Evaluation of the Aboriginal and Torres Strait Islander Mental Health First Aid Program

Mental health literacy in Polynesian Native Hawaiian and Other Pacific Islanders

The high prevalence of mental health problems and underutilization of mental health treatment are more severe among the Native Hawaiian and Other Pacific Islander (NHPI) populations and remain misunderstood and understudied. Examining mental health literacy (MHL) - the knowledge and beliefs about mental disorders - aids their recognition, management, or prevention - has been shown to identify barriers to seeking and receiving care. This study aimed to assess the level of MHL in NHPIs and identify associated demographic variables. Data for this cross-sectional study were collected from 298 US NHPIs via an online questionnaire of the Mental Health Literacy Scale (MHLS). The overall mean MHLS score was 121 (SD = 17.3), with statistically significant higher scores in female participants, >31 years old, Tongan, more educated, and with higher income. This study demonstrated that overall MHL is comparable among NHPI compared to the current literature. However, NHPI men ≤30 years old and with lower income had lower MHL, which may be linked to the mental health disparities specific to this population. Current interventions should focus on increasing knowledge of risk factors, causes, self-treatments, and available professional help regarding mental disorders. Efforts to improve the MHL of NHPI should target men ≤30 years with lower income (<$50 000).

Effects of an Aboriginal and Torres Strait Islander Mental Health First Aid training programme for non-suicidal self-injury on stigmatising attitudes, confidence in ability to assist, and intended and actual assisting actions: an uncontrolled trial with precourse and postcourse measurement and 6-month follow-up

OBJECTIVES

Non-suicidal self-injury (NSSI) is a complex issue affecting Aboriginal and/or Torres Strait Islander Peoples in Australia. We evaluated the effects of an Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA) training course on assisting an Aboriginal and/or Torres Strait Islander person engaging in NSSI, including the effects on stigmatising attitudes, confidence in ability to assist, and intended and actual assisting actions.

DESIGN

Uncontrolled trial with precourse and postcourse measurement (n=49) and 6-month follow-up (n=17).

SETTING

Participants attended courses that were run in Queensland and Victorian communities and through one national organisation.

PARTICIPANTS

Participants were 49 adults who worked directly with Aboriginal and/or Torres Strait Islander Peoples.

INTERVENTION

The 5-hour 'Talking About Non-Suicidal Self-Injury' course was delivered by accredited AMHFA instructors and teaches people how to support an Aboriginal and/or Torres Strait Islander person who is engaging in NSSI.

PRIMARY AND SECONDARY OUTCOME MEASURES

The outcome measures were stigmatising attitudes, confidence in ability to assist, and intended and actual actions to assist a person engaging in NSSI.

RESULTS

Improvements were observed in stigmatising attitudes, with significant changes from precourse in both the 'weak-not-sick' (postcourse p<0.0623; follow-up p=0.0058) and 'dangerous/unpredictable' (postcourse p<0.0001; follow-up p=0.0036) subscales. Participants' confidence in ability to assist increased significantly both postcourse (p<0.0001) and at follow-up (p<0.0001). Despite a high level of endorsement for the nine recommended assisting actions at precourse, significant improvements (p<0.05) were observed in endorsement for six and four of the assisting actions postcourse and at follow-up, respectively. Course content was rated as being somewhat (3.4%), mostly (13.8%) or very (82.7%) culturally appropriate by participants who identified as Aboriginal and/or Torres Strait Islander.

CONCLUSIONS

The results of this uncontrolled trial were encouraging, suggesting that the Talking About Non-Suicidal Self-Injury course was able to improve participants' attitudes, confidence and intended assisting actions.