Evaluation

Mental Health First Aid Research

There is a program of research to evaluate the effects of the Mental Health First Aid (MHFA) training course. So far, four studies have been completed:

1. Uncontrolled trial with the public in 2001

The first evaluation study of MHFA was an uncontrolled trial in 2001 with members of the public living in Canberra. This trial examined the effects of the course on knowledge of mental disorders, stigmatizing attitudes and help provided to others. There were 210 participants who were given questionnaires at the beginning of the course, at the end, and at 6 months follow-up. The course was found to produce the following benefits:

Better recognition of mental disorders from case vignettes.
Changed beliefs about treatment to be more like those of health professionals.
Decreased social distance from people with mental disorders.
Increased confidence in providing help.
Increase in the amount of help provided to others.

Download full report of uncontrolled trial from BMC Psychiatry 2002, 2:10.
http://www.biomedcentral.com/content/pdf/1471-244X-2-10.pdf (Opens in new window).

There is also a report of this article in the British Medical Journal 16 November 2002 :
http://bmj.com/cgi/content/full/325/7373/1133 (Opens in new window).

2. Controlled trial of MHFA in the workplace in 2002

Because the first study had no control group, a second trial was conducted in which course participants were compared with a wait-list control group. This randomized controlled trial was carried out in 2002 with employees of two Australian government departments who did the course during their work time. This trial involved 301 participants who were randomized to either participate immediately in a course or to be wait-listed for 5 months before undertaking the training. The trained group improved more than the wait-list control group in the following areas:

Greater confidence in providing help to others.
Greater likelihood of advising people to seek professional help.
Improved concordance with health professionals about treatments.
Decrease in stigmatizing attitudes.
Improved mental health in the participants themselves.

The mental health benefits of the course to participants were unexpected because the course does not provide therapy and promises no personal benefits. We think the course may mental health benefits by providing participants with good quality information which allows them to make better choices about their own mental health care.

Download full report of workplace trial from BMC Psychiatry 2004, 4:23. http://www.biomedcentral.com/content/pdf/1471-244X-4-23.pdf (Opens in new window).

3. Controlled trial of MHFA with the public in a rural area in 2003

A trial has been carried out with members of the public in a large rural area of New South Wales. This trial was carried out as a partnership between the New South Wales Southern Area Health Service and the Centre for Mental Health Research. In this trial, the catchment area of the Southern Area Health Service was divided into 16 local government areas. Eight of these areas received the course immediately and the other 8 were placed on a waiting list to receive the training later in the year (the controls). There were 753 participants in the trial: 416 of these were in the areas that received the course immediately and 337 were in the control group that was placed on a waiting list to do the course later. People who did the course showed a number of changes relative to the control group:

Better recognition of disorders from case descriptions of a person with either depression or schizophrenia.
Less negative attitudes towards people with mental disorders.
More like health professionals in their beliefs about what treatments are likely to be helpful
Greater confidence in providing help to someone.
More likely to actually provide help to someone.

The course did not change the following:

Number of people with mental disorders that the participant had contact with.
Advising people to seek professional help.

As a follow-up to this trial, we are currently doing a qualitative study asking participants about their experiences in providing help after doing the course. We want to find out how many people actually used their skills following the course and whether they had good or bad experiences in doing so.

Download full report of the rural trial from BMC Psychiatry 2004, 4:33. http://www.biomedcentral.com/content/pdf/1471-244X-4-33.pdf(Opens in new window).

4. Qualitative study of first aiders’ experiences.

People who have completed the Mental Health First Aid course often tell stories about how they have used their first aid skills to help someone. These stories are particularly interesting because they tell about the effects of the first aid on the person helped. In order to systematically analyze such stories, 131 former course participants were approached 19-21 months following the course and asked to complete a questionnaire about their experiences. 94 of these people responded. It was found that 78% had used their first aid skills. Many positive effects were reported, including increased empathy and confidence and being better able to handle crises. There was no evidence that people were over-reaching themselves because of over-confidence. Participants were very positive about the benefits of the course and keen to see it repeated and extended.

Download full report of this study from BMC Psychiatry 2005, 5:43
http://www.biomedcentral.com/content/pdf/1471-244X-5-43.pdf(Opens in new window).

5. Australian National Survey Looks at Mental Health First Aid Responses of the Public.

A national survey of 4000 Australian adults has examined how they would respond to someone they know and care about who has a mental disorder. Survey participants were given a description of a person with either depression or schizophrenia and asked what they would do to help the person. Many people said they would listen to the person and encourage professional help-seeking. However, a significant minority did not even mention these basic first aid strategies. Few said they would contact a professional on the person's behalf or accompany them to a professional. Mental health first aid responses were generally more appropriate in women than men, and in participants with less stigmatizing attitudes. Participants who could correctly recognize depression or schizophrenia in the descriptions also had better first aid responses. These results show that mental health first aid skills need improving in a number of areas. They also show that lack of knowledge of mental disorders and stigmatizing attitudes are barriers to people providing first aid.

Download full report of this survey from BMC Psychiatry 2005, 5:9
http://www.biomedcentral.com/content/pdf/1471-244X-5-9.pdf(Opens in new window).

6. MHFA Training: review of evaluation studies.

Australia and New Zealand Journal of Psychiatry 2006;40:6-8

ANZJP trial review 2006 (PDF)

23-Aug-2006