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Wright J, Chalmers KJ, Rossetto A, Reavley NJ, Kelly CM, Jorm AF. Redevelopment of mental health first aid guidelines for substance use problems: a Delphi study. BMC Psychol 2024; 12:70. [PMID: 38351023 PMCID: PMC10865545 DOI: 10.1186/s40359-024-01561-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 01/29/2024] [Indexed: 02/16/2024] Open
Abstract
BACKGROUND Substance use problems have a major impact on the physical and mental health of individuals, families and communities. Early intervention may have a positive effect on recovery and treatment outcomes for those with substance use problems, reducing related risk and harm. Separate mental health first aid guidelines on how a member of the public could assist someone experiencing or developing alcohol use and drug use problems in high income Western countries were developed using Delphi expert consensus in 2009 and 2011, respectively. This study aimed to synthesise and update these two original guidelines to reflect current evidence and best practice. METHODS The Delphi expert consensus method was used to determine the inclusion of statements in the redeveloped guidelines. A questionnaire was developed using previously endorsed helping statements from the original guidelines on alcohol and drug use problems, as well as relevant content identified in systematic searches of academic and grey literature. Three panels of experts (people with lived experience, support people and professionals) rated statements over three consecutive online survey rounds to determine the importance of their inclusion in the guidelines. Statements endorsed by at least 80% of each panel were included. RESULTS 103 panellists completed all three survey rounds. They rated 469 statements and endorsed 300 of these for inclusion in the redeveloped guidelines. CONCLUSIONS This study has developed a broader and more comprehensive set of guidelines for how to support a person experiencing or developing a substance use problem. The redeveloped guidelines provide more detail on knowledge about and recognition of substance use problems, approaching and assisting people who want to change or are not ready to change, harm reduction, community-based supports and professional help, but have less on physical first aid actions. Mental Health First Aid International will use these guidelines in future updates of their training courses.
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Affiliation(s)
- Judith Wright
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia.
| | - Kathryn J Chalmers
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, 3000, Melbourne, VIC, Australia
| | - Alyssia Rossetto
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
| | - Nicola J Reavley
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, 3000, Melbourne, VIC, Australia
| | - Anthony F Jorm
- Centre for Mental Health and Community Wellbeing, Melbourne School of Population and Global Health , The University of Melbourne, 3010, Parkville, VIC, Australia
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Zhang X, Chen F, Chen Z. Heatwave and mental health. JOURNAL OF ENVIRONMENTAL MANAGEMENT 2023; 332:117385. [PMID: 36738719 DOI: 10.1016/j.jenvman.2023.117385] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/03/2023] [Accepted: 01/25/2023] [Indexed: 06/18/2023]
Abstract
Physical health has been associated with ambient temperature and heatwave. With the frequent occurrence of heatwave, the adaptive effects and mechanisms on mental health remain uncertain. On the basis of the China Health and Nutrition Survey, we estimated the relationship between heatwaves and self-assessed mental health scores in the Chinese population aged 50 and above. This study has identified that with each additional heatwave event, mental health scores decreased by an average of 0.027 points, which is equivalent to 0.3% of the average level. Heat is more likely to affect groups with low education, no medical insurance, and living in rural areas. In mechanistic exploration, we found that stress emotion is a fully mediating effect. Heat led to reduced health activities and more frequent drinking, which may lead to lower psychological well-being. Moreover, good dietary preference is a regulator that can help mitigate the adverse effects of heat on mental health. This study corroborates the impact of heat on spiritual welfare, and demonstrates the mechanisms and channels of impact, which can help reduce global economic losses due to mental health problems.
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Affiliation(s)
- Xin Zhang
- School of Economics, Jinan University, Guangzhou, 510632, China.
| | - Fanglin Chen
- School of Government, Peking University, Beijing, 100871, China.
| | - Zhongfei Chen
- School of Economics, Jinan University, Guangzhou, 510632, China.
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Mendes KN, Peres CHM, Cerqueira AV, Assumpção TA, Loch AA, Reavley NJ. Cultural adaptation of the guidelines for offering mental health first aid to a person after a potentially traumatic event: a delphi expert consensus study in Brazil. BMC Psychiatry 2022; 22:661. [PMID: 36303139 PMCID: PMC9609163 DOI: 10.1186/s12888-022-04269-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 09/19/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Traumatic events increase the risk of mental disorders. In a country with relatively under-developed mental health support systems, services to assist people who have experienced potentially traumatic events may be unavailable. In such situations, people in the community become key sources of support. However, they do not always have the knowledge and skills to offer effective help. This study reports on the cultural adaptation for Brazil of the English-language mental health first aid guidelines for helping someone who has experienced a potentially traumatic event. METHODS A Delphi expert consensus study with two expert panels, one comprising health professionals with experience in the treatment of trauma (n = 33) and the other comprising people with lived experience, (n = 29) was conducted. A questionnaire containing 131 statements from the English language guidelines was translated into Brazilian Portuguese. Participants were asked to rate the importance of actions to be taken to help a person who has experienced a potentially traumatic event and to suggest new items where appropriate. RESULTS Data were collected over two survey rounds. A total of 149 items were included in the final guidelines (110 items from the English-language guidelines and 39 new items created from expert panel comments, in the second round). Immediate action items were endorsed by both panels, while items related to encouraging victims were rejected by the professional panel. The suggested statements mostly related to providing psychological support and attending to the person's subjective experience rather than providing material or structural support. CONCLUSION While there were many similarities with the English-language guidelines for high-income countries, the guidelines also incorporate actions of importance for Brazil, including the emphasis on the first aider's management of the person's subjective experiences. These guidelines may inform Mental Health First Aid training for Brazil and may also be used as standalone resources.
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Affiliation(s)
- Kathlen Nataly Mendes
- grid.11899.380000 0004 1937 0722Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Carlos Henrique Mesquita Peres
- grid.11899.380000 0004 1937 0722Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Amanda Vidotto Cerqueira
- grid.11899.380000 0004 1937 0722Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Thais Alves Assumpção
- grid.11899.380000 0004 1937 0722Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Alexandre Andrade Loch
- grid.11899.380000 0004 1937 0722Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil ,grid.450640.30000 0001 2189 2026Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Sao Paulo, Brazil
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 3010, Melbourne, VIC, Australia.
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Ayoub IA, Peres CHM, Cerqueira AV, Assumpção TA, Loch AA, Reavley NJ. Cultural adaptation of the mental health first aid guidelines for Brazilians with problem drinking: a Delphi expert consensus study. BMC Psychiatry 2022; 22:168. [PMID: 35255851 PMCID: PMC8900433 DOI: 10.1186/s12888-022-03709-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/13/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Harmful use of alcohol is highly prevalent around the world and results in a large disease burden. Most people who meet the criteria for an alcohol use disorder do not receive treatment. Those in a person's social network can be useful in recognizing a problem and encouraging the person to seek treatment. However, many people lack the knowledge and skills to do this effectively. This study reports on the cultural adaptation for Brazil of the 2009 English-language mental health first aid guidelines for helping someone with problem drinking. METHODS A Delphi expert consensus study with two expert panels, one comprising health professionals with experience in the treatment of problem drinking and the other comprising people with lived experience was conducted. Participants rated the importance of actions to be taken to help a person with problem drinking. RESULTS Over two rounds, 60 participants (30 professionals and 30 people with lived experience) rated 197 items. A total of 166 items were included in the final guidelines. CONCLUSIONS While there were many similarities with the English-language guidelines for high-income countries, the guidelines also incorporate actions of importance for Brazil, including compulsory treatment and different approaches to dealing with people with problem drinking. Further research is necessary to assess their impact.
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Affiliation(s)
- Ibrahim Ali Ayoub
- grid.11899.380000 0004 1937 0722Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil
| | - Carlos Henrique Mesquita Peres
- grid.11899.380000 0004 1937 0722Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil
| | - Amanda Vidotto Cerqueira
- grid.11899.380000 0004 1937 0722Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil
| | - Thais Alves Assumpção
- grid.11899.380000 0004 1937 0722Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil
| | - Alexandre Andrade Loch
- grid.11899.380000 0004 1937 0722Laboratorio de Neurociencias (LIM 27), Instituto de Psiquiatria, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP Brazil ,grid.450640.30000 0001 2189 2026Instituto Nacional de Biomarcadores em Neuropsiquiatria (INBION), Conselho Nacional de Desenvolvimento Cientifico e Tecnológico, Sao Paulo, Brazil
| | - Nicola J. Reavley
- grid.1008.90000 0001 2179 088XCentre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3010 Australia
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Development of mental health first aid guidelines for problem drinking: a Delphi expert consensus study in Argentina and Chile. BMC Psychiatry 2022; 22:113. [PMID: 35151295 PMCID: PMC8841054 DOI: 10.1186/s12888-022-03749-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/28/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Among all psychoactive substances, alcohol consumption presents the most significant public health problem and is a leading risk factor for overall disease burden in Latin America. However, most people who meet criteria for a substance use disorder do not receive treatment in primary or secondary care sources. Community members can play a role in helping people to seek help as they are likely to encounter people experiencing problem drinking and recognize the signs. However, many do not have adequate mental health first aid knowledge or skills to provide help. We aimed to culturally adapt the existing English-language mental health first aid guidelines for helping someone with problem drinking for Argentina and Chile. METHODS The Delphi consensus method was used to determine the importance of helping actions translated from the English-language guidelines and to add new actions suggested by expert panellists. The importance of each statement was rated by two expert panels. Panel one included people with lived experience (either their own or as a support person, n = 23) recruited in Argentina and panel two included health professionals (n = 31) recruited in Argentina and Chile. RESULTS Overall, 165 helping actions were endorsed by panellists across two consecutive survey rounds. Endorsed items included 132 of the 182 items translated into Spanish from the English-language guidelines and 33 of the 61 new items generated from panellists' comments in the first survey round. CONCLUSIONS While there were some similarities in recommended helping actions between English-speaking countries, and Argentina and Chile, key differences were seen in attitudes to low-risk drinking. While there was a relatively high level of agreement between health professionals and people with lived experience, some divergence of opinion was seen, particularly in the area of commitment to recovery as a condition for help. Future research should explore the implementation of the guidelines.
