School Mental Health

, Volume 10, Issue 1, pp 48–60 | Cite as

An Evaluation of Youth Mental Health First Aid Training in School Settings

  • Kim GryglewiczEmail author
  • Kristina K. Childs
  • Melanie F. P. Soderstrom
Original Paper


Youth Mental Health First Aid (YMHFA) is a training program designed to help adults working with children and adolescents identify and respond to youth who are experiencing mental health problems or are in crisis. YMHFA is being implemented in a number of educational, child welfare, and juvenile justice settings across the country with little evidence of its effectiveness. As part of a broader mental health program implemented in five schools in a southeastern county in the USA, YMHFA was provided to school personnel over a 2-year period. This study presents the results of a pretest/posttest evaluation of the YMHFA training. In general, results provide preliminary evidence of the effectiveness of the YMHFA training. More specifically, results highlight the importance of YMHFA training for personnel who have never received mental health training/education and for those who do not have experience working with vulnerable youth populations.


Youth Mental Health First Aid Youth mental health Gatekeeper training Teacher education 



This project was funded by the National Institute of Justice (NIJ, Award # 2014-CK-BX-0014) to Drs. Childs and Gryglewicz. The views expressed in this paper do not necessarily reflect the views, opinions, or policies of NIJ; nor does mention of trade names, commercial practices, or organizations imply endorsement by the US Government.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. Aakre, J. M., Lucksted, A., & Browning-McNee, L. A. (2016). Evaluation of youth Mental Health First Aid USA: A program to assist young people in psychological distress. Psychological Services, 13(2), 121–126.CrossRefPubMedGoogle Scholar
  2. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50(2), 179–211.CrossRefGoogle Scholar
  3. Armitage, C. J., & Conner, M. (2001). Efficacy of the theory of planned behaviour: A meta-analytic review. British Journal of Social Psychology, 40(4), 471–499.CrossRefPubMedGoogle Scholar
  4. Aseltine, R. H., James, A., Schilling, E. A., & Glanovsky, J. (2007). Evaluating the SOS suicide prevention program: A replication and extension. BMC Public Health. Scholar
  5. Atkins, M. S., Hoagwood, K. E., Kutash, K., & Seidman, E. (2010). Toward the integration of education and mental health in schools. Administration and Policy in Mental Health and Mental Health Services Research, 37(1–2), 40–47.CrossRefPubMedPubMedCentralGoogle Scholar
  6. Barrett, D. E., & Katsiyannis, A. (2016). Juvenile offending and crime in early adulthood: A large sample analysis. Journal of Child and Family Studies, 25(4), 1086–1097.CrossRefGoogle Scholar
  7. Berkel, C., Mauricio, A. M., Schoenfelder, E., & Sandler, I. N. (2011). Putting the pieces together: An integrated model of program implementation. Prevention Science, 12(1), 23–33.CrossRefPubMedPubMedCentralGoogle Scholar
  8. Bond, K. S., Jorm, A. F., Kitchener, B. A., & Reavley, N. J. (2016). Mental Health First Aid training for Australian financial counsellors: An evaluation study. Advances in Mental Health, 14(1), 65–74.CrossRefGoogle Scholar
  9. Center for Mental Health in Schools (2016). ESSA, equity of opportunity, and addressing barriers to learning. Retrieved from
  10. Cross, W., Matthieu, M. M., Cerel, J., & Knox, K. L. (2007). Proximate outcomes of gatekeeper training for suicide prevention in the workplace. Suicide and Life-Threatening Behavior, 37(6), 659–670.CrossRefPubMedGoogle Scholar
  11. Davidson, M. L. (2016). A criminal justice system-wide response to mental illness: Evaluating the effectiveness of the Memphis Crisis Intervention Team training curriculum among law enforcement and correctional officers. Criminal Justice Policy Review, 27(1), 46–75.CrossRefGoogle Scholar
  12. Essasu, C. (2010). Comorbidity of substance use disorders among community-based and high-risk adolescents. Psychiatry Research, 185, 176–184.CrossRefGoogle Scholar
