Skip to main content
Top
Published in: BMC Psychiatry 1/2010

Open Access 01-12-2010 | Research article

Development of mental health first aid guidelines for Aboriginal and Torres Strait Islander people experiencing problems with substance use: a Delphi study

Authors: Laura M Hart, Sarah J Bourchier, Anthony F Jorm, Leonard G Kanowski, Anna H Kingston, Donna Stanley, Dan I Lubman

Published in: BMC Psychiatry | Issue 1/2010

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Australian Institute of Health and Welfare: Population Characteristics, Aboriginal and Torres Strait Islander Australians (Cat. 4713.0). 2006, Canberra: Australian Institute of Health and Welfare Australian Institute of Health and Welfare: Population Characteristics, Aboriginal and Torres Strait Islander Australians (Cat. 4713.0). 2006, Canberra: Australian Institute of Health and Welfare
2.
go back to reference Australian Institute of Health and Welfare: 2007 National Drug Strategy Household Survey: detailed findings (Cat.PHE 107). 2008, Canberra: Australian Institute of Health and Welfare Australian Institute of Health and Welfare: 2007 National Drug Strategy Household Survey: detailed findings (Cat.PHE 107). 2008, Canberra: Australian Institute of Health and Welfare
3.
go back to reference Australian Bureau of Statistics, Australian Institute of Health and Welfare: The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples 2008 (Cat. 4704.0). 2008, Canberra: Australian Bureau of Statistics, Australian Institute of Health and Welfare Australian Bureau of Statistics, Australian Institute of Health and Welfare: The Health and Welfare of Australia's Aboriginal and Torres Strait Islander Peoples 2008 (Cat. 4704.0). 2008, Canberra: Australian Bureau of Statistics, Australian Institute of Health and Welfare
4.
go back to reference Australian Bureau of Statistics, Australian Institute of Health and Welfare: National Aboriginal and Torres Strait Islander Health Survey 2004-2005 (Cat. 4715.0). 2006, Canberra: Australian Bureau of Statistics, Australian Institute of Health and Welfare Australian Bureau of Statistics, Australian Institute of Health and Welfare: National Aboriginal and Torres Strait Islander Health Survey 2004-2005 (Cat. 4715.0). 2006, Canberra: Australian Bureau of Statistics, Australian Institute of Health and Welfare
5.
go back to reference Lee KSK, Conigrave KM, Patton GC, Clough AR: Cannabis use in remote Indigenous communities in Australia: endemic yet neglected. Medical Journal of Australia. 2009, 190 (5): 228-229.PubMed Lee KSK, Conigrave KM, Patton GC, Clough AR: Cannabis use in remote Indigenous communities in Australia: endemic yet neglected. Medical Journal of Australia. 2009, 190 (5): 228-229.PubMed
6.
go back to reference MacLean SJ, d'Abbs PHN: Petrol sniffing in Aboriginal communities: a review of interventions. Drug & Alcohol Review. 2002, 21 (1): 65-72.CrossRef MacLean SJ, d'Abbs PHN: Petrol sniffing in Aboriginal communities: a review of interventions. Drug & Alcohol Review. 2002, 21 (1): 65-72.CrossRef
7.
go back to reference Select committee on substance abuse in the community, Legislative Assembly of the Northern Territory: Petrol Sniffing in Remote Northern Territory Communities. 2004, Darwin: Legislative Assembly of the Northern Territory Select committee on substance abuse in the community, Legislative Assembly of the Northern Territory: Petrol Sniffing in Remote Northern Territory Communities. 2004, Darwin: Legislative Assembly of the Northern Territory
8.
go back to reference White V, Hayman J-C: Australian secondary school students' use of over-the-counter and illicit substances in 2005. 2006, Canberra: Drug Strategy Branch, Australian Government Department of Health and Ageing White V, Hayman J-C: Australian secondary school students' use of over-the-counter and illicit substances in 2005. 2006, Canberra: Drug Strategy Branch, Australian Government Department of Health and Ageing
9.
