Abstract
BackgroundBangladesh, like other low-resource countries, faces a shortage of a trained mental health workforce to meet its population's mental health needs adequately. The ongoing COVID-19 pandemic has further aggravated this. Mental health first aid (MHFA) is an internationally recognized training program that has been operating in Bangladesh since 2015. It offers a potential way to reduce the mental health treatment gap and skills shortage by training laypeople to help support individuals with mental health issues. The present study evaluated the effectiveness of MHFA training in Bangladesh. MethodsAn online modified Delphi study was conducted consisting of two rounds of a self-administered survey and a consensus workshop. A five-step logic framework was used to develop questionnaire statements (n=111) that consisted of 'general,' 'I,' and 'social impact' statements around the seven MHFA aims. The statements were constructed in English and adapted in Bangla. The expert panel consisted of 20 participants trained in the MHFA program. Participants anonymously stated their opinion on 111 round-1 statements and then on 27 low agreement statements in round-2. The consensus workshop facilitated a group discussion where participants explained their views on the low consensus items. ResultsThe consensus ranged from 61.5% (Aim 3: Promote recovery of good mental health) to 100% (Aim 7: To improve own health and well-being) with an overall consensus of 83.8%. 'Social impact' items produced the most (50%) disagreements. Participants' comments reflected 12 themes of MHFA's effectiveness in fostering and promoting mental health individually and socially. There were nine themes of disagreement reflecting individual, sociocultural, and political barriers to the implementation of MHFA in Bangladesh. Participants made recommendations for the MHFA and mental health initiatives in Bangladesh to increase mental health awareness, acceptance, and support in society.ConclusionMHFA training offers Bangladesh and other low-and-middle-income countries a potential solution to tackle mental health burden at individual and societal levels and the additional challenges that the COVID-19 pandemic poses to mental health.
Experiences in applying skills learned in a mental health first aid training course: a qualitative study of participants' stories