  13. Galaif, E. R., Sussman, S., Newcomb, M. D., & Locke, T. F. (2007). Suicidality, depression, and alcohol use among adolescents: A review of empirical findings. International Journal of Adolescent Medicine and Health, 19(1), 27–35.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Griffiths, K. M., Christensen, H., Jorm, A. F., Evans, K., & Grove, C. (2004). Effect of web-based depression literacy and cognitive-behavioural therapy interventions on stigmatising attitudes to depression. The British Journal of Psychiatry, 185(4), 342–349.CrossRefPubMedGoogle Scholar
  15. Harris, T. B., Chung, W., Hutchins, H. M., & Chiaburu, D. S. (2014). Do trainer style and learner orientation predict training outcomes? Journal of Workplace Learning, 26(5), 331–344.CrossRefGoogle Scholar
  16. Hart, L. M., Mason, R. J., Kelly, C. M., Cvetkovski, S., & Jorm, A. F. (2016). ‘teen Mental Health First Aid’: A description of the program and initial evaluation. International Journal of Mental Health Systems. Scholar
  17. Holmberg, K., & Hjern, A. (2008). Bullying and attention-deficit-hyperactivity disorder in 10-year-olds in a Swedish community. Developmental Medicine and Child Neurology, 50(2), 134–138.CrossRefPubMedGoogle Scholar
  18. Hossain, D., Gorman, D., & Eley, R. (2009). Enhancing the knowledge and skills of advisory and extension agents in mental health issues of farmers. Australasian Psychiatry, 17, S116–S120.CrossRefPubMedGoogle Scholar
  19. Hoza, B., Mrug, S., Gerdes, A. C., Hinshaw, S. P., Bukowski, W. M., Gold, J. A., et al. (2005). What aspects of peer relationships are impaired in children with attention-deficit/hyperactivity disorder? Journal of Consulting and Clinical Psychology, 73(3), 411–423.CrossRefPubMedGoogle Scholar
  20. Jensen, K. B., Morthorst, B. R., Vendsborg, P. B., Hjorthøj, C., & Nordentoft, M. (2016). Effectiveness of Mental Health First Aid training in denmark: A randomized trial in waitlist design. Social Psychiatry and Psychiatric Epidemiology, 51(4), 597–606.CrossRefPubMedGoogle Scholar
  21. Jorm, A. F., Kitchener, B. A., & Mugford, S. K. (2005). Experiences in applying skills learned in a Mental Health First Aid training course: A qualitative study of participants’ stories. BMC Psychiatry. Scholar
  22. Jorm, A. F., Kitchener, B. A., O’Kearney, R., & Dear, K. B. G. (2004). Mental Health First Aid training of the public in a rural area: A cluster randomized trial. BMC Psychiatry. Scholar
  23. Jorm, A. F., Kitchener, B. A., Sawyer, M. G., Scales, H., & Cvetkovski, S. (2010). Mental Health First Aid training for high school teachers: A cluster randomized trial. BMC Psychiatry. Scholar
  24. Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). “Mental health literacy”: A survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment. Medical Journal of Australia, 166(4), 182–186.PubMedGoogle Scholar
  25. Keller, D. P., Schut, L. J. A., Puddy, R., Willams, L., Stephens, R. L., McKeon, R., et al. (2009). Tennessee lives count: Statewide gatekeeper training for youth suicide prevention. Professional Psychology: Research and Practice, 40(2), 126–133.CrossRefGoogle Scholar
  26. Kelly, C. M., Mithen, J. M., Fischer, J. A., Kitchener, B. A., Jorm, A. F., Lowe, A., et al. (2011). Youth Mental Health First Aid: A description of the program and an initial evaluation. International Journal of Mental Health Systems. Scholar
  27. Kessler, R. C., Amminger, G. P., Aguilar-Gaxiola, S., Alonso, J., Lee, S., & Ustun, T. B. (2007). Age of onset of mental disorders: A review of recent literature. Current Opinion in Psychiatry, 20(4), 359–364.CrossRefPubMedPubMedCentralGoogle Scholar
  28. Kitchener, B. A., & Jorm, A. F. (2002). Mental Health First Aid training for the public: Evaluation of effects on knowledge, attitudes and helping behavior. BMC Psychiatry. Scholar
  29. Kitchener, B. A., & Jorm, A. F. (2004). Mental Health First Aid training in a workplace setting: A randomized controlled trial. BMC Psychiatry. Scholar
  30. Lamis, D. A., Underwood, M., & D’Amore, N. (2017). Outcomes of a suicide prevention gatekeeper training program among school personnel. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 38(2), 89–99.CrossRefGoogle Scholar
