Mind over waves: uncovering mental health toolkit gaps for young Australian surf lifesavers through an environmental scan and expert survey

Abstract

Background

Surf lifesavers are volunteer first responders across Australian waterways, performing coastal rescues, and other high-risk activities. Personnel undertaking these activities can include young people, from age 13. The mental health impact of these activities, and of strategies to improve wellbeing, is not well understood. Young surf lifesavers (aged 13–25) are known to be a cohort particularly vulnerable to mental health challenges associated with these tasks. This study aims to assess existing mental health toolkits available online in Australia and New Zealand, in relation to their relevance to this group with the goal of guiding the creation of a helpful, engaging toolkit for this demographic.

Methods

Using an environmental scan methodology, we examined 32 mental health toolkits available online which focus on improving wellbeing. Expert assessments of these tools were undertaken from researcher, psychological, social work, Surf Life Saving Australia (SLSA), and non-SLSA first respondent perspectives to ascertain their relevance for young lifesavers, in accordance with the duties they undertake. Toolkits were scored on their usefulness, relevance, appropriateness, accessibility, and efficacy in addressing general trauma and trauma specific to SLSA duties.

Results

Toolkits were reviewed by 68 experts across several domains. Toolkits intended for first responders and young people scored highest across all variables, while qualitative feedback emphasised strategies to adapt existing toolkits for the target audience either stylistically and tonally or in terms of content or supplementary mental health interventions. No existing toolkit directly targeted experiences associated with the general tasks involved in surf lifesaving. This environmental scan reveals gaps where bespoke mental health toolkits could focus, for instance on the impact of performing rescues and other high-risk situations, such as responding to suicides and self-harm, that arise in Australian waterways; as well as emphasising the value of the SLSA community as a potential protective factor mitigating trauma exposure.

Conclusions

Further work should be undertaken with intended toolkit end users to develop fit-for-purpose resources within a psychosocially supportive context, working with the strengths of young SLSA members.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-025-24686-w.

Introduction

Surf Life Saving Australia (SLSA) provides emergency services across Australia, including rescues of those at risk of illness and injury [1]. These services have been estimated to provide a net economic benefit of $97 billion per year to the Australian community through a workforce primarily comprised of volunteers [1]. SLSA membership spans all life stages, with volunteers able to commence active beach patrols from the age of 13 years [1]. Surf lifesavers can be exposed to high-risk and traumatic experiences as a routine part of their role as first responders [2].

While Surf Life Saving (SLS) personnel play a vital role in Australia’s emergency service ecosystem, understanding the toll this may have on their mental health and wellbeing has been largely overlooked [1]. This is concerning, especially when we consider that SLS personnel are known to contribute to the response and recovery of 11% of coastal suicides [3]. It is also known that 23% of the active patrolling membership are adolescents under the age of 18, a well-established high-risk demographic for developing mental health conditions [4]. Mental ill-health can have significant impacts on individuals’ lives, as well as their work role functioning [5]. Mental health conditions are associated with self-perceived deficits in work quality, accuracy, and speed [6], as well as objective measures of productivity loss and absenteeism [7]. Despite these risks, there has been a paucity of literature exploring how exposure to life-threatening situations as part of their SLS role affects overall mental health, particularly among younger volunteers [8]. These risks should also be balanced alongside studies which suggest club cultures can build resilience and may prove protective against mental ill-health, including among adolescents [9, 10].

Given this knowledge gap, SLSA has developed surveys to measure Mental Health among members in 2021, which found increased mental health vulnerability among adolescent members [8]. In particular, respondents were vulnerable to experiencing post-traumatic stress symptoms (PTSS), as measured through the PCL-5 checklist where each of 20 Diagnostic and Statistical Manual symptoms characteristic of Post-Traumatic Stress Disorder (PTSD) [8, 11]. Exposure to trauma was correlated with post-traumatic stress symptoms, especially among adolescent males (aged 13–17 years old); the longer amount of time an adolescent had been patrolling, the higher their likelihood of experiencing direct trauma; and levels of PTSS severity indicated one in four adolescent survey respondents were at risk of developing Post-Traumatic Stress Disorder (PTSD), as evidenced by PTSS scores on the PCL5 of 33 or higher [8, 11].

The World Health Organisation characterises mental health promotion as a “positive” intervention, where mental health is understood as a “resource” rather than the absence of mental ill-health [12]. Online mental health promotion resources have been identified as a potential means of mental ill-health prevention, early intervention, screening, and help-seeking [13]. These resources can take various forms including online crisis support (such as Lifeline Crisis Chat), self-help, and online cognitive behavioural therapy (CBT) programs (such as moodgym), online peer support forums, mental health assessment tools, training, factsheets, and toolkits [12–18]. Promotion resources work to build resilience, mastery, and coping skills; which can mitigate distressing experiences and help individuals identify where they may require more intensive support [12].

