oppression, particularly in relation to colonialism, age, and access to institutional resources. As researchers, we are acutely aware of how our authority informs the design, analysis, and dissemination of this study, and how it can either challenge or reinforce existing power structures.

Through a commitment to reflexivity, we have approached this research in a way that centers Indigenous perspectives and community priorities. Our collaboration seeks to honor Indigenous self-determination, life promotion, and culturally grounded mental health strategies, while remaining accountable to the youth and communities who have entrusted us with their stories and experiences.

Results

The findings from this research illustrate the significant ways in which We Matter and Yúusnewas have empowered Indigenous youth through culturally resonant peer support models. Although the programs differ in scope – We Matter operates as a national digital platform while Yúusnewas is rooted in localized community initiatives – both programs share fundamental goals of fostering resilience, supporting leadership, and reinforcing cultural continuity. These programs integrate broader peer support best practices, such as shared lived experiences and non-hierarchical relationships, while embedding Indigenous knowledge systems and cultural frameworks central to their success.

The following sections delve into the four core themes that emerged from the analysis: (a) Culture as a Foundation for Wellness, (b) Intergenerational Involvement, (c) Harm Reduction, and (d) Indigenous Youth Political Advocacy and Leadership Development. These themes highlight the unique impacts of each program while underscoring the broader significance of culturally grounded peer support models for mental health promotion and suicide prevention among Indigenous youth.

Culture as a Foundation for Wellness

Culture is a central, transformative force in both We Matter and Yúusnewas. Rather than serving as context or background, cultural knowledge and practices are integral to how Indigenous youth define and experience peer support, mental health, and suicide prevention. Across both programs, cultural connection fosters identity, belonging, and resilience in ways that directly address the ongoing impacts of colonization.

In We Matter, cultural connection is evident through digital storytelling, language revitalization, and Two-Spirit advocacy. For instance, campaigns incorporate Indigenous languages like the Gwich’in phrase Nanakat gwats ‘i’hindii (“Go out to your land”), affirming land as an active source of emotional, spiritual, and physical strength. One peer reflected: “Even when you feel like you have no support or no resources or nobody around you, you have the land. And that in itself is a support and a resource.” The land offers continuity amid disconnection, anchoring youth in ancestral relationships and resisting colonial fragmentation.

Cultural identity is also affirmed through We Matter’s Two-Spirit Dictionary, which challenges colonial erasure by offering Indigenous frameworks for understanding gender and sexual diversity. This resource not only supports Two-Spirit youth in seeing themselves reflected in their cultures but also reframes mental health struggles as connected to systemic, not individual, harms. Storytelling, a cornerstone of We Matter’s programming, enables peers to share teachings, personal experiences, and sacred symbols – such as the eagle feather – as acts of cultural resilience. These stories are not just therapeutic but political, positioning Indigenous youth as knowledge holders and leaders in their own healing. As a complement, the program’s educator toolkit links mental health to structural violence, refusing to depoliticize Indigenous distress and instead framing healing as collective survivance.

In Yúusnewas, culture is embedded through land-based ceremonies, language, and traditional arts. The Culture is Healing initiative exemplifies this approach by creating spaces for youth to engage with teachings and practices that affirm their identities and confront colonial trauma. As one peer described: “I find something different in every Culture is Healing event that we do. Culture is Healing was one of my first times being involved in a sweat lodge. . . That was just an amazing day.” These events offer more than exposure to tradition – they are relational, immersive, and emotionally restorative.

Activities like mask-making, plant walks, and the River Bath ceremony allow youth to reconnect with cultural memory and express identity through both movement and creativity. These moments emphasize land as not just setting but kin – an active participant in healing. In describing the River Bath, peers spoke of releasing emotional burdens and renewing community bonds. Similarly, craft practices like Quillwork and Beading connect youth to ancestral lineages through tactile, embodied memory. One peer explained: “Indigenous youth wellness? It means a lot of things. It means agency over one’s own – mental, spiritual, emotional. . . and community. I think that’s a very important part of Indigenous youth wellness.”

Together, these examples illustrate that for Indigenous youth, cultural connection is not supplemental – it is health itself. Whether through digital media or land-based ceremony, both programs embed culture into their peer support strategies in ways that enact resistance, reclaim identity, and cultivate belonging. In doing so, they offer relational, culturally grounded approaches to suicide prevention that center community and collective healing.

