The Effectiveness of Mental Health First Aid Intervention Among Undergraduate Students in Switzerland

Study Overview
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Brief Summary
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Mental Health First Aid (MHFA) is an educational training program which has been proven effective at increasing knowledge, improving attitudes and reducing the stigma of mental illness among individuals/the general population. Although MHFA has proven effective world-wide, no study has examined the effectiveness of MHFA in Switzerland and very few studies have examined the long-term effects of MHFA and how they might be influenced by cultural differences. This study is a randomized control trial (RCT) that examines the effectiveness of a 12-hour MHFA training program that aims to improve undergraduate students' knowledge of, behaviours towards mental illness and to reduce stigmatization towards mental illness. All participants were 2nd-year students and they were randomly assigned either to an intervention group that would receive the MHFA training course or to a control group without any intervention during the study period. However, the control group had the option to receive the MHFA course after the 12 months of study follow-up was completed. Both groups were assessed at three time points: T0: Baseline survey from mid-September to October 2019, completed by both groups. Intervention: MHFA training program from October 2019-December 2019. T1: Post-intervention with first follow-up survey three months after the MHFA training intervention completed by both groups (from March to May 2020). T2: Follow-up 12 months after the MHFA/ensa training intervention in December 2020 and completed by both groups.

Official Title
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The Effectiveness of Ensa - Mental Health First Aid Training on Knowledge and Mental Health of Undergraduate Students in Switzerland: a Randomised Control Trial.

Conditions
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Preventative Medicine

Intervention / Treatment
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* Other: Mental Health First Aid (educational training program)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 2nd year undergraduate students from universities of applied science in Lausanne and Yverdon-les-Bains. ≥18 years old. Exclusion Criteria: Working and part-time students.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Randomized Control trial with educational intervention
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Mental Health First Aid training program<br>The intervention is a 12-hour face-to-face training course given in small groups. It was delivered as four 3-hour sessions over 4 consecutive weeks. | Other: Mental Health First Aid (educational training program)<br>* The MHFA program is a 12-hour face-to-face training program delivered in four sessions of three hours each across four consecutive weeks by two accredited MHFA instructors. The class was administered in small groups with a maximum of 10-15 students.The program included didactic lectures and role playing to teach students how to recognize and react to the signs and symptoms of mental health illness. Participants enrolled in the intervention group received an accompanying manual with content that covered helping people in mental health crises and/or the early stages of mental health problems. The mental health problems addressed during the training session included depressive symptoms, anxiety, psychotic disorders, and substance use disorders. The mental health crisis situations included suicidal thoughts/attempts and behaviors, acute stress reactions,panic attacks, and acute psychotic behaviors.<br>|
| No Intervention: control group<br>The control group received no intervention during the intervention period. However, they will participate in surveys at three time points (before the intervention, 3 months after the intervention and one year after the intervention). Once their final assessment is completed, controls will be offered the opportunity to take the MHFA training course, if they wish. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Level of knowledge-(changes were assessed at 3 and 12 months) | to measure participants' ability to identify a mental health problem and answer questions based on the content of the MHFA course. Changes of knowledge level before and after the MHFA intervention are also assessed. | 3 months; 12 months | 
| Level of attitudes pertaining to mental illness (changes were assessed at 3 and 12 months) | to measure changes of participants' level of stigmatization and social distance toward mental illness. Changes of before and after the intervention are also assessed. | 3 months; 12 months | 
| behaviors toward mental illness (changes are assessed at 3 and 12 months)) | to measure participants' confidence and intention to provide help and the changes before and after the MHFA are also assessed. | 3 months; 12 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| mental health-quality of life (changes were assessed assessed at 3 and 12 months) | Quality of life using Short-Form Health Survey (SF-12) and change of quality of life were assessed. | 3 months; 12 months | 
| mental health-depression (changes were assessed at 3 and 12 months) | Depression symptoms ( using Patient Health Questionnaire (Brief PHQ-9) and change of depression symptoms were assessed. | 3 months; 12 months | 
| change of mental health-anxiety | Anxiety symptom (using Generalized Anxiety Disorder 7) and changes of anxiety symptoms were assessed. | 3 months; 12 months | 
| change of mental health-ADHD symptoms | ADHD symptoms were assessed using 'ADHD Self-Report Scale (ASRS)' Screener and the change of ADHD symptoms was also assessed. | 3 months; 12 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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mental health first aid;, RCT, undergraduate students;, intervention, education program