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Mental health first aid (MHFA) courses teach community members the knowledge and skills needed to recognize and respond to mental health problems until professional help is received or the crisis resolves. This study aimed to develop a reliable and valid measure of MHFA behaviors. A pool of actions that were recommended and not recommended were selected from MHFA guidelines and developed into two scales measuring either intended or provided support. Items were tested with a sample of 697 adults. Item response theory guided the selection of final items. The Mental Health Support Scale (MHSS) Intended version has 23 items across two subscales and the MHSS–Provided has 12 items across two subscales. These scales demonstrated convergent validity, discrimination between respondents with and without MHFA expertise, and acceptable measurement precision across a range of skill levels. Overall, findings suggest that the MHSS is a valid and useful measure of MHFA behaviors. [ABSTRACT FROM AUTHOR]

Objective: Family and friends can encourage treatment seeking for gambling problems, if they know how to appropriately discuss their concerns. Online information can be helpful in providing advice for this. The aim of this study was to evaluate the usefulness of the online mental health first aid guidelines for helping someone with gambling problems. Method: Between October 2015 and January 2018, people who downloaded the guidelines for helping someone with gambling problems were invited to complete two online surveys, one before downloading the guidelines and another four weeks after. The surveys asked participants how they found out about the guidelines, why they were interested in them and their usefulness. They also asked participants whether they tried to help anyone with gambling problems. Results: The survey was completed by 142 people (pre-download) and 43 (post-download). Approximately three quarters were female and were predominantly from Australia, Canada, Ireland, New Zealand, the UK and USA. Almost half had some gambling training. The majority (93%) found the guidelines useful. Thirty-five per cent helped someone after downloading the guidelines and thought that the guidelines contributed to a successful outcome. Half of those who received help from the participants went on to seek professional assistance. Discussion: Although this study has limitations, it appears that the mental health first aid guidelines for helping someone with gambling problems may be a useful and effective tool for providing members of the public with basic supportive skills. Further work needs to be done to increase the reach and impact of these guidelines. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) disproportionally affects Indigenous Australians. Friends, family and frontline workers (for example, teachers, youth workers) are often best positioned to provide initial assistance if someone is engaging in NSSI. Culturally appropriate expert consensus guidelines on how to provide mental health first aid to Australian Aboriginal and Torres Strait Islanders who are engaging in NSSI were developed in 2009. This study describes the re-development of these guidelines to ensure they contain the most current recommended helping actions. Methods: The Delphi consensus method was used to elicit consensus on potential helping statements to be included in the guidelines. These statements describe helping actions that Indigenous community members and non-Indigenous frontline workers can take, and information they should have, to help someone who is engaging in NSSI. The statements were sourced from systematic searches of peer-reviewed literature, grey literature, books, websites and online materials, and existing NSSI courses. A panel was formed, comprising 26 Aboriginal and Torres Strait Islanders with expertise in NSSI. The panellists were presented with the helping statements via online questionnaires and were encouraged to suggest re-wording of statements and any additional helping statements that were not included in the original questionnaire. Statements were only accepted for inclusion in the guidelines if they were endorsed by ≥90% of panellists as essential or important. Results: From a total of 185 statements shown to the expert panel, 115 were endorsed as helping statements to be included in the re-developed guidelines. Conclusions: A panel of Aboriginal and Torres Strait Islander people with expertise in NSSI were able to reach consensus on appropriate strategies for providing mental health first aid to an Aboriginal and Torres Strait Islander engaging in NSSI. The re-development of the guidelines has resulted in more comprehensive guidance than the earlier version. The re-developed guidelines will form the basis of an Aboriginal mental health first aid short course on NSSI for Indigenous community members and non-Indigenous frontline workers that will be evaluated in an upcoming trial. [ABSTRACT FROM AUTHOR]

