Youth mental health first aid for educators of immigrant-origin youth: A mixed-method evaluation of the virtual delivery approach

There is a high prevalence of mental health challenges among immigrant-origin youth (IOY) as a consequence of unique stressors and risk factors, disparities in access to mental health services, and distress associated with the COVID-19 pandemic. Educators and school staff are in need of effective, accessible, and culturally relevant mental health literacy (MHL) training to accurately recognize and appropriately respond to these mental health concerns. The main goal of this pilot study was to examine initial evidence on the effectiveness, utility, acceptability, and cultural fit of the virtual format of the Youth Mental Health First Aid (YMHFA) training program among educators who work with IOY. A mixed-methods approach was employed through quantitative online surveys at pre-training, post-training, and three-month follow-up as well as qualitative virtual focus groups querying educator and school staff's perspectives. Descriptive and inferential analyses were used to quantitatively analyze survey data. Thematic analysis was used to analyze qualitative data. Findings obtained from a total of 36 educators and school staff working predominantly IOY revealed significant improvements in participants' mental health knowledge, confidence to help, and attitudes towards mental illness that were sustained at three-month follow-up, with some variability based on race, prior mental health training experience, and professional role. The content and format of the virtual YMHFA was also found to be highly rated in its utility and acceptability. Themes related to utility included (a) crisis response skills and knowledge and (b) flexible scope of use of the training. Themes related to acceptability included the (a) presentation of information, (b) accessibility and convenience, (c) interactive nature of the training, (d) timing and scheduling, and (e) limited content. Themes highlighting the strengths and weaknesses associated with the cultural relevance of the training included (a) inclusivity and specificity and (b) cultural sensitivity and awareness. Themes related to recommendations to improve the cultural relevance of the training included (a) additional knowledge and resources, (b) improving representation in scenarios and videos, and (c) tailoring content to a target audience. Based on these initial findings, several implications for implementation of YMHFA training in schools, improving the cultural relevance of YMHFA for IOY, and future directions in research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Development of mental health first-aid guidelines for depression: a Delphi expert consensus study in Argentina and Chile.

BACKGROUND: Depression is one of the most common mental health problems worldwide and, while prevalence rates in Latin America are relatively high, most people who meet the criteria for diagnosis do not receive treatment. Family and friends of a person with depression can play an important role in supporting a person to seek and engage with treatment. However, many people do not have the necessary skills or confidence to help. English-language mental health first aid guidelines have been developed to support people to provide such help. The aim of this study was to culturally adapt these guidelines for Chile and Argentina. METHODS: A Delphi expert consensus study was conducted with two expert panels, one of people with lived experience of depression (either their own or as a carer; n = 26) and one of health professionals (n = 29). Overall, 172 statements from the English-language guidelines were translated and compiled into a questionnaire. Participants were asked to rate statements based on how essential or important those statements were for Chile and Argentina and to suggest new statements if necessary. RESULTS: Data were obtained over two survey rounds. Consensus was achieved on 172 statements. A total of 137 statements were adopted from the English-language guidelines, whereas 35 new endorsed statements were generated from panel suggestions. There were similarities between the English-language guidelines and those for Chile and Argentina. The adapted guidelines did not include some of the items from the English-language guidelines related to commenting on a person's strengths or making judgements about their character, and also incorporated new items related to the incorporation of sociocultural considerations as causes of depression and attention to inequities in mental health. CONCLUSIONS: The significant number of new items underscores the importance of undertaking a careful process of cultural adaptation. Further research on dissemination and incorporation of the guidelines into the Mental Health First Aid training course for Chile and Argentina is still required.

3-day intervention program for family members of hikikomori sufferers: A pilot randomized controlled trial.

