Program Evaluations

Our research base makes us leaders in the field of mental health education.

Evidence-based, evidence-informed and proactively updated.

 

Evaluations

It is important that we evaluate every course we write.

While teaching people about mental health is always a good thing, we also need to know that we are teaching the right amount in the right way. We need to know that coming to a course doesn’t make participants feel distressed and that afterwards, they feel able to help someone who is in need.

Levels of Evidence

Not all research is of the same quality. Understanding what is meant by ‘Levels of Evidence’ can help you to understand what research is of the highest standard. It can take many years for the highest quality of research to become available. Mental Health First Aid courses have been evaluated since the very first course was run in 2000.

The exact definition of the different Levels of Evidence varies a little between countries and even between disciplines. Here is a simple explanation.

A diagram of a pyramid depicting levels of evidence
Level I evidence

Level I evidence is the best kind of evidence available: a systematic review of randomised controlled trials. Researchers look at all the available research and pool the statistics to find out if the results are consistent.

Research consistently shows that Mental Health First Aid courses result in participants being more confident and skilled helpers, with better knowledge and attitudes about mental health problems. Most results are maintained over time.

It doesn’t matter who has done the research, either. In all countries where our course has been adapted and research conducted, the same great results are seen.

Level II evidence

Level II evidence is results from a randomised controlled trial. This means that researchers have taken steps to make sure the intervention is what made the difference, and not something else like a community campaign that happened at the same time.

One group might be offered a control condition such as a physical first aid course or be waitlisted to receive the training later than the first group. Whether someone (or a group of participants, like students in a school) receives the intervention or the control condition needs to be random, too.

An example would be a trial where someone signed up to do some training but didn’t know whether they would get the training right away or 12 months later (called a waitlist control). In the end everyone would get the same training, and if the groups had similar improvements at different times, it would indicate that the intervention worked.

Level III-1 evidence

This evidence comes from the results of a well-designed trial where participants are not allocated randomly. An example of this might be where one person is allocated to ‘Group 1’, the next to ‘Group 2’, the third to ‘Group 1’ and so on.

Level III-2 evidence

This is the sort of evidence that we see when two pre-existing groups receive a different intervention at the same time and we compare their outcomes. If someone created two different campaigns to improve the public’s knowledge of depression and ran those campaigns in two different cities, for example, researchers could look at which city had better knowledge of depression at the end – but it couldn’t say for sure that it was because of the campaign. It could be a useful start, though. The next step might be to use the best campaign in two new cities to see if their results were comparable.

Level III-3 evidence

This is evidence that comes from comparative studies, which includes studies with a historical control (where old data is compared with new data), two or more studies which have no control group but recruit people with similar characteristics and then measure differences before and after the intervention is given, or an interrupted time series without a control group (where data is gathered before an intervention takes place, and then for a long time afterwards. The interruption is the introduction of the intervention).

For example, imagine that we knew that in 2015, each person in a factory made an average of five items per day. In 2016, we ran a campaign to improve workers’ mental health and encourage them to seek help when they felt distressed. In 2017, each worker made an average of 6 items per day. This would suggest that, while more research was needed to be sure, the campaign may have had a positive impact on workers’ productivity.

Level IV evidence

This is evidence that comes from case studies with either post-test or pre-test/post-test outcomes. In a post-test study, a group of people who have received MHFA training might provide data every month for 6 months on whether they used the skills they learnt in the training to help their family and friends.

In a pre-test/post-test study, these people’s skills would be measured before they did a MHFA course, and then immediately afterwards (say, within 1 or 2 weeks). This type of study can tell us whether changes have taken place over time, but they cannot say with certainty that the intervention caused this change.

This type of evidence is useful in the early stages of developing an intervention, because it can tell us what kind of changes we might expect to see in a more rigorously designed study. It can also tell us how we can improve the intervention to  make it more effective.

MHFA Course Evaluations

Read about the research that has been conducted all over the world on the effectiveness of Mental Health First Aid courses.

Level I evidence: systematic reviews

Level I evidence (meta-analyses)

Maslowski, A. K., Lacaille, R. A., Lacaille, L. J., Reich, C. M., & Klingner, J. (2019). Effectiveness of Mental Health First Aid: a meta-analysis. Mental Health Review Journal24(4), 245–261. doi: 10.1108/mhrj-05-2019-0016

Morgan, A. J., Ross, A., & Reavley, N. J. (2018). Systematic review and meta-analysis of Mental Health First Aid training: Effects on knowledge, stigma, and helping behaviour. PLOS One13(5). doi: 10.1371/journal.pone.0197102

Hadlaczky, G., Hökby, S., Mkrtchian, A., Carli, V., & Wasserman, D. (2014). Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: A meta-analysis. International Review of Psychiatry26(4), 467–475. doi: 10.3109/09540261.2014.924910

Level II evidence: randomised controlled trials

Level II Evidence – randomised controlled trials (RCTs)

**Studies with a preceding asterisk have not been peer reviewed**

 

2020

Crawford, G., & Burns, S. (2020). Confidence and motivation to help those with a mental health problem: experiences from a study of nursing students completing mental health first aid (MHFA) training. BMC Medical Education20(1). doi: 10.1186/s12909-020-1983-2

 Hart, L. M., Cropper, P., Morgan, A. J., Kelly, C. M., & Jorm, A. F. (2020). teen Mental Health First Aid as a school-based intervention for improving peer support of adolescents at risk of suicide: Outcomes from a cluster randomised crossover trial. Australian & New Zealand Journal of Psychiatry54(4), 382–392. doi: 10.1177/0004867419885450

 

2019

Morgan, A. J., Fischer, J.-A. A., Hart, L. M., Kelly, C. M., Kitchener, B. A., Reavley, N. J., … Jorm, A. F. (2019). Does Mental Health First Aid training improve the mental health of aid recipients? The training for parents of teenagers randomised controlled trial. BMC Psychiatry19(1). doi: 10.1186/s12888-019-2085-8

 

2018

Davies, E. B., Beever, E., & Glazebrook, C. (2018). A pilot randomised controlled study of the Mental Health First Aid eLearning course with UK medical students. BMC Medical Education18(1). doi: 10.1186/s12909-018-1154-x