Although a recent review indicated that the quality of evidence of included studies examining the efficacy of online mental health promotion resources varied significantly, previous research on online mental health interventions indicates that resources targeted at building young people’s mental health management skills are promising and that young people generally feel comfortable using the internet to learn about mental health [13]. Digital resources can engage demographics that may be otherwise “hard-to-reach” in a proactive way [16]. An area of concern, however, is that completion rates of online programs are relatively low, indicating a need to increase audience engagement [13]. The authors are interested in undertaking a review of mental health toolkits because while they a voluminous, and provide a range of unique mental health promotion potentialities (including scalability and ease of access), little research pertains to their efficacy.

The aim of this study is to identify and assess existing Mental Health toolkits available in Australia and New Zealand, and to explore content in relation to SLSA context. To reduce vulnerability among younger SLS volunteers and to explore relevant and effective resource communication, this present study undertakes an environmental scan of online mental health toolkits that may be useful for volunteers, specifically focusing on those aged 13–25 years old. The 13–25 age group is key for the provision of Mental Health education because 62.5% of individuals with Mental Health conditions experience the onset of their condition by the age of 25 [4]. No previous environmental scan has been undertaken on mental health toolkits for any audience, although reviews have been performed for general mental health resources available to young people [19, 20].

Methods

Using an environmental scan methodology, we reviewed mental health toolkits available online in Australia and New Zealand. While there is variation in environmental scan methodology, it is an established and increasingly popular tool in public health research for reviewing general web-based material through a systematic search [21, 22]. There is limited guidance for undertaking an environmental scan in a public health context as much literature on this methodology comes from business and education sectors [21]. It is, nonetheless, an effective means of establishing with confidence what materials exist, and where there may be resource or knowledge gaps [22]. This method was chosen as most toolkits are designed and published online by non-profit and government bodies, often without a peer review process [23]. The process we used drew on one of the author’s (AEP’s) previous experience of undertaking environmental scans [24, 25], and drew on Barac et al.’s strategy for data extraction and analysis (described below) [23].

Although this project aims to create toolkits for an Australian audience, New Zealand resources were included in the environmental scan because New Zealand and Australia share cultural similarities as neighbouring, high-income countries, and as such can be meaningfully analysed together in public health research [26]. Both countries further have active SLS organisations, and a broader environmental scan would serve to minimise replication of existing tools. However, it is acknowledged that resources from New Zealand would require tailoring to suit Australian audiences (such as direction to Australian phone numbers and websites).

For this study, we propose a definition of toolkits as action-oriented resources that aims to change user/reader mental health related behaviour, rather than merely provide information. They educate users on topics such as taking care of one’s own mental health and looking after the mental health of others. Toolkits are an increasingly popular means of creating participatory approaches to implement high-level guidance for workplace psychosocial safety [27]. It has further been found that young people – our target population – find online mental health resources approachable [13]. Health toolkits are resources (“including,” according to Barac et al., “templates, instruction sheets, literature reviews, videos, and posters, presented in a variety of formats”) bundled into a single package that constitutes knowledge transfer and opportunities for reflection about and implementation of positive health behaviours [23, p. 2]]. In a mental health context, toolkits may provide: education on stress and mental health conditions, how to identify distress, how to seek help, strategies for coping with difficult experiences and emotions, and how to help others.

Search method

Three main sources were searched for this environmental scan. The first was the Mental Health Australia full and associate membership website pages as at 20/03/2023 [28, 29]. As the peak body of the mental health sector in Australia, the membership pages list many mental health organisations, operating both at a national and state/territory level, though with exceptions (most notable being government mental health departments and directorates, and direct service providers). Each of the 132 member organisation websites were searched for the availability of toolkits.

The second source was the Aotearoa New Zealand Digital Tools for Mental Health and Wellbeing 2021 Stocktake as at 13/04/2023 [30]. This is a comprehensive list of digital mental health and wellbeing tools created for the New Zealand context.

The third search source was Google, through several search queries. The first three pages of results were considered for the following search terms: mental health toolkit Australia young people (20/03/2023), mental health toolkit Australia young adults (21/03/2023), mental health toolkit Australia adolescents (21/03/2023), first responders mental health toolkit Australia (21/03/2023), emergency mental health toolkit Australia young (21/03/2023), mental health toolkit Australia volunteer (30/03/2023), and mental health toolkit Australia workplace (30/03/2023).