go back to reference Vos T, Barker B, Stanley L, Lopez A: The burden of disease and injury in Aboriginal and Torres Strait Islander peoples. 2003, Brisbane: Centre for Burden of Disease and Cost-Effectiveness, School of Population Health, The University of Queensland Vos T, Barker B, Stanley L, Lopez A: The burden of disease and injury in Aboriginal and Torres Strait Islander peoples. 2003, Brisbane: Centre for Burden of Disease and Cost-Effectiveness, School of Population Health, The University of Queensland
11.
go back to reference Gary D, Saggers S: Substance misuse. The health of Indigenous Australians. Edited by: Thomson N. 2003, Melbourne: Oxford University Press, 1-10. Gary D, Saggers S: Substance misuse. The health of Indigenous Australians. Edited by: Thomson N. 2003, Melbourne: Oxford University Press, 1-10.
12.
go back to reference Hunter E, Milroy H: Aboriginal and Torres Strait Islander Suicide in Context. Archives of Suicide Research. 2006, 10 (2): 141-157. 10.1080/13811110600556889.CrossRefPubMed Hunter E, Milroy H: Aboriginal and Torres Strait Islander Suicide in Context. Archives of Suicide Research. 2006, 10 (2): 141-157. 10.1080/13811110600556889.CrossRefPubMed
13.
go back to reference Putt J, Delahunty B: Illicit drug use in rural and remote Indigenous communities. Trends and issues in crime and criminal justice Australian Institute of Criminology. 2006, 322 (August): 1-6. Putt J, Delahunty B: Illicit drug use in rural and remote Indigenous communities. Trends and issues in crime and criminal justice Australian Institute of Criminology. 2006, 322 (August): 1-6.
14.
go back to reference Swan P, Raphael B: Ways Forward: National Aboriginal and Torres Strait Islander Mental Health Policy National Consultancy Report. 1995, Canberra: Commonwealth Government of Australia Swan P, Raphael B: Ways Forward: National Aboriginal and Torres Strait Islander Mental Health Policy National Consultancy Report. 1995, Canberra: Commonwealth Government of Australia
15.
go back to reference Burgess PM, Pirkis JE, Slade TN, Johnston AK, Meadows GN, Gunn JM: Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing. Australia New Zealand Journal of Psychiatry. 2009, 43 (7): 615-623. 10.1080/00048670902970858.CrossRef Burgess PM, Pirkis JE, Slade TN, Johnston AK, Meadows GN, Gunn JM: Service use for mental health problems: findings from the 2007 National Survey of Mental Health and Wellbeing. Australia New Zealand Journal of Psychiatry. 2009, 43 (7): 615-623. 10.1080/00048670902970858.CrossRef
16.
go back to reference Wang PS, Angermeyer M, Borges G, Bruffaerts R, Tat Chiu W, G DEG, Fayyad J, Gureje O, Haro JM, Huang Y, et al: Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry. 2007, 6 (3): 177-185.PubMedPubMedCentral Wang PS, Angermeyer M, Borges G, Bruffaerts R, Tat Chiu W, G DEG, Fayyad J, Gureje O, Haro JM, Huang Y, et al: Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry. 2007, 6 (3): 177-185.PubMedPubMedCentral
17.
go back to reference Burns CB, D'Abbs P, Currie BJ: Patterns of petrol sniffing and other drug use in young men from an Australian Aboriginal community in Arnhem Land, Northern Territory. Drug and Alcohol Review. 1995, 14 (2): 159-169. 10.1080/09595239500185221.CrossRefPubMed Burns CB, D'Abbs P, Currie BJ: Patterns of petrol sniffing and other drug use in young men from an Australian Aboriginal community in Arnhem Land, Northern Territory. Drug and Alcohol Review. 1995, 14 (2): 159-169. 10.1080/09595239500185221.CrossRefPubMed
18.
go back to reference Alati R, Peterson C, Rice PL: The development of Indigenous substance misuse services in Australia: beliefs, conflicts and change. Australian Journal of Primary Health. 2000, 6 (2): 49-62. 10.1071/PY00018.CrossRef Alati R, Peterson C, Rice PL: The development of Indigenous substance misuse services in Australia: beliefs, conflicts and change. Australian Journal of Primary Health. 2000, 6 (2): 49-62. 10.1071/PY00018.CrossRef
19.
