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

Abstract

Abstract Background Approximately 3000 people die by suicide each year in Sri Lanka. As family and friends may play a role in supporting a person at risk of suicide to get appropriate help, there is a need for evidence-based resources to assist with this. The aim of this study was to culturally adapt the existing English-language mental health first aid guidelines for helping a person at risk of suicide to the Sri Lankan context. Methods A Delphi expert consensus study was conducted, involving mental health professionals and consumers (people with lived experience) and caregivers, who were identified by purposive and snowball sampling methods. Participants were recruited from a wide variety of professional roles and districts of Sri Lanka in order to maximize diversity of opinion. The original questionnaire was translated into Sinhala and participants were requested to rate each item according to the importance of inclusion in the guidelines. Results Data were collected over two survey rounds. Altogether, 148 people participated in the study (130 health professionals and 18 consumers). A total of 165 items were included in the final guidelines, with 153 adopted from the guidelines for English-speaking countries and 12 generated from the comments of panellists. Conclusions The adapted guidelines were similar to the English-language guidelines. However, new items relating to the involvement of family members were included and some items were omitted because they were not considered appropriate to the Sri Lankan context (particularly those relating to explicit mention of suicide). Further research is warranted to explore the use of these guidelines by the Sri Lankan public, including how they may be incorporated in Mental Health First Aid training.