Abstract

BackgroundNon-suicidal self-injury (NSSI) disproportionally affects Indigenous Australians. Friends, family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is engaging in NSSI. Culturally appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islanders who are engaging in NSSI were developed in 2009. This study describes the re-development of these guidelines to ensure they contain the most current recommended helping actions.MethodsThe Delphi consensus method was used to elicit consensus on potential helping statements to be included in the guidelines. These statements describe helping actions that Indigenous community members and non-Indigenous frontline workers can take, and information they should have, to help someone who is engaging in NSSI. The statements were sourced from systematic searches of peer-reviewed literature, grey literature, books, websites and online materials, and existing NSSI courses. A panel was formed, comprising 26 Aboriginal and Torres Strait Islanders with expertise in NSSI. The panellists were presented with the helping statements via online questionnaires and were encouraged to suggest re-wording of statements and any additional helping statements that were not included in the original questionnaire. Statements were only accepted for inclusion in the guidelines if they were endorsed by ≥90% of panellists as essential or important.ResultsFrom a total of 185 statements shown to the expert panel, 115 were endorsed as helping statements to be included in the re-developed guidelines.ConclusionsA panel of Aboriginal and Torres Strait Islander people with expertise in NSSI were able to reach consensus on appropriate strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander engaging in NSSI. The re-development of the guidelines has resulted in more comprehensive guidance than the earlier version. The re-developed guidelines will form the basis of an Aboriginal mental health first aid short course on NSSI for Indigenous community members and non-Indigenous frontline workers that will be evaluated in an upcoming trial.

Highlights

  • Non-suicidal self-injury (NSSI) disproportionally affects Indigenous Australians

  • Available data indicates that NSSI is a relatively common behaviour among Aboriginal and Torres Strait Islander people, there is limited information available regarding help-seeking behaviours or about how best to support an Aboriginal or Torres Strait Islander person who is engaging in NSSI

  • Questionnaire development The questionnaire contained statements describing helping actions that Indigenous community members and non-Indigenous frontline workers can take, and information they should have, to help an Aboriginal or Torres Strait Islander person who is engaging in NSSI

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Summary

Introduction

Non-suicidal self-injury (NSSI) disproportionally affects Indigenous Australians. Family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is engaging in NSSI. Appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islanders who are engaging in NSSI were developed in 2009. Non-suicidal self-injury (NSSI) refers to injuries that are deliberately self-inflicted and not intended to result in death [1]. NSSI most commonly begins in early adolescence, it occurs in adults, and the most frequently reported self-injury methods are skin cutting, hitting and burning [2]. Survey findings indicate that internal motivations, such as managing difficult emotions and punishing oneself, are among those reasons most frequently reported for engaging in NSSI [6]. Self-injury is rarely used as a means of seeking attention, and self-inflicted cuts and wounds are likely to be covered or hidden

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