go back to reference Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P: ''Mental health literacy'': A survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia. 1997, 166 (4): 182-186.PubMed Jorm AF, Korten AE, Jacomb PA, Christensen H, Rodgers B, Pollitt P: ''Mental health literacy'': A survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia. 1997, 166 (4): 182-186.PubMed
20.
go back to reference Jorm AF: Mental health literacy - Public knowledge and beliefs about mental disorders. British Journal of Psychiatry. 2000, 177 (5): 396-401. 10.1192/bjp.177.5.396.CrossRefPubMed Jorm AF: Mental health literacy - Public knowledge and beliefs about mental disorders. British Journal of Psychiatry. 2000, 177 (5): 396-401. 10.1192/bjp.177.5.396.CrossRefPubMed
21.
go back to reference Kitchener BA, Jorm AF: Mental health first aid: An international programme for early intervention. Early Intervention in Psychiatry. 2008, 2 (1): 55-61. 10.1111/j.1751-7893.2007.00056.x.CrossRefPubMed Kitchener BA, Jorm AF: Mental health first aid: An international programme for early intervention. Early Intervention in Psychiatry. 2008, 2 (1): 55-61. 10.1111/j.1751-7893.2007.00056.x.CrossRefPubMed
22.
go back to reference Kitchener BA, Jorm AF: Mental health first aid training: review of evaluation studies. Australia New Zealand Journal of Psychiatry. 2006, 40 (1): 6-8.CrossRef Kitchener BA, Jorm AF: Mental health first aid training: review of evaluation studies. Australia New Zealand Journal of Psychiatry. 2006, 40 (1): 6-8.CrossRef
23.
go back to reference Kanowski LG, Jorm AF, Hart LM: A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation. International Journal of Mental Health Systems. 2009, 3 (1): 10-10.1186/1752-4458-3-10.CrossRefPubMedPubMedCentral Kanowski LG, Jorm AF, Hart LM: A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation. International Journal of Mental Health Systems. 2009, 3 (1): 10-10.1186/1752-4458-3-10.CrossRefPubMedPubMedCentral
24.
go back to reference Hart LM, Jorm AF, Paxton SJ, Kelly CM, Kitchener BA: First aid for eating disorders. Eating Disorders: the journal of treatment and prevention. 2009, 17 (5): 357-384.CrossRef Hart LM, Jorm AF, Paxton SJ, Kelly CM, Kitchener BA: First aid for eating disorders. Eating Disorders: the journal of treatment and prevention. 2009, 17 (5): 357-384.CrossRef
25.
go back to reference 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: 49-10.1186/1471-244X-10-49.CrossRefPubMedPubMedCentral 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: 49-10.1186/1471-244X-10-49.CrossRefPubMedPubMedCentral
26.
go back to reference Kelly CM, Jorm AF, Kitchener BA, Langlands RL: Development of mental health first aid guidelines for deliberate non-suicidal self-injury: A Delphi study. BMC Psychiatry. 2008, 8: 62-10.1186/1471-244X-8-62.CrossRefPubMedPubMedCentral Kelly CM, Jorm AF, Kitchener BA, Langlands RL: Development of mental health first aid guidelines for deliberate non-suicidal self-injury: A Delphi study. BMC Psychiatry. 2008, 8: 62-10.1186/1471-244X-8-62.CrossRefPubMedPubMedCentral
27.
go back to reference Kelly CM, Jorm AF, Kitchener BA, Langlands RL: Development of mental health first aid guidelines for suicidal ideation and behaviour: A Delphi study. BMC Psychiatry. 2008, 8: 17-10.1186/1471-244X-8-17.CrossRefPubMedPubMedCentral Kelly CM, Jorm AF, Kitchener BA, Langlands RL: Development of mental health first aid guidelines for suicidal ideation and behaviour: A Delphi study. BMC Psychiatry. 2008, 8: 17-10.1186/1471-244X-8-17.CrossRefPubMedPubMedCentral
28.
