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Mental Health First Aid: Training and Resources for Rural Populations

September  5,  2013    

Wendy  Opsahl,  PhD  Manager,  Rural  MHFA  Outreach  Project  

Vice  President,  CommunicaIons,    Atlas  Research  

 

MHFA: Agenda

•  Background      

•  About  Mental  Health  First  Aid    

•  PromoIonal  strategy  

•  Campaign  status  

•  Upcoming  acIviIes  and  presentaIons  

•  EvaluaIon  plans  

•  Q&A    

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Project Background Project:        Reaching  Rural  Safety  Net  Providers  with  MHFA  Funder:        Health  Resources  and  Services  AdministraIon  Manager:    Atlas  Research  Timeline  :  October  2012  –  September  2013  Purpose:  Extend  the  reach  of  MHFA  into  rural  communiIes  naIonwide  

MHFA: About Mental Health First Aid •  Evidence-­‐based  public  educaIon  program  •  Developed  in  Australia  and  introduced  in  the  U.S.  in  2008  •  DemysIfies  mental  illness  and  gives  people  the  capacity  to                  obtain,  process,  and  understand  informaIon  needed  to  make                  decision  and  seek  care  •  Low-­‐cost,  high-­‐impact  program  •  Capable  of  working  and  spreading  effecIvely  throughout  society  

(more  than  100K  people  have  been  trained  since  2008)  •  Operated  in  the  U.S.  by  the  Mental  Health  First  Aid  USA  (members  include  

the  NaIonal  Council  for  Behavioral  Health,  the  Maryland  Dept.  of  Health  and  Mental  Hygiene,  and  the  Missouri  Dept  of  Mental  Health)  

•  Vision:  By  2020,  Mental  Health  First  Aid    in  the  USA  will  be  as  common  as    CPR  and  First  Aid

 

 

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•  Help  offered  to  a  person  developing  a  mental  health  problem  or  experiencing  a  mental  health  crisis  

•  Given  unIl  appropriate  treatment  and  support  are  received  or  unIl  the  crisis  resolves  

•  Not  a  subsItute  for  counseling,  medical  care,  peer  support  or  treatment  

   

MHFA:

About Mental Health First Aid (continued)

•  Mental  health  problems  are  common  

•  Professional  help  is  not  always  on  hand  

–  Individuals  with  mental  health  problems  ocen  do  not  seek  help  

•  Many  people…  –  are  not  well  informed  about  mental  health  problems  –  do  not  know  how  to  respond  

•  MHFA  creates  proven  results  

•  MHFA  is  relevant  for  many  different  populaIons  and  places  including  school,  community,  workplace,  and  home  

•  MHFA  is  low  cost  and  sustainable  

•  MHFA  supports  workplace  wellness  (e.g.,  employee  assistance  program,  etc.  

 

MHFA: Why Mental Health First Aid?

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MHFA: The training consists of: •  Live,  in-­‐person  training  by  cerIfied  instructors    in  your  

community  (online  training  is  not  currently  available)  •  8  hour  session  (can  be  offered  in  1  day  or  in  consecuIve  

sessions)  •  InteracIve  exercises  

Instructor  training  •  5-­‐day  instructor  course  •  Offered  by  naIonal  authoriIes  to  obtain  cerIficaIon  •  Wrifen  exam  and  presentaIon  exam  

 

•  Overview  of  mental  health  problems  

–  Depressive/Mood  disorders  –  Anxiety  disorders  –  Disorders  in  which  psychosis  occurs  –  Substance  use  disorders  –  EaIng  disorders  

•  Mental  Health  First  Aid  for  crisis  situaIons  

•  Mental  Health  First  Aid  for  non-­‐crisis  situaIons  

•  AcIon  Plan  –  Assess  for  risk  of  suicide  or  harm  –  Listen  non-­‐judgmentally  –  Give  reassurance  and  informaIon  –  Encourage  appropriate  professional  help  –  Encourage  self-­‐help  and  other  support  strategies  

MHFA: Participants Learn:

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•  Four  published  randomized  control  trials  and  a  qualitaIve  study  (in  Australia)  –  Increases  mental  health  literacy  –  Expands  individuals’  knowledge  of  how  to  help  someone  in  crisis  –  Connects  individuals  to  needed  services    –  Reduces  sIgma  

•  Study  on  33  US  college  campuses  2009-­‐2011  –  Increased  mental  health  literacy  –  ReducIon  in  social  distance  (decreased  sIgma)    

•  Kitchener  BA,  et  al.  Mental  health  first  aid  training  in  a  workplace  sejng:  A  randomized  and  controlled  trial  [ISRCTNI3249129].  BMC  Psychiatry.  2004;4(23):1-­‐8.  

•  Jorm  AF,  Kitchener  BA,  Fischer  JA,  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-­‐81.    