Intergenerational Involvement With Youth Peers

A key insight from both We Matter and Yúusnewas is the central role of intergenerational relationships in supporting Indigenous youth peer work. These connections do more than pass along knowledge – they bridge generations, create belonging, and sustain communities navigating the long aftermath of colonial disruption. Within both programs, intergenerational engagement is a site of resistance and resurgence, where culture, care, and leadership are cultivated together.

In We Matter, elders’ involvement is not symbolic – it is essential. At gatherings like the Hope Forum, elders offer songs, teachings, and ceremony, creating spaces of cultural safety and emotional restoration. One elder reflected: “First of all, no judgment. There has to be no judgment whatsoever. Anything and everything you need to be available and safe.” This emphasis on non-judgment challenges the alienation Indigenous youth often experience in formal health systems, replacing it with relationships grounded in care and accountability. Elders share not only cultural teachings, but lived experiences that connect past and present struggles – reminding youth that healing is possible and that they are not alone. Alongside elders, We Matter also amplifies Indigenous role models – artists, athletes, and advocates whose stories reflect recent, real experiences with trauma, hope, and growth. Their digital storytelling makes visible the strength already alive in Indigenous communities.

At Yúusnewas, intergenerational relationships are woven through every level of programming. Peer facilitators – many of whom are former participants – lead cultural workshops and harm reduction sessions, sharing their own journeys while holding space for others. This model treats knowledge as reciprocal and relational. One facilitator shared: “Having that honest and open conversation. . . It doesn’t matter if they open up or not. They know that, ‘Okay, [redacted] knows what maybe I’m going through. She knows’.” These connections are not always spoken; they’re felt. As another peer reflected:

[With colonialism]. . . the separation of the generations. . . Community is a place that we need to be safe, that we need to be supported, that we need to be loved. . . It’s like the water from the same well. This one might be a tree, that one might be a flower, but the water comes from the same well.

These words are a reminder that culture and community are not static – they are carried forward in relationships, in practice, in breath. Yúusnewas elders support youth not from a distance but side-by-side, sharing their own stories of substance use, survival, and healing. One elder explained their role in community naloxone training: “They made up signs that said, ‘I’m Naloxone trained’.. . . It’s building again that relationship of no judgment, no stigma.” These programs do not just reconnect generations – they reimagine what that connection can look like in peer support: reciprocal, relational, and rooted in shared experience.

Harm Reduction

Harm reduction is central to both We Matter and Yúusnewas, shaping their peer support models to address the systemic and structural forces impacting Indigenous youth mental health. While often associated with substance use and sexual health (Szalavitz, 2021), both programs extend harm reduction to include mental health and suicide prevention – centering non-judgment, peer empowerment, and relational care. Rather than pathologizing behavior, they locate harm in colonial trauma and offer care that is supportive, accessible, and rooted in cultural values.

In We Matter, harm reduction is woven into suicide prevention messaging through digital storytelling and peer-led campaigns that create space for open discussions about mental health, suicidal ideation, and substance use – free from stigma or judgment. A key initiative is the Hope Pact, a campaign where Indigenous youth wear bracelets symbolizing a commitment to seek support, offer help, and honor their own strength. The Pact is a peer-led response that emerged within the program’s digital mental health work. Through social media, youth share personal reflections and affirmations such as:

“to believe that no matter how hard life gets, there is always a way forward”

“to ask for help when needed”

“to honor their inner strength”

“to offer support and kindness to others”

The campaign connects participants with Hope Ambassadors, trained peers who provide emotional support. One youth shared, “I think young people should have the choice of where they want to turn to, and have the options available to them.” This illustrates We Matter’s framing of healing as a community-rooted and autonomous process, not a prescriptive intervention. Another peer highlighted how the program challenges stigma:

Harm reduction allows people to show up as themselves where they’re at, without needing to be at a certain point to access the programs. It reduces a lot of the stigma around substances. . . It shifts how we talk about substance use as coping mechanisms that make sense, considering the harm Indigenous people have been through. It really takes the rhetoric of moral failing off of people.

This approach actively confronts colonial narratives around morality and addiction, instead embracing acceptance, peer accountability, and resilience.