go back to reference Kingston AH, Jorm AF, Kitchener BA, Hides L, Kelly CM, Morgan AJ, Hart LM, Lubman DI: Helping someone with problem drinking: mental health first aid guidelines - a Delphi expert consensus study. BMC Psychiatry. 2009, 9: 79-10.1186/1471-244X-9-79.CrossRefPubMedPubMedCentral Kingston AH, Jorm AF, Kitchener BA, Hides L, Kelly CM, Morgan AJ, Hart LM, Lubman DI: Helping someone with problem drinking: mental health first aid guidelines - a Delphi expert consensus study. BMC Psychiatry. 2009, 9: 79-10.1186/1471-244X-9-79.CrossRefPubMedPubMedCentral
29.
go back to reference Langlands RL, Jorm AF, Kelly CM, Kitchener BA: First aid recommendations for psychosis: Using the delphi method to gain consensus between mental health consumers, carers, and clinicians. Schizophrenia Bulletin. 2008, 34 (3): 435-443. 10.1093/schbul/sbm099.CrossRefPubMed Langlands RL, Jorm AF, Kelly CM, Kitchener BA: First aid recommendations for psychosis: Using the delphi method to gain consensus between mental health consumers, carers, and clinicians. Schizophrenia Bulletin. 2008, 34 (3): 435-443. 10.1093/schbul/sbm099.CrossRefPubMed
30.
go back to reference Langlands RL, Jorm AF, Kelly CM, Kitchener BA: First aid for depression: A Delphi consensus study with consumers, carers and clinicians. Journal of Affective Disorders. 2008, 105 (1-3): 157-165. 10.1016/j.jad.2007.05.004.CrossRefPubMed Langlands RL, Jorm AF, Kelly CM, Kitchener BA: First aid for depression: A Delphi consensus study with consumers, carers and clinicians. Journal of Affective Disorders. 2008, 105 (1-3): 157-165. 10.1016/j.jad.2007.05.004.CrossRefPubMed
31.
go back to reference Kingston AH, Morgan AJ, Jorm AF, Kitchener BA, Hides L, Kelly CM, Hart LM, Lubman DI: Helping someone with problem drug use: A Delphi consensus study of consumers, carers, and clinicians. BMC Psychiatry. Kingston AH, Morgan AJ, Jorm AF, Kitchener BA, Hides L, Kelly CM, Hart LM, Lubman DI: Helping someone with problem drug use: A Delphi consensus study of consumers, carers, and clinicians. BMC Psychiatry.
32.
go back to reference Hart LM, Jorm AF, Kanowski LG, Kelly CM, Langlands RL: Mental health first aid for Indigenous Australians: using Delphi consensus studies to develop guidelines for culturally appropriate responses to mental health problems. BMC Psychiatry. 2009, 9: 47-10.1186/1471-244X-9-47.CrossRefPubMedPubMedCentral Hart LM, Jorm AF, Kanowski LG, Kelly CM, Langlands RL: Mental health first aid for Indigenous Australians: using Delphi consensus studies to develop guidelines for culturally appropriate responses to mental health problems. BMC Psychiatry. 2009, 9: 47-10.1186/1471-244X-9-47.CrossRefPubMedPubMedCentral
33.
go back to reference Hasson F, Keeney S, McKenna HP: Research guidelines for the Delphi survey technique. Journal of Advanced Nursing. 2000, 32 (4): 1008-1015. 10.1046/j.1365-2648.2000.01567.x.PubMed Hasson F, Keeney S, McKenna HP: Research guidelines for the Delphi survey technique. Journal of Advanced Nursing. 2000, 32 (4): 1008-1015. 10.1046/j.1365-2648.2000.01567.x.PubMed
34.
go back to reference McKenna HP: The Delphi technique: a worthwhile research approach for nursing?. Journal of Advanced Nursing. 1994, 19 (6): 1221-1225. 10.1111/j.1365-2648.1994.tb01207.x.CrossRefPubMed McKenna HP: The Delphi technique: a worthwhile research approach for nursing?. Journal of Advanced Nursing. 1994, 19 (6): 1221-1225. 10.1111/j.1365-2648.1994.tb01207.x.CrossRefPubMed
35.
