Mental Health First Aid

Evidence Rating  
Evidence rating: Some Evidence

Strategies with this rating are likely to work, but further research is needed to confirm effects. These strategies have been tested more than once and results trend positive overall.

Health Factors  
Date last updated

Mental Health First Aid (MHFA) is a training course to help laypeople know how to assist individuals with mental health problems or at risk for problems such as depression, anxiety, and substance use disorders. Courses last 8 to 12 hours and include information about signs and symptoms of mental health problems and appropriate responses, as well as interactive activities using MHFA’s five-step action plan: assess risk of self-harm, listen non-judgmentally, reassure and share information, encourage self-help, and encourage professional help. The MHFA curriculum has been adapted for various populations, including youth, older adults, college students, members of the military, and veterans1, 2 and is often implemented in rural communities3.   

What could this strategy improve?

Expected Benefits

Our evidence rating is based on the likelihood of achieving these outcomes:

  • Increased knowledge of mental health

  • Reduced stigma

What does the research say about effectiveness?

There is some evidence that Mental Health First Aid (MHFA) increases participants’ understanding of mental health and confidence helping individuals with mental health problems, and modestly improves attitudes toward mental illness, with small reductions in stigma4, 5. Effects can persist six months post training; longer term effects are unclear4. However, additional evidence is needed to confirm effects and determine whether individuals at risk for or with mental health problems receive more mental health services after engaging with MHFA participants5.

Following participation in MHFA training courses, college students demonstrate increased knowledge of mental health and confidence in their ability to help others1. Adult participants in a MHFA course adapted for youth appear to increase knowledge about youth emotional distress and confidence assisting young people in psychological distress or crisis6, 7. Participants in a MHFA course adapted for military and veteran populations may improve their responses to others with mental health problems8. In a variety of settings, MHFA has greater effects on participants’ intention to provide help than on help provided, although evidence suggests that such intentions predict future behavior4.

Researchers suggest MHFA has the potential to improve awareness of the importance of mental health and promote service use in rural areas, especially when communities also strengthen treatment infrastructure9, 10, 11.

MHFA has been shown to modestly increase knowledge about and improve attitudes regarding mental illness in Australia, the UK, Sweden, and many other countries4, 12, 13, 14.

How could this strategy impact health disparities? This strategy is rated likely to decrease disparities.
Implementation Examples

Mental Health First Aid (MHFA) has been implemented in over 25 countries since it was first developed and implemented in Australia in 2001. As of January 2019, more than 1 million people have been trained in MHFA across the U.S.2.

The Health Resources and Services Administration (HRSA) funded the development of a MHFA Rural Curriculum in 2013 and continues to promote its use in rural communities3.

Implementation Resources

MHFA-USA - Mental Health First Aid (MHFA) USA. Be the 1 to make a difference.


* Journal subscription may be required for access.

1 Lipson 2014 - Lipson SK, Speer N, Brunwasser S, Hahn E, Eisenberg D. Gatekeeper training and access to mental health care at universities and colleges. Journal of Adolescent Health. 2014;55(5):612-619.

2 MHFA-USA - Mental Health First Aid (MHFA) USA. Be the 1 to make a difference.

3 RHIhub-MHFA - Rural Health Information Hub (RHIhub). Mental Health First Aid (MHFA) offers helping hand in rural communities.

4 Morgan 2018 - Morgan AJ, Ross A, Reavley NJ. Systematic review and meta-analysis of mental health first aid training: Effects on knowledge, stigma, and helping behaviour. Public Library of Science ONE. 2018;13(5):e0197102.

5 RAND-Wong 2015 - Wong EC, Collins RL, Cerully JL. Reviewing the evidence base for Mental Health First Aid: Is there support for its use with key target populations in California? RAND Health Quarterly. 2015;5(1):19.

6 Rose 2017 - Rose T, Leitch J, Collins KS, Frey JJ, Osteen PJ. Effectiveness of Youth Mental Health First Aid USA for social work students. Research on Social Work Practice. 2017:1-12.

7 Aakre 2016 - Aakre JM, Lucksted A, Browning-McNee LA. Evaluation of Youth Mental Health First Aid USA: A program to assist young people in psychological distress. Psychological Services. 2016;13(2):121-126.

8 Mohatt 2017 - Mohatt NV, Boeckmann R, Winkel N, Mohatt DF, Shore J. Military Mental Health First Aid: Development and preliminary efficacy of a community training for improving knowledge, attitudes, and helping behaviors. Military Medicine. 2017;182(1):e1576-e1583.

9 Talbot 2017 - Talbot JA, Ziller EC, Szlosek DA. Mental Health First Aid in rural communities: Appropriateness and outcomes. The Journal of Rural Health. 2017;33(1):82-91.

10 Mendenhall 2013 - Mendenhall AN, Jackson SC, Hase S. Mental Health First Aid USA in a rural community: Perceived impact on knowledge, attitudes, and behavior. Social Work in Mental Health. 2013;11(6):563-577.

11 O’Neill 2014 - O’Neill AM, Leyva VL, Humble MN, Lewis ML, Garcia JA. Mental Health First Aid USA: The implementation of a Mental Health First Aid training program in a rural healthcare setting. Contemporary Rural Social Work. 2014;6:117-125.

12 Hadlaczky 2014 - Hadlaczky G, Hökby S, Mkrtchian A, Carli V, Wasserman D. Mental Health First Aid is an effective public health intervention for improving knowledge, attitudes, and behaviour: A meta-analysis. International Review of Psychiatry. 2014;26(4):467-475.

13 MHFA-England 2017 - MHFA England. Summary of evaluations of Mental Health First Aid. 2017.

14 Svensson 2014 - Svensson B, Hansson L. Effectiveness of Mental Health First Aid training in Sweden. A randomized controlled trial with a six-month and two-year follow-up. PLOS ONE. 2014;9(6):e100911.

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