The above searches were then repeated (13/04/2023) but using “New Zealand” instead of “Australia”. Advanced search settings were used to limit results to websites from the Australian and New Zealand regions.

Screening

All authors discussed appropriate inclusion and exclusion criteria to identify toolkits eligible for analysis, as detailed in Table 1. One author (ES), applied the criteria to the resources found through the environmental scan. Resources were excluded where they were not aimed at one of the demographic groups young surf lifesaver personnel would generally fit into, such as toolkits for young children, parents, educators, or employers. For example, WorkSafe Queensland’s Mental Health Toolkit is intended for workplace leadership and managers rather than general workers [31], and was therefore excluded. In addition, some toolkits, such as the Butterfly Foundation’s toolkit on body image and Instagram [32] was not directly related to a lifesaving context and considered too niche of a topic for inclusion. In some cases, resources were excluded where they were presented in non-toolkit formats such as factsheets, or e-therapy programs like moodgym [33].

Table 1.

Toolkit inclusion and exclusion criteria

Inclusion Criteria

Exclusion Criteria

Eligible toolkits for analysis were defined as those that met all the following: 1) Providing information and resources about mental health. 2) Aimed at young people (broadly defined as those aged under 25, although the toolkit itself did not necessarily have to define “young people” to be included); first responders; volunteers; sports club members; and/or workers. 3) English language (owing to resource constraints and language skills of the research team), and produced in Australia or New Zealand for Australian or New Zealander audiences. 4) Freely available and accessible online in their entirety at the time of review.

Resources were excluded from analysis if any of the following were met: 1) They were aimed at a very specific audience that were not identified as on-topic for young surf lifesavers generally. 2) Mental health information was not presented as a “tool” or “toolkit”. 4) They were under development (i.e., not completed) at the time of review. 5) Payment was required for access.

Toolkit data extraction

Relevant information about resources identified in the search were collated in a custom-built Microsoft Office Excel Spreadsheet. The toolkits were summarised as per Barac et al.’s framework which advises researchers to collect the following information: “toolkit format, toolkit topic (as specified by the toolkit authors), target audience(s) , toolkit content, [and] evidence underlying toolkit content.” [23, p. 5] This required researchers to read each toolkit in full, making notes pertaining each of the above categories. In the present study, one researcher undertook this data extraction. Unless information about evidence base is included in the toolkit itself, researchers needed to seek information from the author’s website, or through an additional web search, to establish the toolkit’s existing evidence base (where possible).

Survey design and recruitment

The extracted toolkit data was included in a Qualtrics survey for assessment by expert reviewers. The study authors, through consensus, created the assessment rubric to be applied to each toolkit, designing the survey so that each toolkit could be assessed in terms of its applicability to the intended SLSA audience. In the process, the formal position description of an SLSA member was included to see how the toolkit might support members in undertaking the essential duties of their role. These questions are included in Table 1 of the Appendix. Given this extracted information and the reviewers’ own experience of following the relevant links to the toolkits, reviewers were asked to assess the strengths and weaknesses of each toolkit, particularly in light of the needs of young SLSA members.

Expert reviewers consisted of a convenience sample of authors’ contacts, who were approached because they held expertise related to psychological wellbeing of the target audience. The survey was sent to individuals via email, direct message, various committees (online and face-to-face), and were completed at mental health workshop events. All information collected during the surveys was confidential and responses were anonymous. Informed consent was obtained through the provision of text or verbal communication, and further through the information sheet and question to indicate consent provided online at the start of the survey.

The survey was quite long, totalling 160 questions about the toolkits, plus additional items to provide consent and ascertain demographic information. Given the length, and given that participants were not reimbursed or offered incentives to complete the survey, respondents were instructed to review as many of the toolkits as was practicable, they were not required to review all toolkits. Toolkits were presented to reviewers in random order to minimise the impact of low completion rates on consistency of data collection.

Appendix 1 includes the questions asked in the assessment of each toolkit. In sum, data under three overarching themes were collected, and which are now described: holistic analysis, SLSA-specific and general trauma support, and open responses on strengths, weaknesses, and relevance.

Holistic analysis

Participants were asked to assess each toolkit holistically in relation to its Usefulness, Relevance, Appropriateness, and Accessibility on a Likert scale of very poor, poor, acceptable, good, or very good.