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Fang L, Lung Y. The Moderating Role of Social Support in the Relationship between Poor Mental Health and Excessive Alcohol Consumption: A Gender-Specific Analysis. Subst Use Misuse 2022; 57:409-417. [PMID: 35067188 DOI: 10.1080/10826084.2021.2019770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Background: Social support can potentially attenuate the positive relationship between poor mental health and excessive drinking. The present study tried to understand: (1) whether there is a gender-specific relationship between poor mental health and excessive drinking; and (2) if and how social support moderates the relationship between poor mental health and excessive drinking. Methods: We analyzed the data from 2016 Behavioral Risk Factor Surveillance System (BRFSS; N = 33,705). Weighted data were stratified by gender and controlled for demographic variables. We assessed poor mental health and social support as correlates of heavy and binge drinking, followed by analyzing the moderation effect of social support X poor mental health interaction terms. Results: Poor mental health is linked with excessive drinking across genders. The interaction analysis shows that social support moderates the effect of ever having a poor mental health day in men's heavy drinking, but the interaction term is not significant in all other excessive drinking models, suggesting that social support may not buffer the negative impact of poor mental health on problem drinking, particularly among women. Conclusion: Individuals with greater mental health challenges are more likely to drink hazardously, regardless of gender. Those who have low level of social support and poor mental health, particularly men, are at risk for heavy drinking. Given the majority of the interaction results is not significant, the study provides limited support for the buffering role of social support between poor mental health and problem drinking.
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Affiliation(s)
- Lin Fang
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Yu Lung
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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Li W, Jorm AF, Wang Y, Lu S, He Y, Reavley NJ. Development of Chinese mental health first aid guidelines for problem drinking: a Delphi expert consensus study. BMC Psychiatry 2021; 21:254. [PMID: 34001047 PMCID: PMC8127318 DOI: 10.1186/s12888-021-03266-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 04/23/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Alcohol use disorders have become the second leading cause of death for mental and substance use disorders in China. However, with early diagnosis and timely treatment, the burden can be mitigated. Family and friends of a person with alcohol use problems are well placed to recognize the signs, encourage professional help-seeking and help the person until treatment is received. We aimed to use the Delphi consensus methodology to develop guidelines about how members of the public can provide this "mental health first aid" to someone with problem drinking in China. METHODS A Chinese-language questionnaire was developed, comprising statements that were endorsed for inclusion in the English-language problem drinking first aid guidelines for high-income countries. Participants were also encouraged to suggest new statements. These statements were evaluated by two Chinese expert panels - a professional panel and a lived experience panel - on how important they believed each statement was for members of the public providing mental health first aid to a person with problem drinking in China. Three survey rounds were conducted. To be included in the final guidelines, statements had to receive a "very important" or "important" rating from at least 80% of participants from each of the panels. RESULTS The majority of statements were rated in the first survey round by 30 mental health professionals and 25 lived experience panel members. One hundred and eighty-one statements met the inclusion criteria and were used to form the guidelines. Compared to the English-language guidelines, the importance of family involvement and mutual support were highlighted by both Chinese expert panels, while a number of statements relating to low-risk drinking were rejected by the lived experience panel. CONCLUSIONS The Chinese-language problem drinking first aid guidelines cover a variety of first aid strategies that members of the public can use when providing initial help to a person with problem drinking, such as how to communicate with the person and what to do if the person is intoxicated. These guidelines will be used as a stand-alone document will also inform the content of Mental Health First Aid training in China.
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Affiliation(s)
- Wenjing Li
- grid.1008.90000 0001 2179 088XCentre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Anthony F. Jorm
- grid.1008.90000 0001 2179 088XCentre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia
| | - Yan Wang
- grid.415630.50000 0004 1782 6212Shanghai Mental Health Centre, Shanghai, China
| | - Shurong Lu
- grid.1008.90000 0001 2179 088XThe Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria Australia ,grid.410734.5Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, China
| | - Yanling He
- grid.415630.50000 0004 1782 6212Shanghai Mental Health Centre, Shanghai, China
| | - Nicola J. Reavley
- grid.1008.90000 0001 2179 088XCentre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie Street, Carlton, VIC 3053 Australia
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Gholami S, Perry LM, Denbo JW, Chavin K, Newell P, Ly Q, St Hill C, Morris-Stiff G, Kessler J, Frankel TL, Parikh ND, Philips P, Salti G, Augustin T, Aucejo F, Debroy M, Coburn N, Warner SG. Management of early hepatocellular carcinoma: results of the Delphi consensus process of the Americas Hepato-Pancreato-Biliary Association. HPB (Oxford) 2021; 23:753-761. [PMID: 33008733 DOI: 10.1016/j.hpb.2020.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND There are many potential treatment options for patients with early stage hepatocellular carcinoma (HCC) and practice patterns vary widely. This project aimed to use a Delphi conference to generate consensus regarding the management of small resectable HCC. METHODS A base case was established with review by members of AHPBA Research Committee. The Delphi panel of experts reviewed the literature and scored clinical case statements to identify areas of agreement and disagreement. Following initial scoring, discussion was undertaken, questions were amended, and scoring was repeated. This cycle was repeated until no further likelihood of reaching consensus existed. RESULTS The panel achieved agreement or disagreement consensus regarding 27 statements. The overarching themes included that resection, ablation, transplantation, or any locoregional therapy as a bridge to transplant were all appropriate modalities for early or recurrent HCC. For larger lesions, consensus was reached that radiofrequency ablation and microwave ablation were not appropriate treatments. CONCLUSION Using a validated system for identifying consensus, an expert panel agreed that multiple treatment modalities are appropriate for early stage HCC. These consensus guidelines are intended to help guide physicians through treatment modalities for early HCC; however, clinical decisions should continue to be made on a patient-specific basis.
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Affiliation(s)
- Sepideh Gholami
- Department of Surgery, University of California, Davis, CA, USA
| | - Lauren M Perry
- Department of Surgery, University of California, Davis, CA, USA
| | - Jason W Denbo
- Department of Gastrointestinal Oncology, H. Lee Moffitt Cancer Center, Tampa, FL, USA
| | - Kenneth Chavin
- Department of Surgery, University Hospitals, Cleveland, OH, USA
| | - Philippa Newell
- Department of Surgery, Providence Portland Medical Center, Portland, OR, USA
| | - Quan Ly
- Department of Surgery, University of Nebraska Medical Center, Omaha, NE, USA
| | - Charles St Hill
- Department of Surgery, University of Nevada Las Vegas, NV, USA
| | | | | | | | - Neehar D Parikh
- Department of Medicine, Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA
| | - Prejesh Philips
- Department of Surgery, University of Louisville, Louisville, KY, USA
| | - George Salti
- Department of Surgery, University of Illinois, Chicago, IL, USA
| | - Toms Augustin
- Department of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Federico Aucejo
- Department of Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Meelie Debroy
- Department of Surgery, University Hospitals, Cleveland, OH, USA
| | - Natalie Coburn
- Department of Surgery, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Bond KS, Cottrill FA, Kelly L, Broughan J, Davies K, Ross AM, Kelly CM. Considerations when offering mental health first aid to a person with an intellectual disability: a Delphi study. BMC Psychol 2021; 9:28. [PMID: 33579383 PMCID: PMC7881599 DOI: 10.1186/s40359-021-00518-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 01/15/2021] [Indexed: 12/04/2022] Open
Abstract
Background People with an intellectual disability experience higher rates of mental health problems, but experience significant barriers to receiving professional help. Increasing the knowledge and skills of those who support them can help to reduce some of these barriers. This study aimed to develop guidelines for offering mental health first aid to a person with an intellectual disability. Methods Using the Delphi research method, a systematic search of websites, books and journal articles was conducted to develop a survey containing items about the knowledge, skills and actions needed for assisting a person with an intellectual disability who is experiencing mental health problems. These items were rated over three survey rounds by an expert panel according to whether they should be included in the guidelines. Results Fifty-three experts completed all three survey rounds (67% retention rate). A total of 202 items were rated over the three rounds to yield 170 endorsed items that were incorporated into the guidelines. The developed guidelines emphasise the need to recognise the unique signs of mental health problems in people with an intellectual disability, and provide appropriate support, communication and respect for people with an intellectual disability. The guidelines will also build the capacity of carers to address behaviours of concern, socially limiting behaviours or seeking professional help when the need arises. The guidelines will be used to develop a mental health first aid course. Conclusion The guidelines and the resultant mental health first aid course will be a helpful resource with the potential to address some of the barriers to mental health help-seeking that people with an intellectual disability experience.