Hart, L. M., Morgan, A. J., Rossetto, A., Kelly, C. M., Mackinnon, A., & Jorm, A. F. (2018). Helping adolescents to better support their peers with a mental health problem: A cluster-randomised crossover trial of teen Mental Health First Aid. Australian & New Zealand Journal of Psychiatry52(7), 638–651. doi: 10.1177/0004867417753552

Moll, S. E., Patten, S., Stuart, H., MacDermid, J. C., & Kirsh, B. (2018). Beyond Silence: A randomized, parallel-group trial exploring the impact of workplace mental health literacy training with healthcare employees. The Canadian Journal of Psychiatry63(12), 826–833. doi: 10.1177/0706743718766051

Reavley, N. J., Morgan, A. J., Fischer, J.-A., Kitchener, B., Bovopoulos, N., & Jorm, A. F. (2018). Effectiveness of eLearning and blended modes of delivery of Mental Health First Aid training in the workplace: randomised controlled trial. BMC Psychiatry18(1). doi: 10.1186/s12888-018-1888-3

*Wai Yee, M. (2018). Exploring the impact of Mental Health First Aid on nursing students’ knowledge and attitudes: A randomised controlled trial. Unpublished thesis. https://uwe-repository.worktribe.com/output/866085

 

2017

Burns, S., Crawford, G., Hallett, J., Hunt, K., Chih, H. J., & Tilley, P. M. (2017). What’s wrong with John? A randomised controlled trial of Mental Health First Aid (MHFA) training with nursing students. BMC Psychiatry17(1). doi: 10.1186/s12888-017-1278-2

Mohatt, N. V., Boeckmann, R., Winkel, N., Mohatt, D. F., & Shore, J. (2017). Military Mental Health First Aid: development and preliminary efficacy of a community training for improving knowledge, attitudes, and helping behaviors. Military Medicine182(1). doi: 10.7205/milmed-d-16-00033

Wong, D. F. K., Lau, Y., Kwok, S., Wong, P., & Tori, C. (2017). Evaluating the effectiveness of Mental Health First Aid program for Chinese people in Hong Kong. Research on Social Work Practice27(1), 59–67. doi: 10.1177/1049731515585149

 

2016

Jensen, K. B., Morthorst, B. R., Vendsborg, P. B., Hjorthøj, C., & Nordentoft, M. (2016). Effectiveness of Mental Health First Aid training in Denmark: a randomized trial in waitlist design. Social Psychiatry and Psychiatric Epidemiology51(4), 597–606. doi: 10.1007/s00127-016-1176-9

Kidger, J., Stone, T., Tilling, K., Brockman, R., Campbell, R., Ford, T., … Gunnell, D. (2016). A pilot cluster randomised controlled trial of a support and training intervention to improve the mental health of secondary school teachers and students – the WISE (Wellbeing in Secondary Education) study. BMC Public Health16(1). doi: 10.1186/s12889-016-3737-y

 

2014

Lipson, S. K., Speer, N., Brunwasser, S., Hahn, E., & Eisenberg, D. (2014). Gatekeeper training and access to mental health care at universities and colleges. Journal of Adolescent Health, 55(5), 612-619. doi:10.1016/j.jadohealth.2014.05.009

Moffitt, J., Bostock, J., & Cave, A. (2014). Promoting well-being and reducing stigma about mental health in the fire service. Journal of Public Mental Health, 13(2), 103-113. doi:10.1108/JPMH-02-2013-0004

Svensson, B., & Hansson, L. (2014). Effectiveness of Mental Health First Aid Training in Sweden. A randomized controlled trial with a six-month and two-year follow-up. PLOS ONE, 9(6), e100911. doi:10.1371/journal.pone.0100911

 

2011

O’Reilly, C. L., Bell, J. S., Kelly, P. J., & Chen, T. F. (2011). Impact of Mental Health First Aid training on pharmacy students’ knowledge, attitudes and self-reported behaviour: a controlled trial. Australian and New Zealand Journal of Psychiatry, 45(7), 549-557. doi:10.3109/00048674.2011.585454

 

2010

Jorm, A. F., Kitchener, B. A., Fischer, J.-A., & Cvetkovski, S. (2010). Mental health first aid training by e-learning: a randomized controlled trial. Australian and New Zealand Journal of Psychiatry, 44(12), 1072-1081. doi:10.3109/00048674.2010.516426

Jorm, A. F., Kitchener, B. A., Sawyer, M. G., Scales, H., & Cvetkovski, S. (2010). Mental health first aid training for high school teachers: a cluster randomized trial. BMC Psychiatry, 10(1), 51. doi:10.1186/1471-244X-10-51

 

2004

Jorm, A. F., Kitchener, B. A., O’Kearney, R., & Dear, K. B. G. (2004). Mental health first aid training of the public in a rural area: a cluster randomized trial [ISRCTN53887541]. BMC Psychiatry, 4(1), 33. doi:10.1186/1471-244X-4-33

As the funder, NSW Health wrote a separate report on this study, which can be found here:
http://www.health.nsw.gov.au/research/Publications/2002-mental-first-aid.pdf

Kitchener, B. A., & Jorm, A. F. (2004). Mental health first aid training in a workplace setting: A randomized controlled trial [ISRCTN13249129]. BMC Psychiatry, 4(1), 23. doi:10.1186/1471-244X-4-23

Level III–IV evidence: other evaluations

Level III and IV evidence (pilot courses and uncontrolled trials)

**Studies with a preceding asterisk have not been peer reviewed**

 

2020

Costello, J., Hays, K., & Gamez, A. M. (2020). Using mental health first aid to promote mental health in churches. Journal of Spirituality in Mental Health, 1-12. doi:10.1080/19349637.2020.1771234

Crone, D. M., Sarkar, M., Curran, T., Baker, C. M., Hill, D., Loughren, E. A., . . . Parker, A. (2019). Mental health first aid for the UK Armed Forces. Health Promotion International, 35(1), 132-139. doi:10.1093/heapro/day112 
A full report of this project is available here: Crone D, Sarkar M, Loughren E, Curran T, Baker C, Hill D, et al. Evaluation of the ‘Mental Health First Aid in the Armed Forces Community’ Project – Final Report [Internet]. 2016. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/uni-gloucestershire-armed-forces-mhfa/

Edgar, S., & Connaughton, J. (2020). Using Mental Health First Aid training to improve the mental health literacy of physiotherapy students. Physiotherapy Canada, e20190036. doi:10.3138/ptc-2019-0036

Gurung, A., Subedi, P., Zhang, M., Li, C., Kelly, T., Kim, C., & Yun, K. (2020). Culturally-appropriate orientation increases the effectiveness of Mental Health First Aid training for Bhutanese refugees: results from a multi-state program evaluation. Journal of Immigrant and Minority Health. doi:10.1007/s10903-020-00986-8

Loureiro, L. M., & Freitas, P. M. (2020). Effectiveness of the mental health first aid program in undergraduate nursing students. Revista de Enfermagem Referência, 5(1), e19078. doi:10.12707/RIV19078.

