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Suicide among internally displaced people remains an under-researched public health issue especially in conflict affected countries. Given the limited and sometimes inaccessible mental health services, there is a need for scalable evidence-based suicide prevention programmes that could be delivered by trained and supervised non-specialists. The Suicide First Aid Guidelines approach aims to support humanitarian workers who deal directly with children and families with the appropriate knowledge and skills to identify and support those at risk of suicide until they can access further specialized support services or until the crisis passes.\ud \ud This paper presents the findings of an online pilot training of 56 humanitarian workers from different sectors (e.g. Child Protection, Nutrition and Mental Health and Psychosocial Support) in conflict affected areas in Syria. The quantitative and qualitative evaluations were based on pre- and post-training questionnaires and revision journals completed between training sessions. Suggestions and examples provided in the journals and during the trainings were incorporated into the succeeding trainings. This was to contextualize and modify the gatekeeper training to fit the Syrian context and provide adaptations for future research and suicide prevention guidelines. Overall, the evaluation indicated that the pilot training raised awareness and improved participants’ knowledge on how to assist a suicidal person, including warning signs. It also contributed to a positive change in attitude or beliefs towards suicide. Although the pilot training was considered adequate for the Syrian context some improvements were suggested.

Domestic/family violence is a widespread major public health and human rights violation issue that runs across ethno-cultural affiliations and economic status. Relative to the actual incidence of family violence, use of services is low, and delayed for years after onset, within the broader Victorian and Australian community. Utilization is even lower for women from immigrant and refugee communities. It has been noted that family violence service utilization by Indian women immigrants in particular was especially low, relative to the size of the Indian population in Victoria. With the Indian culture understood to be traditionally a strongly male-dominated culture, it was deemed important to explore the nature of family violence experience of Indian women living in Australia, and culturally determined barriers to use of services. A partnership was formed to explore this issue through a participatory community theatre approach. Forum Theatre is a powerful tool that uses theatre for generating community understanding around hard to address issues such as domestic violence. Using such theatre-based ethnography, we aimed to identify the key issues, challenges and needs of Indian immigrant families when accessing and using services that could assist in situations of domestic/family violence.

Background: The concept that "suicide is preventable" is fairly recent in Indonesia. Suicide prevention training is also new for community leaders and laypeople. On the other side, in a collectivistic society like Indonesia, community leaders, neighbours, and friends are essential parts of someone's life. Therefore, guidelines to assist first aiders in preventing suicide is urgently needed.\ud \ud Aim: This study aimed to develop guidelines to recognise key warning signs and provide first aid support to Indonesians at potential immediate risk for suicide.\ud \ud Methods: The guidelines was developed through three steps: (i) systematic literature review; (ii) focus group discussions and interviews; and (iii) expert consensus using the Delphi approach. These steps were taken to ensure that the final guidelines reflected the cultural beliefs and norms of the Indonesian context.\ud Results: Three rounds of Delphi resulted in 460 accepted items out of 539 items generated from the literature search and group and individual interviews. Some key differences with other countries where similar studies were carried out were highlighted.\ud \ud Conclusions: This study emphasised the need for gatekeeper training as the ideal way of educating community members on the guidelines.

Background: An understanding of the cultural aspects of suicidal behavior is essential for the development of culturally appropriate suicide prevention and intervention strategies. Aims: This study explored the attitudes toward youth suicide in 686 Italian, Indian and Australian undergraduate students (18–24 years old). Method: A 21-item suicide attitude inventory titled Attitude towards Youth Suicide (AtYS) scale, included in this paper, was used in the three samples. Results: Four factors were extracted, labeled negative attitudes toward suicide, belief that suicide was not preventable, suicide as acceptable and normal, and the existence of risk signs for suicide. Country differences were found for all four subscales, with Indian students having the most negative attitudes toward suicide. Sex differences were found in all three countries with women, on the whole, having less negative attitudes toward suicide, more belief in the preventability of suicide in India and more belief in risk signs for suicide in Italy. Conclusion: Attitudes are linked to suicide in a complex manner. More quantitative and qualitative studies, including in lower-income and non-English speaking Western societies, are needed.