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Affiliation(s)
- Kathy S Bond
- Mental Health First Aid Australia, Parkville, VIC, Australia. .,Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
| | | | - Louise Kelly
- Mental Health First Aid Australia, Parkville, VIC, Australia
| | - Joan Broughan
- Flinders University, Adelaide, SA, Australia.,Victoria University, Melbourne, VIC, Australia.,Monash University, Melbourne, VIC, Australia
| | - Kimberley Davies
- Department of Developmental Disability Neuropsychiatry, University of New South Wales, Sydney, Australia
| | - Anna M Ross
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Parkville, VIC, Australia
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Filia K, Jackson H, Cotton S, Killackey E. Understanding what it means to be socially included for people with a lived experience of mental illness. Int J Soc Psychiatry 2019; 65:413-424. [PMID: 31159628 DOI: 10.1177/0020764019852657] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIMS Social inclusion is increasingly understood to have positive and beneficial implications for the mental health outcomes of people with severe mental illness. The concept is plagued by definitional inconsistencies and a lack of consensus regarding what it means to be socially included, in particular for groups most vulnerable to social exclusion, such as people with mental illness. The aim of this study was to obtain a consensus regarding the key contributors to social inclusion from the perspective of people with and without a lived experience of mental illness (consumers of mental health services, carers, and general community members). METHODS Delphi methodology was employed to reach consensus agreement. The Delphi questionnaire was based on a previous review of the literature and consisted of 147 items categorized into 13 domains. It was presented to participants over three rounds. Participants (N = 104) were recruited into three groups (32 consumers, 32 carers of people with a mental illness, and 40 members of the general community - neither consumers nor carers). Retention of participants from Round 1 to Round 3 was 79.8%. RESULTS Similarities and differences were observed between the groups. A number of items were very strongly endorsed as key contributors to social inclusion, relating to social participation, social supports, housing, neighbourhood, community involvement, employment and education, health and well-being and service utilization. CONCLUSION Findings supported previous work, indicating the importance of having a strong sense of connection with others as well as the importance of safe and stable housing, support services and personal motivation and hope. We obtained a well-rounded perspective among groups regarding the key contributors to social inclusion, with a particular relevance to people living with mental illness. This perspective has significant clinical and research utility.
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Affiliation(s)
- Kate Filia
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Henry Jackson
- 3 Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Sue Cotton
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Eoin Killackey
- 1 Orygen, the National Centre of Excellence in Youth Mental Health, Parkville, VIC, Australia.,2 Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
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Jorm AF, Ross AM. Guidelines for the public on how to provide mental health first aid: narrative review. BJPsych Open 2018; 4:427-440. [PMID: 30450221 PMCID: PMC6235998 DOI: 10.1192/bjo.2018.58] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 07/18/2018] [Accepted: 09/12/2018] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Expert-consensus guidelines have been developed for how members of the public should assist a person with a mental health problem or in a mental health crisis. AIMS This review aimed to examine the range of guidelines that have been developed and how these have been implemented in practice. METHOD A narrative review was carried out based on a systematic search for literature on the development or implementation of the guidelines. RESULTS The Delphi method has been used to develop a wide range of guidelines for English-speaking countries, Asian countries and a number of other cultural groups. The primary implementation has been through informing the content of training courses. CONCLUSION Further work is needed on guidelines for low- and middle-income countries. DECLARATION OF INTEREST A.F.J. is an unpaid member of the Board of Mental Health First Aid International (trading as Mental Health First Aid Australia), which is a not-for-profit organisation.
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Affiliation(s)
- Anthony F Jorm
- Professorial Fellow, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Anna M Ross
- Research Assistant, Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Australia
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Jorm AF, Ross AM, Colucci E. Cross-cultural generalizability of suicide first aid actions: an analysis of agreement across expert consensus studies from a range of countries and cultures. BMC Psychiatry 2018; 18:58. [PMID: 29490626 PMCID: PMC5831714 DOI: 10.1186/s12888-018-1636-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/20/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND A number of Delphi expert consensus studies have been carried out with different countries and cultural groups to develop guidelines on how a member of the public should provide assistance to a person who is suicidal. The present study aimed to determine whether cross-culturally generalizable suicide first aid actions are possible by comparing agreement across these Delphi studies. METHODS Data on endorsement rates for items were compared across six Delphi studies. These studies involved panels of professionals and consumer advocates from English-speaking countries, professionals from Sri Lanka, professionals from Japan, professionals from India, professionals from the Philippines, and professionals and consumer advocates in refugee and immigrant mental health. Correlations were calculated between item endorsement rates across panels. RESULTS There were 18 items that were highly endorsed across all eight of the Delphi panels and an additional 15 items highly endorsed across the panels from the three lower middle-income countries (India, Philippines and Sri Lanka). Correlations across panels in item endorsement rates were all 0.60 or above, but were higher between panels from countries that are socioeconomically similar. CONCLUSIONS There is broad agreement across the diverse expert panels about what are appropriate suicide first aid actions for members of the public, indicating that cross-cultural generalizability is possible. However, there is also some cultural specificity, indicating the need for local tailoring.
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Affiliation(s)
- Anthony F. Jorm
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010 Australia
| | - Anna M. Ross
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010 Australia
| | - Erminia Colucci
- 0000 0001 2179 088Xgrid.1008.9Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, VIC 3010 Australia ,0000 0001 0710 330Xgrid.15822.3cDepartment of Psychology, Middlesex University London, London, UK
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Kitchener BA, Jorm AF. The role of Mental Health First Aid training in nursing education: A response to Happell, Wilson & McNamara (2015). Collegian 2017. [DOI: 10.1016/j.colegn.2016.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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14
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Bovopoulos N, Jorm AF, Bond KS, LaMontagne AD, Reavley NJ, Kelly CM, Kitchener BA, Martin A. Providing mental health first aid in the workplace: a Delphi consensus study. BMC Psychol 2016; 4:41. [PMID: 27485609 PMCID: PMC4971664 DOI: 10.1186/s40359-016-0148-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2016] [Accepted: 07/27/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mental health problems are common in the workplace, but workers affected by such problems are not always well supported by managers and co-workers. Guidelines exist for the public on how to provide mental health first aid, but not specifically on how to tailor one's approach if the person of concern is a co-worker or employee. A Delphi consensus study was carried out to develop guidelines on additional considerations required when offering mental health first aid in a workplace context. METHODS A systematic search of websites, books and journal articles was conducted to develop a questionnaire with 246 items containing actions that someone may use to offer mental health first aid to a co-worker or employee. Three panels of experts from English-speaking countries were recruited (23 consumers, 26 managers and 38 workplace mental health professionals), who independently rated the items over three rounds for inclusion in the guidelines. RESULTS The retention rate of the expert panellists across the three rounds was 61.7 %. Of the 246 items, 201 items were agreed to be important or very important by at least 80 % of panellists. These 201 endorsed items included actions on how to approach and offer support to a co-worker, and additional considerations where the person assisting is a supervisor or manager, or is assisting in crisis situations such as acute distress. CONCLUSIONS The guidelines outline strategies for a worker to use when they are concerned about the mental health of a co-worker or employee. They will be used to inform future tailoring of Mental Health First Aid training when it is delivered in workplace settings and could influence organisational policies and procedures.
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Affiliation(s)
- Nataly Bovopoulos
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Parkville, VIC, 3010, Australia. .,Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia.
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Parkville, VIC, 3010, Australia
| | - Kathy S Bond
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia
| | - Anthony D LaMontagne
- Centre for Population Health Research, School of Health & Social Development, Deakin University, Geelong, VIC, 3220, Australia.,Centre for Health Equity, Melbourne School of Population & Global Health, University of Melbourne, Level 207 Bouverie St, Parkville, VIC, 3010, Australia
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, 207 Bouverie St, Parkville, VIC, 3010, Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia.,School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia
| | - Betty A Kitchener
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia.,School of Psychology, Deakin University, 1 Gheringhap St, Geelong, VIC, 3220, Australia
| | - Angela Martin
- Tasmanian School of Business and Economics, University of Tasmania, Private Bag 84, Hobart, TAS, 7001, Australia
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15
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Bond KS, Jorm AF, Kitchener BA, Kelly CM, Chalmers KJ. Development of guidelines for family and non-professional helpers on assisting an older person who is developing cognitive impairment or has dementia: a Delphi expert consensus study. BMC Geriatr 2016; 16:129. [PMID: 27387756 PMCID: PMC4936264 DOI: 10.1186/s12877-016-0305-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2016] [Accepted: 06/21/2016] [Indexed: 01/08/2023] Open
Abstract
Background Assisting a person with dementia can lead to significant carer burden and possible negative outcomes for the person. Using the Delphi method, this study developed expert consensus guidelines for how family and non-professional carers should assist a person who is developing cognitive impairment, or has dementia or delirium. Methods A systematic search of websites, books and journal articles was conducted to develop a questionnaire containing items about the knowledge, skills and actions needed for assisting a person who is developing cognitive impairment, or has dementia or delirium. These items were rated over three rounds by two international expert panels comprising professionals specialising in research or treatment of dementia, and dementia carer advocates. Results A total of 65 participants (43 in the professional panel and 22 in the carer advocate panel) completed all three survey rounds. Of the 656 survey items that were rated, a total of 389 items were endorsed by at least 80 % of each panel. The endorsed items formed the basis of a guidelines document that explains what family and non-professional carers need to know and do when assisting a person who is developing cognitive impairment, or has dementia or delirium. Conclusions The two groups of experts were able to reach substantial consensus on how to assist a person who is developing cognitive impairment, or has dementia or delirium. Electronic supplementary material The online version of this article (doi:10.1186/s12877-016-0305-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- K S Bond
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia.
