Evaluation of the Conversations about Non-Suicidal Self-Injury Mental Health First Aid Course: Effects on Knowledge, Stigmatising Attitudes, Confidence and Helping Behaviour.

BACKGROUND: Non-suicidal self-injury (NSSI) is a common mental health problem, with a 19% lifetime prevalence in Australian adolescents and 12% in adults. Though rates of professional help-seeking for NSSI are low, disclosure to family and friends is more common, providing opportunities for them to encourage professional support. Mental Health First Aid® Australia's Conversations about Non-Suicidal Self-Injury course provides evidence-based training for the general public to support a person engaging in NSSI. METHODS: This uncontrolled trial evaluated the effects of the Conversations about Non-Suicidal Self-Injury course on participants' knowledge, confidence, stigmatising attitudes, and intended and actual helping behaviours. Surveys were administered pre- and post-course, and at a six-month follow-up. A linear mixed-model analysis determined mean change over time, and effect sizes were estimated using Cohen's d. Course satisfaction was assessed using descriptive statistics and summative content analysis of qualitative data. RESULTS: The pre-course survey was completed by 147 Australian participants (77.5% female, mean age 45.8 years), 137 (93.2%) at post-course and 72 (49%) at follow-up. Knowledge, confidence, quality of intended helping behaviours, and quality of actual helping behaviours increased significantly at both time points. Social distance decreased significantly at all time points and stigma decreased significantly at post-course. The course was perceived to be highly acceptable by participants. CONCLUSIONS: There is initial evidence that the Conversations about Non-Suicidal Self-Injury course is effective and acceptable for members of the public who may support a person engaging in NSSI.

Redevelopment of mental health first aid guidelines for supporting someone experiencing a panic attack: a Delphi study.

BACKGROUND: Panic attacks and panic disorder can have a major impact on the mental health and wellbeing of those who experience them. People with recurrent panic attacks have increased odds of developing a mental disorder and of worsening the course of existing mental disorders. Early intervention efforts at the time that a panic attack occurs might reduce or prevent some of these associated negative outcomes. Expert consensus guidelines for high income Western countries on how to provide mental health first aid for panic attacks were published in 2009. The present study aims to redevelop these guidelines to ensure content reflects current evidence and best practice. METHODS: The Delphi consensus method was used to determine which helping strategies should be included in the redeveloped guidelines. A survey with items on how to assist someone who is having a panic attack was developed using the 2009 guidelines and a systematic search of grey and academic literature. Panellists with lived experience and professional experience rated these items to determine which helping statements should be included in the guidelines. RESULTS: Thirty panellists completed all three surveys. Panellists rated 158 statements, with 83 statements meeting the criteria for inclusion in the redeveloped guidelines. The endorsed statements covered: what the first aider should know about panic attacks, what they should do if they think someone is having a panic attack, what they should do if they are uncertain whether the person is having a panic attack, what they should say and do if they know the person is having a panic attack and what they should do when the panic attack has ended. CONCLUSION: This study has resulted in a more comprehensive set of guidelines than the original version, with the endorsement of 83 helping actions, compared to 27 previously. The redeveloped guidelines provide greater detail on recognising the signs of a panic attack, providing initial assistance, communicating with someone experiencing a panic attack and supporting them to seek appropriate professional help if it is needed. The guidelines will be used in future updates of Mental Health First Aid training courses.

Evaluation of the Conversations About Gambling Mental Health First Aid course: effects on knowledge, stigmatising attitudes, confidence and helping behaviour.

BACKGROUND: The effects of problem gambling are wide-ranging, affecting many aspects of health and negatively impacting the person who gambles, their family and friends, and their community. People experiencing problem gambling have low rates of help-seeking and perceive many barriers to treatment, although evidence suggests that encouragement and support from friends and family can increase rates of help-seeking. Mental Health First Aid Australia's Conversations About Gambling course aims to teach members of the public evidence-based strategies for recognising and responding to signs of problem gambling in a person they know. METHODS: This research evaluated the effects of the Conversations About Gambling course on participants' knowledge, confidence, stigmatising attitudes, intended helping behaviour and actual helping behaviour towards a person experiencing problem gambling. Participants from Australia completed surveys before the course, immediately after the course and six months later. Changes over time (pre-course to post-course, and pre-course to 6-month follow-up) were assessed with linear mixed models. Descriptive statistics and content analyses of open-ended questions pertaining to participants' satisfaction with the course were also produced. RESULTS: Between 2018 and 2020, 166 participants were recruited into this study. At 6-month follow-up 87 participants (52.4%) provided data. Participants' knowledge about gambling and gambling problems, confidence, desire for social distance and intentions to help a person experiencing problem gambling significantly improved from pre-course to post-course, and from pre-course to 6-month follow-up. The quality of some actions taken to support a person they knew who was experiencing problem gambling also improved from pre-course to 6-month follow-up, in line with the teachings of the course. Participants perceived the course to be highly acceptable. CONCLUSIONS: The results of this initial evaluation of Mental Health First Aid Australia's Conversations About Gambling course suggest that it is an effective and acceptable educational intervention for those who wish to support a person experiencing problem gambling.