Visual research methods are increasingly popular within psychology and the social sciences. However, psychology has yet to develop its own specific ethics guidelines for visual research methods. Currently, psychologists undertaking visual and arts-based research draw on ethics guidelines developed by and for allied disciplines that have a more established tradition of visual research, such as visual anthropology and visual sociology. While many of the principles of existing ethics guidelines from allied disciplines are applicable to psychological projects, psychological research has a distinct focus and potential applications, which would benefit from the generation of a set of bespoke guidelines. These should reflect our discipline’s long standing commitment to ethical research practice, and critical stance towards the limitations of inflexible formalistic principles. This article reviews existing guidelines for visual research and provides recommendations for visual research ethics guidelines for psychology, including the importance of ‘staged’ consent, anonymity versus identification, and an expanded field of consideration which may include participants as image producers and owners; the individuals captured in the images taken by participants or researchers and the impact of the research on the eventual audiences for these images.

Access to mental healthcare in low- and middle-income countries (LMICs) is one of the greatest challenges in public health today. One suggestion for improving accessibility is through collaboration between biomedical practitioners and traditional healers. This paper reviews studies of traditional healers’ and biomedical practitioners’ perceptions of collaboration. We conducted a systematic review of online databases, selected journals, and reference lists for relevant studies. Eligible papers were assessed using a tool designed for this review for quality and study characteristics, and qualitative data demonstrating participants’ views were extracted. A total of 14 papers from seven countries were included. The published literature on this topic is relatively homogenous and studies are of variable quality. The findings suggest that, despite differing conceptualisations of mental illness causation, both traditional healers and biomedical practitioners recognise that patients can benefit from a combination of both practices and demonstrate a clear willingness to work together. There are concerns about patients’ safety and human rights regarding traditional methods and some healers are sceptical about the effectiveness of Western psychiatric medication. Despite keeping the inclusion criteria open to all LMICs, 13 of the studies were conducted in Africa, seven of which were in South Africa. This limits the applicability of the findings of this review to the wider LMIC context. The paper concludes with recommendations for research and practice.

This systematic review gathers data from the existing literature on the prevalence and course of psychiatric disorders among unaccompanied refugee minors (URMs). The databases PsychINFO, PubMed, Scopus and Web of Science were searched and reference lists of papers were also manually examined to identify relevant articles. Peer-reviewed journal articles included focused on the mental health of URMs, who were forced to leave their place of residence because of threats of wars. A narrative synthesis was done to analyse the data presented in the studies. Results from the fifteen studies included in the review highlighted the high prevalence of post-traumatic stress disorders (PTSD), depression, and anxiety among URMs. The association between internalizing disorders and exposure to trauma, and time since displacement were examined. Separation from family members, death of parents and close relatives, level of exposure to armed conflicts, and threats to a person were the most frequent stressful life events (SLE) among URMs before migration. Although the number of research done on this vulnerable population is increasing overtime, the review highlights the need for further examination of refugee mental health and the factors affecting symptoms of PTSD, depression, and anxiety.

The aim of this study was to establish mental health and suicide research priorities for people from immigrant and refugee background in Australia. This article focuses on the data relevant to the development of the suicide research agenda. This study was conducted using Delphi consensus method with two rounds of online questionnaires. A total of 138 and 86 participants, respectively, completed the first and second rounds of survey. Participants were policy makers, service providers, academics, service users, and carer advocates in Australia with expertise in mental health and/or suicide among people from immigrant and refugee backgrounds. Of the total 268 research questions included in the questionnaires, 70 questions about suicide were ranked as essential by over 50% respondents (i.e., the set level of consensus). In particular, research questions regarded as the greatest priority related to access and engagement with suicide prevention services, suicide protective and risk factors compared to populations not from immigrant and refugee backgrounds, and culturally appropriate assessment of suicide risk.

