Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: A meta-analysis

Abstract

Mental Health First Aid (MHFA) is a standardized, psychoeducational programme developed to empower the public to approach, support and refer individuals in distress by improving course participants’ knowledge, attitudes and behaviours related to mental ill-health. The present paper aims to synthesize published evaluations of the MHFA programme in a meta-analysis to estimate its effects and potential as a public mental health awareness-increasing strategy. Fifteen relevant papers were identified through a systematic literature search. Standardized effect sizes were calculated for three different outcome measures: change in knowledge, attitudes, and helping behaviours. The results of the meta-analysis for these outcomes yielded a mean effect size of Glass’s Δ = 0.56 (95% CI = 0.38 – 0.74; p < 0.001), 0.28 (95% CI = 0.22 – 0.35; p < 0.001) and 0.25 (95% CI = 0.12 – 0.38; p < 0.001), respectively. Results were homogenous, and moderator analyses suggested no systematic bias or differences in results related to study design (with or without control group) or ‘publication quality’ (journal impact factor). The results demonstrate that MHFA increases participants’ knowledge regarding mental health, decreases their negative attitudes, and increases supportive behaviours toward individuals with mental health problems. The MHFA programme appears recommendable for public health action.

Acknowledgements

We would like to thank Jerzy Wasserman for critically revising the manuscript for important intellectual content, as well as Maria Anna Di Lucca for statistical consultation.

Declaration of interest: The preparation of the manuscript was funded solely through the Swedish National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP) personnel salaries, acquired from Karolinska Institutet (V.C., D.W.), and Stockholm County Council (G.H., S.H., A.M.). Articles included in the analyses were downloaded via the Karolinska Institutet electronic library. The institution of the authors, NASP, also constitutes the scientific and educational basis for MHFA in Sweden. The authors alone are responsible for the content and writing of the paper.