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重新制定心理健康急救指南,以支持正在进行非自杀性自伤行为的原住民和托雷斯海峡岛民。

Re-development of mental health first aid guidelines for supporting Aboriginal and Torres Strait Islanders who are engaging in non-suicidal self-injury.

作者信息

Armstrong Gregory, Ironfield Natalie, Kelly Claire M, Dart Katrina, Arabena Kerry, Bond Kathy, Jorm Anthony F

机构信息

Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie St, Carlton, Victoria, 3010, Australia.

Mental Health First Aid Australia, Level 6, 369 Royal Parade, Parkville, Victoria, 3053, Australia.

出版信息

BMC Psychiatry. 2017 Aug 22;17(1):300. doi: 10.1186/s12888-017-1465-1.

Abstract

BACKGROUND

Non-suicidal self-injury (NSSI) disproportionally affects Indigenous Australians. Friends, family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is engaging in NSSI. Culturally appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islanders who are engaging in NSSI were developed in 2009. This study describes the re-development of these guidelines to ensure they contain the most current recommended helping actions.

METHODS

The Delphi consensus method was used to elicit consensus on potential helping statements to be included in the guidelines. These statements describe helping actions that Indigenous community members and non-Indigenous frontline workers can take, and information they should have, to help someone who is engaging in NSSI. The statements were sourced from systematic searches of peer-reviewed literature, grey literature, books, websites and online materials, and existing NSSI courses. A panel was formed, comprising 26 Aboriginal and Torres Strait Islanders with expertise in NSSI. The panellists were presented with the helping statements via online questionnaires and were encouraged to suggest re-wording of statements and any additional helping statements that were not included in the original questionnaire. Statements were only accepted for inclusion in the guidelines if they were endorsed by ≥90% of panellists as essential or important.

RESULTS

From a total of 185 statements shown to the expert panel, 115 were endorsed as helping statements to be included in the re-developed guidelines.

CONCLUSIONS

A panel of Aboriginal and Torres Strait Islander people with expertise in NSSI were able to reach consensus on appropriate strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander engaging in NSSI. The re-development of the guidelines has resulted in more comprehensive guidance than the earlier version. The re-developed guidelines will form the basis of an Aboriginal mental health first aid short course on NSSI for Indigenous community members and non-Indigenous frontline workers that will be evaluated in an upcoming trial.

摘要

背景

非自杀性自伤行为(NSSI)对澳大利亚原住民的影响尤为严重。如果有人出现非自杀性自伤行为,朋友、家人和一线工作者(如教师、青年工作者)通常最有能力提供初步帮助。2009年制定了关于如何为有非自杀性自伤行为的澳大利亚原住民和托雷斯海峡岛民提供心理健康急救的符合文化习俗的专家共识指南。本研究描述了这些指南的重新制定过程,以确保其包含最新推荐的帮助行动。

方法

采用德尔菲共识法就指南中可能包含的帮助性陈述征求共识。这些陈述描述了原住民社区成员和非原住民一线工作者可以采取的帮助行动,以及他们为帮助有非自杀性自伤行为的人应掌握的信息。这些陈述来源于对同行评审文献、灰色文献、书籍、网站和在线材料以及现有非自杀性自伤行为课程的系统检索。成立了一个由26名在非自杀性自伤行为方面具有专业知识的澳大利亚原住民和托雷斯海峡岛民组成的小组。通过在线问卷向小组成员展示帮助性陈述,并鼓励他们建议对陈述进行重新措辞,以及提出原始问卷中未包含的任何其他帮助性陈述。只有当≥90%的小组成员认可某陈述为必要或重要时,该陈述才会被纳入指南。

结果

向专家小组展示的185条陈述中,有115条被认可为应纳入重新制定的指南中的帮助性陈述。

结论

一个由在非自杀性自伤行为方面具有专业知识的澳大利亚原住民和托雷斯海峡岛民组成的小组能够就为有非自杀性自伤行为的澳大利亚原住民和托雷斯海峡岛民提供心理健康急救的适当策略达成共识。指南的重新制定产生了比早期版本更全面的指导。重新制定的指南将构成一个针对原住民社区成员和非原住民一线工作者的关于非自杀性自伤行为的原住民心理健康急救短期课程的基础,该课程将在即将进行的试验中进行评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/150e/5568063/915921c51065/12888_2017_1465_Fig1_HTML.jpg

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