Background: Despite showing high rates of depression, university students prefer to seek assistance for their depression from informal sources, such as their friends, rather than seeking professional assistance. Therefore, the helping behaviours of those who provide informal help to these students need examination. This study examines the helping intentions of undergraduates in Sri Lanka towards their depressed peers and the correlates of their helping intentions. Method: The undergraduates were presented with a vignette of a hypothetical depressed undergraduate. A total of 4442 undergraduates responded to an open-ended question about how the person in the vignette should be helped if this person was someone they knew well. Their responses were coded in reference to established mental health first aid guidelines. Logistic and linear regression models were used to examine the predictors of their helping intentions. Results: The undergraduates' most common helping intentions were to listen/talk and support their peer. Only around a third considered the need for professional help. The overall quality of their helping intentions was poor, but better among those who recognised the problem as depression and those who had less stigmatising attitudes. There was some evidence that certain helping intentions of the undergraduates which were person-oriented or social networkrelated were better among females, those in higher years of study and among certain non-medical student groups. Intentions to encourage professional help were better among those who recognised the problem, but poorer among those with personal experiences of this problem and among those who perceived this problem to be a weakness and not a sickness. Conclusions: Although the undergraduates may attempt to support their distressed peers, they may not show appropriate helping actions and may not encourage the use of professional assistance. Hence, they need to be educated on how best to respond to their distressed peers. Those with higher levels of stigma and inability to recognise the problem may be at greater risk of showing poorer helping responses towards their distressed peers. [ABSTRACT FROM AUTHOR]

Background: Sri Lanka has one of the highest suicide rates in the world. Gatekeeper programs aimed at specific target groups could be a promising suicide prevention strategy in the country. The aim of this study was to develop guidelines that help members of the public to provide first aid to persons in Sri Lanka who are at risk of suicide. Methods: The Delphi method was used to elicit consensus on potential helping statements to include in the guidelines. These statements describe information members of the public should have and actions they can take to help a person who is experiencing suicidal thoughts. An expert panel, comprised of mental health and suicide experts in Sri Lanka, rated each statement. The panellists were encouraged to suggest any additional action that was not included in the original questionnaire and, in particular, to include items that were culturally appropriate or gender specific. Responses to open-ended questions were used to generate new items. These items were included in the subsequent Delphi rounds. Three Delphi rounds were carried out. Statements were accepted for inclusion in the guidelines if they were endorsed (rated as essential or important) by at least 80 % of the panel. Statements endorsed by 70-79 % of the panel were re-rated in the following round. Statements with less than 70 % endorsement, or re-rated items that did not receive 80 % or higher endorsement were rejected. Results: The output from the Delphi process was a set of endorsed statements. In the first round questionnaire 473 statements were presented to the panel and 58 new items were generated from responses to the open-ended questions. Of the total 531 statements presented, 304 were endorsed. These statements were used to develop the suicide first aid guidelines for Sri Lanka. Conclusion: By engaging Sri Lankans who are experts in the field of mental health or suicide this research developed culturally appropriate guidelines for providing mental health first aid to a person at risk of suicide in Sri Lanka. The guidelines may serve as a basis for developing training for members of the public to provide mental health first aid to persons at risk of suicide as part of Sri Lanka's suicide prevention strategy. [ABSTRACT FROM AUTHOR]

Little is known about the relationship between adults' intentions to assist a hypothetical person experiencing a mental illness and their subsequent first aid actions in reality. This study examines whether the quality of respondents' stated first aid intentions predicts the quality of their helping behaviour towards a person they know in real life. A convenience sample of 820 Australian adults completed two surveys six months apart which asked questions about a hypothetical person experiencing depression with suicidal thoughts, and how they had assisted someone with a similar problem in their lives. The quality of helping intentions at baseline predicted the quality of mental health first aid behaviours at follow-up, as did the quality of past behaviours. In particular, people who intended to assess and assist with the crisis situation in the vignette were five times more likely to perform the same action when helping someone they knew. The quality of past intentions and behaviour, and confidence in helping, were the most significant predictors of behaviour at follow-up. These findings suggest that adults' mental health first aid intentions can be used to predict their subsequent behaviours, therefore, educating communities about effective first aid responses may increase future rates of appropriate help. [ABSTRACT FROM AUTHOR]

There is a significant link between financial difficulties and mental health problems. Those with financial difficulties and mental health problems may be more willing to seek help for financial difficulties than for mental health problems. Therefore, the aim of this study was to determine if Mental Health First Aid (MHFA) training is effective in improving financial counsellors' ability to recognise mental health problems in clients and appropriately support them to get help. Between December 2013 and July 2014, financial counsellors (n = 113) completed either face-to-face or online MHFA training and pre- and post-course surveys measuring MHFA intentions, mental health literacy and stigmatising attitudes. Results showed that MHFA training improved first aid intentions, mental health literacy and confidence in providing help, and reduced stigmatising attitudes. The findings suggest that financial counsellors are in a good position to support clients with mental health problems to get appropriate care and moreover, that MHFA is an appropriate form of training for them. [ABSTRACT FROM PUBLISHER]

