Cultural adaptation of mental health first aid guidelines for depression for Sri Lanka: a Delphi expert consensus study

Madhawee Fernando,Nicola J. Reavley,Madhubhashinee Dayabandara,Amila Chandrasiri

doi:10.1186/s12888-021-03598-0

Abstract

BackgroundFamily and friends can play a key role in supporting a person with depression to seek professional help. However, they may lack the knowledge to do so. English-language guidelines for high-income countries have been developed to assist with this. The aim of this study was to adapt the English mental health first aid guidelines for helping a person with depression to the Sri Lankan context.MethodsA Delphi expert consensus study involving mental health professionals and people with lived experience (either their own or as carers) was conducted. Participants were recruited from inpatient, outpatient and community care settings. The English-language questionnaire was translated into Sinhala and participants were asked to rate the importance of each item for inclusion in the guidelines for Sri Lanka.ResultsData were collected over two survey rounds. A total of 115 panellists (23% male) consisting of 92 mental health professionals and 23 consumers and carers completed the Round 1 questionnaire. A total of 165 items were included in the final guidelines, with 156 adopted from the guidelines for English-speaking countries and 9 generated from the comments of panellists.ConclusionsThe adapted guidelines were similar to the English-language guidelines. However, new items reflecting culturally relevant approaches to autonomy-granting, communication and culture-specific manifestations of depression were reflected in the adapted version. Further research should explore the use of the adapted guidelines, including their incorporation into Mental Health First Aid Training.

Highlights

And friends can play a key role in supporting a person with depression to seek professional help
A study conducted with a Sri Lankan undergraduate student sample showed that approximately 10% reported a diagnosis of Major Depressive Disorder (MDD) and 20% screened positive for depression using the Sinhala and Tamil versions of the (PHQ-9) [7]
The Delphi methodology, which is a systematic method for establishing expert consensus on a topic, was used to achieve consensus on potential statements to be included in the mental health first aid guidelines for depression in Sri Lanka

Summary

Introduction

And friends can play a key role in supporting a person with depression to seek professional help. They may lack the knowledge to do so. The aim of this study was to adapt the English mental health first aid guidelines for helping a person with depression to the Sri Lankan context. A population-based study conducted in Colombo in 2010 reported a 6.6% lifetime prevalence estimate of depression rising to 11.2% if the functional impairment criterion was excluded [6]. A study conducted with a Sri Lankan undergraduate student sample showed that approximately 10% reported a diagnosis of Major Depressive Disorder (MDD) and 20% screened positive for depression using the Sinhala and Tamil versions of the (PHQ-9) [7]. Much higher prevalence rates have been seen in respondents recruited from hospital inpatient and outpatient settings [8,9,10] and people with comorbid chronic illness [11, 12], samples of adolescents [13] and older adults [14]

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Discussion

Conclusion