Development of mental health first aid guidelines for problem drinking: a Delphi expert consensus study in Argentina and Chile

• Published in: BMC psychiatry 2022-02, Vol.22 (1), p.113-10, Article 113
• Main Authors: Agrest, Martín, Tapia-Muñoz, Thamara, Encina, Esteban, Wright, Judith, Ardila-Gómez, Sara, Alvarado, Rubén, Leiderman, Eduardo A, Reavley, Nicola
• Format: Article
• Language: English
• Subjects: Alcohol use; Alcohol use disorders; Alcoholism; Alcoholism - therapy; Argentina; Cardiovascular disease; Care and treatment; Chile; Community; COVID-19; Cultural adaptation; Delphi study; Delphi Technique; Divergence; Drinking behavior; Drug use; First aid; First Aid - methods; First aid in illness and injury; Health education; Health literacy; Humans; Infectious diseases; Language; Laws, regulations and rules; Medical personnel; Mental disorders; Mental Health; Mental health care; Mental Health First Aid (MHFA); Methods; Pandemics; Prevention; Psychiatric services; Psychiatry; Public health; Risk factors; Stigma; Training
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-022-03749-x

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. 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. 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. 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.