SLSA-specific and general trauma support

For each toolkit, respondents were asked to assess how likely the resources therein would assist with potential impacts of eleven specific tasks that SLSA members undertake as first responders, as well as “any other very stressful event or experience.” These eleven tasks are articulated in a supplementary Table 1 in the Appendix. Reviewers were asked to make their assessment on a Likert scale of extremely unlikely, somewhat unlikely, neither likely nor unlikely, somewhat likely, or extremely likely. An average was taken across the SLS-specific questions, giving each toolkit an overall score for its helpfulness in managing the impacts of SLS-specific traumatic events. A separate score was also taken for each toolkit’s helpfulness in managing general trauma per the “any other stressful event or experience” rating.

Open responses

Respondents were also asked to share their thoughts on the general strengths, weaknesses, and relevance of each toolkit. Responses were coded thematically by one author (ES) using an exploratory, inductive analytic approach. Each open response was placed in a Microsoft Excel spreadsheet. Through a process of data immersion, the researchers identified a series of themes that were invoked by respondents. Quotes were extracted, verbatim, for inclusion in this study.

Ethics approval

The study was approved by the Human Research Ethics Committee (HREC 24054) from Central Queensland University, and was further acknowledged and approved by the University of New South Wales (HREC 22265). Participants provided explicit, informed consent at the commencement of the survey.

Results

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 [34]. 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 [35, 36]. Similarly, the Lourdes Hill College toolkit for positive mental health was excluded as it was intended for parents rather than young people themselves [37]. The Village app was excluded because it was not downloadable on an Australian device [38].

Fig. 1.

Environmental Scan Flowchart

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.

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%

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 [39].

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 [40]. 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 [39].

A summary of extracted toolkit data is included in Table 3, which includes each toolkit’s name, citation, topic, format, and target audience. The full extracted toolkit data is provided in Table 3 of the supplementary materials, including an overview of included content, and (where available) evidence underlying each toolkit.

Table 3.

Toolkits included in survey and analysis intended for young people (summary version)

Toolkit name and reference	Topic	Format	Target audience
Mental wealth, Le Va, 2019 [41]	Youth mental wellbeing and mental illness	Website - information, tips, exercises, and resources	Young people, New Zealand
Toolkit for Mentally Healthy Workplaces, Australian Services Union - Victoria and Tasmania, 2018 [42]	Rights around workplace safety as it pertains to mental health	Website - information and resources	Paid workers, Australia
Architects mental wellbeing toolkit, The Architects Mental Wellbeing Forum, 2021 [43]	Promoting a mentally healthy architecture workplace	PDF - actionable tips and resources	Paid workers (architects), Australia
Wellbeing Toolkit, Australian Red Cross, 2022 [44]	Combatting stress and burnout	PDF - information, questionnaires, and activities	Unpaid workers, Australia
Community Trauma Toolkit, Emerging Minds, 2019 [40]	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
Smiling Mind, Smiling Mind, 2023 [2012] [45]	Supporting sleep, meditation, and mindfulness; stress reduction.	App - User answers questions about their interests and mental state and the app suggests activities.	Young people (aged 3 to 18), Australia
My Toolkit - Build Your Space, headspace, 2022 [46]	Learning about mental health, improving own mental health, identifying mental illness, and helping others	Interactive website - users choose modules relevant to them.	Young people, Australia
Healthy headspace Action Plan, headspace, 2019 [47]	Developing a plan to improve one’s own mental health	PDF − 2-page worksheet and reference	Young people, Australia
Students - Mental Health and wellbeing toolkit, State Government of Victoria, 2022 [48]	Improving one’s own mental health and addressing distress/mental illness	Website - reference and advice	Young people (school-aged), Australia
The Mental Health Toolkit for Young People, Kindred, 2022 [49]	Introduction to mental ill-health and distress.	PDF - information and activities	Young people, Australia
Niggle app, Kids Helpline, 2019 [50], Zelenko, Cheers, 2019 [51]	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
Mental fitness toolkit, Peak Fortem, 2021 [52]	Improving “mental fitness”	Interactive website - resources are available in audio, video, and text.	First responders, Australia
Community Responders project, The Australian Centre for Social Innovation, 2019 [53]	How to have a positive, community response to mental ill-health and mental wellbeing	PDF - worksheets and information	Young people, Australia
Club Toolkit, Outside the Locker Room, 2020 [54]	Responding to one’s own or another’s mental health challenges	PDF - reference information	Sports clubs, Australia
Care4Guide, Bushfire and Natural Hazards CRC, 2021 [39]	Mental wellbeing as a first responder	Multiple - a PDF workbook, an interactive course, and downloadable software	Young people, First responders, Australia
AFL Club Mental Health & wellbeing, AFL, 2023 [55]	Information about mental illness and mental health safety in clubs	Multiple - website with webinars, tools, and information.	Sports clubs (AFL players), Australia
Workplace Mental Health Toolkit, Black Dog Institute, 2017 [56]	Handling mental illness at work	PDF - information and guidance	Paid workers, Australia
Workplace Mental Health Toolkit (variation), Black Dog Institute and Healthy Heads, 2021 [57]	Handing mental illness in the truck driving, warehouse, logistics industries	PDF - information and guidance	Paid workers (truck driving, warehouse, logistics), Australia
Work and Mental Health, Beyond Blue, 2022 [58]	Mental wellbeing and mental illness at work	Website - information	Paid workers, Australia
Workplace Mental Health Month Toolkit, WayAhead, 2022 [59]	Activities to promote mental wellbeing in the workplace	Multiple - activities to do on one’s own and collectively, and information	Paid workers, Australia
Fighting Fit, Australian Government - Defence, 2023 [60]	Mental health resources for the Australian Defence Force	Website - list of resources and information	Paid workers, Australia
Workplace Resources for asking “Are you OK?“, R U OK?, 2018 [61]	Workplace mental wellbeing promotion activities.	Website - guides, posters, presentations for hosting RUOK.	Paid workers, Australia
Recovery at Work Toolkit, NSW Government - State Insurance Regulatory Agency, 2023 [62]	Mental health recovery at work	Website - information and resources	Paid workers, Australia
Mental health and wellbeing, CPA Australia, 2021 [63]	Avoiding burnout at work	Website - tips and resources	Paid workers (accountants), Australia
5 ways to wellbeing, Next Gear, 2017 [64]	Mental wellbeing in the construction industry	PDF - activities, information, and resources	Paid workers (construction), Australia
School Leavers’ Toolkit, New Zealand Government - Ministry of Education, 2020 [65]	Caring for your mental health as a school leaver	Website - information and resources	Young people (late-teens), New Zealand
Staying On Track, Just a Thought, 2020 [66]	How to support your mental health during COVID (and beyond)	Website - online course	Young people, New Zealand
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
All right?, Canterbury District Health Board and Mental Health Foundation of New Zealand, 2013 [68]	Mental wellbeing and connection for young people	Website - tools, resources, and products (some available for purchase)	Young people, New Zealand
CALM - Computer Assisted Learning for the Mind, The University of Auckland Faculty of Medical and Health Sciences, 2009 [69]	Managing mental health challenges for young people	Website - information and resources	Young people, New Zealand
Mind. Set. Engage., New Zealand Rugby Union, 2018 [70]	Mental fitness and managing mental illness for rugby players	Website - information	Sports clubs (rugby players), New Zealand
Five Ways to Wellbeing at Work Toolkit, Mental Health Foundation of New Zealand, 2021 [71]	Mental wellbeing at work	PDF - information and worksheets	Paid workers, New Zealand