Effects of the Mental Health First Aid for the suicidal person course on beliefs about suicide, stigmatising attitudes, confidence to help, and intended and actual helping actions: an evaluation.

BACKGROUND: Suicide is a significant concern in Australia and globally. There is a strong argument for training community gatekeepers in how to recognise and support suicidal people in their social network. One such training course is the Mental Health First Aid for the Suicidal Person course. This course was developed using suicide prevention best practice guidelines based on expert opinion (determined using the Delphi Method). METHODS: We evaluated the impact of attending the Mental Health First Aid for the Suicidal Person course on suicide literacy and stigma, confidence in and quality of intended and actual helping behaviours towards a person who is suicidal, and course satisfaction. Surveys were administered before and immediately after the course, and at 6-month follow-up. Data were analysed to yield descriptive statistics (percentages, means, standard deviations), with linear mixed models and generalized linear mixed models being used to test the statistical significance of changes over occasions of measurement. RESULTS: We recruited 284 participants from workplaces and general community networks. The mean age was 41 years and 74% were female. 85% of people undertook the course as part of professional development, and almost half (44%) did the course because they had contact with a suicidal person. The majority (59%) of participants had previous mental health and suicide prevention training. The majority of participants held knowledge (suicide literacy) before undertaking the course. The major effect of training was to strengthen this knowledge. There was a significant improvement from pre-course (M = 1.79, SD 0.56) to post-course (M = 1.48, SD 0.82, p < 0.0001), which was maintained at follow-up (M = 1.51, SD 0.49, p < 0.0001). Confidence in gatekeeper skills significantly improved after the course and at follow-up (M = 3.15, SD 0.95 before the course to M = 4.02, SD 0.68 afterward and 3.87, SD 0.77 at follow-up, p < 0.0001 and p < 0.0001, respectively). The quality of intended helping behaviours significantly improved from pre-course (intended actions M = 4.28, SD 0.58) and to post-course (M = 4.70, SD 0.50, p < 0.0001) and were maintained at follow-up (M = 4.64, SD 0.41, p < 0.0001). There was significant improvement in some of the actions taken by participants to help a suicidal person from pre-course to post-course (e.g. asking about suicidal thoughts and plan, contacting emergency services). The course was highly acceptable to participants. CONCLUSION: These results indicate that this course is an acceptable intervention that delivers a broad spectrum of beneficial outcomes to community and workplace gatekeepers.

Considerations when offering mental health first aid to a person with an intellectual disability: a Delphi study.

BACKGROUND: People with an intellectual disability experience higher rates of mental health problems, but experience significant barriers to receiving professional help. Increasing the knowledge and skills of those who support them can help to reduce some of these barriers. This study aimed to develop guidelines for offering mental health first aid to a person with an intellectual disability. METHODS: Using the Delphi research method, a systematic search of websites, books and journal articles was conducted to develop a survey containing items about the knowledge, skills and actions needed for assisting a person with an intellectual disability who is experiencing mental health problems. These items were rated over three survey rounds by an expert panel according to whether they should be included in the guidelines. RESULTS: Fifty-three experts completed all three survey rounds (67% retention rate). A total of 202 items were rated over the three rounds to yield 170 endorsed items that were incorporated into the guidelines. The developed guidelines emphasise the need to recognise the unique signs of mental health problems in people with an intellectual disability, and provide appropriate support, communication and respect for people with an intellectual disability. The guidelines will also build the capacity of carers to address behaviours of concern, socially limiting behaviours or seeking professional help when the need arises. The guidelines will be used to develop a mental health first aid course. CONCLUSION: The guidelines and the resultant mental health first aid course will be a helpful resource with the potential to address some of the barriers to mental health help-seeking that people with an intellectual disability experience.

Offering mental health first aid to a person experiencing psychosis: a Delphi study to redevelop the guidelines published in 2008.

BACKGROUND: Psychotic illnesses can have a major impact on those who experience them. Timely treatment for psychosis is important and friends, family members and the public can be a facilitating factor in social support and professional help-seeking. Expert consensus guidelines on how to provide mental health first aid to a person experiencing psychosis were developed in 2008. This Delphi study aimed to redevelop the guidelines to reflect current evidence. METHODS: The Delphi consensus method was used to determine which helping strategies should be included in the redeveloped guidelines. A systematic search of grey and academic literature was undertaken to identify strategies on how a member of the public can assist someone experiencing psychosis. These strategies were organised into questionnaire statements. Two expert panels-one comprising people with lived experience (Carers and Consumers) and one of professionals-completed three consecutive rounds of online survey questionnaires to rate the importance of each helping statement for inclusion in the guidelines. Statements were included in the guidelines if they were endorsed by at least 80% of each panel. RESULTS: The expert panels rated 515 statements across three rounds of surveys, with 325 statements meeting the criteria for inclusion in the redeveloped guidelines. 59 panel participants completed all three surveys. CONCLUSIONS: The redeveloped guidelines outline a general set of strategies for providing initial assistance to a person who is experiencing psychosis. Compared to the original guidelines, these redeveloped guidelines provide more detailed instruction for members of the public on how to provide mental health first aid to assist a person experiencing psychosis. The guidelines are available to the public and will be used to update the Mental Health First Aid courses.