While Yúusnewas does not have a formal equivalent to the Hope Pact, it shares similar principles of peer-led harm reduction through educational workshops like Taking Care of Ourselves. These workshops integrate practical training – on substance use, sexual health, first aid, and overdose response – with conversations about mental wellness, self-harm, suicide prevention, and community care. One peer explained: “It’s about building that relationship of no judgment, no stigma. For me, harm reduction is about communication and making sure everyone’s safe.” This illustrates how harm reduction is practiced not just as risk management, but as a relational ethic grounded in cultural values. Yúusnewas fosters spaces of care where peers support one another without surveillance or coercion – most notably reflected in the non-monitoring of youth substance use within the program. This inclusive approach makes space for honesty and trust, supporting healing even amid ongoing struggles.

Elders also play a central role in the program’s harm reduction strategy, offering cultural teachings shaped by lived experience. One elder shared: “Harm reduction is, first of all, no judgment. You need to keep yourself safe. It doesn’t matter what you’re doing or what you need; it should be available.” Their presence reinforces a model of care that is intergenerational, non-hierarchical, and deeply grounded in relational accountability. Harm reduction, in this context, becomes both a teaching and a practice that honors the complexity of Indigenous life in the wake of colonial harm.

These values extend beyond the program walls. One peer described their community-based harm reduction efforts: “I introduced myself and said, ‘If you ever need me, I’m right across the street. I have naloxone kits. I have harm reduction supplies. If you ever need me, please come over’.” This reflection illustrates how Yúusnewas nurtures a culture of mutual aid that ripples through everyday life, building networks of care, safety, and dignity across the community. Together, We Matter and Yúusnewas enact harm reduction not as a clinical toolkit, but as a culturally aligned, youth-led strategy for collective wellness, autonomy, and survival.

Youth Political Advocacy and Leadership Development

We Matter and Yúusnewas both play critical roles in developing leadership and fostering political advocacy among Indigenous youth, addressing the structural inequities that shape their mental health outcomes. Leadership development in these programs is not just an abstract concept; it is deeply rooted in the political realities of colonialism, systemic racism, and the erasure of Indigenous ways of life. Through youth-driven advocacy, both programs empower Indigenous youth to challenge and transform the systems that contribute to mental health disparities. Leadership is framed as an essential pathway to wellness, self-determination, and collective empowerment.

At the core of We Matter is the Ambassadors of Hope program, which equips young Indigenous leaders with the tools to share their stories and advocate for their communities. These Ambassadors travel to different regions, facilitating workshops and leading conversations on mental health and suicide prevention. One Ambassador reflected, “Advocating for my community has strengthened my own mental health and created a sense of collective responsibility.” This reflection highlights the interconnection between advocacy, personal healing, and community transformation, illustrating how leadership can be both personally restorative and socially impactful.

The Ambassadors of Hope also engage in community-based projects that promote wellness through culturally grounded activities. For instance, they have facilitated workshops on healthy coping skills in rural and northern communities and led land-based learning activities, such as snowshoeing. These initiatives, rooted in Indigenous traditions, foster resilience, and help youth reconnect with their cultural identities, reinforcing their roles as leaders within their communities.

In 2022, the Hope Council was formed as an extension of the Ambassadors of Hope program, following the National Hope Forum. The council is composed of Indigenous youth leaders from diverse First Nations, Métis, and Inuit backgrounds, who provide guidance on We Matter’s content, strategies, and materials. As one Hope Council member shared, “We are the ones who understand what’s happening in our communities, and we need to be driving the change.” This council empowers Indigenous youth to shape the direction of We Matter, ensuring that the organization remains youth-led and responsive to the communities it serves.

In Yúusnewas, leadership development is centered on political advocacy and the reclamation of Indigenous knowledge systems through the First Directions program. This program encourages Indigenous youth to engage in conversations about health and well-being, drawing direct connections between Indigenous health and the legacies of colonization. One peer captured the importance of this initiative, stating:

As Indigenous youth, we are starting, once again, to talk about issues that affect our people so that we can share information with our friends and relatives about taking care of our bodies. With colonization and residential schools, a lot of our teachings on how to take care of ourselves were lost – but we’re determined to bring back this knowledge again so that we can be the healthy people that we are meant to be.

This reflection speaks to First Directions’ broader goal of decolonizing health, which encompasses not only physical well-being but emotional and spiritual healing. The program invites Indigenous youth to participate in workshops on critical health topics, such as HIV prevention and sexual health, while also producing short films that amplify their voices. This creative process becomes a form of advocacy, allowing youth to reclaim their narratives and challenge colonial health systems that have historically marginalized Indigenous communities.