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 min to complete for the seventeen respondents who completed 100 or 99% of the survey.

Table 4.

Domain expertise of respondents^a

Domain	n	%
Researchers:a	11	16%
Human Geographyb	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%

^aSeveral reviewers had multiple relevant domains of expertise, so while therewere 68 reviewers, there were 70 responses to this question

^bGeographers focusing on coastal regions, analysis of geographic strata in relation tocoastal safety, risk communication, and similar research were identified as being able to provide relevant feedback

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 workersa (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)

^aStandard deviation not available as there was only one included toolkit in this category

Top scoring 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 [39] 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 [46] ranked within the top five toolkits across variables except “accessibility” and the Smiling Mind app [45] were ranked among the top five toolkits in all categories except “specific trauma”. Emerging Mind’s Community Trauma Toolkit [40] 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 [39]			• “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[46]			• “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[45]			• “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[40]			• “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.

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 [40], 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 [46] and the Niggle app [50]) 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 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 [50], 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 [41] and Niggle [50]) 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 [54] 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 [50]), 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 [52] (alongside Mind. Set. Engage [70]). 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 [46, 47], R U OK [61]?, and the Black Dog Institute [56, 57]. 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 [39] and the Peak Fortem [52] 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 [53] as it “demonstrated a commitment to diversity.” An injury prevention researcher similarly thought the Victorian Government toolkit [48] 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 [64], “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 take 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” (SLSA 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 on the Niggle app [50], 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 [63], architects [43], transport and logistics workers [57], and construction workers [64]) 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 [55] 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 [45])

“[This] Information… could be a reference for the Peer support officers.” (SLSA unpaid worker, Emerging Minds Community Trauma toolkit [40])

“I believe if used correctly would provide resilience prior to [an] incident and additional support post the incident. Peer support could provide some direction to the app.” (SLSA unpaid worker, CALM [69])

“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 [59])

Discussion

To our knowledge, this study has been the first to assess available mental health toolkits for their relevance to a specific population. Here, we assess the relevance of existing resources to young SLSA members. The diversity of expertise among reviewers usefully provided varied insights about how toolkit development for young SLSA members could proceed. Reviewers picked up on different strengths, weaknesses, and use cases of existing toolkits, while still converging on similar conclusions, as is seen by the relatively low standard deviations calculated for mean toolkit scores, and as reflected in free text comments. While it was clear that many of the toolkits reviewed constitute strong resources that would be of some benefit to the young SLSA community, there was no existing toolkit that holistically meets the mental health needs of this demographic.

