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]
Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. Cognitive behavioral therapy is one of the most effective means of treatment for substance abuse and co-occurring mental health disorders. CBT 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 to treat depression, its uses have been expanded to include many issues and the treatment of many mental health 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.
A psychiatrist is a physician who specializes in psychiatry. Psychiatrists are physicians and evaluate patients to determine whether their symptoms are the result of a physical illness, a combination of physical and mental ailments or strictly mental issues. Sometimes a psychiatrist works within a multi-disciplinary team, which may comprise clinical psychologists, social workers, occupational therapists, and nursing staff. Psychiatrists have broad training in a biopsychosocial approach to the assessment and management of mental illness.
Electroconvulsive therapy (ECT) or electroshock therapy (EST) is a psychiatric treatment where 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.
Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.
Self-harm is intentional conduct that is considered harmful to oneself. This is most commonly regarded as direct injury of one's own skin tissues usually without a suicidal intention. Other terms such as cutting, self-injury, and self-mutilation have been used for any self-harming behavior regardless of suicidal intent. Common forms of self-harm include damaging the skin with a sharp object or by scratching, hitting, or burning. The exact bounds of self-harm are imprecise, but generally exclude tissue damage that occurs as an unintended side-effect of eating disorders or substance abuse, as well as societally acceptable body modification such as tattoos and piercings.
Generalized anxiety disorder (GAD) is a mental and behavioral disorder, specifically an anxiety disorder characterized by excessive, uncontrollable and often irrational worry about events or activities. Worry often interferes with daily functioning, and individuals with GAD are often overly concerned about everyday matters such as health, finances, death, family, relationship concerns, or work difficulties. Symptoms may include excessive worry, restlessness, trouble sleeping, exhaustion, irritability, sweating, and trembling.
Mental health encompasses emotional, psychological, and social well-being, influencing cognition, perception, and behavior. According to 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. From the perspectives of positive psychology or holism, mental health may include an individual's ability to enjoy life and to create a balance between life activities and efforts to achieve psychological resilience. Cultural differences, personal philosophy, subjective assessments, and competing professional theories all affect how one defines "mental health". Some early signs related to mental health difficulties are sleep irritation, lack of energy, lack of appetite, thinking of harming oneself or others, self-isolating, and frequently zoning out.
Oppositional defiant disorder (ODD) is listed in the DSM-5 under Disruptive, impulse-control, and conduct disorders and defined as "a pattern of angry/irritable mood, argumentative/defiant behavior, or vindictiveness". This behavior is usually targeted toward peers, parents, teachers, and other authority figures, including law enforcement officials. Unlike conduct disorder (CD), those with ODD do not generally show patterns of aggression towards random people, violence against animals, destruction of property, theft, or deceit. One-half of children with ODD also fulfill the diagnostic criteria for ADHD.
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.
Child and adolescent psychiatry is a branch of psychiatry that focuses on the diagnosis, treatment, and prevention of mental disorders in children, adolescents, and their families. It investigates the biopsychosocial factors that influence the development and course of psychiatric disorders and treatment responses to various interventions. Child and adolescent psychiatrists primarily use psychotherapy and/or medication to treat mental disorders in the pediatric population.
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.
Pediatric psychology is a multidisciplinary field of both scientific research and clinical practice which attempts to address the psychological aspects of illness, injury, and the promotion of health behaviors in children, adolescents, and families in a pediatric health setting. Psychological issues are addressed in a developmental framework and emphasize the dynamic relationships which exist between children, their families, and the health delivery system as a whole.
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. 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 in mental health, and the treatment of mental health problems with novel technological solutions.
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.
