Cultural adaptation of the mental health first aid guidelines for assisting a person at risk of suicide in Namibia: a Delphi expert consensus study

Background Suicide is a significant public health concern in Namibia, and there is a need for evidence-based suicide prevention resources to assist community members who may be in a position to support people at risk of suicide within their social networks. Mental Health First Aid guidelines for assisting a person at risk of suicide have been developed. However, differences in cultural context and health systems indicate the need for local adaptation. This study aimed to culturally adapt the guidelines for assisting a person at risk of suicide in Namibia. Methods A two-round Delphi expert consensus study was conducted with two panels comprising Namibian mental health professionals and individuals with lived experience of suicide ( n = 22) from three regions, predominantly Khomas. Panellists rated 163 statements from the re-developed 2014 Mental Health First Aid suicide-risk guidelines on their importance for inclusion in the Namibia-adapted guidelines and suggested additional culturally relevant actions. Statements were included if endorsed as essential/important by ≥ 80% of panellists. Results After two survey rounds, 164 statements met the pre-specified pooled threshold for inclusion in the adapted guidelines for Namibia, with 159 retained from the original guidelines and 5 generated from panellists’ comments. Conclusions The Namibia-adapted Mental Health First Aid suicide-risk guidelines largely retained the core content of the source guidelines while incorporating locally derived refinements. This study represents a first step toward culturally adapted Mental Health First Aid guidance for Namibia. Further research is needed to evaluate the feasibility, acceptability, and implementation of the guidelines in intended settings.