Mental Health First Aid (MHFA) Training

Coalitions that Adopted

Connections for Mental Wellness – Brown County
Better Together – La Crosse County

Strategy Type

School-based & Community-based

Strategy Goal

Improve understanding of the effects of mental health challenges for adults to support both their peers and youth who are at risk, helping them recognize mental health issues and equipping them with the tools to address and respond to future challenges.

Intended Population

Community members – both adults and youth – in La Crosse and Brown Counties.

Strategy Background

The U.S. Department of Health and Human Services’ National Prevention Strategy (PDF) recommends training key community members to understand, identify, and respond to mental illness and substance misuse in adults and youth. By focusing on increasing mental health literacy for employees and community members not employed in the mental health arena – such as human resource (HR) professionals and supervisors; leaders in faith communities, public agencies, and non-profits; as well as teachers, school staff, parents, and caregivers – one can build resiliency and increase the possibility of an actionable response to poor mental health across all age groups.

In La Crosse and Brown Counties, two separate coalitions worked to train their communities in Mental Health First Aid (MHFA), a training program designed to equip individuals and organizations with the ability to recognize the signs and symptoms of mental health problems and the confidence to address them through an increased understanding of community resources and how to connect others to them.

The program provides instruction on how to respond to someone struggling with a mental health challenge, such as having a panic attack or when a friend or peer is showing signs of a substance use disorder. MHFA includes opportunities to practice using these skills in real-life situations through role plays, scenarios, and other activities that simulate the following:

Panic attacks;
Suicidal thoughts or behaviors;
Nonsuicidal self-injury;
Acute psychosis;
Overdose or withdrawal from alcohol or drug use; and
Reaction to a traumatic event

MHFA training can benefit both youth and adults in every sector of society. Increasing the knowledge and capacity of employees in both youth-serving and adult-serving roles to address mental health challenges helps to build resiliency and reduce negative outcomes, decreasing the likelihood of crises over time. It can benefit communities and workplaces by reducing stigma surrounding mental health issues, making individuals feel more comfortable to reach out for help.

MHFA training also sets individuals and workplaces up for success by creating environments where participants are more knowledgeable about support strategies, treatment options, and where to access resources, allowing them to better assist those around them who may be struggling, and further allowing organizations to develop policies and practices that promote mental health and well-being. This can lead to a more productive and engaged workforce, reduced absenteeism, and improved overall workplace culture.

In both La Crosse and Brown Counties, MHFA training was provided free of charge to all individuals. La Crosse’s Better Together coalition primarily conducted courses in Youth MHFA, Fire & EMS, as well as Public Safety. With an emphasis on Fire & EMS and Public Safety, Better Together helped change culture within the community’s first responders, fostering a healthier, more resilient department. Brown County’s Connections for Mental Wellness coalition primarily trained in Adult MHFA, which focused on building workplace capacity for addressing mental health challenges among co-workers. Both organizations used their community connections across sectors to engage individuals from law enforcement to faith-based organizations working to increase their understanding of mental health issues and the actions needed to address them.

4/9 community trainers in Better Together are police officers, while others come from non-profits, healthcare, and a local university.

The City of La Crosse has 95% of its city employees trained in MHFA – including 100% of its Fire and Police Departments.

Better Together was able to incorporate MHFA training for staff in all La Crosse County school districts, including the largest private school district, as well as multiple youth-serving agencies in the region!

Strategy

In order to successfully implement MHFA in your community, Better Together and Connections for Mental Wellness have listed the following core components to guide you. While these items were key to the coalitions' shared success in LaCrosse and Brown Counties, you should consider what changes might be necessary based on the needs and behavioral health environment of your own community.

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Plan Community Outreach to Participants

Ahead of community outreach to recruit participants, create a simple sign-up form to track participant names, emails, phone numbers, and referral sources. Tracking the referral source aids in future decision making, as it will help measure what sectors outreach has been successful in and where it can be improved. Leveraging your community connections will aid in the dissemination of this application, allowing you to share it via email with organizations throughout your area.

