Suicide first aid guidelines for Sri Lanka: a Delphi consensus study

Abstract

BackgroundSri Lanka has one of the highest suicide rates in the world. Gatekeeper programs aimed at specific target groups could be a promising suicide prevention strategy in the country. The aim of this study was to develop guidelines that help members of the public to provide first aid to persons in Sri Lanka who are at risk of suicide.MethodsThe Delphi method was used to elicit consensus on potential helping statements to include in the guidelines. These statements describe information members of the public should have and actions they can take to help a person who is experiencing suicidal thoughts. An expert panel, comprised of mental health and suicide experts in Sri Lanka, rated each statement. The panellists were encouraged to suggest any additional action that was not included in the original questionnaire and, in particular, to include items that were culturally appropriate or gender specific. Responses to open-ended questions were used to generate new items. These items were included in the subsequent Delphi rounds. Three Delphi rounds were carried out. Statements were accepted for inclusion in the guidelines if they were endorsed (rated as essential or important) by at least 80 % of the panel. Statements endorsed by 70–79 % of the panel were re-rated in the following round. Statements with less than 70 % endorsement, or re-rated items that did not receive 80 % or higher endorsement were rejected.ResultsThe output from the Delphi process was a set of endorsed statements. In the first round questionnaire 473 statements were presented to the panel and 58 new items were generated from responses to the open-ended questions. Of the total 531 statements presented, 304 were endorsed. These statements were used to develop the suicide first aid guidelines for Sri Lanka.ConclusionBy engaging Sri Lankans who are experts in the field of mental health or suicide this research developed culturally appropriate guidelines for providing mental health first aid to a person at risk of suicide in Sri Lanka. The guidelines may serve as a basis for developing training for members of the public to provide mental health first aid to persons at risk of suicide as part of Sri Lanka’s suicide prevention strategy.Electronic supplementary materialThe online version of this article (doi:10.1186/s13033-016-0085-3) contains supplementary material, which is available to authorized users.

Suicide first aid guidelines for assisting persons from immigrant or refugee background: a Delphi study

“…This study aimed to develop guidelines for members of the public to recognise suicide warning signs and assist a person from an immigrant or refugee background who is experiencing suicidal thoughts or engaging in suicidal behaviour until appropriate professional help is received or the crisis resolves. This study aligns with previous works by the authors to produce guidelines for English-speaking countries (Ross, Kelly, & Jorm, 2014), Aboriginal and Torres Strait Islander populations (Hart, Jorm, Kanowski, Kelly, & Langlands, 2009) and some Asian countries (Colucci, Kelly, Minas, Jorm, & Chatterjee, 2010;Colucci, Kelly, Minas, Jorm, & Nadera, 2010;Colucci, Kelly, Minas, Jorm, & Suzuki, 2011;De Silva et al, 2016;Hart et al, 2009). These guidelines could be used to develop training of gatekeepers to identify and respond to cross-cultural differences.…”

Lethal hopelessness: Understanding and responding to asylum seeker distress and mental deterioration

“…The safety plan should be developed as a co‐construction with the asylum seeker (De Silva et al . ; Stanley et al . ), linking their explanatory model of reasons for living and strategies they identify to soothe and comfort distress (Alemi et al .…”

“…Trauma‐informed collaborative safety planning with asylum seekers at risk of suicide and self‐harm should consist of tangible reminders of the person's reasons for living (De Silva et al . ; Stanley et al . ).…”

“…For example, a culturally appropriate safety plan may include names of family members not in Australia, photos of people close to the person in distress, experiences the person wants to have that bring about a calmer sense of self (De Silva et al . ; Stanley et al . ).…”

“…This takes mental health workers to a closer point of understanding depth of distress and immediacy of suicide risk (De Silva et al . ; Stanley et al . ).…”