A need to develop bespoke resources

This environmental analysis and expert review of existing toolkits shows that while there are existing resources that could be adapted for young SLSA members, there is also need for novel resources with tailored information. For example, while the Care4Guide was identified as strong, it was produced in the context of fire response, which has important overlaps with marine rescue and other activities but does not map perfectly. 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.

While reviewers acknowledged the advantages of linking to other resources, they also pointed out the importance of creating a comprehensive toolkit for this specific demographic, so that users are not forced to wade through multiple links, potentially increasing the risk of disengagement. This insight is reflected in the World Health Organization’s own health communications guide, which emphasises the importance of the availability of comprehensive information that is easily navigable for users to find what they need, while also providing links to further, more detailed supplementary information [72]. An advantage of creating a bespoke resource is that users would not be left to draw the parallels and links between an abstract concept (such as “mindfulness”) and their day-to-day lives as a young adult and a SLSA member. However, comprehensive resources we have reviewed (such as Headspace’s Build Your Space) have a large volume of content [46]. As per Headspace’s resource, it would be important to manage large amounts of material through a thoughtful presentation of contents, allowing users to pick content that is relevant to them [46]. This would minimise overwhelm and disengagement.

Comments also highlighted the importance of speaking to younger people in a voice that was approachable and familiar, rather than overly corporatised or formal, as is found through the workplace toolkits. They should avoid the pitfalls of “toxic positivity” – discourse that exaggerates reasons to be happy, hopeful, excited, or other positive emotion [73]. There is a delicate line to draw between providing hope and failing to be realistic about the difficult nature of hardship. These comments may be supplemented by Young and Well Cooperative Research Centre’s overarching participatory framework for involving young people in research and resource development, which advises that “authenticity of voice and ownership by users is central.” [74] Other research around developing mental health resources for young audiences show that it is important to impart a sense of agency rather than being overly directive [75]. Audiences want to be able to identify with characters in any stories told and otherwise have their identity feel represented without falling into tokenism [75]. On a pragmatic level, young people expressed needing to navigate self-care and care for others with practical strategies [75]. Language use must come across as authentic and “relatable” without seeming like adults are encroaching on youth space [76]. It would be impossible to know if these subtle aspects of a toolkit are in balance without extensive collaborative efforts.

An SLSA strengths-based approach

A bespoke SLSA toolkit which harnessed and adapted some existing useful resources, and overcame some of the limitations of the less useful resources would have the opportunity to take a strengths-based approach to their audience. A strengths-based approach to mental health draws on participants’ existing resources – such as character traits, community ties, physical health, feelings of trust, and shared goals – in building wellbeing [77, 78]. Bespoke resources could draw on individual and clubs’ existing assets [78]. such as high levels of physical fitness, opportunities related to SLSA’s proximity to sport, members’ volunteer status, and SLSA’s organisational ethos.

Qualifying as a SLS lifesaver or lifeguard requires SLSA members to undergo physical testing which necessitates a reasonable level of fitness. It is understood that physical activity is a protective factor against mental ill-health [79]. It may be useful for bespoke toolkits to draw on members’ existing fitness levels and interests in swimming, running, surfing, and other beachside physical activities in suggesting practical strategies to manage distress.

Sporting clubs have been identified in previous literature as a potential site for youth mental health promotion, literacy, and support, as well as to foster a sense of belonging and inclusion [80]. This is particularly the case for young males, who tend to be considered generally hard-to-reach with mental health promotion efforts and show lower levels of mental health literacy than their female peers [80]. Although SLSA is not a sports club per se, the club structure, training, teamwork, camaraderie, elite and community surf sports competitions, and physical nature of the work have clear parallels to sporting clubs. Where mental health promotion is carefully and enthusiastically implemented in club settings such as these they provide important opportunities for interventions [81]. To operationalise this implications, clubs need to overcome potential attitudinal barriers such as the belief that clubs are an inappropriate place to discuss mental health and a lack of resources to discuss mental health safely [81]. Moreover, state and national SLS entities can provide strategic support to assist clubs to navigate any challenges with implementation. For example, SLSA provide resources to members through the members website, which would be an excellent location for a bespoke toolkit to sit, and have training modules for members relating to mental health support and first aid. Similarly, Life Saving Victoria have developed a Wellbeing and Mental Health Strategy to assist Victorian clubs to nurture and prioritise mental health and wellbeing of members.