| | - A F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie Street, Parkville, VIC, 3010, Australia
| | - B A Kitchener
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia.,School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - C M Kelly
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia.,School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia
| | - K J Chalmers
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, VIC, 3052, Australia
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16
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Bond KS, Jorm AF, Miller HE, Rodda SN, Reavley NJ, Kelly CM, Kitchener BA. How a concerned family member, friend or member of the public can help someone with gambling problems: a Delphi consensus study. BMC Psychol 2016; 4:6. [PMID: 26842544 PMCID: PMC4739356 DOI: 10.1186/s40359-016-0110-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 01/28/2016] [Indexed: 11/10/2022] Open
Abstract
Background Gambling is an enjoyable recreational pursuit for many people. However, for some it can lead to significant harms. The Delphi expert consensus method was used to develop guidelines for how a concerned family member, friend or member of the public can recognise the signs of gambling problems and support a person to change their gambling. Methods A systematic review of websites, books and journal articles was conducted to develop a questionnaire containing items about the knowledge, skills and actions needed for supporting a person with gambling problems. These items were rated over three rounds by two international expert panels comprising people with a lived experience of gambling problems and professionals who treat people with gambling problems or research gambling problems. Results A total of 66 experts (34 with lived experience and 32 professionals) rated 412 helping statements according to whether they thought the statements should be included in these guidelines. There were 234 helping statements that were endorsed by at least 80 % of members of both of the expert panels. These endorsed statements were used to develop the guidelines. Conclusion Two groups of experts were able to reach substantial consensus on how someone can recognise the signs of gambling problems and support a person to change. Electronic supplementary material The online version of this article (doi:10.1186/s40359-016-0110-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kathy S Bond
- Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC, 3052, Australia.
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 4/207 Bouverie Sreet, Parkville, VIC, 3010, Australia.
| | - Helen E Miller
- Victorian Responsible Gambling Foundation, Level 6, 14-20 Blackwood Street, North Melbourne, VIC, 3051, Australia.
| | - Simone N Rodda
- Turning Point, Eastern Health, 54-62 Gertrude Street, Fitzroy, VIC, 3065, Australia. .,School of Public Health and Psychosocial Studies, AUT University, 90 Akoranga Drive, Auckland, 1142, New Zealand.
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 4/207 Bouverie Sreet, Parkville, VIC, 3010, Australia.
| | - Claire M Kelly
- Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC, 3052, Australia. .,School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
| | - Betty A Kitchener
- Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC, 3052, Australia. .,School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, VIC, 3220, Australia.
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17
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Thombs DL, Gonzalez JMR, Osborn CJ, Rossheim ME, Suzuki S. Resident assistant training program for increasing alcohol, other drug, and mental health first-aid efforts. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2015; 16:508-17. [PMID: 25322950 DOI: 10.1007/s11121-014-0515-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In college and university residence halls, resident assistants (RAs) are expected to serve as first-aid providers to students who may have alcohol, other drug, mental health, and academic problems. Despite this responsibility, evidence-based, first-aid programs have not been developed and tested for the RA workforce. The current study examined effects of an investigational first-aid program designed specifically for RAs. The online Peer Hero Training program is a novel approach to RA training in its use of interactive video dramatizations of incidents involving substance-using or distressed residents. A 9-month randomized trial conducted on eight US campuses compared RAs who participated in the Peer Hero Training program to RAs who received training-as-usual. Participation in the Peer Hero Training program significantly increased RA first-aid efforts for residential students who may have had alcohol, other drug, mental health, or academic problems 6 months after baseline. Compared with those in the training-as-usual condition, RAs in the Peer Hero Training program made more than 10 times as many first-aid efforts for possible alcohol problems, almost 14 times the number of first-aid efforts for possible drug use, almost 3 times the number of first-aid efforts for possible mental health problems, and 3 times the number of first-aid efforts for academic problems. There was no evidence that measured RA attitudes mediated the effects of the intervention. Results of this preliminary evaluation trial suggest that online training using interactive video dramatizations is a viable approach to strengthening RAs' ability to provide alcohol, other drugs, and mental health first-aid to undergraduates.
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Affiliation(s)
- Dennis L Thombs
- Department of Behavioral and Community Health, Texas Prevention Institute, University of North Texas Health Science Center, Fort Worth, TX, 76107-2699, USA,
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18
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Bond KS, Chalmers KJ, Jorm AF, Kitchener BA, Reavley NJ. Assisting Australians with mental health problems and financial difficulties: a Delphi study to develop guidelines for financial counsellors, financial institution staff, mental health professionals and carers. BMC Health Serv Res 2015; 15:218. [PMID: 26037733 PMCID: PMC4453216 DOI: 10.1186/s12913-015-0868-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Accepted: 05/13/2015] [Indexed: 11/04/2022] Open
Abstract
Background There is a strong association between mental health problems and financial difficulties. Therefore, people who work with those who have financial difficulties (financial counsellors and financial institution staff) need to have knowledge and helping skills relevant to mental health problems. Conversely, people who support those with mental health problems (mental health professionals and carers) may need to have knowledge and helping skills relevant to financial difficulties. The Delphi expert consensus method was used to develop guidelines for people who work with or support those with mental health problems and financial difficulties. Methods A systematic review of websites, books and journal articles was conducted to develop a questionnaire containing items about the knowledge, skills and actions relevant to working with or supporting someone with mental health problems and financial difficulties. These items were rated over three rounds by five Australian expert panels comprising of financial counsellors (n = 33), financial institution staff (n = 54), mental health professionals (n = 31), consumers (n = 20) and carers (n = 24). Results A total of 897 items were rated, with 462 items endorsed by at least 80 % of members of each of the expert panels. These endorsed statements were used to develop a set of guidelines for financial counsellors, financial institution staff, mental health professionals and carers about how to assist someone with mental health problems and financial difficulties. Conclusions A diverse group of expert panel members were able to reach substantial consensus on the knowledge, skills and actions needed to work with and support people with mental health problems and financial difficulties. These guidelines can be used to inform policy and practice in the financial and mental health sectors. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-0868-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kathy S Bond
- Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC, 3052, Australia.
| | - Kathryn J Chalmers
- Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC, 3052, Australia.
| | - Anthony F Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 4/207 Bouverie St, Parkville, VIC, 3010, Australia.
| | - Betty A Kitchener
- Mental Health First Aid Australia, Level 6/369 Royal Parade, Parkville, VIC, 3052, Australia. .,School of Psychology, Deakin University, Melbourne, Australia.
| | - Nicola J Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 4/207 Bouverie St, Parkville, VIC, 3010, Australia.
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19
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Defining outcome measures of hospitalization for assessment in the Japanese forensic mental health scheme: a Delphi study. Int J Ment Health Syst 2015; 9:7. [PMID: 25685186 PMCID: PMC4328080 DOI: 10.1186/1752-4458-9-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2014] [Accepted: 01/24/2015] [Indexed: 12/12/2022] Open
Abstract
Background A new legislation concerning forensic mental health was established by the Japanese Government in 2005, the “Act on Medical Care and Treatment for the Persons Who Had Caused Serious Cases under the Condition of Insanity,” or the Medical Treatment and Supervision (MTS) Act. Since it was passed, however, there has been broad controversy over Hospitalization for Assessment (HfA), the first stage of the MTS scheme. Methods Following a comprehensive literature search to assemble a list of candidates, we conducted a Delphi study to establish standard outcome measures for HfA. Results Five Delphi rounds were conducted by 19 panelists including medical practitioners and lawyers. A total of 139 items were accepted as outcome measures for HfA based on panel agreement. Conclusion The Delphi study established a list of HfA outcome measures for the MTS act, which will contribute to the optimization of the new forensic mental health system in Japan. Electronic supplementary material The online version of this article (doi:10.1186/1752-4458-9-7) contains supplementary material, which is available to authorized users.
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20
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Yap MBH, Reavley NJ, Jorm AF. Is the use of accurate psychiatric labels associated with intentions and beliefs about responses to mental illness in a friend? Findings from two national surveys of Australian youth. Epidemiol Psychiatr Sci 2015; 24:54-68. [PMID: 24229559 PMCID: PMC6998129 DOI: 10.1017/s2045796013000607] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Revised: 09/13/2013] [Accepted: 09/16/2013] [Indexed: 11/07/2022] Open
Abstract
Aims. An inherent prerequisite to mental health first-aid (MHFA) is the ability to identify that there is a mental health problem, but little is known about the association between psychiatric labelling and MHFA. This study examined this association using data from two national surveys of Australian young people. Methods. This study involved a national telephonic survey of 3746 Australian youth aged 12-25 years in 2006, and a similar survey in 2011 with 3021 youth aged 15-25 years. In both surveys, respondents were presented with a vignette portraying depression, psychosis or social phobia in a young person. The 2011 survey also included depression with suicidal thoughts and post-traumatic stress disorder. Respondents were asked what they thought was wrong with the person, and reported on their first-aid intentions and beliefs, which were scored for quality of the responses. Results. Accurate labelling of the mental disorder was associated with more helpful first-aid intentions and beliefs across vignettes, except for the intention to listen non-judgementally in the psychosis vignette. Conclusions. Findings suggest that community education programmes that improve accurate psychiatric label use may have the potential to improve the first-aid responses young people provide to their peers, although caution is required in the case of psychosis.