Objective In 2017 the number of refugees around the world reached 25.4 million. These people make up one of the most vulnerable populations globally. This study aims to understand the strategies refugees used to cope with the impact on their mental health by the difficult pre- and post-resettlement circumstances they encountered. Methods A systematic review of articles reporting case studies concerning adult refugees’ experiences in the hosting country. The electronic databases searched were: PubMed, The Cochrane Library, PsycINFO, Embase, Scopus and Web of Science. Eligible manuscripts were examined through a narrative synthesis. Results Twenty-two articles fitted the inclusion criteria and four main themes were highlighted: reasons for fleeing; the impact of negative experiences on mental health; supportive experiences and coping strategies; and experiences of mental health treatment. Conclusions Refugees present a significant impact on mental health due to pre- and post-migration experiences. The approach offered to this group and reported as the most effective to deal with such an impact was the multidimensional approach that, besides caring for the psychic aspects, contemplated the cultural context of each one, assisted in housing, employment, financial aid, support with learning the new language and social activities.

SummaryThe World Health Organization report Preventing Suicide: A Global Imperative provides governments with guidance for comprehensive suicide prevention strategies. However, it does not mention the role that compulsory admission to hospital of psychiatric patients should have in policies for suicide prevention. This was a missed opportunity for international discussion and guidance about a measure that, although widely used, is becoming increasingly controversial in light of the existing evidence and human rights norms.

Objective: Suicide rates vary across different cultural groups and some immigrant or refugee populations display higher risk for suicide. This study aimed to produce guidelines to help members of the public provide assistance to a person from an immigrant or refugee background who is having suicidal thoughts or displaying suicidal behaviour.\ud \ud Method: The Delphi expert consensus method was used to identify warning signs and first aid actions to include in guidelines. Forty- four professionals and/or advocates with lived experience were asked to rate whether each statement contained in an online questionnaire should be included in the guidelines and to suggest additional statements considered by the respondent to be particularly relevant to a person from an immigrant or refugee background. The Delphi process started with 473 statements and 80 new items were written based on suggestions from panel members.\ud \ud Results: Out of the total 553 statements, 345 were endorsed as appropriate warning signs or helping actions. These statements were used to develop the guidelines.\ud \ud Discussion: The guidelines specific to people from immigrant or refugee backgrounds contain additional items to those included in similar guidelines for English-speaking countries. The guidelines may be used for gatekeeper training for suicide prevention in culturally diverse societies.

Forgiveness has proven to be beneficial for the physical and mental health of individuals. In sufferers of posttraumatic stress disorder (PTSD) after man-made traumatic events, it is often believed to have a positive effect to forgive the transgressor. This systematic review identifies and presents a summary ofthe literature into the association of symptoms of PTSD with forgiveness after man-made traumatic events. The bibliography databases EMBASE, PubMed/Medline, PsycInfo, PsycExtra, Scopus, and Web of Science were searched. Thirteen studies met the inclusion criteria. The review shows significant differences between individual studies regarding the type of trauma, the setting, the forgiveness concept, and the measurement instruments used for PTSD and forgiveness. Only 1 study could not establish a significant correlation between forgiveness and PTSD symptoms. The other studies found that higher forgiveness levels were associated with lower PTSD-related symptoms scores, but other factors have to be taken into account, as demographic variables, the relationship between transgressor and survivor of trauma, the type and severity of trauma, and other variables were also shown to be relevant.

In many parts of the world, young adult women have higher levels of common mental disorders than men. The exacerbation of domestic violence (DV) by migration is a salient social determinant of poor mental health. Ecological models describe factors contributing to DV as operating at individual, family, cultural, and societal levels. We explored the interplay among these factors in an Indian community living in Melbourne, Australia, in a qualitative participatory action research study using a modified Forum Theater approach. We here present findings on connections between migration, societal factors, and social/family/cultural factors in DV. The study captured the voices of women living in the community as they describe how DV contributes to their emotional difficulties. Improved understanding of the sociocultural dynamics of DV and the associated social distress in this migrant Indian community can be used to guide the development of culturally sensitive prevention and response programs to assist migrant women from the Indian subcontinent who present with psychopathology and suicidal behaviors associated with DV.

Limited research has been conducted worldwide on the experiences that children and young people from refugee backgrounds have with mental health services, despite evidence that they have significant vulnerability to the development of mental health problems and to suicidal behaviour and that those with mental ill-health typically underutilise services. The authors were particularly interested in barriers and facilitators to service access and engagement, and conducted two qualitative research projects to improve understanding of the issues – the first with service providers experienced in the refugee area and the second with young refugee service users. The aim of this project was to compare the perspectives of professionals and service users and to identify similarities and differences. The perspectives of the service users and providers were strikingly similar. The analysis identified 21 implications for policy makers, agencies and practitioners, which ranged from issues concerning cultural sensitivity, background matching and mental health literacy to accessibility, setting boundaries and expectations and implementing a holistic and outreach approach. There is a range of specific, practical measures that policy makers and service providers can introduce to enhance access to and engagement with mental health services for young people from refugee backgrounds.

