Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait islanders who are experiencing suicidal thoughts and behaviour

Abstract

BackgroundSuicide is a leading cause of death among Indigenous Australians. Friends, family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is suicidal. Culturally appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islander persons who are experiencing suicidal thoughts or behaviour were developed in 2009. This study describes the re-development of these guidelines to ensure they contain the most current recommended helping actions.MethodsThe Delphi consensus method was used to elicit consensus on potential helping statements to be included in the guidelines. These statements describe helping actions that Indigenous community members and non-Indigenous frontline workers can take, and information they should have, to help someone who is experiencing suicidal thoughts or displaying suicidal behaviour. A panel was formed, comprising 27 Aboriginal and Torres Strait Islander people who have expertise in Indigenous suicide prevention. The panellists were presented with the helping statements via online questionnaires and were encouraged to suggest re-wording of statements and any additional helping statements that were not included in the original questionnaire. Statements were only accepted for inclusion in the guidelines if they were endorsed by ≥90% of panellists as essential or important.ResultsFrom a total of 301 statements shown to the expert panel, 172 were endorsed as helping statements to be including in the re-developed guidelines.ConclusionsAboriginal and Torres Strait Islander suicide prevention experts were able to reach consensus on appropriate strategies for providing mental health first aid to an Aboriginal or Torres Strait Islander person experiencing suicidal thoughts or behaviour. The re-development of the guidelines has resulted in more comprehensive guidance than the earlier version, for which the panel had rated 166 helping statements and had endorsed 52. These re-developed guidelines can be used to inform Indigenous suicide gatekeeper training courses.Electronic supplementary materialThe online version of this article (10.1186/s12888-018-1809-5) contains supplementary material, which is available to authorized users.

Cultural adaptation of the mental health first aid guidelines for depression used in English-speaking countries for China: a Delphi expert consensus study

“…Despite the relatively large panel sizes, there were drop-outs across the 2 nd and 3 rd rounds of the study. Such drop-outs have also been commonly reported in similar Delphi studies conducted in English-speaking countries [25,28,38] or LMICs [30][31][32]. As the first round of survey took approximately 1 hour (55 minutes on average) to complete, the time commitment required for Round 1 may have deterred panellists from participating in subsequent rounds, particularly in the consumer and carer panel (retention rate of 60% over Round 2 and 30% over Round 3).…”

Cultural adaptation of the mental health first aid guidelines for depression used in English-speaking countries for China: a Delphi expert consensus study

“…Despite the relatively large panel sizes, there were drop-outs across the 2 nd and 3 rd rounds of the study. Such drop-outs have also been commonly reported in similar Delphi studies conducted in English-speaking countries [28,32,42] or LMICs [34][35][36]. As the first round of survey took approximately 1 hour (55 minutes on average) to complete, the time commitment required for Round 1 may have deterred panellists from participating in subsequent rounds, particularly in the consumer and carer panel (retention rate of 60% over Round 2 and 30% over Round 3).…”

“…By using this method to develop an evidence base to guide decisions, policymakers and practitioners can move beyond relying on their own experience and draw on the accumulated experience of a larger, expert group [41]. This method has been widely used in disparate fields [41], including in mental health research, for example in the development of mental health first aid guidelines for English-speaking countries and some LMICs [30,32,34,42].…”

“…Moreover, it is important to point out that, due to the scarcity of relevant advocacy organisations or support networks in China, consumers and carers in this study were recruited individually from clinical settings, which means they are most likely to give ratings and comments based on their own lived experience, rather than on wider knowledge of this topic, as was the case with previous studies conducted in English-speaking countries [30][31][32]42].…”

Guidelines for the public on how to provide mental health first aid: narrative review

“… 37 Similarly, the correlations for items on suicidal thoughts and behaviours were 0.79 and 0.77, respectively. 38 Again, these results indicate a high degree of cross-cultural generalisability. However, there were also differences, e.g.…”