Witry, M., Karamese, H., & Pudlo, A. (2020). Evaluation of participant reluctance, confidence, and self-reported behaviors since being trained in a pharmacy Mental Health First Aid initiative. PLoS ONE, 15(5), e0232627. doi:10.1371/journal.pone.0232627 

Zhuang, X. Y., Wong, D. F. K., Ng, T. K., & Poon, A. (2019). Effectiveness of Mental Health First Aid for Chinese-speaking international students in Melbourne. Research on Social Work Practice, 30(3), 275-287. doi:10.1177/1049731519890398

 

2019

Ashoorian, D., Albrecht, K.-L., Baxter, C., Giftakis, E., Clifford, R., Greenwell-Barnden, J., & Wylde, T. (2019). Evaluation of Mental Health First Aid skills in an Australian university population. Early Intervention in Psychiatry, 13(5), 1121-1128. doi:10.1111/eip.12742

Banh, M. K., Chaikind, J., Robertson, H. A., Troxel, M., Achille, J., Egan, C., & Anthony, B. J. (2018). Evaluation of Mental Health First Aid USA using the Mental Health Beliefs and Literacy Scale. American Journal of Health Promotion, 33(2), 237-247. doi:10.1177/0890117118784234

Haggerty, D., Carlson, J. S., McNall, M., Lee, K., & Williams, S. (2019). Exploring Youth Mental Health First Aider training outcomes by workforce affiliation: a survey of Project AWARE participants. School Mental Health, 11(2), 345-356. doi:10.1007/s12310-018-9300-5

Hart, L. M., Bond, K. S., Morgan, A. J., Rossetto, A., Cottrill, F. A., Kelly, C. M., & Jorm, A. F. (2019). Teen Mental Health First Aid for years 7–9: a description of the program and an initial evaluation. International Journal of Mental Health Systems, 13(1), 71. doi:10.1186/s13033-019-0325-4

Lee, O. E., & Tokmic, F. (2019). Effectiveness of mental health first aid training for underserved Latinx and Asian American immigrant communities. Mental Health & Prevention, 13, 68-74. doi:10.1016/j.mhp.2018.12.003

*Massie, M. (2019). Mental health literacy: A review of applications and effectiveness in the higher education workplace. Unpublished thesis. Available from: https://open.library.ubc.ca/cIRcle/collections/graduateresearch/42591/items/1.0379563

Rose, T., Leitch, J., Collins, K. S., Frey, J. J., & Osteen, P. J. (2017). Effectiveness of Youth Mental Health First Aid USA for social work students. Research on Social Work Practice, 29(3), 291-302. doi:10.1177/1049731517729039

Uribe Guajardo, M. G., Kelly, C., Bond, K., Thomson, R., & Slewa-Younan, S. (2019). An evaluation of the teen and Youth Mental Health First Aid training with a CALD focus: an uncontrolled pilot study with adolescents and adults in Australia. International Journal of Mental Health Systems, 13(1), 73. doi:10.1186/s13033-019-0329-0

A full report of this project is available here: https://researchdirect.westernsydney.edu.au/islandora/object/uws:52086/

 

2018

Boukouvalas, E. A., El-Den, S., Chen, T. F., Moles, R., Saini, B., Bell, A., & O’Reilly, C. L. (2018). Confidence and attitudes of pharmacy students towards suicidal crises: patient simulation using people with a lived experience. Social Psychiatry and Psychiatric Epidemiology, 53(11), 1185-1195. doi:10.1007/s00127-018-1582-2

Crooks, C. V., Lapp, A., Auger, M., van der Woerd, K., Snowshoe, A., Rogers, B. J., . . . Caron, C. (2018). A feasibility trial of Mental Health First Aid First Nations: acceptability, cultural adaptation, and preliminary outcomes. American Journal of Community Psychology, 61(3-4), 459-471. doi:10.1002/ajcp.12241
A full report of this project is available here: https://www.csmh.uwo.ca/docs/mhfa_fn/MHFA-FN—Comprehensive-Report.pdf

El-Den, S., Chen, T. F., Moles, R. J., & O’Reilly, C. (2018). Assessing Mental Health First Aid skills using simulated patients. American Journal of Pharmaceutical Education, 82(2), 6222. doi:10.5688/ajpe6222

Gryglewicz, K., Childs, K. K., & Soderstrom, M. F. P. (2018). An evaluation of Youth Mental Health First Aid training in school settings. School Mental Health, 10(1), 48-60. doi:10.1007/s12310-018-9246-7

Kubo, H., Urata, H., Katsuki, R., Hirashima, M., Ueno, S., Suzuki, Y., . . . Kato, T. A. (2018). Development of MHFA-based 2-h educational program for early intervention in depression among office workers: A single-arm pilot trial. PLOS One, 13(12), e0208114. doi:10.1371/journal.pone.0208114

McCormack, Z., Gilbert, J. L., Ott, C., & Plake, K. S. (2018). Mental health first aid training among pharmacy and other university students and its impact on stigma toward mental illness. Currents in Pharmacy Teaching and Learning, 10(10), 1342-1347. doi:10.1016/j.cptl.2018.07.001

Nakagami, Y., Kubo, H., Katsuki, R., Sakai, T., Sugihara, G., Naito, C., . . . Kato, T. A. (2018). Development of a 2-h suicide prevention program for medical staff including nurses and medical residents: A two-center pilot trial. Journal of Affective Disorders, 225, 569-576. doi:10.1016/j.jad.2017.08.074 