The focus on advocacy in Yúusnewas extends beyond individual leadership. The program fosters sustained networks of youth leaders who continue to mentor their peers long after the workshops conclude. As one peer reflected, “We’re learning for ourselves, but also so we can go back and help others in our communities.” This multidirectional exchange of knowledge ensures that the leadership developed within Yúusnewas has far-reaching impacts, creating systems of advocacy, empowerment, and resilience across Indigenous communities.

In addition to this emphasis on reclaiming traditional knowledge, the youth involved in Yúusnewas also engage with broader political realities. One peer spoke to the unique position Yúusnewas occupies in addressing the intersection of colonialism and capitalism, stating:

Because the political climate I guess we’re in now and in late capitalism or late colonialism right now, we’re literally just planting seeds at this point, because Yúusnewas is the only program in all of Canada like it. . . Yúusnewas did give me the space to start doing things and get paid for it.

This statement illustrates how Yúusnewas not only provides opportunities for advocacy but also creates meaningful spaces for Indigenous youth to claim leadership roles and access material support to advocate.

The leadership development in both programs emphasizes proactive visions of the future rather than simply reacting to colonial harms. As another peer reflected, “There’s so many ways to think about what’s wrong in a way that’s reframing it to be like, ‘This is what we want. This is what we want for not only ourselves but society’.” This sentiment underscores how leadership and advocacy within these programs are framed not only as resistance but as a means of envisioning and working toward a more just and equitable future.

For many youth, leadership development also involves reclaiming personal agency and becoming role models within their communities. As one peer shared:

I feel like a guardian, like a role model. I got off the streets. I’m really good with politics. I’m really good with interacting with people and whatnot, and I like to be a good role model. I like when kids look up to me, I like when teenagers look up to me. I like when I start a workshop and I can get all the kids to open up right away and make them feel comfortable, and that makes me feel really good to be in a room.

This quote illustrates how youth may not only gain leadership skills but also become the role models they once needed, embodying the transformative power of lived experience.

Discussion

Indigenous youth-led peer support programs offer a culturally grounded response to mental health promotion and suicide prevention, and understanding their core components is essential to recognizing how these spaces foster Indigenous youth wellness. Drawing on data from interviews, program observation, and digital content analysis, this qualitative study identified four foundational strategies enacted across two programs: (a) Culture as a Foundation for Wellness, (b) Intergenerational Involvement, (c) Harm Reduction, and (d) Indigenous Youth Political Advocacy and Leadership Development. While these elements were embedded in the design of both We Matter and Yúusnewas, this research goes beyond merely confirming their presence. Through youth narratives and situated observations, we examined how these strategies are practiced, interpreted, and experienced by Indigenous youth, revealing the relational, cultural, and political dimensions of peer support that extend beyond formal program descriptions. Although these themes share some parallels with broader peer support literature, their enactment in these programs reflects culturally specific forms of knowledge, healing, and community-building. Moreover, while the strategies were consistent across both programs, each implemented them in ways that were responsive to their particular regional, relational, and organizational contexts.

Young people in both We Matter and Yúusnewas build on existing literature by demonstrating the importance of fostering community bonds through creating spaces for shared experiences and cultural practices. This aligns with research indicating that connection to culture and community is a critical component of wellness for Indigenous youth (Blacklock et al., 2020; Gfellner, 2016; Gray & Cote, 2019; Snowshoe et al., 2017). Simpson (2014) describes these forms of cultural reconnection as acts of radical resurgence – a form of Indigenous self-determination. By building community and engaging in everyday cultural practices, these young people enact resurgence in daily life, mirroring for one another a sense of positive Indigeneity that grows into a movement greater than the sum of its parts (Simpson, 2014). The cultural practices described by youth in this study also strengthen ties between youth and intergenerational knowledge holders, which could serve as a model for other communities impacted by historical trauma. In some ways, the sharing of cultural practices also aligns with broader peer support practices that aim to foster community, mutual aid, and positive role modeling (Fortuna et al., 2022). However, Indigenous peer support not only fosters community and mutual aid (Fortuna et al., 2022), it does so in ways deeply rooted in Indigenous knowledge systems. By centering practices such as storytelling, land-based healing, and intergenerational mentorship, these programs enact peer support as a form of cultural resurgence rather than simply a tool for mental health recovery (Simpson, 2014; Iseke, 2013). This culturally distinct approach moves beyond conventional peer support models by affirming Indigenous identity and self-determination.