Backgrounds: Hikikomori, pathological social withdrawal, is becoming a crucial mental health issue in Japan and worldwide. We have developed a 3-day family intervention program for hikikomori sufferers based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). This study aims to confirm the effectiveness of the 3-day program by a randomized controlled trial. Methods: This study was registered on the UMIN Clinical Trials Registry (UMIN000037289). Fifteen parents were assigned to the treat as usual (TAU) group (TAU only; Age Mean, 65.6; SD, 7.8), and 14 to the Program group (program + TAU; Age Mean, 67.9; SD, 8.6). This study was discontinued due to the COVID-19 pandemic; the recruitment rate was 36.3% of our target sample size of 80. Results: Perceived skills improved temporally and stigma temporally worsened in the TAU group. Confidence decreased and attitude showed no change in both groups. Aggressive behaviors of hikikomori sufferers were significantly worsened in the Program group; however, no serious domestic violence was reported. In the TAU group, Avoidance and irregular life patterns were improved. Activity levels were worsened in both groups. Two participants (16.7%) in the Program group and one participant (7.7%) in the TAU group reported actual behavioral changes (e.g., utilizing support). Conclusion: We could not draw general conclusions on the effectiveness of the program due to the study discontinuation. Nevertheless, this study indicates the necessity for revision of the program to improve family members' confidence in engaging with hikikomori sufferers, with safer approaching by families.

Youth mental health first aid for educators of immigrant-origin youth: A mixed-method evaluation of the virtual delivery approach

There is a high prevalence of mental health challenges among immigrant-origin youth (IOY) as a consequence of unique stressors and risk factors, disparities in access to mental health services, and distress associated with the COVID-19 pandemic. Educators and school staff are in need of effective, accessible, and culturally relevant mental health literacy (MHL) training to accurately recognize and appropriately respond to these mental health concerns. The main goal of this pilot study was to examine initial evidence on the effectiveness, utility, acceptability, and cultural fit of the virtual format of the Youth Mental Health First Aid (YMHFA) training program among educators who work with IOY. A mixed-methods approach was employed through quantitative online surveys at pre-training, post-training, and three-month follow-up as well as qualitative virtual focus groups querying educator and school staff's perspectives. Descriptive and inferential analyses were used to quantitatively analyze survey data. Thematic analysis was used to analyze qualitative data. Findings obtained from a total of 36 educators and school staff working predominantly IOY revealed significant improvements in participants' mental health knowledge, confidence to help, and attitudes towards mental illness that were sustained at three-month follow-up, with some variability based on race, prior mental health training experience, and professional role. The content and format of the virtual YMHFA was also found to be highly rated in its utility and acceptability. Themes related to utility included (a) crisis response skills and knowledge and (b) flexible scope of use of the training. Themes related to acceptability included the (a) presentation of information, (b) accessibility and convenience, (c) interactive nature of the training, (d) timing and scheduling, and (e) limited content. Themes highlighting the strengths and weaknesses associated with the cultural relevance of the training included (a) inclusivity and specificity and (b) cultural sensitivity and awareness. Themes related to recommendations to improve the cultural relevance of the training included (a) additional knowledge and resources, (b) improving representation in scenarios and videos, and (c) tailoring content to a target audience. Based on these initial findings, several implications for implementation of YMHFA training in schools, improving the cultural relevance of YMHFA for IOY, and future directions in research are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Counting on U training to enhance trusting relationships and mental health literacy among business advisors: protocol for a randomised controlled trial.

BACKGROUND: Financial distress is thought to be a key reason why small-medium enterprise (SME) owners experience higher levels of mental health conditions compared with the broader population. Business advisors who form trusting, high-quality relationships with their SME clients, are therefore well placed to: (1) help prevent/reduce key sources of financial distress, (2) better understand the business and personal needs of their clients and, (3) recognise the signs and symptoms of mental health conditions and encourage help-seeking where appropriate. The aim of this study is to compare the effectiveness of relationship building training (RBT) combined with mental health first aid (MHFA) training for business advisors with MHFA alone, on the financial and mental health of their SME-owner clients. METHODS: This is a single blind, two-arm randomised controlled trial. Participants will be business advisors who provide information, guidance and/or assistance to SME owner clients and are in contact with them at least 3 times a year. The business advisors will invite their SME-owner clients to complete 3 online surveys at baseline, 6- and 12-months. Business advisors will be randomised to one of two conditions, using a 1:1 allocation ratio: (1) MHFA with RBT; or (2) MHFA alone, and complete 3 online surveys at baseline, 2- and 6-months. Primary outcomes will be measured in the business advisors and consist of the quality of the relationship, stigmatizing attitude, confidence to offer mental health first aid, quality of life and provision of mental health first aid. Secondary outcomes will be measured in the SME owners and includes trust in their business advisors, the quality of this relationship, financial wellbeing, financial distress, psychological distress, help-seeking behaviour, and quality of life. To complement the quantitative data, we will include a qualitative process evaluation to examine what contextual factors impacted the reach, effectiveness, adoption, implementation, and maintenance of the training. DISCUSSION: As there is evidence for the connections between client trust, quality of relationship and financial and mental wellbeing, we hypothesise that the combined RBT and MHFA training will lead to greater improvements in these outcomes in SME owners compared with MHFA alone. TRIAL REGISTRATION: ClinicalTrials.gov : NCT04982094 . Retrospectively registered 29/07/2021. The study started in February 2021 and the recruitment is ongoing.