PURPOSE OF REVIEW: Violence against women and children is increasingly recognized as an important and urgent public health social and human rights issue cutting across geographical socioeconomic and cultural boundaries. There is a large and growing body of literature that demonstrates the negative impact of such violence on the victims mental and physical health as well as several other consequences on them their families and communities. However this literature for the most part comes from the so-called developed countries. This review at the opposite focused on current literature on prevention of domestic/family violence against children and women in low-income and middle-income countries (LMICs). RECENT FINDINGS: Establishing effective prevention programmes for domestic violence against women and children in LMICs requires an understanding of the sociopolitical economic and cultural settings and a multilevel collaboration among various stakeholders. SUMMARY: This review confirms the lack of research in the so-called developing countries and provides suggestions for further research and prevention efforts in this setting.

Mental health is a critical issue in Indonesia, since its population ranks among the top five in the world and the prevalence of common mental disorders is 11.6% of the adult population. However, the need to build an effective mental health-care system that is accessible to the whole population has only been recently addressed. The Aceh tsunami in 2004 brought to the forefront an unexpected window of opportunity to build a mental health-care system. Integration of mental health care into primary health care is a key strategy to close the treatment gap for people with mental disorders. Existing integration of psychologists into primary health care is a big step to meet the shortage of mental health-care specialists. As primary mental health care is an emerging field, the perspectives of Indonesian experts on Indonesian mental health care are needed to develop a curriculum for training psychologists to work in primary health care. In this study, data have been collected through semi-structured interviews with 24 Indonesian mental health experts, and three focus group discussions with 26 psychologists. Overall, experts agreed that to be able to work in primary health-care psychologists should have roles and training ranging from clinical to advocacy skills. Participants also agreed that psychologists should work in the community and contribute to primary health care as service providers and that strong collaborations between psychologists and other primary health-care providers are the key; these can be developed partly through referral and by respecting each other's unique strengths.

A range of service development initiatives has been implemented in Australia to improve the cultural responsiveness of mental health services. In Victoria, cultural portfolio holders (CPHs) are responsible for leading service development activities that address the needs of individuals and families from different cultural backgrounds. The aim of this research was to obtain consensus from CPHs around how their role contributes to improving the cultural responsiveness of mental health services. Information from a literature review and a focus-group discussion with 13 CPHs was used to develop a survey. All CPH network members were then invited to participate in an online study that collected background information and consisted of two surveys. Consensus was reached regarding 42 statements. These concerned activities undertaken by CPHs within services and with other organisations, the position of CPHs within organisational structures and the potential for further developing the CPH role. Cultural portfolio holders have the potential to lead service reforms that can improve an organisation’s cultural responsiveness. To do so they require the support of organisation-based leaders and a statewide transcultural mental health service.

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. Electronic supplementary material The online version of this article (doi:10.1186/s13033-016-0085-3) contains supplementary material, which is available to authorized users.

People from refugee background are known to be vulnerable to the development of mental health problems and to suicide because of the pre-migration events they have experienced and the difficulties associated with moving from their homeland to a usually different society. Concerns have been expressed that, in spite of this, young refugees' rates of contact with mental-health services are substantially lower than expected. This systematic literature review aimed to summarize what is known about the use of mental-health services by children and young people of refugee background and to identify factors that may constitute impediments to service use as well as factors that may facilitate access to and engagement with services. This article presents the main findings in relation to mental-health services utilization by children and young people of refugee background. An overview of literature on the general (i.e. adults or not-youth specific) refugee population has also been included to provide, where possible...