*Schweers, A. (2018). Perceptions of Mental Health First Aid Training deputies received in a jail setting. Unpublished thesis. Available from: https://etd.ohiolink.edu/pg_10?0::NO:10:P10_ACCESSION_NUM:ysu1546427525796788#abstract-files

Uribe Guajardo, M. G., Slewa-Younan, S., Kitchener, B. A., Mannan, H., Mohammad, Y., & Jorm, A. F. (2018). Improving the capacity of community-based workers in Australia to provide initial assistance to Iraqi refugees with mental health problems: an uncontrolled evaluation of a Mental Health Literacy Course. International Journal of Mental Health Systems, 12(1), 2. doi:10.1186/s13033-018-0180-8

 

2017

Morrissey, H., Moss, S., Alexi, N., & Ball, P. (2017). Do Mental Health First Aid™ courses enhance knowledge? The Journal of Mental Health Training, Education and Practice, 12(2), 69-76. doi:10.1108/JMHTEP-01-2016-0003

Svensson, B., & Hansson, L. (2017). Mental health first aid for the elderly: A pilot study of a training program adapted for helping elderly people. Aging & Mental Health, 21(6), 595-601. doi:10.1080/13607863.2015.1135873

 

2016

Aakre, J. M., Lucksted, A., & Browning-McNee, L. A. (2016). Evaluation of Youth Mental Health First Aid USA: A program to assist young people in psychological distress. Psychological Services, 13(2), 121-126. doi:10.1037/ser0000063

Bond, K. S., Jorm, A. F., Kitchener, B. A., & Reavley, N. J. (2016). Mental Health First Aid training for Australian financial counsellors: An evaluation study. Advances in Mental Health, 14(1), 65-74. doi:10.1080/18387357.2015.1122704

*Cregan. K., Phipps, D., Lowndes, J., & Bolat, S. (2016). Higher Education Mental Health First Aid – Phase 1 Evaluation Report. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/he-mhfa-pilot/

Crisanti, A. S., Luo, L., McFaul, M., Silverblatt, H., & Pyeatt, C. (2015). Impact of Mental Health First Aid on confidence related to mental health literacy: a national study with a focus on race-ethnicity. Psychiatric Services, 67(3), 350-353. doi:10.1176/appi.ps.201400375

El-Den, S., O’Reilly, C. L., & Chen, T. F. (2016). Does Mental Health First Aid training affect MPharm students’ literacy, knowledge and attitudes towards perinatal depression? A pre-test/post-test pilot study. Research in Social and Administrative Pharmacy, 12(5), e26. doi:10.1016/j.sapharm.2016.05.066

Fessey, V., James, G., & Pengelly, T. (2016). Mental Health First Aid: equipping the nurses of the future. British Journal of Nursing, 25(15), 858-859. doi:10.12968/bjon.2016.25.15.858

Hart, L. M., Mason, R. J., Kelly, C. M., Cvetkovski, S., & Jorm, A. F. (2016). ‘teen Mental Health First Aid’: a description of the program and an initial evaluation. International Journal of Mental Health Systems, 10(1), 3. doi:10.1186/s13033-016-0034-1

Martin, J. (2016). An exploratory study of the benefits of youth mental health literacy studies for social work students. Social Work in Mental Health, 14(1), 42-60. doi:10.1080/15332985.2015.1057312

 

2015

Bond, K. S., Jorm, A. F., Kitchener, B. A., & Reavley, N. J. (2015). Mental health first aid training for Australian medical and nursing students: an evaluation study. BMC Psychology, 3(1), 11. doi:10.1186/s40359-015-0069-0

Subedi, P., Li, C., Gurung, A., Bizune, D., Dogbey, M. C., Johnson, C. C., & Yun, K. (2015). Mental health first aid training for the Bhutanese refugee community in the United States. International Journal of Mental Health Systems, 9(1), 20. doi:10.1186/s13033-015-0012-z

 

2014

Massey, J., Brooks, M., & Burrow, J. (2014). Evaluating the effectiveness of Mental Health First Aid training among student affairs staff at a Canadian university. Journal of Student Affairs Research and Practice51(3), 323–336. doi: 10.1515/jsarp-2014-0032

 

2013

*Borrill, J., & Kuczynska, P. (2013). Evaluation of Youth Mental Health First Aid Training in the North-East of England. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/ne-england-youth-mhfa-evaluation/

*Hawkin, N., & Birmingham and Solihul Mental Health Foundation Trust (2013). The use of Mental Health First Aid in supporting people working in the Prevent agenda. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/bsmhft-and-counter-terrorism-unit-mhfa-course-feedback/

*Jaman, P., Patterson, P., & Pearson, L. (2013). Mental Health First Aid England: is improving the mental health literacy of the population contributing to a public health priority? Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/birmingham-and-coventry-uni-mhfa-course-evaluations-summary/

Mendenhall, A. N., Jackson, S. C., & Hase, S. (2013). Mental Health First Aid USA in a rural community: perceived impact on knowledge, attitudes, and behavior. Social Work in Mental Health, 11(6), 563-577. doi:10.1080/15332985.2013.812542

Morawska, A., Fletcher, R., Pope, S., Heathwood, E., Anderson, E., & McAuliffe, C. (2013). Evaluation of mental health first aid training in a diverse community setting. International Journal of Mental Health Nursing, 22(1), 85-92. doi:10.1111/j.1447-0349.2012.00844.x

 

2012

Hart, L. M., Jorm, A. F., & Paxton, S. J. (2012). Mental health first aid for eating disorders: pilot evaluation of a training program for the public. BMC Psychiatry, 12(1), 98. doi:10.1186/1471-244X-12-98

 

2011

*Borrill, J. (2011). Mental Health First Aid England and North East Mental Health Development Unit Partnership Project. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/mental-health-first-aid-north-east-england/

Kelly, C. M., Mithen, J. M., Fischer, J. A., Kitchener, B. A., Jorm, A. F., Lowe, A., & Scanlan, C. (2011). Youth Mental Health First Aid: a description of the program and an initial evaluation. International Journal of Mental Health Systems, 5(1), 4. doi:10.1186/1752-4458-5-4