•  Speer,  N.,  Eisenberg,  D.,  Hahn,  E.,  Brunwasser,  S.,  &  Xu,  S.  Effects  of  a  peer-­‐based  gatekeeper  training  program  on  college  mental  health  outcomes.  [Manuscript  in  Prepara=on].  2011.  

 

MHFA: Evidenced Effectiveness

MHFA: Who can take the training course? Anyone!  Examples  include:    

 

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   AK  859  (20)  

HI  0  (1)  

PR    148  (2)  

WA  2,867  (56)  

 

OR  1,567  (28)  

CA  14,714  (514)  

NV  201  (2)  

ID  425  (11)  

MT  215  (4)  

WY    14  (1)  

UT  571  (27)  

AZ  3,960  (86)  

CO  6,540  (169)  

NM  3,181  (63)  

TX  4,715  (197)  

OK  1,378  (26)  

KS  4,319  (98)  

NE  440  (13)  

SD  1,137  (25)  

ND  319  (3)   MN  

1,765  (24)  

IA  6,175  (92)  

MO  7,473  (291)  

AR  525  (13)  

LA  123  (4)  

MS  857  (68)  

AL  629  (10)  

GA  2,339    (84)  

FL  1,126  (53)  

SC  116  (5)  

TN  

WV  0  (1)  

OH  922    (24)  

IN  478  (30)  

IL  6,149  (118)  

KY  377  (12)  

MI  4,192  (87)  

             NY  2,161  (67)  

PA  5,052  (182)  

NC  1,758  (31)  

VA  2,037  (61)  

ME  143  (4)  

WI  329    (9)  

809  (23)    

0.1%  or  more  

0.04%-­‐0.99%  

0.025%-­‐0.039%  

0.01%-­‐0.024%  

Less  than  0.01%  

No  data  

PERCENTAGE    OF  POPULATION  TRAINED  

ALGEE-­‐OMETER   Over  100,000  First  Aiders  in  the  US    Trained  by  over  3,000  Instructors  

MD  3,735  (217)  

DE  65  (3)  

NJ  663  (17)  

CT  1,740  (27)  

RI  304  (7)  

MA  760  (26)  

NH  10  (1)  

DC  825  (41)  

VT  233  (35)  

GUAM  37  (0)  

•  MHFA  in  President  Obama’s  Report:  RecommendaIons  from  the  Gun  Violence  PrevenIon  Task  Force  

–  Make  Sure  Students  and  Young  Adults  Get  Treatment  for  Mental  Health  Issues:  Three  quarters  of  mental  illnesses  appear  by  the  age  of  24,  yet  less  than  half  of  children  with  diagnosable  mental  health  problems  receive  treatment.  To  increase  access  to  mental  health  services  for  young  people,  we  should:  

•  Provide  “Mental  Health  First  Aid”  training  to  help  teachers  and  staff  recognize  signs  of  mental  illness  in  young  people  and  refer  them  to  treatment.  

•  Support  young  adults  ages  16  to  25,  who  have  the  highest  rates  of  mental  illness  but  are  the  least  likely  to  seek  help,  by  giving  incen=ves  to  help  states  develop  innova=ve  approaches.  

•  Help  break  the  cycle  of  violence  in  schools  facing  pervasive  violence  with  a  new,  targeted  ini=a=ve  to  provide  their  students  with  needed  services  like  counseling.  

•  Train  5,000  more  social  workers,  counselors,  and  psychologists,  with  a  focus  on  those  serving  students  and  young  adults.  

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MHFA: Public Policy

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•  April  19,  2013:  US  Senate  passed  Harkin/Alexander  MH  Amendment  (vote  of  95-­‐2)  –  which  included  authorizaIon  for  mental  health  awareness  training  grant  program  at  SAMHSA  (modeled  aTer  Mental  Health  First  Aid)  

•  Mental  Health  First  Aid  Act  2013  (H.R.  274)  (S.153):  Status  Pending  

–  In  a  statement  on  the  Senate  floor,  Majority  Leader  Reid  expressed  his  commitment  to  allowing  votes  on  a  number  of  addi=onal  amendments,  including  Senator  Stabenow’s,  that  did  not  receive  a  vote  

•  State  LegislaOve  AcOon:  Arizona,  Virginia,  Texas,  Washington,  Illinois,  Michigan,  Florida,  California,  Maryland  

•  Toolkit  for  State  LegislaOve  OpOons  

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MHFA: Public Policy

Mental Health: Challenges facing rural communities

20%  of  our  naIon’s  populaIon  lives  in  rural  areas.    Many  health  dispariIes  exist  for  people  who  live  in  rural  communiIes.    The  most  substanIal  barriers  to  an  individual’s  ability  to  obtain  mental  health  and  substance  abuse  services  are:  

–  Availability  –  limited  number  of  providers;  

–  Accessibility  –  distance,  transportaIon,  financing  of  services;  and  

–  Acceptability  –  willingness  to  seek  services  given  sIgma  surrounding  mental  health  and  substance  abuse.  