In this article, the authors explored the associations between suicide rates and a large number of sociocultural indexes, within the sociological framework provided by Durkheim and taking into account recent sociological theories. The analyses were performed on a sample of 87 nations and a subsample of posttraditional societies. The authors found strong positive (linear) correlations between suicide rates and measures of secularization, and curvilinear relationships between measures of individualization and suicide rates. Negative associations were found between suicide rates and measures of individualization in a subsample of posttraditional countries. Following the postmodernization and reflexive modernization theories, the authors argue that a new form of individualization is in place in secular–rational societies. This form of individualization exercises a negative effect on suicide rates through its positive influence on social integration and regulation.

Interest in focus group discussions has grown recently, and so has the recognition of them as a valuable method for qualitative data collection. Despite increasing popularity, they are not an easy option, and moderators must find appropriate ways to approach participants to achieve good-quality data. A path to reach this aim is the inclusion in the focus group agenda of some “exercises” (or activity-oriented questions) that are enjoyable and productive supplements to questions. Exercises provide a different way of gathering information and are beneficial, for instance, for more reflective participants. They can help focus the group's attention on the core study topic and also make subsequent comparative analysis more straightforward. They can also be helpful with young people and to discuss sensitive topics. The author describes and provides suggestions for use and examples of several exercises, illustrating their application in a research project investigating the cultural meaning of youth suicide in university students in Italy, India, and Australia.

Different scholars have expressed the same regret for the lack of research on ethnocultural differences in youth suicide behavior and the need to conduct more comparative studies, necessary to develop culturally responsive prevention and intervention strategies. The authors reviewed 82 publications on youth suicide that have considered, to different degrees, the ethnicity/culture of the population studied. Part 1 of this article explored youth suicide rates and methods (SLTB, this issue), while the present paper examines risk and precipitating factors and attitudes toward suicide in young people from a cross-cultural perspective.

The study of ethnocultural aspects of suicidal behaviour is, at the moment, still a neglected area. The relatively few studies available are mainly on adults; young people usually are not examined separately. The authors reviewed 82 publications on youth suicide that have addressed, to different degrees, the ethnicity/culture of the population studied. Following a description of the main characteristics shared by these researches (e.g., predominance of studies on Blacks, Whites, and Hispanics; lack of qualitative methodology, etc.), the rates and methods of youth suicide, from a cross-cultural perspective are discussed.

Refugee young people have been identified as a group with high risk for mental health problems, due to their experience of trauma, forced migration, and stressors associated with settlement. A high prevalence of mental health problems is reported in this group, however some research suggests refugee young people have low rates of mental health service access. There is little information available on barriers and facilitators to mental service delivery for this group. Using data from 15 focus groups and five key informant interviews with a total of 115 service providers from 12 agencies in Melbourne, Australia, this paper explores barriers and facilitators to engaging young people from refugee backgrounds with mental health services. Eight key themes emerged: cultural concepts of mental health, illness, and treatment; service accessibility; trust; working with interpreters; engaging family and community; the style and approach of mental health providers; advocacy; and continuity of care.

Culture is a central but debated concept in many disciplines and its complexity may become an even bigger source of argument in Suicidology. In spite of the intricacy of the study of this construct, the paper illustrates that various scholars have recognised the relevance of culture and ethnicity in the understanding of suicidal behaviour. The author provides evidence of the need to pay more attention to the meaning and interpretation of suicide in cross-cultural research and underlines the necessity to establish cultural-sensitive prevention strategies. The paper closes by providing methodological considerations and suggestions for future research on cultural aspects of suicidal behaviour.

A few years ago I took a break from my position as a researcher at the Global and Cultural Mental Health Unit at the University of Melbourne to pursue further studies in visual anthropology. I wanted to develop my skills in using photography and film—two tools I am passionate about—as research instruments in my fields of interest, cultural psychiatry and global mental health. Harry Minas, the Unit director, had collaborated for several years with the Indonesian Ministry of Health; thanks to this support I was, albeit with a few hurdles, given access to research (by means of ethnographic film-documentary) an issue I felt strongly about: the violations of human rights of people with mental illness.