*Khaliq, F. (2011). Evaluation of Mental Health First Aid Training for Voluntary and Charitable Services working with Black and Minority Ethnic individuals in Bristol, Avon and Wiltshire Mental Health Partnership Trust. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/nhs-report-bristol-mhfa-training-bme-communities/

2010

*Borrill, J. (2010). Mental Health First Aid Training: Initial Evaluation by Private Sector Participants. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/university-westminsternbspprivate-sector-evaluation/

*Brandling, J. (2010). Evaluating Mental Health First Aid Training for Line Managers working in the public sector. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/university-bath-school-health/

*Brett-Jones, J. (2010). NHS Camden Mental Health First Aid Programme Review. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/nhs-camden-review/

*Heer, B. (2010). Mental Health First Aid training evaluation. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/nhs-islington/

Kato, T. A., Suzuki, Y., Sato, R., Fujisawa, D., Uehara, K., Hashimoto, N., . . . Otsuka, K. (2010). Development of 2-hour suicide intervention program among medical residents: First pilot trial. Psychiatry and Clinical Neurosciences, 64(5), 531-540. doi:10.1111/j.1440-1819.2010.02114.x

Lam, A. Y. K., Jorm, A. F., & Wong, D. F. K. (2010). Mental health first aid training for the Chinese community in Melbourne, Australia: effects on knowledge about and attitudes toward people with mental illness. International Journal of Mental Health Systems, 4(1), 18. doi:10.1186/1752-4458-4-18

Pierce, D., Liaw, S.-T., Dobell, J., & Anderson, R. (2010). Australian rural football club leaders as mental health advocates: an investigation of the impact of the Coach the Coach project. International Journal of Mental Health Systems, 4(1), 10. doi:10.1186/1752-4458-4-10

*Robson, J., & Bostock, J. (n.d.). Evaluation of Mental Health First Aid Training for Flood Recovery Workers. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/northumberland-evaluation-mhfa-training-flood-recovery-workers/

*Robson, J., &  Bostock, J. (2010). Evaluation of Mental Health First Aid Training with Northumberland Fire and Rescue Service. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/northumberland-fire-and-rescue/

2009

Hossain, D., Gorman, D., & Eley, R. (2009). Enhancing the knowledge and skills of Advisory and Extension Agents in mental health issues of farmers. Australasian Psychiatry, 17(sup1), S116-S120. doi:10.1080/10398560902948365

Hossain, D., Gorman, D., Eley, R., & Coutts, J. (2009). Farm Advisors’ reflections on Mental Health First Aid training. Australian e-Journal for the Advancement of Mental Health, 8(1), 105-111. doi:10.5172/jamh.8.1.105

Kanowski, L. G., Jorm, A. F., & Hart, L. M. (2009). A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation. International Journal of Mental Health Systems, 3(1), 10. doi:10.1186/1752-4458-3-10

Minas, H., Colucci, E., & Jorm, A. F. (2009). Evaluation of Mental Health First Aid training with members of the Vietnamese community in Melbourne, Australia. International Journal of Mental Health Systems, 3(1), 19. doi:10.1186/1752-4458-3-19

 

2008

*MacDonald, K.M., Cosquer, C., & Flockton, A. (2008). An Evaluation of the Impact of MHFA Training in Kingston Upon Hull. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/mental-health-first-aid-hull/

Sartore, G.-M., Kelly, B., Stain, H. J., Fuller, J., Fragar, L., & Tonna, A. (2008). Improving mental health capacity in rural communities: Mental health first aid delivery in drought-affected rural New South Wales. Australian Journal of Rural Health, 16(5), 313-318. doi:10.1111/j.1440-1584.2008.01005.x

 

2002

Kitchener, B. A., & Jorm, A. F. (2002). Mental health first aid training for the public: evaluation of effects on knowledge, attitudes and helping behavior. BMC Psychiatry, 2(1), 10. doi:10.1186/1471-244X-2-10

There is also a report of this article in the British Medical Journal, available from: http://bmj.com/cgi/content/full/325/7373/1133

 

Reviews

Researchers will often review existing research in a given area to better understand the current evidence base and help them answer particular questions (e.g. whether a training program is effective for a particular group of people).

Reviews enable people to quickly become familiar with the evidence in a given field of research. A special type of review, called a systematic review, is often done to gather all of the available studies on a topic in a rigorous way, and forms the basis for Level I evidence. The MHFA program has been included in many different reviews since 2006, with most reviews supporting the positive effects of the training on people’s knowledge, attitudes and confidence.

View Reviews

**Studies with a preceding asterisk have not been peer reviewed**

2020

El-Den, S., Moles, R., Choong, H.-J., & O’Reilly, C. (2020). Mental Health First Aid training and assessment among university students: A systematic review. Journal of the American Pharmacists Association. doi:10.1016/j.japh.2019.12.017

Waqas, A., Malik, S., Fida, A., Abbas, N., Mian, N., Miryala, S., . . . Naveed, S. (2020). Interventions to reduce stigma related to mental illnesses in educational institutes: a systematic review. Psychiatric Quarterly. doi:10.1007/s11126-020-09751-4

 

2018

*Bell, N., Evans, G,, Beswick, A., & Moore, A. (2018). Summary of the evidence on the effectiveness of Mental Health First Aid (MHFA) training in the workplace. Derbyshire, U.K.: Health and Safety Executive. Available from: http://www.hse.gov.uk/research/rrhtm/rr1135.htm

Jorm, A. F., & Ross, A. M. (2018). Guidelines for the public on how to provide mental health first aid: narrative review. BJPsych Open, 4(6), 427-440. doi:10.1192/bjo.2018.58

Lo, K., Gupta, T., & Keating, J. L. (2018). Interventions to promote mental health literacy in university students and their clinical educators. A systematic review of randomised control trials. Health Professions Education, 4(3), 161-175. doi:10.1016/j.hpe.2017.08.001

Scantlebury, A., Parker, A., Booth, A., McDaid, C., & Mitchell, N. (2018). Implementing mental health training programmes for non-mental health trained professionals: A qualitative synthesis. PLOS One, 13(6), e0199746. doi:10.1371/journal.pone.0199746

