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Estimated marginal means and mean difference or proportions and odds ratio over time between Physical First Aid (PFA) and teen Mental Health First Aid (tMHFA).
Source publication
Background:
teen Mental Health First Aid (tMHFA) is a classroom-based training programme for students aged 15-18 years to improve supportive behaviours towards peers, increase mental health literacy and reduce stigma. This research evaluated tMHFA by comparing it to a matched emergency Physical First Aid (PFA) training programme.
Methods:
A clus...
Citations
... For instance, poor relationships with peers are closely related to informal help-seeking in both whole and adolescents with mental health problems, indicating the role of peer engagement in supporting adolescents' help-seeking. Programmes such as Teen Mental Health First Aid (Hart et al., 2018) and MAKINGtheLINK (Lubman et al., 2020) are effective in equipping adolescent peers with necessary knowledge and skills, which can positively impact professional help-seeking and ultimately lead to improved mental health. Addressing barriers at a particular level (e.g. ...
Background
Help‐seeking provides opportunities for early prevention and intervention of mental health problems. However, little is known about factors that impact help‐seeking from a life‐course and socioecological perspective. This study aimed to examine factors that impact adolescents' formal and informal help‐seeking in three population groups: the whole population, adolescents with depressive symptoms and adolescents with anxiety symptoms.
Methods
We drew on data from the Longitudinal Study of Australian Children birth cohort. Participants were followed from birth to 14–15 years. Based on previous literature and life‐course and socioecological models, we measured a range of factors at individual and family, interpersonal and community levels at three time points (0–1 year, 4–5 years and 12–13 years). Outcomes at 14–15 years were help‐seeking behaviours divided into three categories (formal help from health professionals, close informal help from friends and family members and broad informal help from other sources). Generalised linear models with logit‐binomial links were used.
Results
There were varying and common patterns of influencing factors across the three population groups and sources of help‐seeking. In the whole population, five common factors (female, previous depressive or anxiety symptoms, discrimination and bully victimisation) were associated with all three sources of help‐seeking. Among adolescents with depressive or anxiety symptoms, four common barriers to help‐seeking were male adolescents, speaking a language other than English, having poor relationships with peers and less social support.
Conclusion
Both intrinsic and extrinsic barriers exist for adolescents' mental health help‐seeking. There are priority groups of adolescents with mental health problems who are unlikely to seek support and warrant attention. There is a need for multisector collaborations to address barriers to mental health care and promote help‐seeking among adolescents.
... The correlation between mental health literacy and professional help-seeking behavior in our study aligns with findings from a study in Saudi Arabia and a Swiss study [19,26] [19,26]. On a group of 10 students a trial conducted to experience the effect of being aware of mental health problems and the influence of that awareness on this group ability to recognize mental health problems, and when to seek help, and the results were better mental health literacy, and good recognition of mental health problem that require help seeking from a professional [27]. ...
Background
Mental health literacy (MHL) and help-seeking behaviors are pivotal in managing mental well-being, especially among Egyptian undergraduates. Despite the importance and prevalent psychological distress in this group, limited research has addressed MHL and associated behaviors in Egypt. This study aimed to assess the levels of MHL and help-seeking behavior among Egyptian university students.
Methods
A cross-sectional study was conducted across ten Egyptian universities during the academic year 2022–2023. A convenience sample of 1740 students was obtained through online questionnaires distributed via social media platforms. The survey comprised demographic characteristics, the Mental Health Literacy Scale (MHLS), and the General Help Seeking Behavior Questionnaire (GHSPQ).
Results
Among 1740 Egyptian undergraduates, medical students scored higher in recognizing disorders (p < 0.05), while non-medical students excelled in attitudes (p < 0.05). A strong correlation was observed between attitudes toward mental illness and total mental health literacy (coefficients of 0.664 and 0.657). Univariate analysis indicated a significant association with professional help-seeking (OR = 1.023). Females, individuals aged 21 or above, and non-medical students were more likely to seek mental health information (OR = 1.42, 1.82, 1.55 respectively). Help-seeking behavior for emotional problems was more inclined towards intimate partners, whereas suicidal thoughts prompted seeking professional help.
Conclusion
The findings advocate for comprehensive mental health education, particularly in rural areas, and emphasis on the role of personal relationships in mental well-being. Implementing these insights could foster improved mental health outcomes and reduce related stigma in Egypt.
