A Feasibility Trial of Mental Health First Aid First Nations: Acceptability, Cultural Adaptation, and Preliminary Outcomes

• Published in: American journal of community psychology 2018-06, Vol.61 (3-4), p.459-471
• Main Authors: Crooks, Claire V., Lapp, Andrea, Auger, Monique, Woerd, Kim, Snowshoe, Angela, Rogers, Billie Jo, Tsuruda, Samantha, Caron, Cassidy
• Format: Article
• Language: English
• Subjects: Action research; Adaptation; Colonialism; Community; Community research; Consciousness; Feasibility trial; First aid; Health problems; Health promotion; Illnesses; Indigenous peoples; Mental health; Mental health literacy; Mixed methods; Native North Americans; Original; Polls & surveys; Self-efficacy; Teaching; Well being
• ISSN: 0091-0562; 1573-2770
• DOI: 10.1002/ajcp.12241

The Mental Health First Aid First Nations course was adapted from Mental Health First Aid Basic to create a community‐based, culturally safe and relevant approach to promoting mental health literacy in First Nations contexts. Over 2.5 days, the course aims to build community capacity by teaching individuals to recognize and respond to mental health crises. This feasibility trial utilized mixed methods to evaluate the acceptability, cultural adaptation, and preliminary effectiveness of MHFAFN. Our approach was grounded in community‐based participatory research principles, emphasizing relationship‐driven procedures to collecting data and choice for how participants shared their voices. Data included participant interviews (n = 89), and surveys (n = 91) from 10 groups in four provinces. Surveys contained open‐ended questions, retrospective pre‐post ratings, and a scenario. We utilized data from nine facilitator interviews and 24 facilitator implementation surveys. The different lines of evidence converged to highlight strong acceptability, mixed reactions to the cultural adaptation, and gains in participants’ knowledge, mental health first aid skill application, awareness, and self‐efficacy, and reductions in stigma beliefs. Beyond promoting individual gains, the course served as a community‐wide prevention approach by situating mental health in a colonial context and highlighting local resources and cultural strengths for promoting mental well‐being. Highlights There are high rates of mental health challenges in many community and urban First Nations contexts. The lack of appropriate and effective services underscores the need for community‐based approaches. Mental Health First Aid First Nations adapted an existing program to include a cultural context. Some participants considered the cultural focus a strength, but a minority found it inadequate. Participants reported gains in knowledge, self‐efficacy and skills, and decreased stigma beliefs.