Mental health first aid training
Mental health first aid training teaches members of the public how to help a person who is experiencing varying degrees of worsening mental health issues. [1] Like traditional first aid training, mental health first aid training does not teach people to treat or diagnose mental health or substance use conditions. [2] Instead, the training teaches people how to offer initial support until appropriate professional help is received or until the crisis resolves. [2]
History
The first mental health first aid training program was developed in Australia in 2001 by a research team led by Betty Kitchener and Anthony Jorm. [3] The program was created to teach members of the general public how to provide initial support to people experiencing mental health problems, as well as to connect them with appropriate professional help and community resources. [4] They tested the idea that giving first aid for mental health could lessen the effects of mental health problems, speed up recovery, and make suicide less likely by educating students on common mental health crises [1] including feelings of suicide, deliberate self-harm, panic attacks, or symptoms of psychosis, and how to deal with these situations. [1] [5] The idea was to reduce the stigma associated with mental illness and make it more likely that people with mental health problems would seek help, which would reduce the risk of the person coming to harm. [1]
Mental health first aid training programs are provided by different organizations around the world, many of them non-profit. They have been implemented in countries such as the United States, Canada, the United Kingdom, Ireland, and a number of other European, Asian, and African countries. [6]
Public reception
General media articles and videos indicate that mental health first aid training has political and celebrity proponents, such as former US president Barack Obama, [7] former US first lady Michelle Obama, [8] and singer/actress Lady Gaga. [9]
A few bills of law have been proposed by politicians in countries such as Australia [10] and the United Kingdom [11] to make mental health first aid training compulsory in schools and other organizations. Although considered good practice in several countries, mental health first aid training is not legally imposed for organizations anywhere in the world.
Curriculum
The curriculum for mental health first aid training typically includes the following topics:
- Symptoms associated with common mental health conditions such as depression, anxiety, schizophrenia, bipolar disorder, and eating disorders, as well as a general overview of mental health and mental illnesses. [5] [2]
- Common warning signs of mental illnesses, such as mood, behavior, and cognitive changes. [5]
- Information about local counseling and psychiatric services, and how to help others gain access to them. [5]
Using the knowledge from those topics, participants are trained on a step-by-step action plan for providing mental health first aid, including how to: [12]
- Evaluate the risk of suicide or harm
- Approach safely and appropriately
- Listen non-judgmentally
- Provide reassurance
- Encourage appropriate professional assistance
- Promote self-help
- Additional support strategies
Depending on the program, there may be additional modules that target specific populations, such as children and adolescents, the elderly, or veterans. [13] or conditions such as substance use disorder and its related issues and challenges. [13] All of these topics are covered in order to develop participants' mental health literacy which consists of the knowledge, skills, and confidence necessary to recognize and respond appropriately to signs of mental illness and substance use disorders. [13]
Research on mental health first aid training
A number of systematic reviews and meta-analyses have been carried out to review data concerning the effectiveness of mental health first aid training on participants' knowledge of mental health conditions and subsequent helping behaviors. [2]
A meta-analysis conducted in 2014 concluded that mental health first aid training increases participants' knowledge of mental health, reduces their negative views, and increases their supportive behaviors toward people with mental health issues. [14]
A meta-analysis conducted in 2018 concluded that mental health first aid training enhances participants' knowledge, awareness, and beliefs about successful treatments for mental diseases. [15] At follow-up, there were slight improvements in the amount of assistance provided to a person with a mental health problem, but the nature of the change in the offered behaviors was unclear. [15]
A systematic review conducted in 2020 showed that mental health first aid training had conflicting effects on how trainees applied the skills they learned, but no influence on how beneficial their actions were for the mental health of the recipients. [16]
A systematic review conducted in 2020 focused on youth and adolescent mental health first aid training and found significant improvements in the understanding, recognition, stigmatizing perceptions, helping motivations, and helping behavior of youth and adolescent participants. [17] The most frequently stated improvement was in knowledge and confidence, while the least frequently reported improvement was in helping behavior. [17]
As of 2024, the mental health first aid programme has been exported to over 25 countries and trained up over 6 million people worldwide, with over 1 million trained within Australia [18] [19]
Cognitive behavioral therapy (CBT) is a form of psychotherapy that aims to reduce symptoms of various mental health conditions, primarily depression, PTSD and anxiety disorders. Cognitive behavioral therapy focuses on challenging and changing cognitive distortions and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed as an approach to treat depression, CBT is often prescribed for the evidence-informed treatment of many mental health and other conditions, including anxiety, substance use disorders, marital problems, ADHD, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies.