Whitmore, M., Stewart, K., Pollard, J., van Belle,  J., Yang, M., & Van Stolk, C. (2018). Promising practices for health and wellbeing at work: A review of the evidence landscape London, U.K.: Public Health England. Available from: https://www.rand.org/pubs/research_reports/RR2409.html

 

2016

Hanisch, S. E., Twomey, C. D., Szeto, A. C. H., Birner, U. W., Nowak, D., & Sabariego, C. (2016). The effectiveness of interventions targeting the stigma of mental illness at the workplace: a systematic review. BMC Psychiatry, 16(1), 1. doi:10.1186/s12888-015-0706-4

 

2015

Wong, E. C., Collins, R. L., & Cerully, J. L. (2015). Reviewing the evidence base for Mental Health First Aid: is there support for its use with key target populations in California? RAND Health Quarterly, 5(1), 19. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5158252/

 

2013

Day A, Francisco A. Social and emotional wellbeing in Indigenous Australians: Identifying promising interventions. Australian and New Zealand Journal of Public Health. 2013; 37:350–355. Full text

https://onlinelibrary.wiley.com/doi/full/10.1111/1753-6405.12083

 

2012

*Ganshorn H.,&  Michaud, N. (2012). Mental Health First Aid: An Evidence Review. Ottawa, Canada: Mental Health Commission of Canada; Available from: https://www.mentalhealthcommission.ca/sites/default/files/mhfa_evidence_review_eng_0_0_0.pdf

 

2010

Szeto, A. C. H., & Dobson, K. S. (2010). Reducing the stigma of mental disorders at work: A review of current workplace anti-stigma intervention programs. Applied and Preventive Psychology, 14(1), 41-56. doi:10.1016/j.appsy.2011.11.002

This article reviews MHFA as a workplace anti-stigma program. Further, MHFA is listed as the only international program in this space with published evidence of effectiveness.

 

2006

Kitchener, B. A., & Jorm, A. F. (2006). Mental Health First Aid Training: review of evaluation studies. Australian & New Zealand Journal of Psychiatry, 40(1), 6-8. doi:10.1080/j.1440-1614.2006.01735.x

Additional Research

Many other academic studies and articles about MHFA programs have been published. These do not all fit within the Levels of Evidence, but they have an important place in MHFA’s evidence base. Some studies tell us more about how MHFA is thought to work within particular settings (process evaluations and implementation studies), while others investigate participants’ and Instructors’ experiences of completing and delivering MHFA courses (qualitative research).

Many academics and experts have written commentaries and editorials about MHFA, covering topics such as local and international milestones, lessons learnt and what the future research into MHFA programs might look like. Research that is not published in an academic journal, for example a PhD thesis, can also provide important insights. These studies help us to better understand the effects of MHFA training and how we can improve the training.

Additional research and reports

Other articles

**Studies with a preceding asterisk have not been peer reviewed**

 

Qualitative research (e.g. interviews, focus groups, analysis of open-ended questions from surveys)

 

2019

Auger, M., Crooks, C. V., Lapp, A., Tsuruda, S., Caron, C., Rogers, B. J., & van der Woerd, K. (2019). The essential role of cultural safety in developing culturally-relevant prevention programming in First Nations communities: Lessons learned from a national evaluation of Mental Health First Aid First Nations. Evaluation and Program Planning, 72, 188-196. doi:10.1016/j.evalprogplan.2018.10.016

Hung, M. S. Y., Lam, S. K. K., & Chow, M. C. M. (2019). Nursing students’ experiences of mental health first aid training: A qualitative descriptive study. Collegian, 26(5), 534-540. doi:10.1016/j.colegn.2019.02.006

O’Reilly, C.L., Moles, R.J., Boukouvalas, E., & El-Den, S. (2019). Assessing students’ mental health crisis skills via consumers with lived experience: a qualitative evaluation. The Journal of Mental Health Training, Education and Practice, 14(5), 361-371. doi:10.1108/JMHTEP-01-2019-0007

2018

Bovopoulos, N., LaMontagne Anthony, D., Martin, A., & Jorm, A. (2018). Exploring the role of mental health first aid officers in workplaces: A qualitative study using case study methodology. International Journal of Workplace Health Management, 11(6), 366-381. doi:10.1108/IJWHM-06-2018-0082

*Roberts-Holmes, G., Mayer, S., Jones, P., & Lee, S. F. (2018).Evaluation of Phase One of the Youth MHFA in Schools programme: “The training has given us a vocabulary to use.” Available from: https://mhfastorage.blob.core.windows.net/mhfastoragecontainer/5603f429f9cae811814fe0071b668081/Youth-MHFA-in-Schools-programme-UCL-evaluation-report.pdf?sv=2015-07-08&sr=b&sig=ExjA90JwnoGjWVIusdg7vKVmbZM%2FhDShGmcTU3l4hEI%3D&se=2019-02-28T16%3A37%3A07Z&s

Rossetto, A., Jorm, A. F., & Reavley, N. J. (2018). Developing a model of help giving towards people with a mental health problem: a qualitative study of Mental Health First Aid participants. International Journal of Mental Health Systems, 12(1), 48. doi:10.1186/s13033-018-0228-9

 

2017

Kelly, J., & Birks, M. (2017). ‘It’s the simple things you do first that start the process of help’: Undergraduate nursing and midwifery students’ experiences of the Mental Health First Aid course. Collegian, 24(3), 275-280. doi:10.1016/j.colegn.2016.04.004

*Singh, D. (2017).  Supporting students and promoting mental health: Experiences of secondary school MHFA-certified teachers. Unpublished thesis. Available from: https://tspace.library.utoronto.ca/bitstream/1807/77196/1/Singh_Devan_201706_MT_MTRP.pdf

2016

Bovopoulos, N., LaMontagne, A., Martin, A., & Jorm, A. (2016). Delivering mental health first aid training in Australian workplaces: exploring instructors’ experiences. International Journal of Mental Health Promotion, 18(2), 65-82. doi:10.1080/14623730.2015.1122658

