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

Abstract

Background Depression is one of the most common mental health problems worldwide and, while prevalence rates in Latin America are relatively high, most people who meet the criteria for diagnosis do not receive treatment. Family and friends of a person with depression can play an important role in supporting a person to seek and engage with treatment. However, many people do not have the necessary skills or confidence to help. English-language mental health first aid guidelines have been developed to support people to provide such help. The aim of this study was to culturally adapt these guidelines for Chile and Argentina. Methods A Delphi expert consensus study was conducted with two expert panels, one of people with lived experience of depression (either their own or as a carer; n = 26) and one of health professionals (n = 29). Overall, 172 statements from the English-language guidelines were translated and compiled into a questionnaire. Participants were asked to rate statements based on how essential or important those statements were for Chile and Argentina and to suggest new statements if necessary. Results Data were obtained over two survey rounds. Consensus was achieved on 172 statements. A total of 137 statements were adopted from the English-language guidelines, whereas 35 new endorsed statements were generated from panel suggestions. There were similarities between the English-language guidelines and those for Chile and Argentina. The adapted guidelines did not include some of the items from the English-language guidelines related to commenting on a person’s strengths or making judgements about their character, and also incorporated new items related to the incorporation of sociocultural considerations as causes of depression and attention to inequities in mental health. Conclusions The significant number of new items underscores the importance of undertaking a careful process of cultural adaptation. Further research on dissemination and incorporation of the guidelines into the Mental Health First Aid training course for Chile and Argentina is still required.

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

“…Interestingly, this is partially consistent with findings from other recently adapted MHFA guidelines in Chile and Argentina, where attention to social determinants—in terms of risk exposure or addressing vulnerable groups—seems to be more relevant to the lived experience experts [ 85 ]. This wider view of suicide risk is more in line with a public health approach [ 36 ].…”

“…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

“…Unlike previous studies to adapt other English MHFA guidelines to Chile and Argentina [ 55 , 56 ], Round 1 statements were not comparable to the finalised English guidelines but to Round 1 statements evaluated by Australian experts in 2019. This situation offered us the opportunity to compare Australian with Chilean and Argentinian opinions towards a very similar set of statements.…”

“…Furthermore, similar to the other MHFA Delphi studies in Chile and Argentina, those for drinking problems [ 55 ], depression [ 56 ], psychosis [ 57 ] and suicide risk [ 60 ], the local experts were somewhat reluctant to expand the role of mental health first aiders when helping someone exposed to a PTE. Nevertheless, the panellists did endorse that first aiders show openness, listen empathetically and be willing to listen even when the person is being repetitive; they endorsed items about the first aider being able to interpret non-verbal language to understand when it is safe to approach, when it is safe to talk or when it is better to just be present.…”

“…Accepting the limitations of first aider’s role did not include prioritising their self-care. Notably, this consideration for disregarding self-care was absent in other local mental health first aid guidelines that adapted the Australian guidelines; when helping someone with drinking problems [ 55 ], depression [ 56 ], psychosis [ 57 ] or suicide risk [ 60 ], Chilean and Argentinian experts considered that the first aider’s self-care was indeed a priority.…”