Mental illness is prevalent in the USA and worldwide. This chapter focuses on poverty and perinatal morbidity as risk factors for mental illness, specifically the association of poverty experience in adolescence and low birth weight with depression in young adulthood. A report by Australia's National Health and Medical Research Council describes the full spectrum of perinatal morbidity, which includes frequent events such as maternal/infant separation due to admission to a special care facility, common conditions such as prematurity, low birth weight, and intrauterine growth restriction, and sentinel events such as major neurological or physical disability. Two depression measures are examined: the Center for Epidemiological Studies Depression (CES-D) scale of depressive symptoms and self-reported clinically diagnosed depression. Mental health is an important facet of overall health in adulthood, yet relatively little research has taken a life-course approach to understanding how illnesses such as depression develop.

Enhancing primary health care to incorporate mental health services is a key strategy for closing the treatment gap for people with mental disorders. The integration of psychological care into primary health care is a critical step in addressing poor access to mental health specialists. As the psychology profession is increasingly called upon to prepare psychologists for primary health care settings, an international experts' consensus is valuable in guiding the development of a high-quality curriculum for psychologists working in the primary health care context. A Delphi method was used to gain a consensus on the most appropriate roles and training for psychologists. Initial constructs and themes were derived from a detailed literature review and sent to 114 international experts in primary mental health care from five continents. Overall, 52 experts who participated agreed that psychologists should have wide-ranging roles and skills including clinical, health promotion and advocacy skills. This study has identified the specific roles and training needed by psychologists to enable them to work more effectively in primary health care settings. The consensus will inform the development of a curriculum for psychologists working in primary health care in Indonesia, and is part of a broader suite of studies.

Background This study aimed to develop guidelines for how a member of the Japanese public should provide mental health first aid to a person who is suicidal. Methods The guidelines were produced by developing a questionnaire containing possible first aid actions and asking an expert panel of 32 Japanese mental health professionals to rate whether each action should be included in the guidelines. The content of the questionnaire was based on a systematic search of the relevant evidence and claims made by authors of consumer and carer guides and websites. The panel members were asked to complete the questionnaire by web survey. Three rounds of the rating were carried and, at the end of each round, items that reached the consensus criterion were selected for inclusion in the guidelines. During the first round, panel members were also asked to suggest any additional actions that were not covered in the original questionnaire (to include items that are relevant to local cultural circumstances, values, and social norms). Responses to these open-ended questions were used to generate new items. Results The output from the Delphi process was a set of agreed upon action statements. The Delphi process started with 138 statements, 38 new items were written based on suggestions from panel members and, of these 176 items, 56 met the consensus criterion. These statements were used to develop the guidelines appended to this article. Conclusions There are a number of actions that are considered to be useful for members of the Japanese public when they encounter someone who is experiencing suicidal thoughts or engaging in suicidal behaviour. Although the guidelines are designed for members of the public, they may also be helpful to health professionals working in health and welfare settings who do not have clinical mental health training.

Background The aim of this project was to investigate in members of the Vietnamese community in Melbourne the impact of Mental Health First Aid (MHFA) training on attitudes to people with mental illness and on knowledge about mental disorders. Our hypotheses were that at the end of the training participants would have increased knowledge of mental disorders and their treatments, and decreased negative attitudes towards people with mental disorders. Methods Respondents were 114 participants in two-day MHFA training workshops for the Vietnamese community in Melbourne conducted by two qualified MHFA trainers. Participants completed the research questionnaire prior to the commencement of the training (pre-test) and at its completion (post-test). The questionnaires assessed negative attitudes towards people with mental illness (as described in four vignettes), ability to recognise the mental disorders described in the vignettes, and knowledge about how to assist someone with one of these disorders. Responses to open-ended questions were content analysed and coded. To evaluate the effect of the training, answers to the structured questions and to the coded open-ended questions given at pre- and post-test were compared using McNemar tests for dichotomous values and Wilcoxon tests for other scores. Results Between pre- and post-test there was significant improvement in recognition of mental disorders; more targeted and appropriate mental health first aid responses, and reduction in inappropriate first aid responses; and negative attitudes to the people described in the vignettes declined significantly on many items of the stigma scale. Conclusion A two-day, MHFA training course for general members of the Vietnamese community in Melbourne demonstrated significant reductions in stigmatising attitudes, improved knowledge of mental disorders and improved knowledge about appropriate forms of assistance to give to people in the community with mental disorder. There is sufficient evidence to scale up to a population level program for the Vietnamese community, and a need for longitudinal evaluation of such a scaled up program.