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Affiliation(s)
- M. B. H. Yap
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia
- Melbourne School of Population Health, University of Melbourne, Australia
| | - N. J Reavley
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia
- Melbourne School of Population Health, University of Melbourne, Australia
| | - A. F. Jorm
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia
- Melbourne School of Population Health, University of Melbourne, Australia
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21
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Doyle K, Hungerford C. Adapting evidence-based interventions to accommodate cultural differences: where does this leave effectiveness? Issues Ment Health Nurs 2014; 35:739-44. [PMID: 25259636 DOI: 10.3109/01612840.2014.901452] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Evidence-based interventions are an essential part of delivering contemporary mental health services. Many such interventions, however, are developed with and for mainstream population groups. Practitioners and researchers alike will often adapt tools, practices, processes or programmes to meet the needs of culturally diverse populations groups, but wonder if and how such adaptations will affect outcomes. This paper considers the processes by which evidence-based interventions can be adapted by health professionals in any context; and includes an example of a successful cultural adaptation to an evidence-based intervention. The successful implementation of the Aboriginal Mental Health First Aid programme in Australia illustrates the potential for adapted interventions to support improvements in the health outcomes of people from culturally diverse backgrounds. The paper concludes by outlining the steps mental health professionals can take when adapting evidence-based interventions for use in their own workplace settings.
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Affiliation(s)
- Kerrie Doyle
- Disciplines of Nursing and Midwifery, Faculty of Health, University of Canberra, Canberra, Australia
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22
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Ross AM, Kelly CM, Jorm AF. Re-development of mental health first aid guidelines for suicidal ideation and behaviour: a Delphi study. BMC Psychiatry 2014; 14:241. [PMID: 25213799 PMCID: PMC4199061 DOI: 10.1186/s12888-014-0241-8] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 08/18/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Suicide continues to be a leading cause of death globally. Friends and family are considered best positioned to provide initial assistance if someone is suicidal. Expert consensus guidelines on how to do this were published in 2008. Re-developing these guidelines is necessary to ensure they contain the most current recommended helping actions and remain consistent with the suicide prevention literature. METHODS The Delphi consensus method was used to determine the importance of including helping statements in the guidelines. These statements describe helping actions a member of the public can take, and information they should have, to help someone who is experiencing suicidal thoughts. Systematic searches of the available suicide prevention literature were carried out to find helping statements. Two expert panels, comprising 41 suicide prevention professionals and 35 consumer advocates respectively, rated each statement. Statements were accepted for inclusion in the guidelines if they were endorsed by at least 80% of each panel. RESULTS Out of 436 statements, 164 were endorsed as appropriate helping actions in providing assistance to someone experiencing suicidal thoughts or engaging in suicidal behaviour. These statements were used to form the re-developed guidelines. CONCLUSION The re-development of the guidelines has resulted in more comprehensive guidance than the earlier version, with the endorsement of 164 helping actions, compared to 30 previously. These guidelines will form the basis of a suicide prevention course aimed at educating members of the public on providing first aid to someone who is experiencing suicidal thoughts.
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Affiliation(s)
- Anna M Ross
- Melbourne School of Population and Global Health, Level 4, 207 Bouverie St, The University of Melbourne, Melbourne, Victoria 3010 Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, Victoria 3052 Australia ,School of Psychology, Deakin University, Burwood, Victoria 3125 Australia
| | - Anthony F Jorm
- Melbourne School of Population and Global Health, Level 4, 207 Bouverie St, The University of Melbourne, Melbourne, Victoria 3010 Australia
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23
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Ross AM, Kelly CM, Jorm AF. Re-development of mental health first aid guidelines for non-suicidal self-injury: a Delphi study. BMC Psychiatry 2014; 14:236. [PMID: 25134432 PMCID: PMC4197339 DOI: 10.1186/s12888-014-0236-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 08/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Up to 12% of Australian adults and almost one in five adolescents are estimated to have engaged in non-suicidal self-injury (NSSI) at some time in their life. Friends and family are most likely to notice signs of NSSI, but may be unsure how to intervene. Mental health first aid guidelines were developed in 2008 on how to do this through providing initial support and encouraging appropriate professional help-seeking. This study aims to re-develop the 2008 NSSI first aid guidelines to ensure they contain current recommended helping actions and remain consistent with the NSSI intervention literature. METHODS The Delphi consensus method was used to determine the importance of the inclusion of helping statements in the guidelines. These statements describe helping actions a member of the public can take, and information they should have, to help someone who is engaging in NSSI. Systematic searches of the available NSSI intervention literature were conducted to find helping statements. Two expert panels, comprising 28 NSSI professionals and 33 consumer advocates, rated the importance of each statement. RESULTS 98 out of 220 statements were endorsed as appropriate helping actions in providing assistance to someone engaging in NSSI. These statements were used to form the updated mental health first aid guidelines for NSSI. CONCLUSION The re-development of the guidelines has resulted in more comprehensive guidance than the original version (98 versus 30 statements containing helping actions). This substantial increase in endorsed statements adds detail and depth to the guidelines, as well as covers additional ways of providing guidance and support.
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Affiliation(s)
- Anna M Ross
- Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie St, 3010 Parkville, Victoria Australia
| | - Claire M Kelly
- Mental Health First Aid Australia, Level 6, 369 Royal Parade, 3052 Parkville, Victoria Australia ,School of Psychology, Deakin University, Burwood, Victoria 3125 Australia
| | - Anthony F Jorm
- Melbourne School of Population and Global Health, The University of Melbourne, Level 4, 207 Bouverie St, 3010 Parkville, Victoria Australia
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Hadlaczky G, Hökby S, Mkrtchian A, Carli V, Wasserman D. Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: a meta-analysis. Int Rev Psychiatry 2014; 26:467-75. [PMID: 25137113 DOI: 10.3109/09540261.2014.924910] [Citation(s) in RCA: 199] [Impact Index Per Article: 19.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Mental Health First Aid (MHFA) is a standardized, psychoeducational programme developed to empower the public to approach, support and refer individuals in distress by improving course participants' knowledge, attitudes and behaviours related to mental ill-health. The present paper aims to synthesize published evaluations of the MHFA programme in a meta-analysis to estimate its effects and potential as a public mental health awareness-increasing strategy. Fifteen relevant papers were identified through a systematic literature search. Standardized effect sizes were calculated for three different outcome measures: change in knowledge, attitudes, and helping behaviours. The results of the meta-analysis for these outcomes yielded a mean effect size of Glass's Δ = 0.56 (95% CI = 0.38 - 0.74; p < 0.001), 0.28 (95% CI = 0.22 - 0.35; p < 0.001) and 0.25 (95% CI = 0.12 - 0.38; p < 0.001), respectively. Results were homogenous, and moderator analyses suggested no systematic bias or differences in results related to study design (with or without control group) or 'publication quality' (journal impact factor). The results demonstrate that MHFA increases participants' knowledge regarding mental health, decreases their negative attitudes, and increases supportive behaviours toward individuals with mental health problems. The MHFA programme appears recommendable for public health action.
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Affiliation(s)
- Gergö Hadlaczky
- National Centre for Suicide Research and Prevention of Mental Ill-Health, Karolinska Institutet , Stockholm , Sweden
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25
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Chalmers KJ, Bond KS, Jorm AF, Kelly CM, Kitchener BA, Williams-Tchen A. Providing culturally appropriate mental health first aid to an Aboriginal or Torres Strait Islander adolescent: development of expert consensus guidelines. Int J Ment Health Syst 2014; 8:6. [PMID: 24467923 PMCID: PMC3922159 DOI: 10.1186/1752-4458-8-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 12/10/2013] [Indexed: 11/26/2022] Open
Abstract
Background It is estimated that the prevalence of mental illness is higher in Aboriginal and Torres Strait Islander adolescents compared to non-Aboriginal adolescents. Despite this, only a small proportion of Aboriginal youth have contact with mental health services, possibly due to factors such as remoteness, language barriers, affordability and cultural sensitivity issues. This research aimed to develop culturally appropriate guidelines for anyone who is providing first aid to an Australian Aboriginal or Torres Strait Islander adolescent who is experiencing a mental health crisis or developing a mental illness. Methods A panel of Australian Aboriginal people who are experts in Aboriginal youth mental health, participated in a Delphi study investigating how members of the public can be culturally appropriate when helping an Aboriginal or Torres Strait Islander adolescent with mental health problems. The panel varied in size across the three sequential rounds, from 37–41 participants. Panellists were presented with statements about cultural considerations and communication strategies via online questionnaires and were encouraged to suggest additional content. All statements endorsed as either Essential or Important by ≥ 90% of panel members were written into a guideline document. To assess the panel members’ satisfaction with the research method, participants were invited to provide their feedback after the final survey. Results From a total of 304 statements shown to the panel of experts, 194 statements were endorsed. The methodology was found to be useful and appropriate by the panellists. Conclusion Aboriginal and Torres Strait Islander Youth mental health experts were able to reach consensus about what the appropriate communication strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander adolescent. These outcomes will help ensure that the community provides the best possible support to Aboriginal adolescents who are developing mental illnesses or are in a mental health crisis.
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Affiliation(s)
| | | | | | - Claire M Kelly
- Mental Health First Aid Australia, Parkville, Victoria, Australia.