go back to reference Johnston E: Chapter 15. The harmful use of alcohol and other drugs. National Report. 1991, Royal Commission into Aboriginal Deaths in Custody. Canberra: Australian Government Publishing Service, 2: Johnston E: Chapter 15. The harmful use of alcohol and other drugs. National Report. 1991, Royal Commission into Aboriginal Deaths in Custody. Canberra: Australian Government Publishing Service, 2:
36.
go back to reference Ary DV, Tildesley E, Hops H, Andrews J: The influence of parent, sibling, and peer modeling and attitudes on adolescent use of alcohol. Substance Use and Misuse. 1993, 28 (9): 853-880. 10.3109/10826089309039661. Ary DV, Tildesley E, Hops H, Andrews J: The influence of parent, sibling, and peer modeling and attitudes on adolescent use of alcohol. Substance Use and Misuse. 1993, 28 (9): 853-880. 10.3109/10826089309039661.
37.
go back to reference Komro KA, Maldonado-Molina MM, Tobler AL, Bonds JR, Muller KE: Effects of home access and availability of alcohol on young adolescents' alcohol use. Addiction. 2007, 2007 (102): 10- Komro KA, Maldonado-Molina MM, Tobler AL, Bonds JR, Muller KE: Effects of home access and availability of alcohol on young adolescents' alcohol use. Addiction. 2007, 2007 (102): 10-
38.
go back to reference Marsiglia FF, Kulis S, Hecht ML: Ethnic labels and ethnic identity as predictors of drug use among middle school students in the southwest. Journal of Research on Adolescence. 2001, 11 (1): 21-48. 10.1111/1532-7795.00002.CrossRef Marsiglia FF, Kulis S, Hecht ML: Ethnic labels and ethnic identity as predictors of drug use among middle school students in the southwest. Journal of Research on Adolescence. 2001, 11 (1): 21-48. 10.1111/1532-7795.00002.CrossRef
39.
go back to reference Fogarty G, White C: Difference between values of Australian Aboriginal and Non-Aboriginal students. Journal of Cross Cultural Psychology. 1994, 25 (3): 394-408. 10.1177/0022022194253006.CrossRef Fogarty G, White C: Difference between values of Australian Aboriginal and Non-Aboriginal students. Journal of Cross Cultural Psychology. 1994, 25 (3): 394-408. 10.1177/0022022194253006.CrossRef
40.
go back to reference Brady M: Ethnography and understandings of Aboriginal drinking. Journal of Drug Issues. 1992, 22 (3): 699-712.CrossRef Brady M: Ethnography and understandings of Aboriginal drinking. Journal of Drug Issues. 1992, 22 (3): 699-712.CrossRef
41.
go back to reference Brady M, Nicholls R, Henderson G, Byrne J: The role of a rural sobering-up centre in managing alcohol-related harm to Aboriginal people in South Australia. Drug and Alcohol Review. 2006, 25 (3): 201-206. 10.1080/09595230600644657.CrossRefPubMed Brady M, Nicholls R, Henderson G, Byrne J: The role of a rural sobering-up centre in managing alcohol-related harm to Aboriginal people in South Australia. Drug and Alcohol Review. 2006, 25 (3): 201-206. 10.1080/09595230600644657.CrossRefPubMed
42.
go back to reference Brady M: Heavy Metal: The Social Meaning of Petrol Sniffing in Australia. 1992, Canberra: Aboriginal studies press Brady M: Heavy Metal: The Social Meaning of Petrol Sniffing in Australia. 1992, Canberra: Aboriginal studies press
43.
go back to reference National Health and Medical Research Council: Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. 2003, Canberra: National Health and Medical Research Council National Health and Medical Research Council: Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. 2003, Canberra: National Health and Medical Research Council
Metadata
Title
Development of mental health first aid guidelines for Aboriginal and Torres Strait Islander people experiencing problems with substance use: a Delphi study
Authors
Laura M Hart
Sarah J Bourchier
Anthony F Jorm
Leonard G Kanowski
Anna H Kingston
Donna Stanley
Dan I Lubman
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Psychiatry / Issue 1/2010
Electronic ISSN: 1471-244X
DOI
https://doi.org/10.1186/1471-244X-10-78

Other articles of this Issue 1/2010

BMC Psychiatry 1/2010 Go to the issue