  31. Laye-Gindhu, A., & Schonert-Reichl, K. A. (2005). Nonsuicidal self-harm among community adolescents: Understanding the “whats” and “whys” of self-harm. Journal of Youth and Adolescence, 34(5), 447–457.CrossRefGoogle Scholar
  32. Loveland, J. M., Lounsbury, J. W., Welsh, D., & Buboltz, W. C. (2007). The validity of physical aggression in predicting adolescent academic performance. British Journal of Educational Psychology, 77(1), 167–176.CrossRefPubMedGoogle Scholar
  33. Massey, J., Brooks, M., & Burrow, J. (2014). Evaluating the effectiveness of Mental Health First Aid training among student affairs staff at a Canadian university. Journal of Student Affairs Research and Practice, 51(3), 323–336.CrossRefGoogle Scholar
  34. Masten, A. S., Roisman, G. I., Long, J. D., Burt, K. B., Obradovic, J., Riley, J. R., et al. (2005). Developmental cascades: Linking academic achievement and externalizing and internalizing symptoms over 20 years. Developmental Psychology, 41(5), 733–746.CrossRefPubMedGoogle Scholar
  35. Matthieu, M. M., Chen, Y., Schohn, M., Lantinga, L. J., & Knox, K. L. (2009). Educational preferences and outcomes from suicide prevention training in the Veterans Health Administration: One-year follow-up with healthcare employees in Update New York. Military Medicine, 174(11), 1123–1131.CrossRefPubMedPubMedCentralGoogle Scholar
  36. Merikangas, K. R., He, J., Brody, D., Fisher, P. W., Bourden, K., & Kortez, D. S. (2010a). Prevalence and treatment of mental disorders among US children in the 2001–2004 NHANES. Pediatrics, 125(1), 75–81.CrossRefPubMedGoogle Scholar
  37. Merikangas, K. R., He, J., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010b). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication—Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 980–989.CrossRefPubMedPubMedCentralGoogle Scholar
  38. Minas, H., Colucci, E., & Jorm, A. F. (2009). Evaluation of Mental Health First Aid training with members of the Vietnamese community in Melbourne, Australia. International Journal of Mental Health Systems. Scholar
  39. Mohatt, N. V., Boeckmann, R., Winkel, N., Mohatt, D., & Shore, J. (2017). Military Mental Health First Aid: Development and preliminary efficacy of a community training for improving knowledge, attitudes, and helping behaviors. Military Medicine, 182(1), e1576–e1583.CrossRefPubMedGoogle Scholar
  40. Moon, J., Williford, A., & Mendenhall, A. (2017). Educators’ perceptions of youth mental health: Implications for training and the promotion of mental health services in schools. Children and Youth Services Review, 73, 384–391.CrossRefGoogle Scholar
  41. Morawska, A., Fletcher, R., Pope, S., Heathwood, E., Anderson, E., & McAuliffe, C. (2013). Evaluation of Mental Health First Aid training in a diverse community setting. International Journal of Mental Health Nursing, 22, 85–92.CrossRefPubMedGoogle Scholar
  42. National Council of Behavioral Health (2017). Youth Mental Health First Aid. Retrieved from
  43. O’Reilly, C. L., Bell, S., Kelly, P. J., & Chen, T. F. (2011). Impact of Mental Health First Aid training on pharmacy students’ knowledge, attitudes and self-reported behaviour: A controlled trial. Australian and New Zealand Journal of Psychiatry, 45, 549–557.CrossRefPubMedGoogle Scholar
  44. Perou, R., Bitsko, R. H., Blumberg, S. J., Pastor, P., Ghandar, R. M., Gfroerer, J. C., et al. (2013). Mental health surveillance among children—United States, 2005–2011. Morbidity and Mortality Weekly Report, 62(02), 1–35. Retrieved from the Centers for Disease Control and Prevention
  45. Pierce, D., Liaw, S. T., Dobell, J., & Anderson, R. (2010). Australian rural football club leaders as mental health advocates: An investigation of the impact of the Coach the Coach project. International Journal of Mental Health Systems. Scholar
  46. Poppen, M., Sinclair, J., Hirano, K., Lindstrom, L., & Unruh, D. (2016). Perceptions of mental health concerns for secondary students with disabilities during transition to adulthood. Education and Treatment of Children, 39(2), 221–246.CrossRefGoogle Scholar
