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This systematically evaluated the evidence for Mental Health First Aid (MHFA) training, focusing on trainees’ mental health literacy, attitudes & helping-related behaviours, & impact that MHFA had on people who came into contact with the trainees (the recipients).

It’s said only around 11% of people seek psychological treatment despite its worldwide prevalence, & that a lack of awareness of the significance of symptoms & fear of stigma & social rejection appear to hamper treatment seeking. Further, it’s said “adults with mental illnesses are often perceived by the general public as dangerous and burdensome” (p245).

MHFA is a “manualized interactive curriculum program that educates … about mental illness [and the] main objectives are to increase the trainees’ knowledge of mental health concerns, decrease stigmatizing attitudes … and increase confidence and helping behaviors” (p245).

16 studies met inclusion criteria – 11 Randomised Controlled Trials (RCT) and 5 quasi-RCT. MHFA curriculum involved between 6 to 14-h training protocols.

Results:

Overall, analysis of 16 controlled trials revealed that MHFA is an effective intervention for trainees exposed to the curriculum and that “these findings support the use of MHFA as an educational tool, though there is still room for further improvement” (p257).

Largest effect sizes were found for knowledge outcome (trainees’ awareness of mental health & skills to listen & support) and trainee confidence in helping someone—both moderate effects. Thus, MHFA training increases the mental health literacy of trainees and these gains “appeared to be stable when assessed at follow-up as well”; but authors were surprised that the gains from MHFA when re-assessed later on weren’t stronger.

Trainee attitude (their personal attitudes towards mental health & its stigmas, & social distancing from people with a mental illness) and actual helping behaviour had small effect sizes.

This study found that the confidence to assist was greater than the actual help provided. It’s noted that further research is needed looking at _actual_ helping behaviour given due to MHFA training, rather than just the confidence in helping.

Further, no increase in actual helping behaviour or confidence was found to occur over time – which would be expected if they had more opportunities to provide aid. Authors suggest that perhaps confidence may decrease over time if people don’t use the skills, and since the follow-up period was short, people just may not have had enough time to actually utilise the skills.

MHFA was found to have a small, but statistically significant effect on the trainees’ own degrees of psychological distress – suggesting that it may, to a degree, assist the trainees themselves.

Evidence was evaluated regarding the effects for the recipients of the aid – with no detectable effects being observed for recipients in any of the outcomes (e.g. knowledge, attitudes, help received or sought, psychological distress). It’s said that to date, a major limitation of MHFA research is looking at the effects of MHFA on the people who receive aid.

Improvements to MHFA curriculum may be accelerated by “involving people who have a mental health disorder or have experienced a mental health crisis … in the actual training … [as this] contact with people who have mental illnesses may help reduce stigma” (p258).

In summary, “the results of this meta-analysis support the effectiveness of MHFA for the trainees yet are inconclusive for the recipients.” (p259).

Authors: Amy K. Maslowski, Rick A. LaCaille, Lara J. LaCaille, Catherine M. Reich, Jill Klingner, 2019, Mental Health Review Journal

Study Link: https://doi.org/10.1108/MHRJ-05-2019-0016

Link to the LinkedIn article: https://www.linkedin.com/pulse/effectiveness-mental-health-first-aid-meta-analysis-ben-hutchinson