Mental health first aid
Mental Health First Aid is a training program that teaches members of the public how to help a person developing a mental health problem (including a substance use problem), experiencing a worsening of an existing mental health problem or in a mental health crisis. Like traditional first aid, Mental Health First Aid does not teach people to treat or diagnose mental health or substance use conditions. Instead, the training teaches people how to offer initial support until appropriate professional help is received or until the crisis resolves. While first aid for physical health crises is a familiar notion in developed countries, conventional first aid training has not generally incorporated mental health problems.
Mental health problems are common in the community, so members of the public are likely to have close contact with people affected. However, many people are not well informed about how to recognize mental health problems, how to provide support and what are the best treatments and services available. Furthermore, many people developing mental disorders do not get professional help or delay getting professional help. Someone in their social network who is informed about the options available for professional help can assist the person to get appropriate help. In mental health crises, such as a person feeling suicidal, deliberately harming themselves, having a panic attack or being acutely psychotic, someone with appropriate mental health first aid skills can reduce the risk of the person coming to harm.
There is also stigma and discrimination against people with mental health problems, which may be reduced by improving public understanding of their experiences.
The Mental Health First Aid Program was developed in Australia by Betty Kitchener and Anthony Jorm in 2000. Since 2003, this Mental Health First Aid Program has spread to a number of other countries (Bermuda, Cambodia, Canada, China, Denmark, England, Finland, Hong Kong, Ireland, Japan, Malta, Nepal, Netherlands, New Zealand, Northern Ireland, Portugal, Saudi Arabia, Singapore, Scotland, South Africa, Sweden, United States, Wales). By 2015, over one million people had been trained in mental health first aid worldwide.
Research on mental health first aid training
A number of studies have been carried out showing the people who are trained in mental health first aid showed improved knowledge, confidence, attitudes and helping behaviour. A meta-analysis of data from 15 evaluation studies concluded that mental health first aid training "increases participants' knowledge regarding mental health, decreases their negative attitudes, and increases supportive behaviours toward individuals with mental health problems" There has also been research to develop international guidelines on the best strategies for mental health first aid. Mental health first aid training has been included in the Substance Abuse and Mental Health Services Administration's (SAMHSA) National Registry of Evidence-based Programs and Practices.
Mental Health First Aid in Australia
In Australia, Mental Health First Aid training is run by the not-for-profit charity Mental Health First Aid International (trading as Mental Health First Aid Australia). A range of training courses are offered:
- Standard Mental Health First Aid is a 12-hour face-to-face course for adults to learn to assist other adults. Culturally adapted versions of this course are available for Chinese and Vietnamese Australians. eLearning and blended versions of the Standard course have been tailored for a range of professional groups, including pharmacists, the legal profession, financial counsellors, medical students and nursing students.
- Youth Mental Health First Aid is a 14-hour face-to-face course adults to learn to assist adolescents.
- Aboriginal and Torres Strait Islander Mental Health First Aid is a 14-hour face-to-face culturally-adapted course for adults to learn to assist Aboriginal and Torres Strait Islander adults. It is run by Aboriginal or Torres Strait Islander instructors.
- teen Mental Health First Aid is a 3.5-hour classroom-based course that teaches high school students in Years 10-12, how to provide mental health first aid to their friends.
By 2015, Mental Health First Aid training had been received by over 350,000 people, which is more than 2% of the Australian adult population.
Mental Health First Aid training programs in Australia have won a number of awards for excellence including:
- Gold Achievement Award 2007 - The Winner of the Mental Health Promotion Mental Illness Prevention Program or Project category at the The MHS Conference
- Suicide Prevention Australia - 2005 Life Award
- Victorian Public Health Programs Award for Innovation, 2006
- Enterprise and Resourcefulness Award - NSW Aboriginal Health Awards 2010
- Silver Achievement Award for Aboriginal and Torres Strait Islander Program- Mental Health Promotion or Mental Illness PreventionProgram or Project category at the TheMHS Conference 2010
- Silver Achievement Award for Youth Mental Health First Aid Program - TheMHS, Mental Health Promotion or Mental Illness Prevention Program Category, 2014
Mental Health First Aid in England
Mental Health First Aid (MHFA) came to England in 2007 and was developed and launched under the Department of Health: National Institute for Mental Health in England as part of a national approach to improving public mental health. Mental Health First Aid England was launched as a community interest company in 2009.
