Suicide first aid guidelines for Indonesia: a Delphi consensus study

Abstract

Background

The concept that “suicide is preventable” is fairly recent in Indonesia. Suicide prevention training is also new for community leaders and laypeople. On the other side, in a collectivistic society like Indonesia, community leaders, neighbours, and friends are essential parts of someone’s life. Therefore, guidelines to assist first aiders in preventing suicide is urgently needed.

Aim

This study aimed to develop guidelines to recognise key warning signs and provide first aid support to Indonesians at potential immediate risk for suicide.

Methods

The guidelines was developed through three steps: (i) systematic literature review; (ii) focus group discussions and interviews; and (iii) expert consensus using the Delphi approach. These steps were taken to ensure that the final guidelines reflected the cultural beliefs and norms of the Indonesian context.

Results

Three rounds of Delphi resulted in 460 accepted items out of 539 items generated from the literature search and group and individual interviews. Some key differences with other countries where similar studies were carried out were highlighted.

Conclusions

This study emphasised the need for gatekeeper training as the ideal way of educating community members on the guidelines.

Keywords:

• Suicide prevention
• guidelines
• gatekeepers training
• first aider
• Delphi
• Indonesia
• LMIC
• South-East Asia

Acknowledgements

We would like to thank Nurul Kusuma Hidayati and Fuad Hamsyah for the contribution to the Delphi items preparation and data collection and the team in the Center for Public Mental Health for the help with data collection. We are also deeply grateful to all participants who took part in the interviews, focus groups or Delphi study. The artwork for the Suicide First Aid Guidelines for Indonesia was designed by Agus Sugianto/Anto SG.

Disclosure statement

No potential competing interest was reported by the author(s).

Data availability statement

The raw data are not made available as the size of the Expert Panel was small and they may potentially be identified. However, the aggregated results for each Delphi item is provided in the Appendix.

Additional information

Funding

This work was partially supported by the Ministry of Research, Technology and Higher Education of Indonesia under the grant number 015/SP2H/LT/DRPM/II/2016 and by the Faculty of Psychology, Universitas Gadjah Mada under grant number 2435/UN1/FPSI/UP4/PM.02.02/2019.