Background: Many adolescents have poor mental health literacy, stigmatising attitudes towards people with mental illness, and lack skills in providing optimal Mental Health First Aid to peers. These could be improved with training to facilitate better social support and increase appropriate help-seeking among adolescents with emerging mental health problems. teen Mental Health First Aid (teen MHFA), a new initiative of Mental Health First Aid International, is a 3 × 75 min classroom based training program for students aged 15-18 years. Methods: An uncontrolled pilot of the teen MHFA course was undertaken to examine the feasibility of providing the program in Australian secondary schools, to test relevant measures of student knowledge, attitudes and behaviours, and to provide initial evidence of program effects. Results: Across four schools, 988 students received the teen MHFA program. 520 students with a mean age of 16 years completed the baseline questionnaire, 345 completed the post-test and 241 completed the three-month follow-up. Statistically significant improvements were found in mental health literacy, confidence in providing Mental Health First Aid to a peer, help-seeking intentions and student mental health, while stigmatising attitudes significantly reduced. Conclusions: teen MHFA appears to be an effective and feasible program for training high school students in Mental Health First Aid techniques. Further research is required with a randomized controlled design to elucidate the causal role of the program in the changes observed. [ABSTRACT FROM AUTHOR]

Objective Method Results Discussion Trial registration This study involves a cluster randomised controlled trial (cRCT) of the effectiveness of Mental Health First Aid (MHFA) Training for China.A two-arm wait- list cRCT will be conducted in 6 settings: 2 health services, 2 workplaces and 2 community settings in Shanghai. We aim to include a total of 120 participants. The cluster level will be defined as the setting. Intervention settings will be paired according to type and one of each pair will be randomly allocated to the intervention (the MHFA Training for China) or the wait-list control group, with a 1:1 allocation.Participants will be asked to complete questionnaires at baseline (T1) and 1 month (T2) and 7 months after completing the training (T3). Participants in the control group will be asked to complete questionnaires at corresponding times. The primary outcome will be intended support towards someone experiencing a mental health problem or in a mental health crisis. Secondary outcome measures will include recognition of depression in a vignette; beliefs about the helpfulness of interventions; helping actions; confidence in providing mental health first aid; and stigmatising attitudes towards a person with a mental health problem.Findings will demonstrate whether the culturally adapted MHFA Training for China can enhance intended support, knowledge, attitudes and supportive actions towards someone developing a mental health problem or in a mental health crisis.Findings could provide evidence for disseminating MHFA Training for China more widely, potentially improving support for people experiencing mental health problems and benefiting their wellbeing.The trial is registered with the International Standard Randomised Controlled Trial Number’ (ISRCTN) Registry. Date 18 February 2023, ISRCTN21096283. [ABSTRACT FROM AUTHOR]

The aim of the study was to carry out a survey of Japanese high school students in order to assess their beliefs about how best to help those with depression, social phobia and psychosis/schizophrenia. In 2011, 311 Japanese high school students aged 15–19 years filled out an anonymous self-report questionnaire distributed via teachers. Participants were given a case vignette describing depression, schizophrenia or social phobia. Subsequent questions covered their beliefs about the best way to help the person (mental health first-aid actions). The first-aid actions most commonly rated as helpful were listening to the person's problems in an understanding way and talking to the person firmly about getting their act together. Less than 20% of respondents rated suggesting professional help seeking as likely to be helpful. First-aid intentions and beliefs about first-aid behaviours in young Japanese people are of relatively low quality. As part of education to improve mental health literacy in Japan, young people need to be informed about avoiding potentially harmful forms of interaction with those developing mental disorders, as well as about potentially helpful ones, with a particular focus on facilitating professional help seeking. [ABSTRACT FROM PUBLISHER]