MHFA England offer a range of courses:
- Standard MHFA, a two-day course which qualifies a participant to become a Mental Health First Aider
- Youth MHFA, a two-day course which qualifies a participant to become a Youth Mental Health First Aider. This course is designed for those who are working, living or interacting with young people. It was first launched in England in 2010 and revised and re-launched in October 2013.
- Youth MHFA Schools & Colleges, a one-day course which is based on Youth MHFA and designed to fit into school training timetables.
- Armed Forces MHFA, a two-day course which qualifies participants to become an Armed Forces Mental Health First Aider. This course was designed for the whole Armed Forces community, including veterans, serving personnel and their families. It was launched 2013. In March 2016 the research findings from an evaluation report conducted by the University of Gloucestershire into the effectiveness of the Armed Forces MHFA training will be published.
- MHFA Lite, a three-hour introductory awareness course launched which is based on the Standard MHFA course. MHFA Lite was launched in 2011. There is also a Lite version of the Youth MHFA course.
- MHFA Instructor Training, a seven-day course accredited by the Royal Society for Public Health to qualify as a Mental Health First Aid instructor who can deliver one or all of the two-day courses (Standard, Youth and Armed Forces).
Since 2007, more than 114,000 Mental Health First Aiders have been trained in England and more than 1,600 people have trained as Mental Health First Aid instructors. The Department of Health encouraged all employers in England to provide Mental Health First Aid training as one of three steps in its 2012 ‘No Health Without Mental Health: Implementation Framework’. In 2016 Mental Health First Aid was recommended for all workplaces by the charity Business in the Community.
Mental Health First Aid in the USA
In 2008, the National Council for Behavioral Health, in partnership with the Missouri Department of Mental Health and the Maryland Department of Health and Mental Hygiene, brought Mental Health First Aid to the United States. Since 2008, more than 500,000 people have been trained in Mental Health First Aid USA by an instructor base of more than 9,000. There are people trained in Mental Health First Aid USA in all 50 states, Puerto Rico and Guam. The course is offered to a variety of audiences, including hospital staff, employers and business leaders, faith communities and law enforcement.
In 2012, Youth Mental Health First Aid was introduced in the United States to prepare trainees to help youth ages 12–18 that may be developing or experiencing a mental health challenge. Specialized versions of Mental Health First Aid USA including the Veterans, Public Safety, Higher Education, Rural and Older Adults modules and a Spanish version of the Youth and Adult curriculum are also available.
Mental Health First Aid USA was included in President Barack Obama's plan to reduce gun violence and increase access to mental health services. In 2014, Congress appropriated $15 million to SAMHSA to train teachers and school personnel in Youth Mental Health First Aid. In 2015, an additional $15 million was appropriated to support other community organizations serving youth. The Mental Health First Aid Act of 2015 (S. 711/H.R. 1877) has broad bi-partisan support and would authorize $20 million annually for training the American public. Fifteen states have made Mental Health First Aid a priority by appropriating state funds, including Texas which allocated $5 million.
Mental Health First Aid in Canada
Mental Health First Aid (MHFA) debuted in Canada in 2007, and has operated under the leadership of the Mental Health Commission of Canada since early 2010.
MHFA Canada offers a range of courses, which, upon completion, certifies a participant in Mental Health First Aid:
- MHFA Basic, a two-day 12 hour course
- MHFA for Adults who Interact with Youth, a two-day 14 hour course
- MHFA Northern Peoples, a three-day 18 hour course
- MHFA First Nations, a three-day 20 hour course
- MHFA Instructor Training, a course which allows the participant to become a Mental Health First Aid instructor.
Different instructor courses are required to become a MHFA Basic, Youth, First Nations or Northern Peoples instructor. The duration of these courses vary from five to six days. First Nations & Northern People adaptations require 2 instructors/facilitators to deliver the course.
Additional course adaptions are in development, including courses for Inuit, Seniors and Veterans.
Since 2007, more than 197,000 Canadians have been trained in Mental Health First Aid, and more than 1,000 people have been trained as instructors.