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Rossetto A, Jorm AF, Reavley NJ. Quality of helping behaviours of members of the public towards a person with a mental illness: a descriptive analysis of data from an Australian national survey. Ann Gen Psychiatry 2014; 13:2. [PMID: 24438434 PMCID: PMC3898824 DOI: 10.1186/1744-859x-13-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2013] [Accepted: 01/14/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Courses such as Mental Health First Aid equip members of the public to perform appropriate helping behaviours towards people experiencing a mental illness or mental health crisis. However, studies investigating the general public's knowledge and skills in relation to assisting a person with a mental illness are rare. This study assesses the quality of mental health first aid responses by members of the Australian public using data from a national survey. METHODS Participants in a national survey of mental health literacy were assigned one of six vignettes (depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia or post-traumatic stress disorder) and asked an open-ended question about how they would help the character in the vignette. The 6,019 respondents were also asked if and how they had helped a person in real life with a similar problem. Responses to these questions were scored using a system based on an action plan developed from expert consensus guidelines on mental health first aid. RESULTS The quality of responses overall was poor, with participants scoring an average of 2 out of 12. The most commonly reported actions for both questions were listening to the person, providing support and information and encouraging them to seek appropriate professional help. Actions such as assessing and assisting with crisis were rarely mentioned, even for the depression with suicidal thoughts vignette. CONCLUSIONS The quality of the Australian public's mental health first aid knowledge and skills requires substantial improvement. Particular attention should be given to helping people recognise that anxiety disorders such as social phobia require professional help and to improving responses to a suicidal person.
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Affiliation(s)
- Alyssia Rossetto
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Level 3, 207 Bouverie Street, Carlton, Victoria 3010, Australia.
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Hart LM, Jorm AF, Paxton SJ, Cvetkovski S. Mental health first aid guidelines: an evaluation of impact following download from the World Wide Web. Early Interv Psychiatry 2012; 6:399-406. [PMID: 22379952 DOI: 10.1111/j.1751-7893.2012.00345.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Mental health first aid guidelines provide the public with consensus-based information about how to assist someone who is developing a mental illness or experiencing a mental health crisis. The aim of the current study was to evaluate the usefulness and impact of the guidelines on web users who download them. METHOD Web users who downloaded the documents were invited to respond to an initial demographic questionnaire, then a follow up about how the documents had been used, their perceived usefulness, whether first-aid situations had been encountered and if these were influenced by the documents. RESULTS Over 9.8 months, 706 web users responded to the initial questionnaire and 154 responded to the second. A majority reported downloading the document because their job involved contact with people with mental illness. Sixty-three web users reported providing first aid, 44 of whom reported that the person they were assisting had sought professional care as a result of their suggestion. Twenty-three web users reported seeking care themselves. A majority of those who provided first aid reported feeling that they had been successful in helping the person, that they had been able to assist in a way that was more knowledgeable, skilful and supportive, and that the guidelines had contributed to these outcomes. CONCLUSIONS Information made freely available on the Internet, about how to provide mental health first aid to someone who is developing a mental health problem or experiencing a mental health crisis, is associated with more positive, empathic and successful helping behaviours.
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Affiliation(s)
- Laura M Hart
- Centre for Youth Mental Health, University of Melbourne, Parkville, Victoria, Australia.
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Hart LM, Jorm AF, Paxton SJ. Mental health first aid for eating disorders: pilot evaluation of a training program for the public. BMC Psychiatry 2012; 12:98. [PMID: 22856517 PMCID: PMC3549729 DOI: 10.1186/1471-244x-12-98] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2011] [Accepted: 05/14/2012] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Eating disorders cause significant burden that may be reduced by early and appropriate help-seeking. However, despite the availability of effective treatments, very few individuals with eating disorders seek treatment. Training in mental health first aid is known to be effective in increasing mental health literacy and supportive behaviours, in the social networks of individuals with mental health problems. Increases in these domains are thought to improve the likelihood that effective help is sought. However, the efficacy of mental health first aid for eating disorders has not been evaluated. The aim of this research was to examine whether specific training in mental health first aid for eating disorders was effective in changing knowledge, attitudes and behaviours towards people with eating disorders. METHODS A repeated measures, uncontrolled trial was conducted to establish proof of concept and provide guidance on the future design of a randomised controlled trial. Self-report questionnaires, administered at baseline, post-training and 6-month follow-up, assessed the effectiveness of the 4-hour, single session, mental health first aid training. RESULTS 73 participants completed the training and all questionnaires. The training intervention was associated with statistically significant increases in problem recognition and knowledge of appropriate mental health first aid strategies, which were maintained at 6-month follow-up. Sustained significant changes in attitudes and behaviours were less clear. 20 participants reported providing assistance to someone with a suspected eating disorder, seven of whom sought professional help as a result of the first aid interaction. Results provided no evidence of a negative impact on participants or the individuals they provided assistance to. CONCLUSIONS This research provides preliminary evidence for the use of training in mental health first aid as a suitable intervention for increasing community knowledge of and support for people with eating disorders to seek appropriate help. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12611001181998.
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Affiliation(s)
- Laura M Hart
- Melbourne School of Population Health, University of Melbourne, Parkville, VIC, Australia.
| | - Anthony F Jorm
- Melbourne School of Population Health, University of Melbourne, Parkville, VIC, Australia
| | - Susan J Paxton
- School of Psychological Science, La Trobe University, Bundoora, VIC, Australia
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Ross AM, Hart LM, Jorm AF, Kelly CM, Kitchener BA. Development of key messages for adolescents on providing basic mental health first aid to peers: a Delphi consensus study. Early Interv Psychiatry 2012; 6:229-38. [PMID: 22240091 DOI: 10.1111/j.1751-7893.2011.00331.x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM Most young people fail to receive professional treatment for mental disorders; however, they do indicate a preference for sharing problems with peers. This article describes key messages about knowledge and actions to form the basis of a basic mental health first aid (MHFA) course for adolescents to increase recognition of and help seeking for mental health problems by teaching the best knowledge and helping actions a young person can undertake to support a peer with a mental health problem. METHODS The Delphi method was used to achieve consensus among Australian and Canadian youth mental health experts regarding the importance of statements that describe helping actions a young person can take, and information they should have, to support a friend with a mental health problem. There were two expert panels, one consisting of 36 youth mental health consumer advocates and the other of 97 Youth MHFA instructors. Panellists rated each statement according to how appropriate it would be as a basic mental health first aid message for both a junior adolescent (12-15 years) and a senior adolescent (16-18 years). RESULTS Out of 98 statements, 78 were endorsed as key basic MHFA messages for junior adolescents and 81 were endorsed for senior adolescents. CONCLUSION The study has identified key messages for adolescents on how they can help a peer. These messages will form the basis of the curriculum for an MHFA course for adolescents, which will aim to facilitate early recognition of and help seeking for mental health problems in adolescents.
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Affiliation(s)
- Anna M Ross
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.
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Yap MB, Reavley NJ, Jorm AF. Associations between awareness of beyondblue and mental health literacy in Australian youth: Results from a national survey. Aust N Z J Psychiatry 2012; 46:541-52. [PMID: 22679206 DOI: 10.1177/0004867411435288] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The aim of this paper is to examine whether Australian young people's awareness of beyondblue is associated with better recognition of depression and anxiety disorders, and better quality of beliefs about possible interventions and first-aid actions for these problems. METHOD In 2011, a telephone interview was conducted with a national sample of 3021 Australians aged between 15 and 25 years. Participants were presented with a vignette portraying depression, depression with suicidal thoughts, social phobia, post-traumatic stress disorder or psychosis in a young person. They were then asked about recognition of the disorder portrayed, their beliefs about the helpfulness or harmfulness of various interventions and first-aid actions, and their awareness of beyondblue. The quality of youths' beliefs was scored against health professionals' ratings of the same list of interventions and first-aid actions. RESULTS Beyondblue awareness was associated with more accurate recognition of the disorder portrayed in all vignettes except social phobia. It was also associated with beliefs about the helpfulness of first-aid actions that were more closely aligned with professional ratings for the depression, psychosis and social phobia vignettes. However, it was associated with beliefs about interventions for the psychosis vignette only. CONCLUSIONS Overall, the associations of beyondblue awareness with better mental health literacy were not specific to depression and anxiety disorders, which are their main focus. Beyondblue awareness is mostly unrelated to treatment beliefs, but seems to have non-specific associations with recognition of disorders and first-aid beliefs.
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Affiliation(s)
- Marie B Yap
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, VIC 3052, Australia.
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Yap MBH, Jorm AF. Young people's mental health first aid intentions and beliefs prospectively predict their actions: findings from an Australian National Survey of Youth. Psychiatry Res 2012; 196:315-9. [PMID: 22377574 DOI: 10.1016/j.psychres.2011.10.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 09/05/2011] [Accepted: 10/04/2011] [Indexed: 11/19/2022]
Abstract
Little is known about whether mental health first aid knowledge and beliefs of young people actually translate into actual behavior. This study examined whether young people's first aid intentions and beliefs predicted the actions they later took to help a close friend or family member with a mental health problem. Participants in a 2006 national survey of Australian youth (aged 12-25 years) reported on their first aid intentions and beliefs based on one of four vignettes: depression, depression with alcohol misuse, psychosis, and social phobia. At a two-year follow-up interview, they reported on actions they had taken to help any family member or close friend with a problem similar to the vignette character since the initial interview. Of the 2005 participants interviewed at follow-up, 608 reported knowing someone with a similar problem. Overall, young people's first aid intentions and beliefs about the helpfulness of particular first aid actions predicted the actions they actually took to assist a close other. However, the belief in and intention to encourage professional help did not predict subsequent action. Findings suggest that young people's mental health first aid intentions and beliefs may be valid indicators of their subsequent actions.
