Enhancing mental health literacy in rural America: Growth of Mental Health First Aid program in rural communities in the United States from 2008–2016.

Background: teen Mental Health First Aid (tMHFA) is a classroom-based training programme for students aged 15–18 years to improve supportive behaviours towards peers, increase mental health literacy and reduce stigma. This research evaluated tMHFA by comparing it to a matched emergency Physical First Aid (PFA) training programme. Methods: A cluster-randomised crossover trial matched four public schools in two pairs and then randomised each to first receive tMHFA or PFA for all Year 10 students. In the subsequent calendar year, the new Year 10 cohort received the opposite intervention, giving eight cohorts. Online surveys were administered at baseline and 1 week post-training, measuring quality of first aid intentions, mental health literacy, problem recognition and stigmatising beliefs, towards fictional adolescents with depression and suicidality (John) and social anxiety (Jeanie). Results: A total of 1942 students were randomised (979 received tMHFA, 948 received PFA), 1605 (84%) analysed for the John vignette at baseline and 1116 (69% of baseline) provided post-training data. The primary outcomes, ‘helpful first aid intentions’ towards John/Jeanie, showed significant group-by-time interactions with medium effect sizes favouring tMHFA ( ds = 0.50–0.58). Compared to PFA, tMHFA students also reported significantly greater improvements in confidence supporting a peer ( ds = 0.22–0.37) and number of adults rated as helpful ( ds = 0.45–0.46) and greater reductions in stigmatising beliefs ( ds = 0.12–0.40) and ‘harmful first aid intentions’ towards John/Jeanie ( ds = 0.15–0.41). Conclusions: tMHFA is an effective and feasible programme for increasing supportive first aid intentions and mental health literacy in adolescents in the short term. tMHFA could be widely disseminated to positively impact on help seeking for adolescent mental illness.

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Evaluation of Mental Health First Aid USA Using the Mental Health Beliefs and Literacy Scale

American Journal of Health Promotion ◽

10.1177/0890117118784234 ◽

2018 ◽

Vol 33 (2) ◽

pp. 237-247 ◽

Cited By ~ 3

Author(s):

My K. Banh ◽

Jeremy Chaikind ◽

Hillary A. Robertson ◽

Mary Troxel ◽

Justine Achille ◽

...

Keyword(s):

Mental Health ◽

United States ◽

Health Beliefs ◽

Repeated Measures ◽

The United States ◽

First Aid ◽

Mental Health First Aid ◽

Positive Effects ◽

Mental Health Beliefs ◽

The Impact

Purpose: This study assessed the impact of Mental Health First Aid (MHFA) in the United States with a theoretically based and psychometrically sound measure, the Mental Health Beliefs and Literacy Scale (MBLS). Design: Online MBLS surveys were administered pre-MHFA training, 3-weeks post-training, and 6-months posttraining. Setting: Mental Health First Aid trainings carried out across the United States. Participants: Six hundred sixty-two trainees were contacted, and 273 (41%) completed the presurvey. Of those, 63% filled out the postsurvey and 35% completed the 6-month survey. Seventy-six individuals completed all 3 surveys. Intervention: Mental Health First Aid is an 8-hour education program to help the general public identify, understand, and respond to signs of mental illness and substance abuse; to date, almost 1 million people have been trained. Measure: The MLBS, based on the Unified Theory of Behavior Change framework, consists of attitudinal, social-, and skill-based constructs affecting the intention to perform and achievement of MHFA actions and reports of their actual completion. Analysis: Change across time points was assessed using multivariate repeated measures analysis of variance. Results: Significant short- and longer term changes were found in internally consistent constructs tapping positive beliefs about MHFA actions, the confidence and intention to perform them as well as mental health literacy. Conclusion: The MBLS documented strong positive effects of MHFA training that were greater in individuals without prior mental health training, the intended targets of MHFA efforts.

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