Cultural adaptation of the mental health first aid guidelines for assisting a person at risk of suicide in Brazil: a Delphi expert consensus study

Abstract

Background Suicide is a major public health concern in Brazil, with nearly 115,000 Brazilians dying by suicide in 2010–2019. As support for individuals at risk of suicide may come from the community, particularly family and friends, it is fundamental that evidence-based programs or resources to improve such support are in place when needed. This study aimed to culturally adapt the mental health first aid guidelines for assisting a person at risk of suicide used in English-speaking countries for Brazil. Methods A Delphi expert consensus study was conducted among a diverse range of Brazilian health professionals and individuals with lived experience of suicide (n = 60). A total of 161 items from the mental health first aid questionnaire used in English-speaking countries were translated and used in the Brazilian questionnaire. Participants were asked to rate the appropriateness of those items to the Brazilian culture and to recommend any new items when appropriate. Results Data were collected over two survey rounds. Consensus was achieved on 145 items. While 123 out of 161 items were adopted from the English guidelines, 22 new endorsed items were created from the expert panel comments. Conclusions Even though there were similarities among the Brazilian and English-language guidelines, the adapted guidelines incorporated actions that were specific to the Brazilian culture, such as new items emphasising the role of family and friends. Further research is warranted on dissemination and uptake of the guidelines in Brazil as well as research into incorporation of the guidelines into Mental Health First Aid (MHFA) training for Brazil.

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

“…Statements were immediately excluded from the guidelines if they were rated as essential or important by less than 70% of any panel. These percentage levels are in line with previous Delphi studies to culturally adapt mental health first aid guidelines [ 24 , 25 ].…”

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.…”

“…Drawing on previous studies of cultural adaptation of mental health first aid guidelines for suicide risk for China [ 81 ], Sri Lanka [ 82 ] and Brazil [ 83 ], a consortium of Chilean, Argentinian and Australian global mental health researchers and clinicians used the Delphi expert consensus methodology to culturally adapt guidelines to train lay members of the community and non-specialized health care providers interested in providing mental health first aid to someone at risk of suicide in Chile and Argentina.…”

Cultural adaptation of the mental health first aid guidelines for depression in Brazil: a Delphi expert consensus study

“…For instance, recent cultural adaptations of the mental health first aid guidelines for depression in China [24] and Sri Lanka [25] suggest that even though the adapted depression guidelines were similar to the English-language guidelines, some statements related to respect for one's autonomy, involvement of the family [24,25], and health communication style [25] were culturally-specific and needed to be added to the adapted guidelines. Likewise, the cultural adaptation of the mental health first aid guidelines for suicide in Brazil emphasized the importance of family and friends' involvement when assisting someone at risk of suicide [26].…”