Offering mental health first aid to a person after a potentially traumatic event: a Delphi study to redevelop the 2008 guidelines.

BACKGROUND: Trauma has a major impact on the mental health and wellbeing of people globally. Friends, family and members of the public are often well positioned to provide initial assistance if someone is experiencing extreme distress following a potentially traumatic event. Expert consensus guidelines for high income, Western countries on how to do this were published in 2008. The aim of the current study was to re-develop these guidelines to ensure they are current and reflect best practice. METHODS: The Delphi consensus method was used to determine which helping statements should be included in the guidelines. Helping statements were derived from a systematic search of literature that considered how a member of the public could help someone experiencing extreme distress following a potentially traumatic event. Two expert panels, comprising 28 mental health professionals with expertise in managing trauma and 26 consumer advocates, rated each statement. Statements were accepted for inclusion in the guidelines if they were endorsed by at least 80% of each panel. RESULTS: Out of 183 statements, 103 were endorsed as appropriate helping actions in providing assistance to someone experiencing extreme distress following a potentially traumatic event. These statements were used to form the re-developed guidelines. CONCLUSION: This study has resulted in a more comprehensive set of guidelines than the original version, with the endorsement of 103 helping actions, compared to 65 previously. The updated guidelines better represent the complexities of experiencing trauma and the considered approach required when providing first aid after a potentially traumatic event. The additional guidance on providing initial assistance, talking about the trauma, offering short-term assistance and seeking appropriate professional help reflects current knowledge. A notable addition is the inclusion of content on how a first aider can assist after a disclosure of abuse. The guidelines are available to the public and will inform future updates of Mental Health First Aid training courses.

Teen Mental Health First Aid for years 7-9: a description of the program and an initial evaluation.

BACKGROUND: A teen Mental Health First Aid training course for high school students in years 10-12 (tMHFA 10-12) has previously been evaluated in uncontrolled and randomized controlled trials and found to improve Mental Health First Aid intentions, mental health literacy and to reduce stigma. This 3 × 75-min course has more recently been adapted for younger students in years 7-9 (tMHFA 7-9). The present study reports an initial uncontrolled trial of this new training course which aimed to assess feasibility and acceptability of the course and test effects on knowledge, attitudes and behaviour. METHODS: An uncontrolled trial was carried out in five schools with measures taken at pre-test, post-test and 3-month follow-up. The outcomes measured were: quality of first aid intentions to help peers, confidence in helping, stigmatising attitudes, recognition of anxiety disorder, number of adults thought to be helpful, help-seeking intentions, quality of support provided to a peer, quality of support received, and psychological distress. Questions were also asked about satisfaction with the course. RESULTS: There were 475 students (mean age 13.86 years) who provided data at baseline, with 76% of these providing data at post-test and 75% at follow-up. Sustained changes at follow-up were found for: number of adults thought to be helpful, some components of stigma, recognition of anxiety disorder, and quality of support provided to a peer. However, there was an unexpected decline in willingness to tell others about a mental health problem. Most students found the information presented to be new, easy to understand, and useful. CONCLUSIONS: The tMHFA 7-9 training course produced some positive changes that were sustained over 3 months. However, the changes were not as strong as previously found for older high school students, suggesting the need for further refinement of the course.

Offering mental health first aid to a person with depression: a Delphi study to re-develop the guidelines published in 2008.

BACKGROUND: Depressive disorder is ranked as the largest contributor to non-fatal health burden. However, with prompt treatment, outcomes can improve. Family and friends are well placed to recognise the signs of depression and encourage early help seeking. Guidelines about how members of the public can provide mental health first aid to someone who is experiencing depression were developed in 2008. A Delphi study was conducted to re-develop these guidelines to ensure they are current and reflect best practice. METHODS: A survey was developed using the 2008 depression mental health first aid guidelines and a systematic search of grey and academic literature. The questionnaire contained items about providing mental health first aid to a person with depression. These items were rated by two international expert panels - a lived experience panel (consumers and carers) and a professional panel. RESULTS: Three hundred and fifty-two items were rated by 53 experts (36 with lived experience and 17 professionals) according to whether they should be included in the revised guidelines. There were 183 items that met the criteria to be included in the updated guidelines. CONCLUSIONS: This re-development has added detail to the previous version of the guidelines, giving more guidance on the role of the first aider and allowing for a more nuanced approach to providing first aid to someone with depression. These guidelines are available to the public and will be used to update the Mental Health First Aid courses.