... Similarly, Tognazzini et al. (2008) found that there may be a lack of education and awareness among healthcare professionals regarding mental illness. Supporting evidence suggests that mental health training may enhance the competencies and understanding of those who receive it, allowing them to assist those with mental illness more effectively (Hart et al., 2018;Rose et al., 2019). It is imperative that school and decision-makers consider these substantial associated factors and initiate efforts to enhance universities' and colleges' students' understanding of mental illness. ...
Background
The social disapproval or stigma surrounding mental illness contributes to the postponement of individuals seeking assistance and frequently undermines therapeutic alliances between mental illness sufferers and health care professionals.
Aims
This study explored perceptions and attitudes towards individuals with mental illness among college healthcare students in Indonesia.
Methods
This study used a qualitative method. Twenty five students enrolled in six healthcare programs were interviewed using a semi structured format. The data analysis adopted a thematic analysis.
Results
Our thematic analysis generated four main themes: (1) general perceptions of mental health and mental illness; (2) knowledge about mental illness; (3) mental health stigma; and (4) mental health stigma campaigns.
Conclusions
The participants exhibited positive perceptions of mentally ill people. Students understood mental health, and they exhibited positive attitudes toward mentally ill people. Some students have stigma and lack of confidence to assist those who have mental illness. Further efforts are required to acquaint students with mental health issues and facilitate their interaction with mentally ill individuals. Anti-stigma campaigns are required to combat the pervasive stigmatization of individuals with mental illness. It is recommended to conduct a more extensive study about the stigma that students encounter in relation to mentally ill individuals.
... The core teaching of tMHFA is a five-point Action Plan, based on key messages developed through a Delphi expert consensus study (Ross et al., 2012), which includes: (1) Look for warning signs; (2) Ask how they are; (3) Listen up; (4) Help them connect with an adult; and (5) Your friendship is important (shorten as 'Look, Ask, Listen, Help, Your friend'). The tMHFA training programme has been licensed in 17 different countries and regions, and there is evidence that it is effective in improving the quality of mental health first aid intentions towards peers with depression and suicide risk, or peers with anxiety, as well as in increasing mental health literacy and reducing stigma among adolescents (Hart et al., 2018(Hart et al., , 2022. ...
... The depression stigma scale developed by Griffiths et al. (2004) was modified by Hart et al. for use to measure the levels of personal stigma towards John/Jeanie vignette in tMHFA (Hart et al., 2018) (scale can be seen in Supplement 3). This scale consists of three distinct dimensions of 'Weaknot-sick' (i.e. ...
... These findings are in line with the theory of planned behaviour (Ajzen, 1991), according to which one's knowledge, attitudes and confidence can influence the engagement in a behaviour via enhanced intention. Additionally, we observed that some demographic factors were significantly related to the quality of both helpful and harmful behaviours, with being female and speaking English at home as protective factors, which is similar to the findings from other studies on adolescents' first aid actions (Hart et al., 2018). ...
It is unclear how well intentions to support an adolescent peer with a mental health problem or in crisis translate into actual help-giving behaviours. Using data from a longitudinal study, this analysis aimed to investigate the associations between mental health first aid intentions and supportive behaviours among adolescents. A sample of 2749 Australian adolescents were included in the baseline analyses of 12 intention items and other covariates. At 12- and 18-month follow-up, 733 and 520 students reported valid data on their help-giving behaviours. Linear and logistic regression models were employed to examine the associations. High-to-moderate concordance was observed between baseline first aid intentions and the corresponding helping behaviours during follow-up assessments, with exceptions in items related to seeking help from adults/professionals or suicide. The overall quality of first aid intentions at baseline was significantly associated with that of helping behaviours at 12-month follow-up, after adjusting for potential confounders. Eleven of the 12 measured intentions prospectively predicted corresponding actions at 12 months, and in seven of them such predictive effect remained significant up to 18 months after training delivery. These findings suggest that adolescents’ first aid intentions can predict their helping behaviours, thus supporting the notion that training programmes that improve adolescents’ first aid intentions have the potential to translate into actual actions. Future research is warranted to narrow the gap between certain intentions and behaviours, particularly those related to seeking help from adults/professionals and suicide.
... This highlights the need for planning and implementing mental health awareness campaigns and other innovative strategies to spread knowledge on mental health and the treatment of mental illness in the community, educational institutions and other organizations worldwide. Previous studies have reported the positive impact of similar interventions, such as Mental Health First Aid training and mental health-promoting messages through social media (Halsall et al., 2019;Hart et al., 2018;Rose et al., 2019). According to the World Health Organization, the health sector has four key roles in achieving the goal of mental health for all. ...