 Rural  communiIes  have  a  chronic  shortage  of  behavioral  health  providers.  Approximately  57%  of  the  federally  designated  mental  health  professional  shortage  areas  are  in  non  metropolitan  counIes.  

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Q: How does the rural curriculum differ from the regular curriculum? It’s  culturally  adapted.    It  features:    Discussions  on  what  rural  communiIes  can  do  with  a  lack  of  or  limited  resources  and  services,  and    PracOce  sessions  include  rural-­‐relevant  scenarios  such  as  farming-­‐related  situaIons  and  long-­‐distance  travel  to  health  care.    Trainers  can  become    rural-­‐cerOfied.  

MHFA: Promotional Strategy •  Created  a  contact  database  (4,000  items  so  far)  •  Created  a  web  presence  •  Partnered  with  HRSA  and  SAMHSA  Regional  Offices  •  Distributed  lefer  from  Dr.  Terry  Adirim  (Director  of  the  Office  of                Special  Health  Affairs)  and  Rural  Quick  Start  Guide  •  Sent  a  news  release  to  rural  media  outlets  •  Followed  up  with  everyone  who  received  the  lefer  from  Dr.  Adirim  •  Provide  ongoing  technical  assistance  and  referrals      •  Published  arIcle  in  May  issue  of  Rural  Roads  magazine  •  Published  arIcle  in  Na=onal  Council  Magazine      

 

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MHFA: Target Audiences

MHFA: Campaign Status •     70+  (documented)  training  referrals  to  date  •     35+  states  represented  •     Round  1:  all  regions  have  been  contacted  •     Round  2:  focusing  on  states  not  represented  •     1  month  of  campaign  acIvity  remaining  

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MHFA: Presentations

Date   Conference  Name   OrganizaOon   LocaOon  

Apr  9   Annual  Conference   NaIonal  Council  for  Behavioral  Healthcare   Las  Vegas,  NV  

May  7-­‐10   Annual  Rural  Health  Conference   NaIonal  Rural  Health  AssociaIon     Louisville,  KY  

Jul  17-­‐20   Rural  Areas  Conference   NaIonal  InsItute  for  Social  Work  and  Human  Services  in  Rural  Areas   Millersville,  PA  

Aug  1   Annual  Conference   NaIonal  AssociaIon  for  Rural  Mental  Health   San  Antonio,  TX  

Aug  7   Webinar   NaIonal  Area  Health  EducaIon  Centers   NaIonal  

Aug  29   Annual  ConvenIon   Community  AcIon  Partnership   Chicago,  IL  

Sept  5   Webinar   NaIonal  OrganizaIon  of  State  Offices  of  Rural  Health   NaIonal  

Oct  22   West  Virginia  Rural  Health  Conference   WV  Rural  Health  AssociaIon   Roanoke,  WV  

Rural Quick Start Guide

Guide  includes  informaOon  and  suggesOons  regarding:  

•  PotenIal  parIcipants  •  Ways  to  find  an  instructor  •  Cost  •  Supplies  and  equipment  •  OrganizaIon  Ips  •  MarkeIng  Ips    Available  on  MHFA  website  

                 

 

 

Purpose:  To  assist  people  in  coordinaIng  a    MHFA  training  course  in  their  community  

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Meeting Your Community’s Need for Access to Mental Health Services: Community Conversations Toolkit (in development)

Guided  discussions  include:  •  Community  values  about    

behavioral  care  •  Current  benefits  and  services  •  Needed  services  •  Financing  and  sustainability  •  AcIon  steps  

     

           

The  toolkit  contains:  •  Planning  guide  •  FacilitaIon  Ips  •  FacilitaIon  script  •  Outreach  flyer  •  Sample  agenda  •  Summary  template  •  EvaluaIon  form    

 

Purpose:  To  assist  rural  communiIes  in  bringing  together  behavioral  health  and  primary  care  providers  and  collaboraIng  around  important  services  and  resources  to  improve  access  to  care  for  those  in  need.  

MHFA: Plans for Evaluation •  How  is  RMHFA  training  associated  with  the  delivery  of                  mental  health  services  and  community  behavioral  health  partnerships?  •  Case  study  approach  •  MulIple  sources  of  informaIon  (e.g.,  direct  observaIons,  parIcipant  observaIons,  interviews  and/or                          focus  groups,  documents,  archival  records,  audiovisual  materials,  or  physical  arIfacts)    •  Consulted  with  HRSA  and  SAMHSA  evaluators  on  design  and  methodology  

 

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THANK  YOU  FOR  MORE  INFORMATION  

 Wendy  Opsahl,  PhD  

701-­‐610-­‐8632    wopsahl@atlasresearch.us  

 Mental  Health  First  Aid  

www.mentalhealthfirstaid.org    

www.mentalhealth.gov