Indicators of mental health literacy and Mental Health First Aid skill application in a large sample of U.S. trainees.

Background

Mental Health First Aid (MHFA) is the largest mental health literacy training program in the world, yet few studies assess how different indicators of mental health literacy are associated with trainees' skill application.

Aims

To examine associations between indicators of mental health literacy and MHFA skill application in a sample of trainees.

Methods

The study analyzed data from a 2021 cross-sectional survey of MHFA trainees in New York City (n = 2,378). Participants completed measures of three mental health literacy indicators: general knowledge, referral resource knowledge, and stigma. They also reported use of five MHFA ALGEE "action plan" skills within the past six months, yielding a count variable (range 0-5; 5 reflecting highest-quality skill application). Participants also indicated whether they directly connected a recipient to treatment (direct handoff; 0 = no; 1 = yes). Multivariable Poisson and logistic regression models assessed associations between literacy indicators, modeled separately and simultaneously, with higher-quality skill application and direct handoffs.

Results

In models including all indicators simultaneously, only referral resource knowledge -but not stigma or general knowledge- was uniquely associated with higher-quality skill application (IRR = 1.03, 95% CI 1.01 - 1.05, p < 0.01) and likelihood of direct handoffs (AOR = 1.26, 95% CI 1.16 - 1.38, p < 0.0001).

Conclusions

Knowledge of referral resources may be a key, modifiable driver of higher-quality MHFA skill application in community settings.