Abstract
BackgroundApproximately 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.MethodsA 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.ResultsData 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.ConclusionsThe 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.
Highlights
3000 people die by suicide each year in Sri Lanka
The Delphi method was used to obtain consensus between mental health professionals and people with lived experience on appropriateness of statements to be included in the guidelines on helping a person at risk of suicide in Sri Lanka
Minor changes were made to some statements to make them more appropriate to the Sri Lankan health system and cultural context, e.g., emergency ambulance services which can be summoned by public are not available everywhere in Sri Lanka so this item was replaced with ‘calling Suwasariya (1990) ambulance service or organizing an alternative means to take the person to hospital’
Summary
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. Suicide is an important public health issue worldwide, with nearly 800,000 people dying by suicide every year [1]. In 2016, suicide accounted for 1.4% of all deaths worldwide and was the 16th leading cause of death [2]. In 1995, Sri Lanka had the highest female suicide rate in the world (at 47 per 100,000 people) [4]. Recommendations suggested in the 1997 report of the Presidential committee on the prevention of suicides were implemented and have contributed to a decline in suicide mortality from 60 per 100,000 people in 1995 to 18.5 per 100,000 in 2011 [5].
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