Background Courses such as Mental Health First Aid equip members of the public to perform appropriate helping behaviours towards people experiencing a mental illness or mental health crisis. However, studies investigating the general public's knowledge and skills in relation to assisting a person with a mental illness are rare. This study assesses the quality of mental health first aid responses by members of the Australian public using data from a national survey. Methods Participants in a national survey of mental health literacy were assigned one of six vignettes (depression, depression with suicidal thoughts, early schizophrenia, chronic schizophrenia, social phobia or post-traumatic stress disorder) and asked an open-ended question about how they would help the character in the vignette. The 6,019 respondents were also asked if and how they had helped a person in real life with a similar problem. Responses to these questions were scored using a system based on an action plan developed from expert consensus guidelines on mental health first aid. Results The quality of responses overall was poor, with participants scoring an average of 2 out of 12. The most commonly reported actions for both questions were listening to the person, providing support and information and encouraging them to seek appropriate professional help. Actions such as assessing and assisting with crisis were rarely mentioned, even for the depression with suicidal thoughts vignette. Conclusions The quality of the Australian public's mental health first aid knowledge and skills requires substantial improvement. Particular attention should be given to helping people recognise that anxiety disorders such as social phobia require professional help and to improving responses to a suicidal person. [ABSTRACT FROM AUTHOR]

Aim: Mental health first aid guidelines provide the public with consensus-based information about how to assist someone who is developing a mental illness or experiencing a mental health crisis. The aim of the current study was to evaluate the usefulness and impact of the guidelines on web users who download them. Method: Web users who downloaded the documents were invited to respond to an initial demographic questionnaire, then a follow up about how the documents had been used, their perceived usefulness, whether first-aid situations had been encountered and if these were influenced by the documents. Results: Over 9.8 months, 706 web users responded to the initial questionnaire and 154 responded to the second. A majority reported downloading the document because their job involved contact with people with mental illness. Sixty-three web users reported providing first aid, 44 of whom reported that the person they were assisting had sought professional care as a result of their suggestion. Twenty-three web users reported seeking care themselves. A majority of those who provided first aid reported feeling that they had been successful in helping the person, that they had been able to assist in a way that was more knowledgeable, skilful and supportive, and that the guidelines had contributed to these outcomes. Conclusions: Information made freely available on the Internet, about how to provide mental health first aid to someone who is developing a mental health problem or experiencing a mental health crisis, is associated with more positive, empathic and successful helping behaviours. [ABSTRACT FROM AUTHOR]

Objective: Mental Health First Aid training is a course for the public that teaches how to give initial help to a person developing a mental health problem or in a mental health crisis. The present study evaluated the effects of Mental Health First Aid training delivered by e-learning on knowledge about mental disorders, stigmatizing attitudes and helping behaviour. Method: A randomized controlled trial was carried out with 262 members of the Australian public. Participants were randomly assigned to complete an e-learning CD, read a Mental Health First Aid manual or be in a waiting list control group. The effects of the interventions were evaluated using online questionnaires pre- and post-training and at 6-months follow up. The questionnaires covered mental health knowledge, stigmatizing attitudes, confidence in providing help to others, actions taken to implement mental health first aid and participant mental health. Results: Both e-learning and the printed manual increased aspects of knowledge, reduced stigma and increased confidence compared to waiting list. E-learning also improved first aid actions taken more than waiting list, and was superior to the printed manual in reducing stigma and disability due to mental ill health. Conclusions: Mental Health First Aid information received by either e-learning or printed manual had positive effects, but e-learning was better at reducing stigma. [ABSTRACT FROM AUTHOR]

Abstract: Background: It is unclear how members of the public can best support individuals who are developing a depressive episode before appropriate professional help is received. Methods: To assess expert consensus, we used the Delphi Method. An expert panel consisting of 167 mental health consumers, carers and clinicians was recruited from developed English-speaking countries. A 99-item questionnaire about how to help someone with depression was developed from a variety of resources. The panel members rated each item according to whether they believed the statement should be included in the first aid recommendations. The results were analysed by comparing consensus rates across the three groups. Three rounds were required to consolidate consensus levels. Results: Sixty-four items were endorsed by ≥80% of panel members from all three groups as essential or important. These items were grouped under the following headings: recognising and acknowledging depression; approaching someone who may be depressed; how to be supportive; what is not helpful for a person who may have depression; whether to encourage the person to seek professional help; whether to encourage the person to use self-help strategies; what to do if the person does not want help. Limitations: These recommendations may not be applicable outside developed English-speaking countries. Conclusions: By informing the content of training courses, these recommendations will improve the provision of first aid to individuals who are developing a depressive episode and facilitate the uptake of appropriate professional help. [Copyright &y& Elsevier]