Involuntary commitment, civil commitment, or involuntary hospitalization/hospitalisation is a legal process through which an individual who is deemed by a qualified person to have symptoms of severe mental disorder is detained in a psychiatric hospital (inpatient) where they can be treated involuntarily. This treatment may involve the administration of psychoactive drugs, including involuntary administration. In many jurisdictions, people diagnosed with mental health disorders can also be forced to undergo treatment while in the community; this is sometimes referred to as outpatient commitment and shares legal processes with commitment.
Electroconvulsive therapy (ECT) or electroshock therapy (EST) is a psychiatric treatment during which a generalized seizure is electrically induced to manage refractory mental disorders. Typically, 70 to 120 volts are applied externally to the patient's head, resulting in approximately 800 milliamperes of direct current passing between the electrodes, for a duration of 100 milliseconds to 6 seconds, either from temple to temple or from front to back of one side of the head. However, only about 1% of the electrical current crosses the bony skull into the brain because skull impedance is about 100 times higher than skin impedance.
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by executive dysfunction occasioning symptoms of inattention, hyperactivity, impulsivity and emotional dysregulation that are excessive and pervasive, impairing in multiple contexts, and developmentally-inappropriate.
Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. According to the World Health Organization (WHO), it is a "state of well-being in which the individual realizes his or her abilities, can cope with the normal stresses of life, can work productively and fruitfully, and can contribute to his or her community". It likewise determines how an individual handles stress, interpersonal relationships, and decision-making. Mental health includes subjective well-being, perceived self-efficacy, autonomy, competence, intergenerational dependence, and self-actualization of one's intellectual and emotional potential, among others.
Despite the scientifically well-established nature of attention deficit hyperactivity disorder (ADHD), its diagnosis, and its treatment, each of these has been controversial since the 1970s. The controversies involve clinicians, teachers, policymakers, parents, and the media. Positions range from the view that ADHD is within the normal range of behavior to the hypothesis that ADHD is a genetic condition. Other areas of controversy include the use of stimulant medications in children, the method of diagnosis, and the possibility of overdiagnosis. In 2009, the National Institute for Health and Care Excellence, while acknowledging the controversy, stated that the current treatments and methods of diagnosis are based on the dominant view of the academic literature.
Emotional and behavioral disorders refer to a disability classification used in educational settings that allows educational institutions to provide special education and related services to students who have displayed poor social and/or academic progress.
Bipolar disorder in children, or pediatric bipolar disorder (PBD), is a rare mental disorder in children and adolescents. The diagnosis of bipolar disorder in children has been heavily debated for many reasons including the potential harmful effects of adult bipolar medication use for children. PBD is similar to bipolar disorder (BD) in adults, and has been proposed as an explanation for periods of extreme shifts in mood called mood episodes. These shifts alternate between periods of depressed or irritable moods and periods of abnormally elevated moods called manic or hypomanic episodes. Mixed mood episodes can occur when a child or adolescent with PBD experiences depressive and manic symptoms simultaneously. Mood episodes of children and adolescents with PBD are different from general shifts in mood experienced by children and adolescents because mood episodes last for long periods of time and cause severe disruptions to an individual's life. There are three known forms of PBD: Bipolar I, Bipolar II, and Bipolar Not Otherwise Specified (NOS). The average age of onset of PBD remains unclear, but reported age of onset ranges from 5 years of age to 19 years of age. PBD is typically more severe and has a poorer prognosis than bipolar disorder with onset in late-adolescence or adulthood.