Qualitative comments emphasised values of pragmatism, inclusion, and connection in building a fit-for-purpose toolkit alongside an organisational culture that would foster wellbeing. These values reflect SLSA’s stated overarching strategic goals around community-building, diversity and inclusion, as well as upholding the safety of its membership [82], which may provide opportunities to shape toolkit messaging in line with organisational priorities.

Mentally healthy contexts

In large, dispersed organisation settings such as SLSA, mental health toolkits provide opportunities for proactive, practical knowledge transfer at scale [23]. At the same time, toolkits cannot do the heavy lifting of mental health promotion by themselves. For instance, where a member has dealt with a highly emotive, challenging, or catastrophic event, providing them with a toolkit would be inappropriate. Delivering toolkits at the correct time – for example as part of disaster preparation, or as part of routine mental health training – is imperative. These results will help to define the placement and role of toolkits within the context of a SLS mental health strategy/framework.

Toolkits are ideally delivered alongside a comprehensive approach to mental health among this vulnerable first responder demographic. Individualised resources such as these, while potentially useful, may also fall into the trap of transforming environmental, public, and community health risks into a matter of personal responsibility [83]. Such a response would fail to account for the ways that volunteering may create trauma, instead attributing distress to individual vulnerability, lack of resilience, or failure to cope [83, 84]. It would further neglect the potential wellbeing pathways offered by social transformation towards psychosocial risk management [84]. SLSA does already have mental health supports available such as a free Employee Assistance Program (EAP) for members, critical incident support, and, in some states (such as Queensland), identified peer support officers [85–87]. Life Saving Victoria have recently articulated and promoted a Wellbeing and Mental Health Strategy [88]. In planning bespoke toolkit dissemination, as has been observed previously, clubs may experience an increase in demand for supports and services as greater awareness allows audiences to identify that they may be in need of help [89]. Upon bespoke toolkit dissemination, SLSA will need to be equipped to effectively cope with additional help-seeking demands through appropriate supports and referrals.

Evidence generation

SLSA has an organisational duty-of-care to its members, a duty-of-care that may be particularly profound towards its younger, and more vulnerable members [8]. This highlights the necessity of efforts to ground toolkit development with an evidence-base, of which this environmental scan and toolkit analysis provides a first step. A limitation of many existing toolkits, notwithstanding some notable exceptions as recorded in Table 2, is that they apparently tend to lack an underlying evidence base [23]. Although this survey has focused on toolkits developed within government and non-for-profit sectors, a similar lack of evidence for commercial apps for wellness and stress management has likewise been identified [17].

An optimal toolkit tailored to SLSA members, however, would utilise an evidence base to ensure that it is helpful and is used in practice. Ideally, a toolkit design process would draw on available evidence and would generate further evidence as to its efficacy through a co-design process. The inclusion of all stakeholders in mental health research, promotion, and program evaluation is a relatively nascent practice, but recognised as an important means to ensure beneficial outcomes are achieved as those with experiential expertise are centred in the process of creating resources that best help and engage them [90].

Drawing from thematic discussions of credibility in the environmental scan, SLSA may also consider the utility of including well-regarded mental health organisations – particularly related to youth and/or first responder mental health – as stakeholders in co-design processes.

Many reviewer comments highlighted the importance of the audience’s experience of holistic experience of toolkits – including language, format, and visual design – alongside the substance of the content itself. These insights may suggest that focus group and user experience testing could be worthwhile investments towards increasing uptake.

Beyond relevance to SLS as an organisation, and its young volunteers, our findings can be of assistance to those looking to optimise development and delivery of toolkits for young people, as well as develop toolkits to support other community or volunteer organisations such as youth sport [91]. Across these contexts researchers should examine optimal strategies for the integration of mental health support resources and training into volunteer induction and regular training, as well as facilitate co-design of materials with end-users to enhance relevance and uptake [91, 92]. From a policy perspective, this research highlights mental ill-health is a problem which currently received limited resourcing within volunteer organisations such as SLS [93]. Funding could be allocated to support recognition of mental ill-health among the volunteer emergency services workforce and consistent provision of resources to improve mental health for this at-risk cohort.