- Mental health triage - A brief overview of the Australian concept for dealing with psychiatric emergencies, similar to regular triage.
- Political abuse of psychiatry
- Involuntary commitment
References and notes
- Kitchener, B.A., Jorm, A.F. & Kelly, C.M. (2015). Mental Health First Aid International Manual. Melbourne: Mental Health First Aid International.
- Kohn R, Saxena S, Levav I, Saraceno B. The treatment gap in mental health care. Bull World Health Organ 2004; 82: 858-866.
- Kitchener BA, Jorm AF. (2008). Mental Health First Aid: an international program for early intervention. Early Intervention in Psychiatry, 2, 55-61.
- Mental Health First Aid International Newsletter, November 2012. https://mhfa.com.au/sites/default/files/MHFA-I-Newsletter-Nov-12-web.pdf
- University of Canberra. "Betty Kitchener AM Chancellor's Alumni Award Winner". Retrieved 25 September 2015.
- Hadlaczky G, Hökby S, Mkrtchian A, Carli V, Wasserman D. Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: a meta-analysis. International Review of Psychiatry 2014; 26: 467-475.
- Langlands, R.L, Jorm, A.F., Kelly, C.M. & Kitchener, B. (2008). First aid for depression: A Delphi consensus study with consumers, carers and clinicians. Journal of Affective Disorders, 105, 157-165.
- Langlands RL, Jorm AF, Kelly CM, Kitchener BA. (2008). First aid recommendations for psychosis: using the Delphi method to gain consensus between mental health consumers, carers and clinicians. Schizophrenia Bulletin, 34, 435-443.
- Ross AM, Kelly CM, Jorm AF. Re-development of mental health first aid guidelines for suicidal ideation and behaviour: a Delphi study. BMC Psychiatry 2014; 14: 241.
- Ross AM, Kelly CM, Jorm AF. Re-development of mental health first aid guidelines for non-suicidal self-injury: a Delphi study. BMC Psychiatry 2014; 14: 236.
- SAMHSA. "Intervention Summary Mental Health First Aid". Retrieved 2 November 2013.
- Minas, H., Colucci, E. & Jorm, A.F. (2009). Evaluation of Mental Health First Aid training with members of the Vietnamese community in Melbourne, Australia. International Journal of Mental Health Systems, 3, 19.
- Lam, A.Y.K., Jorm, A.F. & Wong, D.F.K. (2010). Mental health first aid training for the Chinese community in Melbourne, Australia: effects on knowledge about and attitudes toward people with mental illness. International Journal of Mental Health Systems, 4, 18.
- Bond KS, Jorm AF, Kitchener BA, Reavley NJ. Mental health first aid training for Australian medical and nursing students: an evaluation study. BMC Psychology 2015; 3: 11.
- Bond KS, Jorm AF, Kitchener BA, Reavley NJ. Mental Health First Aid training for Australian financial counsellors: An evaluation study. Advances in Mental Health 2016; in press.
- Kelly CM, Mitten JM, Fischer JA, Kitchener BA, Jorm AF, Lowe A, Scanlan C.Youth mental health first aid: a description of the program and an initial evaluation. Int J Ment Health Syst 2011; 5: 4.
- Kanowski LG, Jorm AF, Hart LM. A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation. Int J Ment Health Syst 2009; 3: 10.
- Kelly CM, Mitten JM, Fischer JA, Kitchener BA, Jorm AF, Lowe A, Scanlan C.‘teen Mental Health First Aid’: a description of the program and an initial evaluation. Int J Ment Health Syst 2016; 10: 3.
- Mental Health First Aid Australia. "Mental Health First Aid Australia Media Release 6th March 2015" (PDF). Retrieved 25 September 2015.
- Mental Health First Aid Australia. "Mental Health First Aid Awards". Retrieved 1 February 2016.
- Mental Health First Aid Australia- original Australian program
- Psykisk Førstehjælp (MHFA Denmark) official website
- MHFA England official website
- MHFA Canada official website
- MHFA Hong Kong official website
- MHFA Japan official website
- Scotland's Mental Health First Aid official website
- MHFA Singapore official website
- MHFA South Africa official website
- Första hjälpen till psykisk hälsa (MHFA Sweden) official website
- MHFA USA official website
- MHFA Wales official website