Objective: To review studies evaluating mental health first aid (MHFA) training. Method: Review of three published trials: one uncontrolled with members of the public in a city, one randomized controlled efficacy trial in a workplace setting and one cluster randomized effectiveness trial with the public in a rural area. Results: Most mental health first aiders tend to be middle-aged women whose work involves people contact. All trials found the following statistically significant benefits 5–6 months post-training: improved concordance with health professionals about treatments, improved helping behaviour, greater confidence in providing help to others and decreased social distance from people with mental disorders. Only one trial evaluated the mental health benefits to participants and this found positive effects. Conclusions: Although MHFA training has been found to change knowledge, attitudes and helping behaviours, and even benefit the mental health of participants, there has not yet been an evaluation of the effects on those who are the recipients of the first aid. [ABSTRACT FROM AUTHOR]

Background: Members of the public can potentially take action to assist someone in their social network who is distressed and at risk of suicide. The present study used data from a community survey to examine training experiences and sociodemographic factors associated with the quality of assistance provided in such situations. Methods: A national telephone survey using random digit dialing was carried out with Australian adults on attitudes and intentions toward helping someone in severe distress or at risk of suicide, as well as actions taken. Participants were asked open-ended questions about their intentions to assist a hypothetical person in a vignette and about any actions they took to assist a family member or friend in distress over the previous 12 months. Each participant randomly received 1 of 6 vignettes which varied by gender and degree of suicidality portrayed. 3002 participants provided data on intentions and 932 on actions taken. Quality of Intentions and Quality of Actions were scored on 12-point scales. Results: Quality of Intentions and Quality of Actions correlated 0.28. Quality of Intentions was associated with more overt suicidality in the vignette, age 31–59 years, female gender, university education, speaking English at home, being non-Indigenous and all forms of suicide training (professional, Mental Health First Aid and other). Quality of Actions was associated with female gender, university education and other suicide training. Conclusions: Training on suicide prevention is associated with better quality of intentions and actions to help a person at risk of suicide. There are sub-groups in the population who are in greater need of such training because they have poorer quality of intentions to help and are less likely to have received training. These include males, less educated people and people from non-English speaking backgrounds. [ABSTRACT FROM AUTHOR]

Abstract: Background: Youths are important sources of first aid for people close to them who are experiencing mental health problems, but their skills are not optimal. A better understanding of predictors of young people''s first aid intentions and beliefs will facilitate future efforts to improve their mental health first aid skills. Methods: Young people''s first aid intentions and beliefs were assessed by a national telephone survey of 3746 Australian youth aged 12–25years in 2006. A similar survey was repeated in 2011 with 3021 youths aged 15–25years. In both surveys, youths were presented with a vignette portraying depression, psychosis, social phobia, or depression with alcohol misuse in a young person. The 2011 survey also included depression with suicidal thoughts and post-traumatic stress disorder. Respondents reported on any past-year experience of mental health problems and treatment, exposure to beyondblue and mental health information at school or work. Results: The potential value of encouraging professional treatment was not universally recognized, although young people were mostly aware of and reported the intention to take supportive actions. Respondent age, sex, experience of mental health problems, type of mental disorder, and exposure to mental health information at school, work, or beyondblue all predicted some intentions and beliefs. Some improvements in beliefs were observed between surveys. Limitations: Actual first aid actions and their helpfulness were not measured. Conclusions: Future efforts should target adolescents, males and those with recent mental health problems who had not received help. Beyondblue and school and work settings may be promising avenues for these efforts. [Copyright &y& Elsevier]

While peers are a common source of informal help for young people with a mental health problem, evidence suggests that the help they provide is inadequate. By examining predictors of the quality of mental health first aid provided by adolescents to their peers, future interventions can be targeted to adolescents most at risk of providing poor help. Students ( n =518) from Australian secondary schools were presented with two vignettes, depicting persons experiencing depression with suicidal thoughts, and social phobia. Participants were asked what they thought was wrong with the person, and how they would help them. Stigma towards the person was also assessed. Additionally, participants were asked if they had recently helped anyone in their own lives with a mental health problem, and, if so, what they did. The overall quality of help reported in response to the vignettes or an actual person was low; a particular inadequacy was the low rate of engaging the help of an adult. Being female, and believing that the person is sick rather than weak, consistently predicted better help-giving. [ABSTRACT FROM AUTHOR]