MHFA Application (PDF)

Recruit Trainers

To begin the process of recruiting trainers, it’s key to look throughout the community and identify organizations and workplaces across various sectors to bring in a diverse group of individuals that allows MHFA to reach multiple industries. Consider people who are embedded in the community or their workplace – leaders from healthcare, education, faith-based organizations, parents, and law enforcement – and would be able to provide training as part of their work, such as HR professionals, supervisors, and leaders within their respective organizations.

Tip: Recruiting trainers within law enforcement is a very powerful tactic, as police around the nation are directing more attention to crisis response and intervention.

Certify Trainers

Certification for conducting MHFA involves a three-to-five-day training offered in-person or virtually to learn in-depth instruction of the MHFA curriculum and facilitation, including best teaching practices, how to receive feedback, and an evaluation of each candidate’s ability to facilitate the course. If you pass the evaluation, certification does not expire as long as you conduct three courses per year and follow through with training for best practices if they are released by MHFA.

Note: If you are already certified in Adult MHFA, an additional Youth MHFA certification requires passing an extra day and a half course or vice versa.

Market the Training

Marketing efforts may involve a wide range of tactics, such as setting up tables at local events for people to learn about MHFA and sign-up for scheduled trainings, word of mouth at networking events, local outreach to youth-serving agencies, and even earned media. Leveraging your connections with local institutions to spread awareness of MHFA and showcase its benefits can be extremely beneficial in recruiting participants.

"Back-Check Suicide" puts hockey tourney on mental-health power play - WXOW
Brown County Flyer (PDF)

Registering participants for the virtual session requires you, the designated training organizer, to send the National Council for Wellbeing participant names, phone numbers, emails, and the scheduled training date. The Council will then send curriculum materials for you to hand out on the day of the training. For virtual sessions, the Council will then share a registration link with the participants, leaving them responsible for following through with the sign-up process. Once sign-up is complete, digital materials are shared directly to the participant’s email.

Conduct Data Analysis

The MHFA pre-test and post-test provide information on whether the training is successful to ensure people are gaining the intended knowledge and information as set out by the National Council for Wellbeing. These evaluations allow you to gauge whether the objectives of the training have been met, which is important for trainers looking to improve on course instruction.

Showcase Results

Using the data collected from course evaluations, pre and post-tests, you can report out on the MHFA trainings to host organizations and showcase the training’s success. This can lead not only to additional trainer certifications, but also the embedding of MHFA curriculum in an organization’s onboarding, thus improving the long-term sustainability of the training.

Challenges & Tactics to Address Them

Navigating successful strategy implementation can be complex, and obstacles will arise that set your plan back.

List of Challenges & Tactics

From conducting a training virtually to keeping up with a changing curriculum, the path forward is often uncertain and challenging. The following section includes common challenges faced when coordinating a MHFA training and tactics recommended by both Better Together and Connections for Mental Wellness to address them and pave the way for successful implementation.

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Duration of Trainings

Due to the length of MHFA trainings, organizations may have limited availability to host them. It’s important to keep your mission in mind in these scenarios. Being flexible in scheduling the trainings to ensure they are conducted to fidelity and within the host organizations availability is crucial. This can mean splitting the training into four-hour sections on consecutive days or scheduling full sessions on short notice.

On the other hand, discussions had during the training can run longer than anticipated, leading to the course extending beyond the eight-hour mark. Being respectful of the thoughts, stories, and opinions of participants is important, but to keep the course on track, consider continuing certain discussions after the course has been completed.

Virtual Training

In virtual settings, the MHFA training is difficult to conduct, as participants find it difficult to stay engaged in the content for eight hours in front of a computer. Some may not show up for the training, leading to wasted finances. Moreover, not all individuals who would like to participate have access to a computer, decreasing the number of potential participants. To avoid the difficulties of virtual MHFA training, consider a shorter alternative to MHFA or host trainings in-person only.

Changing Curriculum

Through the years, MHFA training has gone through a number of changes regarding the trainer certification process, the trainee registration process, and shifts between virtual and in-person instruction, while maintaining a consistent and comprehensive curriculum. To keep up with these changes, it’s important to maintain consistent interaction with the interface and hold regular trainings.

Group Buy-in

There are many mental health training options on the market, and obtaining enough group buy-in to select the right one can be a challenge. While pitching MHFA, it’s important to note it has research to back its effectiveness. Over the past decade, there has been a growing number of studies showing the efficacy of MHFA to increase knowledge, reduce stigma, and increase the confidence of those helping others in distress. This robust training provides a comprehensive overview of responding to mental health challenges by educating on the necessary resources for individuals to aid those in crisis.

