An ‘Initiative Assessment Log’ was then completed (Table 2). Information from any evaluation or other reports about the initiative in Wales was considered for relevance at this stage and pertinent information summarised into the log along with the Summary Evidence Grade and other information. A final ‘Initiative Grade’ was then applied by one reviewer using set criteria (see Annex). This therefore takes into account both the evidence of potential effectiveness and evidence of actual effectiveness in Wales, where available. This Initiative Grade’ will feed directly into the Programme Budgeting and Marginal Analysis which forms the decision-making framework for the Health Improvement Review. Initiative grades were checked for consistency by comparison and discussion amongst the review team.
3. Findings of the assessment Table 1: Evidence Mapping Table for Mental Health First Aid Study Details Study design Outcome measures Main findings Results Evidence Grading Include? Reason for exclusion O’ Reilly et al, 2011 Mental health aid Pharmacy students Controlled trial, non randomized Baseline survey instrument conducted in 59 individuals receiving training and 199 controls. Pre-post survey in intervention and control group. Evaluation of mental health literacy, the 7-item social distance scale, and 16 items related to behaviour. This demonstrated that MHFA training can reduce pharmacy students' mental health stigma, improve recognition of mental disorders and improve confidence in providing services to consumers with a mental illness in the pharmacy setting. The MHFA training improved the participants' ability to correctly identify a mental illness (p = 0.004). There was a significant mean decrease in total social distance of 2.18 (SD 3.35) p <0.001 for the MHFA group, indicating less stigmatizing attitudes. There were improvements in recognition of helpful interventions with participants' views becoming more concordant with health professional views about treatments for depression (p = 0.009) and schizophrenia (p = 0.08), and participants were +/- Yes Evidence for of training in achieving goals but no evidence for improved patient/ client outcomes reported trial
people with mental disorders Kitchener et al 2004 RCT (n=301) The Mental Health Aid training has shown itself to be not only an effective way The found a number of benefits from this training course, including greater confidence in providing help +/- Yes Evidence for
Mental health aid Workplace setting Training course versus waiting list for course Confidence in helping others Likelihood o advising people to seek professional help knowledge to improve participants' mental health literacy but also to improve their own mental health. It is a course that has high applicability across the community. to others, greater likelihood of advising people to seek professional help, improved concordance with health professionals about treatments, and decreased stigmatizing attitudes. An additional unexpected but exciting finding was an improvement in the mental health of the participants themselves. of training in achieving goals but no evidence for improved patient/ client outcomes Evaluation of the Mental Health aid Training Courses MIND Cymru Survey via 1. The reaction of student – what they thought and felt about the training they received 2. Student – the resulting increase in Concluded that the course appears effective and is well evaluated. The researchers suggest a promotional leaflet for the training and to build on the benefits for employers and employees In to establish the impact of the MHFA course, participants were asked how prepared they felt to help someone in mental distress before they took the course. Ninety six (60%) participants felt prepared to help, but unsure of their ability to do so, 36 (22.5%) did not feel comfortable in their ability +/- INCLUDE Evaluation of the MHFA programme in Wales Comment: The study is relatively small with a response
University of Glamorgan knowledge or capability 3. Student behaviour – the extent of behaviour and capability improvement and evidence of the or application of knowledge 4. The results – the effects on the business or environment resulting from the trainee’s performance to help, with 28 (17.5%) feeling confident in their ability to help. After the course: Of the 160 participants, 154 (96%) felt confident or better prepared to help, with only six (4%) feeling that they would like some further training before putting their skills into practice. Participants were asked how many times since taking the MHFA course they had used the skills learned. Of the 160 responding, 105 (66%) had used their MHFA skills to help someone in distress, of whom thirty nine (24%) had used their skills on more than three occasions. The remaining 55 (34%) rate of 11%, n=160 which may mean that bias is present but not possible to say whether this would make the outcome more or less favourable.
10.2. Were the results compared with those of others who have investigated the same question? If so, were allowances made for potential differences in study methodology? 10.3. Did the study discuss the generalisability of the results to other settings and patient/client groups? 10.4. Did the study allude to, or take account of, other important factors in the choice or decision under consideration (e.g. distribution of costs and consequences, or relevant ethical issues)? 10.5. Did the study discuss issues of implementation, such as the feasibility of adopting the ‘preferred’ programme given existing financial or other constraints, and whether any freed resources could be redeployed to other worthwhile programmes? Annex 3 Evidence of Cost-effectiveness Grading Based upon the appraisal strategy above a subjective judgement of the overall balance of economic evidence was made by the economic evidence sub-group and the following traffic light system of grading was used. Green I Green II Amber I Amber II Red I Red II Large frequency of good quality economic showing as appraised by Drummond et al’s 2005 Checklist for a sound economic evaluation Small frequency of good quality economic showing as appraised by Drummond et al’s 2005 Checklist for a sound economic evaluation Fair quality economic showing as appraised by Drummond et al’s 2005 Checklist for a sound economic evaluation Fair quality evidence however, showing mixed evidence of as appraised by Drummond et al’s 2005 Checklist for a sound economic evaluation Poor quality evidence showing was not as appraised by Drummond et al’s Checklist for a sound economic evaluation No