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Watkins RE, Elliott EJ, Mutch RC, Payne JM, Jones HM, Latimer J, Russell E, Fitzpatrick JP, Hayes L, Burns L, Halliday J, D'Antoine HA, Wilkins A, Peadon E, Miers S, Carter M, O'Leary CM, McKenzie A, Bower C. Consensus diagnostic criteria for fetal alcohol spectrum disorders in Australia: a modified Delphi study. BMJ Open 2012; 2:bmjopen-2012-001918. [PMID: 23100447 PMCID: PMC3488737 DOI: 10.1136/bmjopen-2012-001918] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate health professionals' agreement with components of published diagnostic criteria for fetal alcohol spectrum disorders (FASD) in order to guide the development of standard diagnostic guidelines for Australia. DESIGN A modified Delphi process was used to assess agreement among health professionals with expertise or experience in FASD screening or diagnosis. An online survey, which included 36 Likert statements on diagnostic methods, was administered over two survey rounds. For fetal alcohol syndrome (FAS), health professionals were presented with concepts from the Institute of Medicine (IOM), University of Washington (UW), Centers for Disease Control (CDC), revised IOM and Canadian diagnostic criteria. For partial FAS (PFAS), alcohol-related neurodevelopmental disorder (ARND), and alcohol-related birth defects (ARBD), concepts based on the IOM and the Canadian diagnostic criteria were compared. SETTING/PARTICIPANTS 130 Australian and 9 international health professionals. RESULTS Of 139 health professionals invited to complete the survey, 103 (74.1%) responded, and 74 (53.2%) completed one or more questions on diagnostic criteria. We found consensus agreement among participants on the diagnostic criteria for FAS, with the UW criteria most commonly endorsed when compared with all other published criteria for FAS. When health professionals were presented with concepts based on the Canadian and IOM diagnostic criteria, we found consensus agreement but no clear preference for either the Canadian or IOM criteria for the diagnosis of PFAS, and no consensus agreement on diagnostic criteria for ARND. We also found no consensus on the IOM diagnostic criteria for ARBD. CONCLUSIONS Participants indicated clear support for use of the UW diagnostic criteria for FAS in Australia. These findings should be used to develop guidelines to facilitate improved awareness of, and address identified gaps in the infrastructure for, FASD diagnosis in Australia.
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Affiliation(s)
- Rochelle E Watkins
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
| | - Elizabeth J Elliott
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Raewyn C Mutch
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
- Department of Health Western Australia, Child and Adolescent Health Service, Perth, Australia
| | - Janet M Payne
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
| | - Heather M Jones
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
| | - Jane Latimer
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Elizabeth Russell
- Russell Family Fetal Alcohol Disorders Association, Cairns, Queensland, Australia
| | - James P Fitzpatrick
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- The George Institute for Global Health, Sydney, New South Wales, Australia
| | - Lorian Hayes
- Centre for Chronic Disease, School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Lucinda Burns
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Victoria, Australia
| | - Jane Halliday
- Public Health Genetics, Genetic Disorders, Murdoch Childrens Research Institute, Melbourne, Australia
| | - Heather A D'Antoine
- Menzies School of Health Research, Charles Darwin University, Darwin, Northern Territory, South Australia, Australia
| | - Amanda Wilkins
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
- Department of Health Western Australia, Child and Adolescent Health Service, Perth, Australia
| | - Elizabeth Peadon
- Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
- The Children's Hospital at Westmead, Sydney, New South Wales, Australia
| | - Sue Miers
- National Organisation for Fetal Alcohol Syndrome and Related Disorders, Adelaide, Australia
| | - Maureen Carter
- Nindilingarri Cultural Health Services, Fitzroy Crossing, Western Australia, Australia
| | - Colleen M O'Leary
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
- Centre for Population Health Research, Curtin University, Perth, Western Australia, Australia
| | - Anne McKenzie
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
| | - Carol Bower
- Telethon Institute for Child Health Research, Centre for Child Health Research, The University of Western Australia, Perth, Western Australia, Australia
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Jorm AF, Kitchener BA. Noting a landmark achievement: Mental Health First Aid training reaches 1% of Australian adults. Aust N Z J Psychiatry 2011; 45:808-13. [PMID: 21827342 DOI: 10.3109/00048674.2011.594785] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Anthony F. Jorm
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Betty A. Kitchener
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
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Colucci E, Kelly CM, Minas H, Jorm AF, Suzuki Y. Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in Japan. Int J Ment Health Syst 2011; 5:12. [PMID: 21592409 PMCID: PMC3108941 DOI: 10.1186/1752-4458-5-12] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 05/19/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study aimed to develop guidelines for how a member of the Japanese public should provide mental health first aid to a person who is suicidal. METHODS The guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 32 Japanese mental health professionals to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms). Responses to these open-ended questions were used to generate new items. RESULTS The output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 38 new items were written based on suggestions from panel members and, of these 176 items, 56 met the consensus criterion. These statements were used to develop the guidelines appended to this article. CONCLUSIONS There are a number of actions that are considered to be useful for members of the Japanese public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to health professionals working in health and welfare settings who do not have clinical mental health training.
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Affiliation(s)
- Erminia Colucci
- Centre for International Mental Health, Melbourne School of Population Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Claire M Kelly
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Harry Minas
- Centre for International Mental Health, Melbourne School of Population Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Anthony F Jorm
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Yuriko Suzuki
- Department of Adult Mental Health, National Institute of Mental Health, NCNP, Kodaira, Tokyo, Japan
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Kelly CM, Mithen JM, Fischer JA, Kitchener BA, Jorm AF, Lowe A, Scanlan C. Youth mental health first aid: a description of the program and an initial evaluation. Int J Ment Health Syst 2011; 5:4. [PMID: 21272345 PMCID: PMC3041764 DOI: 10.1186/1752-4458-5-4] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2010] [Accepted: 01/27/2011] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adolescence is the peak age of onset for mental illness, with half of all people who will ever have a mental illness experiencing their first episode prior to 18 years of age. Early onset of mental illness is a significant predictor for future episodes. However, adolescents and young adults are less likely than the population as a whole to either seek or receive treatment for a mental illness. The knowledge and attitudes of the adults in an adolescent's life may affect whether or not help is sought, and how quickly. In 2007, the Youth Mental Health First Aid Program was launched in Australia with the aim to teach adults, who work with or care for adolescents, the skills needed to recognise the early signs of mental illness, identify potential mental health-related crises, and assist adolescents to get the help they need as early as possible. This paper provides a description of the program, some initial evaluation and an outline of future directions. METHODS The program was evaluated in two ways. The first was an uncontrolled trial with 246 adult members of the Australian public, who completed questionnaires immediately before attending the 14 hour course, one month later and six months later. Outcome measures were: recognition of schizophrenia or depression; intention to offer and confidence in offering assistance; stigmatising attitudes; knowledge about adolescent mental health problems and also about the Mental Health First Aid action plan. The second method of evaluation was to track the uptake of the program, including the number of instructors trained across Australia to deliver the course, the number of courses they delivered, and the uptake of the YMHFA Program in other countries. RESULTS The uncontrolled trial found improvements in: recognition of schizophrenia; confidence in offering help; stigmatising attitudes; knowledge about adolescent mental health problems and application of the Mental Health First Aid action plan. Most results were maintained at follow-up. Over the first 3 years of this program, a total of 318 instructors were trained to deliver the course and these instructors have delivered courses to 10,686 people across all states and territories in Australia. The program has also spread to Canada, Singapore and England, and will spread to Hong Kong, Sweden and China in the near future. CONCLUSIONS Initial evaluation suggests that the Youth Mental Health First Aid course improves participants' knowledge, attitudes and helping behaviour. The program has spread successfully both nationally and internationally. TRIAL REGISTRATION ACTRN12609000033246.
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Affiliation(s)
- Claire M Kelly
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia.
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Ryan SM, Jorm AF, Kelly CM, Hart LM, Morgan AJ, Lubman DI. Parenting strategies for reducing adolescent alcohol use: a Delphi consensus study. BMC Public Health 2011; 11:13. [PMID: 21210993 PMCID: PMC3022696 DOI: 10.1186/1471-2458-11-13] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 01/06/2011] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND International concern regarding the increase in preventable harms attributed to adolescent alcohol consumption has led to growing political and medical consensus that adolescents should avoid drinking for as long as possible. For this recommendation to be adopted, parents and guardians of adolescents require information about strategies that they can employ to prevent or reduce their adolescent's alcohol use that are supported by evidence. METHODS The Delphi method was used to obtain expert consensus on parenting strategies effective in preventing and reducing adolescent alcohol consumption. A literature search identified 457 recommendations for parents to reduce their adolescent child's alcohol use. These recommendations were presented to a panel of 38 Australian experts who were asked to rate their importance over three survey rounds. RESULTS There were 289 parenting strategies that were endorsed as important or essential in reducing adolescent alcohol use by ≥90% of the panel. These strategies were categorised into 11 sub-headings: things parents should know about adolescent alcohol use, delaying adolescent's introduction to alcohol, modelling responsible drinking and attitudes towards alcohol, talking to adolescents about alcohol, establishing family rules, monitoring adolescents when unsupervised, preparing adolescents for peer pressure, unsupervised adolescent drinking, what to do when an adolescent has been drinking without parental permission, hosting adolescent parties, and establishing and maintaining a good parent-child relationship. The endorsed strategies were written into a document suitable for parents. CONCLUSIONS A comprehensive set of parenting strategies for preventing or reducing adolescent alcohol consumption were identified. These strategies can be promoted to parents to help them implement national recommendations for use of alcohol by young people.