Kirschbaum, M., Peterson, G., & Bridgman, H. (2016). Mental health first aid training needs of Australian community pharmacists. Currents in Pharmacy Teaching and Learning, 8(3), 279-288. doi:10.1016/j.cptl.2016.02.015

 

2015

Byrne, K., McGowan, I., & Cousins, W. (2015). Delivering Mental Health First Aid: an exploration of instructors’ views. International Journal of Mental Health Promotion, 17(1), 3-21. doi:10.1080/14623730.2014.995422

Crisanti, A. S., Pasko, D. K., Pyeatt, C., Silverblatt, H., & Anastasoff, J. (2015). Dissemination challenges associated with mental health first aid in New Mexico: Insights from instructors. Journal of Rural Mental Health, 39(1), 13-21. doi:10.1037/rmh0000013

Lucksted, A., Mendenhall, A. N., Frauenholtz, S. I., & Aakre, J. M. (2015). Experiences of graduates of the Mental Health First Aid-USA course. International Journal of Mental Health Promotion, 17(3), 169-183. doi:10.1080/14623730.2015.1013670

Ploper, V., Jones, R., Kraus Dana, J., Schmidt, A., & Corrigan, P. (2015). Feedback from American participants of a Mental Health First Aid training course. Journal of Public Mental Health, 14(2), 118-121. doi:10.1108/JPMH-04-2014-0016

Svensson, B., Hansson, L., & Stjernswärd, S. (2015). Experiences of a Mental Health First Aid Training program in Sweden: A descriptive qualitative study. Community Mental Health Journal, 51(4), 497-503. doi:10.1007/s10597-015-9840-1

 

 

2011

*Potter, G. (2011). How are the skills learnt on Mental Health First Aid training used to help people with mental health problems? Unpublished thesis. Available from: https://mhfaengland.org/mhfa-centre/research-and-evaluation/understanding-how-skills-learnt-mhfa-course-are-applied/

Terry, J. (2010). Experiences of instructors delivering the Mental Health First Aid training programme: a descriptive qualitative study. Journal of Psychiatric and Mental Health Nursing, 17(7), 594-602. doi:10.1111/j.1365-2850.2010.01557.x

 

2010

Hossain, D. and Gorman, D. and Eley, R. & Coutts, J. (2010). Value of mental health first aid training of advisory and extension agents in supporting farmers in rural Queensland. Rural and Remote Health, 10(4), 1593-1603. Available from: https://eprints.usq.edu.au/18147/

Terry, J. (2010). Experiences of instructors delivering the Mental Health First Aid training programme: a descriptive qualitative study. Journal of Psychiatric and Mental Health Nursing, 17(7), 594-602. doi:10.1111/j.1365-2850.2010.01557.x

 

2005

Jorm, A. F., Kitchener, B. A., & Mugford, S. K. (2005). Experiences in applying skills learned in a mental health first aid training course: a qualitative study of participants’ stories. BMC Psychiatry, 5(1), 43. doi:10.1186/1471-244X-5-43

 

Editorials, discussion papers and commentaries

 

2020

Mantzios, M. (2020). Mental health first aid and exciting opportunities for peer-support networks within universities with prospects of influencing public health and treatment. Journal of Public Health, 28(2), 219-221. doi:10.1007/s10389-019-01057-5

Mantzios, M., Cook, A., & Egan, H. (2019). Mental Health First Aid for students in the health professions: Exploring opportunities for experiential learning in higher education. Health Professions Education, 5(4), 281-282. doi:10.1016/j.hpe.2019.03.001

Mantzios, M., Egan, H., & Cook, A. (2020). Mental Health First Aid in the UK: how important is first aid when professional mental health services are in dire straits? SN Comprehensive Clinical Medicine, 2, 759–760. doi:10.1007/s42399-020-00282-4

Mei, C., McGorry, P. D. (2020). Mental health first aid: strengthening its impact for aid recipients. Evidence-Based Mental Health. doi: 10.1136/ebmental-2020-300154

 

2019

Chowdhary, A., Zlotnikova, V., Lucas, C., & Lonie, J. M. (2019). How do mental health first aid ™ interventions influence patient help-seeking behaviours? A dilemma for pharmacist mental health first aid responders. Research in Social and Administrative Pharmacy, 15(1), 106-108. doi:10.1016/j.sapharm.2018.02.010

Diprose Adams, S. H. G. (2019). Mental health first aid for firearm owners: Addressing the elephant in the room. Alternative Law Journal, 44(4), 308-313. doi:10.1177/1037969X19856758

Jorm, A. F., Kitchener, B. A., & Reavley, N. J. (2019). Mental Health First Aid training: lessons learned from the global spread of a community education program. World Psychiatry, 18(2), 142-143. doi:10.1002/wps.20621

Mantzios, M., Cook, A., & Egan, H. (2019). Mental health first aid embedment within undergraduate psychology curriculums: an opportunity of applied experience for psychology students and for enhancing mental health care in higher education institutions. Higher Education Pedagogies, 4(1), 307-310. doi:10.1080/23752696.2019.1640631

Rickles, N., Wertheimer, A., & Huang, Y. (2019). Training community pharmacy staff how to help manage urgent mental health crises. Pharmacy, 7(3). doi:10.3390/pharmacy7030133

 

2018

Hart, L. M., Cox, G. R., & Lees, L. (2018). Teaching mental health first aid in the school setting: a novel approach to improving outcomes for common adolescent mental disorders. Current Opinion in Pediatrics, 30(4). doi: 10.1097/MOP.0000000000000639

Jorm, A. F., & Kitchener, B. A. (2018). The truth about Mental Health First Aid training. Psychiatric Services, 69(4), 492-492. doi:10.1176/appi.ps.201800006

 

2015

Bonnar, F. (2015). Mental Health First Aid: triage for the mind. British Journal of Nursing, 24(14), 724-724. doi:10.12968/bjon.2015.24.14.724

Happell, B., Wilson, R., & McNamara, P. (2015). Undergraduate mental health nursing education in Australia: More than Mental Health First Aid. Collegian, 22(4), 433-438. doi:10.1016/j.colegn.2014.07.003

Hounsell, C. (2015). Mental health first aid training helps cut stress in the workplace. Occupational Health, 67(2), 11. Retrieved from https://search.proquest.com/docview/1667196137?accountid=12372