Additionally, this study drew attention to the ways Indigenous peer support uses cultural practices to challenge mainstream beliefs and misconceptions about mental health. Both programs attempt to normalize conversations around mental health. This aligns with the original and enduring philosophy behind peer support, which aims to reduce mental health stigma by centering the voices of those with lived experience and recognizing that experience as expertise (Fortuna et al., 2022). However, the findings here show how these principles can be enacted in a culturally grounded way that incorporates Indigenous practices and ways of knowing. We Matter and Yúusnewas realize these ideals through storytelling, harm reduction, and culturally affirming spaces. Storytelling is a time-honored practice in many Indigenous communities – used to pass knowledge between generations – and is a core component of Indigenous ways of knowing (Iseke, 2013). Storytelling and other peer-led approaches described in this study may reduce stigma and lower barriers to care in ways that resonate culturally with Indigenous youth.

Importantly, this study highlights how peer support programs can expand access through digital platforms and community-based activities, reaching isolated youth. Digital peer support is relatively new and emerged sharply during the COVID-19 pandemic (Fortuna et al., 2022). Early research suggests digital peer support, across age and context, provides benefits similar to in-person support, including potential reductions in mental health challenges for participants (Fortuna et al., 2020).

Digital peer support, while increasingly recognized as effective (Fortuna et al., 2020), is particularly significant in Indigenous contexts where geographic and systemic barriers often limit access to culturally relevant care (Ansloos et al., 2022). Many Indigenous youth live in remote or underserved areas, making digital platforms vital tools for connection, advocacy, and cultural knowledge sharing. Our findings indicate that improved accessibility is a key strength of digital delivery, especially for rural or remote Indigenous youth, or those facing other barriers to in-person programs. Nevertheless, digital inequities remain a persistent challenge, as many Indigenous communities face unreliable internet, high connectivity costs, and limited infrastructure (McMahon et al., 2021). Despite these barriers, Indigenous youth have adapted digital spaces to maintain relational accountability, share stories of resilience, and cultivate Indigenous digital sovereignty. This suggests that digital peer support for Indigenous youth is not merely an adaptation of mainstream models, but an extension of long-standing Indigenous relational practices into technological spaces – while underscoring the need for equitable digital infrastructure.

This study also suggests that peer support may play a pivotal role in preventing crisis. By equipping peers with crisis de-escalation and harm reduction tools, peer support programs may prevent crises from escalating. In the broader peer support literature, opinions differ regarding the training peer support workers should have and what role they should play in crisis. Traditional models emphasize experience as expertise, while newer, health system-adjacent models stress the importance of at least some formal crisis training (Fortuna et al., 2022). The crisis support models identified here demonstrate how Indigenous peer support merges traditional knowledge with mental health practices, centering Indigenous concepts of autonomy and relational accountability. Emphasizing peer-led support, storytelling, and collective care may offer an alternative to reliance on emergency services.

Finally, young people in our study stressed the potential for peer support to foster leadership and self-determination. The idea of self-determination is central to peer support as originally conceptualized (Mead et al., 2001). Individuals experiencing mental health challenges often find themselves defined by deficits, subject to expert professionals who prescribe solutions. Peer support counters this by emphasizing strengths, autonomy, and the leadership capabilities of peers (de Beer et al., 2022). Through nurturing these acts of self-determination, We Matter and Yúusnewas also advance Indigenous health sovereignty. They provide a decolonizing model of mental health care that can inspire both Indigenous and non-Indigenous communities.

In addition to these strengths, some tensions emerge from our study in conversation with the broader literature. Balancing autonomy with crisis intervention remains complex. Peer support centers on respect for autonomy; however, during acute mental health crises in traditional treatment, autonomy is often compromised for safety. Literature on suicide prevention in peer support notes the difficulty of deciding if and when peer supporters should compromise autonomy, shifting into a more professional role (Huisman & van Bergen, 2019). This is especially complex where peer supporters lack crisis training. A related concern from mental health professionals is that peer-led spaces are valuable but may not suffice when crises exceed peer supporters’ capacity (de Beer et al., 2022; Huisman & van Bergen, 2019). Developing integrated pathways with professional services can reduce the pressure on peer supporters to exceed their limits or compromise their role, while offering a broader continuum of care.