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Affiliation(s)
- Siobhan M Ryan
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Claire M Kelly
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Laura M Hart
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Amy J Morgan
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Dan I Lubman
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
- Turning Point Alcohol and Drug Centre, Eastern Health and Monash University, Victoria, Australia
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Kingston AH, Morgan AJ, Jorm AF, Hall K, Hart LM, Kelly CM, Lubman DI. Helping someone with problem drug use: a Delphi consensus study of consumers, carers, and clinicians. BMC Psychiatry 2011; 11:3. [PMID: 21208412 PMCID: PMC3022807 DOI: 10.1186/1471-244x-11-3] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Accepted: 01/05/2011] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Problem use of illicit drugs (i.e. drug abuse or dependence) is associated with considerable health and social harms, highlighting the need for early intervention and engagement with health services. Family members, friends and colleagues play an important role in supporting and assisting individuals with problem drug use to seek professional help, however there are conflicting views about how and when such support should be offered. This paper reports on the development of mental health first aid guidelines for problem drug use in adults, to help inform community members on how to assist someone developing problem drug use or experiencing a drug-related crisis. METHODS A systematic review of the scientific and lay literature was conducted to develop a 228-item survey containing potential first-aid strategies to help someone developing a drug problem or experiencing a drug-related crisis. Three panels of experts (29 consumers, 31 carers and 27 clinicians) were recruited from Australia, Canada, New Zealand, the United Kingdom, and the United States. Panel members independently rated the items over three rounds, with strategies reaching consensus on importance written into the guidelines. RESULTS The overall response rate across three rounds was 80% (86% consumers, 81% carers, 74% clinicians). 140 first aid strategies were endorsed as essential or important by 80% or more of panel members. The endorsed strategies provide information and advice on what is problem drug use and its consequences, how to approach a person about their problem drug use, tips for effective communication, what to do if the person is unwilling to change their drug use, what to do if the person does (or does not) want professional help, what are drug-affected states and how to deal with them, how to deal with adverse reactions leading to a medical emergency, and what to do if the person is aggressive. CONCLUSIONS The guidelines provide a consensus-based resource for community members who want to help someone with a drug problem. It is hoped that the guidelines will lead to better support and understanding for those with problem drug use and facilitate engagement with professional help.
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Affiliation(s)
- Anna H Kingston
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Amy J Morgan
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Kate Hall
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Laura M Hart
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Claire M Kelly
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia
| | - Dan I Lubman
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Victoria, Australia,Turning Point Alcohol and Drug Centre, Eastern Health and Monash University, Victoria, Australia
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Colucci E, Kelly CM, Minas H, Jorm AF, Nadera D. Mental Health First Aid guidelines for helping a suicidal person: a Delphi consensus study in the Philippines. Int J Ment Health Syst 2010; 4:32. [PMID: 21167076 PMCID: PMC3017011 DOI: 10.1186/1752-4458-4-32] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Accepted: 12/20/2010] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND This study aimed to develop guidelines for how a member of the Filipino public should provide mental health first aid to a person who is suicidal. METHODS The guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 34 Filipino mental health clinicians to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms). Responses to these open-ended questions were used to generate new items. RESULTS The output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 48 new items were written based on suggestions from panel members and, of these 186 items, 102 met the consensus criterion. These statements were used to develop the guidelines appended to this paper. The guidelines are currently being translated into local languages. CONCLUSIONS There are a number of actions that are considered to be useful for members of the public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to non-mental health professionals working in health and welfare settings.
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Affiliation(s)
- Erminia Colucci
- Centre for International Mental Health, Melbourne School of Population Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Claire M Kelly
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Harry Minas
- Centre for International Mental Health, Melbourne School of Population Health, The University of Melbourne, Parkville, Victoria 3010, Australia
| | - Anthony F Jorm
- Mental Health First Aid Training and Research Program, Orygen Youth Health Research Centre, Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria 3052, Australia
| | - Dinah Nadera
- Faculty of Management and Development Studies, UP Open University, Los Banos, Laguna, Philippines
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Hart LM, Bourchier SJ, Jorm AF, Kanowski LG, Kingston AH, Stanley D, Lubman DI. Development of mental health first aid guidelines for Aboriginal and Torres Strait Islander people experiencing problems with substance use: a Delphi study. BMC Psychiatry 2010; 10:78. [PMID: 20932326 PMCID: PMC2964528 DOI: 10.1186/1471-244x-10-78] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Accepted: 10/08/2010] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Problems with substance use are common in some Aboriginal communities. Although problems with substance use are associated with significant mortality and morbidity, many people who experience them do not seek help. Training in mental health first aid has been shown to be effective in increasing knowledge of symptoms and behaviours associated with seeking help. The current study aimed to develop culturally appropriate guidelines for providing mental health first aid to an Aboriginal or Torres Strait Islander person who is experiencing problem drinking or problem drug use (e.g. abuse or dependence). METHODS Twenty-eight Aboriginal health experts participated in two independent Delphi studies (n = 22 problem drinking study, n = 21 problem drug use; 15 participated in both). Panellists were presented with statements about possible first aid actions via online questionnaires and were encouraged to suggest additional actions not covered by the content. Statements were accepted for inclusion in the guidelines if they were endorsed by ≥ 90% of panellists as either 'Essential' or 'Important'. At the end of the two Delphi studies, participants were asked to give feedback on the value of the project and their participation experience. RESULTS From a total of 735 statements presented over two studies, 429 were endorsed (223 problem drinking, 206 problem drug use). Statements were grouped into sections based on common themes (n = 7 problem drinking, n = 8 problem drug use), then written into guideline documents. Participants evaluated the Delphi method employed, and the guidelines developed, as useful and appropriate for Aboriginal and Torres Strait Islander people. CONCLUSIONS Aboriginal health experts were able to reach consensus about culturally appropriate first aid for problems with substance use. Many first aid actions endorsed in the current studies were not endorsed in previous international Delphi studies, conducted on problem drinking and problem drug use in non-Indigenous people, highlighting the need for culturally specific first aid strategies to be employed when assisting Aboriginal or Torres Strait Islander people.
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Affiliation(s)
- Laura M Hart
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Sarah J Bourchier
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Leonard G Kanowski
- Aboriginal Mental Health and Drug & Alcohol, Greater Western Area Health Service, New South Wales Department of Health, Orange, New South Wales, Australia
| | - Anna H Kingston
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia
| | - Donna Stanley
- Aboriginal Mental Health and Drug & Alcohol, Greater Western Area Health Service, New South Wales Department of Health, Orange, New South Wales, Australia
| | - Dan I Lubman
- Orygen Youth Health Research Centre, University of Melbourne, Parkville, Victoria, Australia,Turning Point Alcohol and Drug Centre, Eastern Health and Monash University, Fitzroy, Victoria, Australia
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Kelly CM, Jorm AF, Kitchener BA. Development of mental health first aid guidelines on how a member of the public can support a person affected by a traumatic event: a Delphi study. BMC Psychiatry 2010; 10:49. [PMID: 20565918 PMCID: PMC2904289 DOI: 10.1186/1471-244x-10-49] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2008] [Accepted: 06/21/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People who experience traumatic events have an increased risk of developing a range of mental disorders. Appropriate early support from a member of the public, whether a friend, family member, co-worker or volunteer, may help to prevent the onset of a mental disorder or may minimise its severity. However, few people have the knowledge and skills required to assist. Simple guidelines may help members of the public to offer appropriate support when it is needed. METHODS Guidelines were developed using the Delphi method to reach consensus in a panel of experts. Experts recruited to the panels included 37 professionals writing, planning or working clinically in the trauma area, and 17 consumer or carer advocates who had been affected by traumatic events. As input for the panels to consider, statements about how to assist someone who has experienced a traumatic event were sourced through a systematic search of both professional and lay literature. These statements were used to develop separate questionnaires about possible ways to assist adults and to assist children, and panel members answered either one questionnaire or both, depending on experience and expertise. The guidelines were written using the items most consistently endorsed by the panels across the three Delphi rounds. RESULTS There were 180 items relating to helping adults, of which 65 were accepted, and 155 items relating to helping children, of which 71 were accepted. These statements were used to develop the two sets of guidelines appended to this paper. CONCLUSIONS There are a number of actions which may be useful for members of the public when they encounter someone who has experienced a traumatic event, and it is possible that these actions may help prevent the development of some mental health problems in the future. Positive social support, a strong theme in these guidelines, has some evidence for effectiveness in developing mental health problems in people who have experienced traumatic events, but the degree to which it helps has not yet been adequately demonstrated. An evaluation of the effectiveness of these guidelines would be useful in determining their value. These guidelines may be useful to organisations who wish to develop or revise curricula of mental health first aid and trauma intervention training programs and policies. They may also be useful for members of the public who want immediate information about how to assist someone who has experienced a potentially traumatic event.
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Affiliation(s)
- Claire M Kelly
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia.
| | - Anthony F Jorm
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia
| | - Betty A Kitchener
- Orygen Youth Health Research Centre, Centre for Youth Mental Health, University of Melbourne, Australia
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