This study aimed to explore self and public stigma towards mental illness and associated factors among university students from 11 Arabic-speaking countries. This cross-sectional study included 4241 university students recruited from Oman, Saudi Arabia, the United Arab Emirates (UAE), Syria, Sudan, Bahrain, Iraq, Jordan, Lebanon, Palestine and Egypt. The participants completed three self-administrative online questionnaires—Demographic Proforma (age, gender, family income, etc.), Peer Mental Health Stigmatization Scale and Mental Health Knowledge Questionnaire. There was a significant difference in the average mean between the 11 countries (p < 0.01) based on stigma agreement (self) and stigma awareness (public). The mean stigma agreement towards mental illnesses among university students was 19.7 (SD = 6.0), with the lowest in Lebanon, 15.9 (SD = 5.1) and the highest in UAE, 24.1 (SD = 5.6). The factors associated with stigma agreement included poor knowledge, being male, high family income, age, weak cumulative grade point average (cGPA), mothers with primary education, an unemployed parent, students in scientific colleges and fathers who completed secondary or university degrees. Furthermore, the factors associated with stigma awareness included good knowledge, acceptable cGPA and having a father who has a low income and is illiterate. Stigma towards mental illness varies among university students across Arabic-speaking countries. There is a need to sensitize youngsters to the need for a humanitarian approach in society to individuals affected by mental health concerns. Major governmental reforms must be initiated for the provision of mental health services for individuals with mental illnesses.
... 10,11 Many youth report that if they were to experience a mental health problem, they would first turn to a friend. 12,13 Teens, however, are less likely than adults to: (1) recognize symptoms as mental illness, (2) suggest professional help be sought, or (3) ask about suicidal thoughts. The attitudes and suggestions of friends are known to strongly influence the likelihood a young person will disclose their problems to an adult or seek out professional help. ...
... The attitudes and suggestions of friends are known to strongly influence the likelihood a young person will disclose their problems to an adult or seek out professional help. 12 Increasing skills in providing support to peers is an untapped but powerful pathway for reducing untreated mental illness and suicide risk in youth. ...
... [17][18][19][20] To fill a gap in direct programming to teens, a classroom-based curriculum, tMHFA was developed in Australia in 2012 for youth in grades 10 to 12. 21,22 Three trials of tMHFA have been conducted in Australia, including two randomized controlled trials, finding increased mental health literacy as well as reduced stigmatizing attitudes immediately following tMHFA and 1 year later. 12,16,22,23 tMHFA also showed a statistically significant increase in Australian adolescents' recognition of and support for suicidal peers. 24 Full details of the US adaptation process of tMHFA are summarized elsewhere. ...
Background:
teen Mental Health First Aid (tMHFA) is an Australian school-based universal program for grade 10 to 12 students. tMHFA teaches teens how to recognize and respond to a peer in crisis or experiencing mental health concerns.
Methods:
Schools implementing tMHFA in 2019 and 2020 were propensity score matched, yielding a sample of instructors (n = 130) and students (n = 1915) in 44 high schools in 24 American states. Effectiveness and acceptability were assessed with student surveys at baseline and after implementation.
Results:
There were significant findings for primary outcomes, including improved helpful first aid intentions (Cohen ds = 0.57 to 0.58), confidence supporting a peer (ds = 0.19 to 0.31); the number of adults rated as helpful (ds = 0.37 to 0.44); and reductions in stigmatizing beliefs (ds = 0.21 to 0.40) and "harmful first aid intentions" (ds = 0.11 to 0.42). Instructors and students rated the program favorably with students sharing improvements on their recognition and responses to mental health problems and crises.
Conclusion:
tMHFA is an effective, feasible, and scalable training program for increasing mental health literacy and decreasing mental health stigma in adolescents in the short term, consistent with trials of tMHFA in Australian adolescents.
... Specifically, the tMHFA Action Plan involves: (1) Look for warning signs; (2) Ask how they are; (3) Listen up; (4) Help them connect with an adult; and (5) Your friendship is important, which were shortened as "Look, Ask, Listen, Help, Your Friend" for an easy to remember format [9]. There is good evidence that the tMHFA intervention is an effective and feasible program for improving supportive behaviours towards peers, increasing mental health literacy and reducing stigma among adolescents [8,11,13]. ...