Addressing the emotional toll on peer supporters is also critical. Finding sustainable ways to care for the caretakers remains unresolved. Youth peer supporters frequently cite maintaining their own mental health as a challenge, pointing to role confusion, inadequate training and supervision, and stigma from other providers (de Beer et al., 2022; Huisman & van Bergen, 2019). This may be especially true in newer peer support models where a designated “peer support worker” gives but does not receive support. Mitigating factors include robust training, supervision, and support for these workers (de Beer et al., 2022). Additionally, some peer supporters find that their roles enhance their own mental health (Fortuna et al., 2022). Further research should investigate conditions that make Indigenous peer support sustainable and healthy for all participants.

Both We Matter and Yúusnewas were successful in achieving their goals of promoting culturally grounded peer support and fostering Indigenous youth wellness. While they share core strategies – peer-led leadership, cultural continuity, harm reduction, and intergenerational involvement – their differences lie primarily in scope, structure, and stage of development. Yúusnewas, a regionally based and more established program, has developed long-standing, proximal partnerships that support sustained, place-based programming. We Matter, while newer in origin, has grown into a national organization offering both digital and in-person programming, with strong regional connections and ongoing partnerships across diverse geographies. Its national scope enables it to reach youth in remote and underserved areas, while still cultivating relational engagement through peer-led gatherings and leadership initiatives. These contextual distinctions foreground different strengths: Yúusnewas offers depth through community-embedded relationships, while We Matter provides broad accessibility and innovative, youth-driven engagement across a wide range of settings. While this study did not assess clinical outcomes or program efficacy in a conventional sense, our findings suggest that both programs embody wise practices – that is, context-specific, culturally rooted approaches to Indigenous wellness and suicide prevention that reflect the strengths, needs, and knowledge systems of the communities they serve.

Limitations and Future Directions

One limitation of this study is its qualitative focus on only two programs in Canada, raising questions about the generalizability of the findings to other contexts. Data collection spanned 3 years (2019–2022), which introduced challenges related to changes over time. During this period, programs adapted their structures, underwent leadership transitions, or shifted focus in response to external factors – including the COVID-19 pandemic. Although this allowed for examining program resilience and responsiveness, it also meant participant perspectives varied depending on when they were interviewed.

Additionally, this study did not evaluate the success of the program components identified. Future research should assess program efficacy to better understand how each strategy impacts mental health outcomes and suicide prevention. More investigation is also needed to determine whether these components are shared across other Indigenous and non-Indigenous peer support programs, both within and beyond Canada. Such work could provide comparative insights into common foundational elements while highlighting context-specific adaptations.

The COVID-19 pandemic significantly influenced both programs’ implementation and accessibility, often reshaping their structure and reach. We Matter, already operating in digital spaces, may have expanded its engagement as more Indigenous youth sought online support amid isolation and heightened mental health stressors. However, this digital focus could have limited deeper, in-person connections – especially for those lacking stable internet access or private environments. Meanwhile, Yúusnewas, rooted in community-based, in-person programming, was disrupted by restrictions on gatherings. These challenges led to hybrid models and reduced participation. Although some events moved online, core elements of land-based and cultural programming required face-to-face engagement, limiting accessibility under public health restrictions. Additionally, all interviews were conducted remotely due to COVID-19 measures, which may have affected participant comfort, the depth of responses, and overall engagement.

Finally, it remains unclear whether and how these programs could be scaled to different contexts. While core values – such as culture as a foundation for wellness and intergenerational involvement – could be widely applicable, specific cultural practices that enhance program effectiveness are likely to vary by community. For Indigenous peer support, future research should explore how to expand programming without compromising cultural integrity. Examining programs in other settings could reveal both shared and divergent approaches, helping to inform best practices for adaptation and implementation.

Conclusion and Implications

This study examined two Indigenous peer support programs in Canada. We Matter and Yúusnewas are culturally grounded, peer-led mental health models that merge standard peer support practices with Indigenous cultural healing to support Indigenous youth well-being. Both programs share core elements – culture as a foundation for wellness, intergenerational involvement, harm reduction, and leadership development – yet each implements these components differently in response to local contexts. These findings may guide other Indigenous communities in designing or adapting similar programs to meet their unique needs. Moreover, these flexible and relevant program elements hold potential for broader adaptation in urban or non-Indigenous settings.