Data Analysis

Data from pre- and post-test results is not readily available for the training organizer to view; however, the course evaluation will allow you to pull bar graphs or Likert scales on how successful you are as an instructor. While the training organizers can retrieve this information through a formal request on the MHFA interface, raw data is not available, so consider keeping track of data on your own, including qualitative information through an informal check-in survey.

Organizational Costs

When training large organizations, the costs incurred by the training organizer can be significant. Coordinating a cost-share plan with the organization requesting the training can address this issue if they have funding available.

Cost incurred may include:

Manual
Processing Guide
Venue reservation
Trainer Reimbursement

Brown County Statistics

MHFA trainings

756

Brown County residents trained in MHFA

MHFA instructors certified in Northeast Wisconsin

Best Practices

Through the process of implementing their respective behavioral health strategies, each AHW-funded coalition recorded its lessons learned to streamline their strategy processes going forward. Tried-and-true best practices also enhance the likelihood of achieving desired outcomes. The following section includes an insightful list of learned best practices Better Together and Connections for Mental Wellness recommend other organizations employ to steer their strategy towards successful implementation.

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Two-Presenter Approach

During trainings, it is helpful to have two presenters in the session to balance the large amount of content. While one person is presenting, the other can handle the technical side of moving through slides, sharing handouts, and administering polls. Additionally, if a participant needs to step out of the room due to the nature of the content, having a second presenter on hand allows the training to move forward uninterrupted, while the other is able to check-in on the participant.

Coalition Network

One extremely beneficial tactic for MHFA trainers is the creation of a separate coalition of MHFA instructors across a large region (i.e., not limited to the county) where instructors can collaborate, share best practices, and mentor those looking to learn more. The partnerships built and collaboration with existing collective impact organizations aids in building a stronger community network through shared resources, information, and ideas.

Note: Connections for Mental Wellness joined the Community Information System and the formation of a Collective Impact Hub where four initiatives shared space, resources, and served as a “think tank” for addressing higher levels of system change.

Create a Positive Learning Environment

If funds permit, when conducting a training, provide snacks and beverages to show the group appreciation and foster a positive learning environment.

Community Events

Curating events with leaders from various sectors to conduct mass trainings in both Adult and Youth MHFA increases the role those leaders play in supporting those living with mental illness and their capacity to share resources. These community events can help generate media buzz, thus increasing the community’s awareness of MHFA and further growing the opportunity for scheduling trainings.

One Mind Pledge

As more law enforcement agencies look to develop crisis intervention tactics, it is immensely beneficial for them sign the One Mind Pledge, which requires the entire local law enforcement to train in MHFA and improve their capacity to serve the community in mental health crisis situations. This can lead to increased dialogue among public safety – EMS, police, and firefighters – about the trauma they experience and the importance of self-care.

Note: In the City of La Crosse, the Chief of Police signed on to the One Mind pledge. In partnership with Better Together, law enforcement staff were trained as MHFA trainers leading to trainings for the fire department, city employees, bus drivers, and more!

Mental Health 101

Not all organizations will have the time or capacity to participate in a full 8-hour MHFA training. In this event, an option separate from MHFA should be used as a precursor, allowing you to introduce participants to mental health response tactics. This basic training can ultimately lead organizations and individuals to follow through with a full MHFA training.

Data Collection

Tabulating the data you collect will allow you to analyze results by various demographics, such as workforce and community sector, informing your work and letting you know where in the community to conduct more outreach for trainings. The data you collect will also be helpful in evaluating yourself as an instructor.

Survey Participants

If you or your organization’s work involves more than just MHFA, it is beneficial to survey participants to monitor the perception of a company or organization’s culture surrounding mental wellness, assess the effect of trainings on mental wellness policies and practices, as well as employee attitudes. This will establish a baseline for training participants and capture changes in employee knowledge, attitudes, and practices over time.

Trainer Selection

Certifying trainers is an expensive process, so it is important to select trainers who are likely to stay committed to the work long-term. Recruit those who have shown a commitment to the community and dedication to improving mental health in it.

La Crosse County Statistics