Three questionnaires were administered (pre-test, post-test and 6-month follow-up) and are included as Additional File
1. In only the pre-test questionnaire, participants were asked about sociodemographic characteristics, reasons for doing the course, any previous mental health training and history of personal and family mental health problems.
The questionnaire was based on a mental health literacy survey reported previously [13 (
link),14 (
link)]. Participants were presented with two vignettes of a 15 year old, one portraying major depression (Jenny) and one portraying schizophrenia (John). They were given the open-ended question "What, if anything, do you think is wrong with Jenny/John?" Open-ended responses were classified into categories based on coding rules used in a recent study [15 (
link)]. Multiple responses were allowed. Scoring was conducted by two researchers who rated responses individually and later arrived at a consensus score for each response. Kappa coefficients for inter-rater reliability were computed for both vignettes.
First aid intentions were measured by open-ended questions asking participants what they would do to help each of the young people portrayed in the vignettes. For scoring purposes, a checklist was developed, based on the Mental Health First Aid Action Plan [4 (
link)]. It incorporates the 5 basic actions described by the acronym 'ALGEE'. Responses were scored out of a possible total of 10 against the checklist, using a 3 point scale (0 = no mention or inadequate response, 1 = superficial response without details, 2 = specific details/actions). If a response contained the word "ALGEE", but nothing else, 1 point was given per action, i.e. total of 5 points. Extra points were given only where specific detail was given for an action. One person scored all the responses. However, to ensure inter-rater reliability, a random sample of 60 responses was independently scored by three other researchers, who later arrived at a consensus.
Confidence in providing first aid was measured by asking participants "How confident would you feel in helping Jenny/John?" Confidence was rated on a 5-point Likert scale ranging from 1 ('not at all') to 5 ('extremely') for each of the vignettes [15 (
link)].
Stigmatising attitudes were measured by a Personal Stigma scale and a Perceived Stigma scale [16 (
link)]. Scales were modified to suit attitudes towards adolescents rather than towards adults [17 (
link)]. In Personal Stigma, the respondent was asked about their own attitudes towards the person described in each vignette while in the Perceived Stigma scale respondents were asked what they thought other people's attitudes were towards each person in the vignette.
Knowledge of mental disorders was measured by a 21 item true/false questionnaire specifically designed to cover information in the course. Response options for each item were 'agree', 'disagree' or 'don't know'. Scoring was based on 1 point per correct response, with 'don't know' being counted as incorrect.
Mental health first aid actions taken were assessed by asking how often a participant has talked to a young person about a mental health problem in the past 6 months. If they had talked with someone, the participant was asked to check the actions they took from a list of 9 options as follows: 1) Spent time listening to their problem; 2) Helped to calm them down; 3) Talked to them about suicidal thoughts; 4) Recommended they seek professional help; 5) Recommended self-help strategies; 6) Gave them information about their problem; 7) Gave them information about local services; 8) Made an appointment for them with services; and 9) Referred them to books or websites about their problem. An additional 'other' category was included for participants to provide details of any other actions undertaken, which were not included in the list. Scoring was based on 1 point per action taken.
The post-test and follow-up questionnaires were the same as the pre-test questionnaire except that both omitted the sociodemographic questions and the questions about actions taken were omitted from the post-test questionnaire.
Questionnaires were given out to participants prior to the commencement of training in the first session. On immediate completion of the training course a post-test questionnaire was given out. Six months thereafter, a follow-up questionnaire was sent to participants by post. Participants who did not submit their 6-month follow-up questionnaire within two weeks of it being sent were posted another follow-up questionnaire with a reminder letter. Where no response was received within a further two week period, a phone call was made to participants, encouraging them to complete the questionnaire and return it at their earliest convenience. A third follow-up questionnaire was posted to participants who had indicated that they had changed address and not received the questionnaire.
Kelly C.M., Mithen J.M., Fischer J.A., Kitchener B.A., Jorm A.F., Lowe A, & Scanlan C. (2011). Youth mental health first aid: a description of the program and an initial evaluation. International Journal of Mental Health Systems, 5, 4.