... Scale items were derived over the course of tMHFA evaluations [8,13] and comprehensively revised during multiple workshops by a research group with expertise in tMHFA courses and/or general mental health first aid evaluations to ensure that they covered the spectrum of actions from the tMHFA Action Plan and reflected the key supportive strategies of tMHFA training. Given the importance of item selection and writing for the validity of a scale [22], a pilot survey of the MHSSA was conducted among its target population (i.e., adolescents aged 14-18 years, n = 23) to ensure that items were written at an age-appropriate reading level [8]. ...
... The Depression Stigma Scale developed by Griffiths et al. [31] was modified by Hart et al. for use with the John/ Jeanie vignettes in tMHFA [13]. Yap et al. [27] examined the properties of the scale in young people and reported that there were three distinct dimensions of "weak-notsick" (i.e., viewing mental illness as a sign of personal weakness, rather than a medical illness), "dangerous/ unpredictable" (i.e., seeing people with mental illness as dangerous or unpredictable), and "would not tell anyone" (i.e., would not tell anyone if they themselves had a mental health problem, reflecting personal stigma). ...
Background
The Mental Health Support Scale for Adolescents (MHSSA) is a criterion-referenced measure of adolescents’ supportive intentions towards peers with mental health problems, which was developed for use in evaluations of adolescent mental health interventions, such as the teen Mental Health First Aid (tMHFA) program. The present study aimed to examine the validity and reliability of the MHSSA.
Methods
A sample of 3092 school students (Mean ± SD: 15.9 ± 0.4 years old) and 65 tMHFA Instructors (the adult group with known expertise in tMHFA) completed the 12 items of the MHSSA. A sub-sample of 1201 students repeated the scale after a 3-4-week interval. Item concordance rates with the tMHFA Action Plan across helpful and harmful intentions scales were calculated. Scale reliabilities were assessed using agreement coefficients from a single test administration and test-retest reliability measured by intraclass correlation coefficients. The mean differences of MHSSA scores of students and Instructors were compared using independent samples t-tests, while convergent validity was tested via correlations of the scale with validated measures of confidence in providing help, social distance and personal stigma.
Results
The average score of Instructors was significantly higher than that of students. The scale was positively associated with confidence in providing help, whilst negatively associated with social distance and dimensions of personal stigma. All scales of MHSSA had high agreement coefficients (all > 0.80) and fair to good test-retest reliability over 3–4 weeks.
Conclusions
The MHSSA shows evidence of validity and reliability for use among adolescents for evaluating the quality of intentions to help peers with mental health problems.
... Participants were asked to respond to seven statements assessing personal stigma using a fivepoint Likert scale, ranging from 1 ('strongly disagree') to 5 ('strongly agree'). The statements were divided into three components: 'I-would-not-tell-anyone' , 'Weak-notsick' , and 'Dangerous/unpredictable' subscales, as utilised and validated in prior studies [41,[48][49][50]. The 'I-wouldnot-tell-anyone' subscale comprised one item that focused on the belief that it is better not to tell others if they had a similar problem (e.g., "You would not tell anyone if you had a problem like Dawood/ Miriam's"). ...
Background
Arabic-speaking refugee and migrant populations form a significant proportion of Australia’s population. Despite high levels of psychological distress among Arabic-speaking populations, low uptake of mental health services has been demonstrated. Evidence suggests poor levels of mental health literacy (MHL) and high levels of stigmatising attitudes among Arabic-speaking populations, which may act as barriers to help-seeking behaviours. This study aimed to explore the relationships between measures of mental illness stigma, socio-demographic factors and psychological distress, as well as to determine the factors associated with MHL (i.e., correct recognition of mental illness and knowledge of causes) among Arabic-speaking refugee and migrant populations in Australia.
Methods
Participants were recruited from non-government organisations in Greater Western Sydney that provided support services to Arabic-speaking migrants and/or refugees. As this study is nested within an interventional pilot study evaluating a culturally tailored MHL program, only the pre-intervention survey responses for 53 participants were utilised. The survey measured key aspects of MHL (i.e., recognition of mental illness, knowledge of causes), levels of psychological distress (using K10 scale), and stigmatising attitudes towards mental illness (using Personal Stigma Subscales and Social Distance Scale).
