Long-Term Changes in Beliefs, Knowledge, and Behaviors after Mental Health First Aid USA Training

Introduction: With increasing recognition for the need to increase mental health awareness in the US, federal agencies have invested in providing Mental Health First Aid (MHFA) USA training to the public. MHFA aims to help non-mental health professionals recognize, understand, and respond to signs of mental health and substance use disorders. To date, over one million people in the US have been trained in MHFA. Although MHFA has been well-evaluated internationally, to our knowledge, no evaluation has been completed in the US using a psychometrically-tested instrument. This study aims to evaluate the effectiveness of MHFA by examining changes in trainees’ attitudes, beliefs, knowledge, confidence, and intention to perform MHFA-related behaviors.

Methods: A national, representative sample of 1086 MHFA trainees enrolled in an Adult or Youth MHFA course participated in the study. Participants completed the Mental Health Beliefs and Literacy Scale (MBLS), a reliable tool developed to evaluate the impact of MHFA trainings, at baseline, 3-months, and 6-months post training. Of the 1086 trainees who completed the baseline survey, 222 trainees completed both the 3mo and 6mo follow-up. Changes over time were measured using repeated-measures ANCOVA.

Results: There were significant changes in all 12 constructs between baseline and 3-months, most remaining significant at 6mo follow-up. Trainees reported significant changes over time in their own beliefs and attitudes about mental health problems (p < .005); their obligation to apply the skills they learned (p < .001); and their perceptions about whether people important to them believed they should perform MHFA-prescribed behaviors (p = .001). Trainees reported significant changes over time in both confidence in their ability to perform MHFA-prescribed behaviors (p < .001) and likelihood that they would perform these behaviors (p < .001). In addition, trainees reported increased intent to perform MHFA-prescribed behaviors (p < .001). Trainees’ mental health literacy also increased over time (p < .001). Trainees with low baseline MHFA-recommended behaviors had the most significant changes in these behaviors at 3-months, most of which persisted to 6-months. Participants with minimal or no past mental health training had more substantial improvements in mental health literacy, as well as in the positive value of MHFA-recommended behaviors and confidence in performing them when compared to participants with previous mental health training.

Conclusions: These results suggest that MHFA USA training may be an effective strategy to promote changes in attitudes, beliefs about positive impact, mental health knowledge, confidence, and intention to perform MHFA-related behaviors.