Kroll, H. (2015). Mental health first aid: Addressing mental health as a public health priority. Perspectives in Public Health, 135(1), 12-14. Available from: http://journals.sagepub.com/doi/10.1177/1757913914562120

 

2012

Anderson, R. J., & Pierce, D. (2012). Assumptions associated with mental health literacy training – Insights from initiatives in rural Australia. Advances in Mental Health, 10(3), 258-267. doi:10.5172/jamh.2012.10.3.258

Jorm, A. F. (2012). Mental health literacy: Empowering the community to take action for better mental health. American Psychologist, 67(3), 231-243. doi:10.1037/a0025957

 

2011

Jorm, A. F., & Kitchener, B. A. (2011). Noting a landmark achievement: Mental Health First Aid training reaches 1% of Australian adults. Australian and New Zealand Journal of Psychiatry, 45(10), 808-813. doi:10.3109/00048674.2011.594785

Jorm, A. F., & Kitchener, B. A. (2011). Giving support to a suicidal person. BMJ, 343, d5680. doi:10.1136/bmj.d5680

Rosenberg, L. (2011). Mental Health First Aid: A “radical efficiency” in health promotion. The Journal of Behavioral Health Services & Research, 38(2), 143-145. doi:10.1007/s11414-011-9236-0

 

2010

Zilnyk, A. (2010). Mental Health First Aid — a life skill we should all have? Perspectives in Public Health, 130(2), 61-62. doi:10.1177/1757913909360452

 

2008

Kitchener, B. A., & Jorm, A. F. (2008). Mental Health First Aid: an international programme for early intervention. Early Intervention in Psychiatry, 2(1), 55-61. doi:10.1111/j.1751-7893.2007.00056.x

 

Other research (e.g. process evaluations, implementation studies, research that evaluates MHFA training as part of a different project)

 

2020

Atanda, O., Callaghan, P., Carter, T., Durcan, G., O’Shea, N., Brown, S. D., Reavey, P., Vangeli, E., White, S., & Wood, K. V. (2020). Evaluation of Mental Health First Aid from the Perspective Of Workplace End UseRs—EMPOWER: protocol of cluster randomised trial phase. Trials, 21(1), 715. https://doi.org/10.1186/s13063-020-04636-0

 

2019

National Indigenous Australians Agency (2019). Summary of evaluation of Mental Health First Aid Training on Groote Eylandt and Bickerton Island. Australian Government: Canberra. Available from: 

https://www.niaa.gov.au/resource-centre/indigenous-affairs/summary-evaluation-mfa

Rodgers, G., Burns, S., & Crawford, G. (2019). “I was able to actually do something useful”: evaluating the experiences of university students after completing Mental Health First Aid: a mixed-methods study. Advances in Mental Health, 1-23. doi:10.1080/18387357.2019.1663709

*Sandtorv, E. D. (2019). Mental Health First Aid Training: Evaluating a brief training intervention for college students. ELAIA, 2(14).
Available from: https://digitalcommons.olivet.edu/elaia/vol2/iss1/14

Spiker, D. A., & Hammer, J. H. (2019). A model of intention to provide mental health first aid in college students. Journal of Mental Health, 1-8. doi:10.1080/09638237.2019.1644493

 

2018

Jorm, A. F., Nicholas, A., Pirkis, J., Rossetto, A., & Reavley, N. J. (2018). Associations of training to assist a suicidal person with subsequent quality of support: results from a national survey of the Australian public. BMC Psychiatry, 18(1), 132. doi:10.1186/s12888-018-1722-y

*Narayanasamy, M., Geraghty, J., Colle, C., Nouri, F., Thomson, L., Callaghan, P., et al. (2018). MENtal health first aid in The wORkplace (MENTOR): A feasibility study. Available from: https://www.iosh.co.uk/MHFAworkplace

 

2017

Talbot, J. A., Ziller, E. C., & Szlosek, D. A. (2017). Mental Health First Aid in rural communities: appropriateness and outcomes. The Journal of Rural Health, 33(1), 82-91. doi:10.1111/jrh.12173

 

2014

Appleby, M., & Bourke, J. (2014). Promoting law student mental health literacy and wellbeing: a case study from The College of Law, Australia. International Journal of Clinical Legal Education. 461. Available from http://journals.northumbria.ac.uk/index.php/ijcle/article/viewFile/18/23

 

2013

Mendenhall, A. N., & Jackson, S. C. (2013). Instructor insights into delivery of Mental Health First Aid USA: A case study of mental health promotion across one state. International Journal of Mental Health Promotion, 15(5), 275-287. doi:10.1080/14623730.2013.853420

 

2011

Perceval, M., Fuller, J., & Holley, A. M. (2011). Farm-Link: Improving the mental health and well-being of people who live and work on NSW farms. International Journal of Mental Health, 40(2), 88-110. doi:10.2753/IMH0020-7411400205

 

2009

*Gillinson, S., Horne, M., & Baeck, P. (2009). Radical efficiency: Different, better, lower cost public services. London: National Endowment for Science, Technology and the Arts. Available from: http://www.networkforeurope.eu/files/files/radical-efficiency-nesta-180610.pdf
The MHFA Program was chosen as one of 10 case studies of ‘Radical efficiency’ in action across the world. ‘Radical efficiency’ is about different, better and lower cost public services – innovation that delivers much better public outcomes for much lower cost. See also: NESTA Innovation Unit. Practical guide: Radical efficiency [Internet]. London: National Endowment for Science, Technology and the Arts; 2010. Available from: https://www.nesta.org.uk/report/radical-efficiency-practical-guide/

 

2007

*Stevenson, R., & Alvy, N. (2007). Evaluation of Scotland’s Mental Health First Aid. Edinburgh NHS Scotland. Available from http://www.healthscotland.com/documents/2119.aspx

 

Questions We Still Haven’t Answered

There is plenty for the MHFA programs worldwide still to research. Some of the research we hope to conduct in the future include:

How MHFA programs implemented in large workplaces can improve productivity and organisational culture over time

What it’s like for a person who has been helped by an MHFAider and what could make our programs even better

Which aspects of our courses have the greatest impact on MHFAiders’ skills

With more to follow.

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