Results
The Personal Stigma subscale of ‘Dangerous/unpredictable’ was strongly positively correlated with participants’ K10 psychological distress scores and strongly negatively correlated with years of education completed. There were moderate negative correlations between two Personal Stigma subscales (‘Dangerous/unpredictable’ and ‘I-would-not-tell-anyone’) and the length of stay in Australia. Being female was associated with an increase in personal stigma demonstrated by higher scores for ‘I-would-not-tell-anyone’ subscale than males. Similarly, increase in age was associated with a decrease on scores of the personal stigma ‘Dangerous/unpredictable’.
Conclusions
While future research with larger sample size are needed, the study findings can be considered as adding to the evidence base on mental illness related stigma in Arabic-speaking populations. Further, this study provides a starting point in developing the rationale for why population sub-group specific interventions are required to address mental illness stigma and improve MHL among Arabic-speaking refugee and migrant populations in Australia.
... A randomized cluster crossover trial comparing tMHFA to Physical First Aid among adolescents was then conducted in Australia and found that young people receiving tMHFA were significantly more likely to report helpful first aid intentions, increased mental health literacy, and less likely to endorse stigmatizing attitudes about mental illness than those who received physical first aid training (Hart et al., 2018). Hart and colleagues (2020) analyzed helping behaviors related to suicidal thoughts and behaviors. ...
... Just as Mental Health First Aid Australia-the organization that delivers A.U. tMHFA to schools in Australia-has safety protocols for instructors and schools (Hart et al., 2016(Hart et al., , 2018, the National Council encouraged schools to develop a student safety protocol. The National Council created a sample protocol for schools to use as a template if they did not have one already in place that included steps for reaching out to the teen and their parents/caregivers and referring them to a professional mental health clinician when necessary. ...
... The A.U. tMHFA curriculum provides implementation guidance for instructors and schools to use the program in their local context (Hart et al., 2016(Hart et al., , 2018. YMHFA instructors recommended modifying the A.U. guidance with additional resources for helping schools and organizations integrate the US tMHFA curriculum into their overall mental health promotion and crisis response plan. ...
teen Mental Health First Aid (tMHFA) is an evidence-based program developed in Australia that teaches young people in grades 10–12 how to identify and respond to signs of mental health challenges and crises among peers. Recognizing the growing adolescent mental health crisis in the USA, the National Council for Mental Wellbeing, in partnership with a Johns Hopkins University research team, used a multimethod research approach to adapt the program culturally and contextually from Australia to the USA. The goals of the study were to engage adolescents, MHFA instructors, and content area experts (N = 171) in a process to determine: how to retain the elements of the course that were evidence-based and effective while adapting the program for US students, what topics to add so US students have the essential information and skills teens needed to help a friend experiencing a mental health challenge or crisis, what changes to make to curriculum materials to ensure the style and delivery resonate with US students, and what tools to include so the program is implemented safely and with fidelity in diverse US schools. This paper outlines the adaptation process, including engaging participants, identifying key recommendations for modification, and making changes to the tMHFA program. The findings demonstrate the types of adaptations that may be needed to facilitate implementation and maintenance of program effectiveness when introducing tMHFA to new populations of students in the USA. In addition, the process outlined can be replicated toward this purpose as the program continues to expand both in the USA and in other countries.
... So adolescents spend less time with their parents, and parental control and influence decrease with age. In addition, the effects of peers becoming more prominent [43] offer to teach the components of mental health literacy to them by themselves as a suggested solution. In the present study, there was no significant relationship between household income and high school students' depression health literacy, which may be due to the age of the participants and lack of knowledge about the exact family income [44]. ...
Background:
Given the high prevalence of depressive disorders in the present world and the lack of adequate awareness about prevention and appropriate interventions, increasing mental health literacy is vital for promoting mental health to reduce depression and its consequences.
Methods:
In this descriptive cross-sectional study, participants were recruited among the second high school students in the 2018-2019 academic year. The sample size was 2038, and samples were selected by multistage cluster sampling from different areas of Tehran. Demographic variables like age, gender, level of education, and parents' characteristics and mental health literacy questions in treatment and prevention areas were evaluated.
Results:
Analyses showed that of high school students, 83% considered getting help from psychiatrists and 80% considered learning stress management as the best preventive measures, while as the best treatment measures, 79.5% considered counseling the best place to refer for visiting a professional and 45% selected general counseling centers.
Conclusion:
The study results showed that high school students have a positive attitude toward preventing and treating depressive disorders, getting help from specialists, and useful measures for depressed people. But they did not know enough about preventive measures, including learning effective coping skills, reading self-help books, and continuing to take psychiatric medications. Planning and providing the necessary training are important, especially for high school students.
