Cultural adaptation of the guidelines for offering mental health first aid to a person after a potentially traumatic event: a delphi expert consensus study in Brazil

Abstract

Background: Traumatic events increase the risk of mental disorders. In a country with relatively under-developed mental health support systems, services to assist people who have experienced potentially traumatic events may be unavailable. In such situations, people in the community become key sources of support. However, they do not always have the knowledge and skills to offer effective help. This study reports on the cultural adaptation for Brazil of the English-language mental health first aid guidelines for helping someone who has experienced a potentially traumatic event. Methods: A Delphi expert consensus study with two expert panels, one comprising health professionals with experience in the treatment of trauma (n = 33) and the other comprising people with lived experience, (n = 29) was conducted. A questionnaire containing 131 statements from the English language guidelines was translated into Brazilian Portuguese. Participants were asked to rate the importance of actions to be taken to help a person who has experienced a potentially traumatic event and to suggest new items where appropriate. Results: Data were collected over two survey rounds. A total of 149 items were included in the final guidelines (110 items from the English-language guidelines and 39 new items created from expert panel comments, in the second round). Immediate action items were endorsed by both panels, while items related to encouraging victims were rejected by the professional panel. The suggested statements mostly related to providing psychological support and attending to the person’s subjective experience rather than providing material or structural support. Conclusion: While there were many similarities with the English-language guidelines for high-income countries, the guidelines also incorporate actions of importance for Brazil, including the emphasis on the first aider’s management of the person’s subjective experiences. These guidelines may inform Mental Health First Aid training for Brazil and may also be used as standalone resources.

Development of mental health first-aid guidelines for suicide risk: a Delphi expert consensus study in Argentina and Chile

“…This study is similar to other Delphi studies conducted by our team to culturally adapt the MHFA guidelines to Chile and Argentina [ 84 , 85 ] and by those of the broader research group to adapt guidelines in several other countries [ 81 – 83 , 86 , 87 ]. It comprised four stages: [ 1 ] The development of the first-round survey; [ 2 ] Expert panel member recruitment; [ 3 ] Data collection and analyses for the round 1 and 2 surveys; and [ 4 ] Guidelines development.…”

Development of mental health first-aid guidelines for a person after a potentially traumatic event: A Delphi expert consensus study in Argentina and Chile

“…According to the local panellists, the first aider should not only seek to collaborate with (and follow directives of) professional first responders if they are present but also know their limitations as a person and in terms of the scope of their role. A similar suggestion was seen in Brazil; in the context of adapting the 2009 Australian MHFA guidelines for trauma, the Brazilian team emphasised first aider’s need to recognize their own limits and respect them [ 19 ]. Interestingly, the Chilean and Argentinian lived experience panellists did not endorse first aider’s self-protection, possibly due to a view that protecting the victims is the most important thing (something that contradicts PFA principles that underscore the importance of self-care in a helping situation [ 35 ]) and suggests the lived experience panellists’ expectation of a first aider’s “heroism” [ 58 ].…”

“…Some people may experience multiple traumatic events [ 18 ]. Countries exposed to natural disasters (e.g., Chile), developing countries and other countries with high levels of inequality (e.g., Chile and Argentina) may combine frequent PTE exposure with chaotic urbanisation and underprepared or underfinanced response teams, resulting in an explosive combination and a higher risk [ 19 ]. Furthermore, Chile and Argentina share a history of state and political violence that has been transmitted across generations [ 20 ] and has shaped cultural processes that included the elaboration of collective trauma, social mourning, and calls for truth and justice in both countries [ 21 ].…”

Differences in Psychological Vulnerability, Mental Health Liter-Acy, Positive Mental Health, and Health Behaviours in Portu-Guese Higher Education Students: A Cross-Sectional Study

“…MHL is essential for students' health promotion because it refers to knowledge of how to obtain and maintain good mental health (recognise mental disorders, help-seeking efficacy, and help-seeking strategies) (Sykes et al, 2021). Some studies highlight the need to invest in programmes to promote MHL on campuses and mental health first aid skills (Forbes et al, 2022;Mendes et al, 2022). Good levels of MHL allow students to recognise signs and symptoms of mild to moderate problems, when and where to seek help and develop self-management skills to improve well-being versus psychological suffering.…”