Strengths, limitations, and future work

While there was no existing toolkit that entirely catered for the mental health toolkit needs of young SLSA members, a strength of this study is that the high level of involvement of individuals with experience in SLSA and related state bodies meant that reviewers were often able to imagine how resources could be adapted to fit the idiosyncrasies of this environment. Some reviewers reflected on where resources would be kept (for instance, whether a poster would gather dust in a club room), or how to encourage members to use toolkits (for instance, by stating the proportion of members that already utilise it and incorporating interactivity through gamification). Reviewers reflected on the usefulness of existing toolkit content, particularly for general mental health information. In creating a tailored resource, there exists a large amount of content that could (with permission) be adapted to an SLSA context. Our quantitative results indicate that existing toolkits created for first responders and young people are good candidates for adaptation.

This study has several limitations. Firstly, by limiting our analysis to mental health “toolkits” in Australia and New Zealand that were free to access and could be conceivably relevant to young SLSA members, we were not able to capture the diversity of mental health resources available. However, including all factsheets, videos, websites, and other internet resources regarding mental health would have been an impossibly broad scope for this environmental scan and analysis. Few studies have focused on health toolkits in general despite their wide implementation in health promotion [23]. There have been previous environmental scans of online mental health resources for young people [19, 20], but none were found that have focused on toolkits specifically. Thus, there is a significant literature gap that validates the toolkit focus we have taken.

Our method may have led to limitations resulting from potentially insufficient validation of the search strategy and inclusion/exclusion criteria across more investigators. This limitation may have contributed to inappropriate toolkits being included in the analysis, such as the Architects Mental Wellbeing Toolkit. Although it is preferable to include too many toolkits rather than too few to understand the scope of toolkits currently available, the inclusion of potentially extraneous materials may have contributed to the additional limitation that the survey conducted was exceptionally long.

The length of the survey was clear to us from the outset, and we received anecdotal feedback from reviewers and occasional survey comments to this effect. The length of the survey is an unfortunate complication of undertaking such an extensive environmental scan. It meant that not all reviewers were able to review all toolkits – though all answers that were made were recorded and included in this analysis – which compromised the consistency of the results. However, this study addressed this limitation through randomisation, which meant that each toolkit was reviewed on average by 13.76 reviewers. The relatively small standard deviation (1.72) suggests that randomisation was effective. Further, this study does not intend to make definitive statements about the strengths and weaknesses of all existing toolkits, but rather to identify strategies to create or adapt a toolkit relevant for young SLSA members which capitalise on positive aspects of existing resources and identify potential pitfalls for this specific audience.

Although 44% of reviewers were SLSA members, no data was collected for reviewer age, and some of these participants may be older than 25 years. A potential limitation of this analysis is that a relatively small proportion of total feedback was from the cohort that would use any resulting mental health toolkit. There may be limitations with adults’ estimations young people’s preferences, or on the mental health content they would most benefit from. Guessing what may be relevant for young cohorts can compromise uptake and efficacy of resulting materials [94]. This limitation has been partially addressed in a survey study canvassing toolkit content, format, and activity preferences of existing young SLSA members. Future work will more deeply embed the lived experiences of young SLSA members in later stages of toolkit development with extensive consultation and co-design with a larger number of target audience representatives. Understanding mental health impacts in SLS is important for advocacy to promote SLS in the first responder role. The next steps for SLS are to develop national level documents (i.e., mental health and wellbeing framework) to guide and support SLS entities at all levels to promote mental health and wellbeing among SLS membership [92].

Conclusion

Overall, this study finds opportunities to produce bespoke toolkits relevant to the impact of high-risk situations in Australian waterways that incorporate the strengths of SLSA membership, while also learning from and building upon existing effective mental health toolkits.

Authors’ contributions

ES wrote the main manuscript text; SF applied for ethics approval. SF, JL, and AP provided supervision and contributed to participant recruitment. AP conducted a 10% coding check. All authors reviewed the manuscript.

Funding

Not applicable.

Data availability

The datasets generated and/or analysed during the current study are not publicly available due to the potentially identifying nature of comments but data are available from the corresponding author on reasonable request.Raw data has also been attached to this submission.

Declarations

Ethics approval and consent to participate

The study was conducted in accordance with the Australian National Statement on Ethical Conduct in Human Research (2023) and approved by the Human Research Ethics Committee (HREC 24054) from Central Queensland University. It was further acknowledged and approved by the University of New South Wales (HREC 22265). Participants provided explicit, informed consent at the commencement of the survey.

Consent for publication

Not applicable.

Competing interests

The authors declare the following competing interests: SF is a volunteer surf lifesaver based in Queensland and is the SLSA National Well-being Advisor, SLSQ State Lifesaving Officer, and SLSQ Research Panel Chair (volunteer level). JCL is employed by Surf Life Saving Australia.