  47. Quiroga, C. V., Janosz, M., Lyons, J. S., & Morin, A. S. (2012). Grade retention and seventh-grade depression symptoms in the course of school dropout among high-risk adolescents. Psychology, 3(9), 749–755.CrossRefGoogle Scholar
  48. Reinke, W. M., Stormont, M., Herman, K. C., Puri, R., & Goel, N. (2011). Supporting children’s mental health in schools: Teacher perceptions of needs, roles, and barriers. School Psychology Quarterly, 26(1), 1–13.CrossRefGoogle Scholar
  49. Rostain, A. L., Ramsay, J. R., & Waite, R. (2015). Cultural background and barriers to mental health care for African American adults. The Journal of Clinical Psychiatry, 76(3), 279–283.CrossRefPubMedGoogle Scholar
  50. Selby, E. A., Anestis, M. D., & Joiner, T. E. (2008). Understanding the relationship between emotional and behavioral dysregulation: Emotional cascades. Behaviour Research and Therapy, 46(5), 593–611.CrossRefPubMedGoogle Scholar
  51. Stephan, S., Brandt, N., Lever, N., Acosta-Price, O., & Connors, E. (2012). Key priorities, challenges and opportunities to advance an integrated mental health and education research agenda. Advances in School Mental Health Promotion, 5(2), 125–138.CrossRefGoogle Scholar
  52. Stephan, S. H., Sugai, G., Lever, N., & Connors, E. (2015). Strategies for integrating mental health into schools via a multitiered system of support. Child and Adolescent Psychiatric Clinics of North America, 24(2), 211–231.CrossRefPubMedGoogle Scholar
  53. Suldo, S., Thalji, A., & Ferron, J. (2011). Longitudinal academic outcomes predicted by early adolescents’ subjective well-being, psychopathology, and mental health status yielded from a dual factor model. The Journal of Positive Psychology, 6(1), 17–30.CrossRefGoogle Scholar
  54. Svensson, B., & Hansson, L. (2014). Effectiveness of Mental Health First Aid training in Sweden. A randomized controlled trial with a six-month and two-year follow-up. PLoS ONE, 9(6), e100911.CrossRefPubMedPubMedCentralGoogle Scholar
  55. The White House (2013, January). Now is the time: The president’s plan to protect our children and our communities by reducing gun violence. Retrieved from
  56. Tompkins, T. L., Witt, J., & Abraibesh, N. (2009). Does a gatekeeper suicide prevention program work in a school setting? Evaluating training outcome and moderators of effectiveness. Suicide and Life-Threatening Behavior, 39(6), 671–681.CrossRefPubMedGoogle Scholar
  57. U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau (2010). The mental and emotional well-being of children: A portrait of states and the nation 2007. Retrieved from
  58. Vogel, D. L., Wester, S. R., & Larson, L. M. (2007). Avoidance of counseling: Psychological factors that inhibit seeking help. Journal of Counseling & Development, 85(4), 410–422.CrossRefGoogle Scholar
  59. Walter, H. J., Gouze, K., & Lim, K. G. (2006). Teachers’ beliefs about mental health needs in inner city elementary schools. Journal of the American Academy of Child and Adolescent Psychiatry, 45(1), 61–68.CrossRefPubMedGoogle Scholar
  60. Wong, D. F. K., Lau, Y., Kwok, S., Wong, P., & Tori, C. (2017). Evaluating the effectiveness of Mental Health First Aid program for Chinese people in Hong Kong. Research on Social Work Practice, 27(1), 59–67.CrossRefGoogle Scholar
  61. Wyman, P. A., Brown, C. H., Inman, J., Cross, W., Schmeelk-Cone, K., Guo, J., et al. (2008). Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. Journal of Consulting and Clinical Psychology, 76(1), 104–115.CrossRefPubMedPubMedCentralGoogle Scholar
  62. Wyman, P. A., Brown, C. H., LoMurrary, M., Schmeelk-Cone, K., Petrova, M., Wang, Q., et al. (2010). An outcome evaluation of the Sources of Strength suicide prevention program delivered by adolescent peer leaders in high schools. American Journal of Public Health, 100(9), 1653–1661.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Kim Gryglewicz
    • 1
    Email author
  • Kristina K. Childs
    • 2
  • Melanie F. P. Soderstrom
    • 2
  1. 1.School of Social Work, College of Health and Public AffairsUniversity of Central FloridaOrlandoUSA
  2. 2.Department of Criminal Justice, College of Health and Public AffairsUniversity of Central FloridaOrlandoUSA

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