A residential treatment center (RTC), sometimes called a rehab, is a live-in health care facility providing therapy for substance use disorders, mental illness, or other behavioral problems. Residential treatment may be considered the "last-ditch" approach to treating abnormal psychology or psychopathology.
Mental health literacy has been defined as "knowledge and beliefs about mental disorders which aid their recognition, management and prevention. Mental health literacy includes the ability to recognize specific disorders; knowing how to seek mental health information; knowledge of risk factors and causes, of self-treatments, and of professional help available; and attitudes that promote recognition and appropriate help-seeking". The concept of mental health literacy was derived from health literacy, which aims to increase patient knowledge about physical health, illnesses, and treatments.
Parent management training (PMT), also known as behavioral parent training (BPT) or simply parent training, is a family of treatment programs that aims to change parenting behaviors, teaching parents positive reinforcement methods for improving pre-school and school-age children's behavior problems.
Youth suicide is when a young person, generally categorized as someone below the legal age of majority, deliberately ends their own life. Rates of youth suicide and attempted youth suicide in Western societies and elsewhere are high. Female youth are more likely to attempt suicide than male youth but less likely to die from their attempt. For example, in Australia, suicide is second only to motor vehicle accidents as its leading cause of death for adolescents and young adults aged 15 to 25.
Major depressive disorder, often simply referred to as depression, is a mental disorder characterized by prolonged unhappiness or irritability. It is accompanied by a constellation of somatic and cognitive signs and symptoms such as fatigue, apathy, sleep problems, loss of appetite, loss of engagement, low self-regard/worthlessness, difficulty concentrating or indecisiveness, or recurrent thoughts of death or suicide.
Mindfulness-Based Stress Reduction (MBSR) therapy is a mindfulness-based program (MBP) designed for stress management and used to treat other conditions. It is structured as an eight to ten week group program.
Triple P is a parenting intervention with the main goals of increasing the knowledge, skills, and confidence of parents and reducing the prevalence of mental health, emotional, and behavioral problems in children and adolescents. The program was originally specifically tailored for at risk children and parents, but there are now different levels of Triple P designed to work together as a broad, universal, public health approach. This program is based on principles of community psychology.
Betty Ann Kitchener is an Australian Mental Health educator who co-founded Mental health first aid training along with Professor Anthony Jorm.
Australian Rotary Health (ARH) is a national, not-for-profit organisation which funds health research and provides community education about health in Australia. The organisation supports work on a broad range of health problems, but specialises in mental health. It is supported by Australian Rotary Clubs.
Prevention of mental disorders are measures that try to decrease the chances of a mental disorder occurring. A 2004 WHO report stated that "prevention of these disorders is obviously one of the most effective ways to reduce the disease burden." The 2011 European Psychiatric Association (EPA) guidance on prevention of mental disorders states "There is considerable evidence that various psychiatric conditions can be prevented through the implementation of effective evidence-based interventions." A 2011 UK Department of Health report on the economic case for mental health promotion and mental illness prevention found that "many interventions are outstandingly good value for money, low in cost and often become self-financing over time, saving public expenditure". In 2016, the National Institute of Mental Health re-affirmed prevention as a research priority area.
The relationships between digital media use and mental health have been investigated by various researchers—predominantly psychologists, sociologists, anthropologists, and medical experts—especially since the mid-1990s, after the growth of the World Wide Web and rise of text messaging. A significant body of research has explored "overuse" phenomena, commonly known as "digital addictions", or "digital dependencies". These phenomena manifest differently in many societies and cultures. Some experts have investigated the benefits of moderate digital media use in various domains, including mental health, and treating mental health problems with novel technological solutions. Studies have also suggested that certain digital media use, such as online support communities, may offer mental health benefits, although the effects are quite complex.
Anthony Jorm is an Australian researcher who has made contributions in the areas of psychology, psychiatry and gerontology. He also co-founded mental health first aid training with mental health educator Betty Kitchener.