Mental Health First Aid training and assessment in Australian medical, nursing and pharmacy curricula: a national perspective using content analysis.

BACKGROUND: Suicide is among the leading causes of death among people aged 15 to 29 worldwide. Healthcare professionals interact with people at risk of suicide regularly, yet mental health and crisis first aid training is lacking in curricula. Mental Health First Aid (MHFA) training teaches crucial communication and crisis first aid skills and is increasingly recognised as integral to healthcare education. This study aimed to explore the extent of, as well as barriers and enablers to MHFA training delivery and assessment in Australian medical, nursing and pharmacy curricula. METHODS: All accredited Australian medical, nursing and pharmacy program providers were identified through Australian Health Practitioner Regulation Agency and National Boards websites and invited to participate in a semi-structured interview. A purpose-designed interview guide explored if and how MHFA training was delivered and assessed in curricula, as well as perceptions of and barriers and enablers to MHFA training. Interview recordings were transcribed verbatim, allowing for deductive content analysis to compare MHFA training provision across programs. RESULTS: Of 75 invited program providers, 36 (48%; 13 medical, 13 nursing and 10 pharmacy) participated, of which 15 representatives (42%; six medical, two nursing and six pharmacy) reported providing MHFA training to students. Differences in mandating training, year level of students completing training, type of training delivered and source of MHFA instructors were identified. Barriers to MHFA implementation included perceived adequacy of existing curricula, lack of funding and time, while facilitators included perceived benefit and availability of funding. CONCLUSION: MHFA training is provided to more than one third of medical, nursing and pharmacy students in Australia. Increased funding may facilitate the integration of MHFA as a minimum standard of mental health training for future healthcare professionals. Further research exploring the effectiveness of MHFA in improving behaviours and its impact on patient outcomes is warranted. TRIAL REGISTRATION: This study was approved by the University of Sydney Human Research Ethics Committee [Project number: 2020/087].

A Systematic Review of Youth and Teen Mental Health First Aid: Improving Adolescent Mental Health.

PURPOSE: Adolescent mental illness often goes undetected. Youth and teen Mental Health First Aid (MHFA) are variations of adult MHFA that aims to help adults and adolescents recognize the signs and provide help where appropriate. We conducted a systematic review to summarize the current evidence for youth and teen MHFA, providing direction for future training and research. METHODS: A systematic search was performed on September 12, 2020 on PubMed, Embase, PsycINFO, ERIC, and Cochrane using keywords related to teen or youth MHFA, adolescents, and mental health. A narrative synthesis was then carried out. RESULTS: Of the 695 articles identified, 14 studies were included. All studies were from the U.S. and Australia. All studies demonstrated significant improvements in knowledge, recognition, stigmatizing attitudes, confidence, helping intentions, and helping behavior in both adult and youth participants. Improvement in knowledge and confidence was most reported, and improvement in helping behavior was the least reported. There is encouraging evidence of long-term benefits after the training. CONCLUSIONS: More studies need to be conducted in non-Western countries, high-risk populations, and different professional settings. Future interventions could also consider different modes of learning, longer-term follow-up, and the measurement of outcomes that evaluate the quality of helping behavior.