New mental health first aid guidelines tailored specifically for Argentina and Chile have been developed to help community members identify and assist individuals experiencing psychosis. The guidelines, published in the journal BMC Psychiatry, were adapted using the Delphi expert consensus method, involving both healthcare professionals and individuals with lived experiences of psychosis.
The original guidelines, which were first created for use in high-income, English-speaking countries, were translated and culturally modified for Argentina and Chile. This adaptation process involved two panels of experts – one composed of healthcare professionals and the other made up of people with personal experience of psychosis or as carers. A total of 275 statements were evaluated over two rounds of surveys. Of these, 244 statements, including 26 newly generated ones, were ultimately approved for inclusion in the local guidelines.
The study found that while many aspects of the original English-language guidelines were applicable, several statements were rejected due to cultural differences. The Argentinian and Chilean panels were less likely to support recommendations regarding self-help techniques and respecting the autonomy of people who are experiencing psychosis. Instead, there was a strong emphasis on the involvement of mental health professionals, even in situations where the original guidelines suggested layperson intervention.
Additionally, the local experts did not support many of the recommendations that focused on promoting healthy lifestyles or substance abuse. It appears that mental health professionals in Argentina and Chile are less confident in the value of non-professional assistance and self-help initiatives compared to their counterparts in countries where the guidelines originated. This reluctance may be reflective of the mental health systems in both countries, which have historically focused more on professional-led treatment rather than community or peer-based support.
The experts also agreed that caution should always be exercised when communicating with a person experiencing psychosis, not just when the individual is in crisis or behaving aggressively. They stressed the importance of safety precautions for first aiders, with the need for immediate professional intervention whenever a situation feels unsafe. This illustrates a significant shift towards prioritising the involvement of healthcare workers over non-professional interventions.
Despite these differences, the local experts recognised the importance of early intervention in psychosis, which is often linked to better outcomes. The new guidelines place an emphasis on reducing stigma, increasing mental health literacy, and ensuring that individuals experiencing psychosis can access mental health services promptly.
Developing these culturally adapted guidelines is an important step towards improving the mental health support available in Argentina and Chile. However, challenges remain in terms of acceptance and implementation. A greater emphasis on recovery-oriented principles, which include promoting autonomy and the active participation of community members, could improve the acceptance of these guidelines among mental health professionals. Further research and development of a mental health first aid training course specifically for Chile and Argentina are required to ensure these guidelines make a positive impact.
