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Rosmann: Mental Health First Aid helps rural residents

Mental Health First Aid, a course to train people to assess warning signs of behavioral health concerns, is gaining advocates in many countries around the world, including the U.S.

It can have particular benefits for farm and other rural residents who live where there is a shortage of behavioral health professionals and sometimes a reluctance to seek mental health and substance abuse treatment, even when needed.

The intent of Mental Health First Aid is to improve caregiving to people with behavioral health symptoms through better understanding by trained peers who undertake preliminary mental health assessments and refer people for appropriate professional follow-up care. The program is designed to improve the well-being of people dealing with behavioral health issues and to prevent their suffering and self-harm.

The National Council for Behavioral Health (, which facilitates the project, says that as of December 2013, more than 140,000 people in communities across the country have been trained in this type of first aid through a network of 3,000 certified instructors.

Training began in 2001 in Australia and has spread through many countries, including Cambodia, Canada, China, England, Japan, Saudi Arabia, Sweden and the U.S.

Certified Mental Health First Aid trainers must complete and pass a 40-hour course, and providers must pass an 8- to 12-hour course and recertify every three years.

The provider course trains people to:

  • Recognize signs of behavioral health problems, including panic, depression, bipolar disorder, schizophrenia, eating disorders, addictions and deliberate self-harm.
  • Not be judgmental, but to assess objectively and offer understanding.
  • Connect people needing help with resources for diagnosis and health care.
  • Provide emotional stabilization in times of need.
  • And, while focused on 12- to 25-year-olds, the program offers basic tools for assisting people of all ages.

The cost for the week-long instructor training is approximately $1,500, and the cost for the shorter, more focused provider training is about $120.

The website,, offers additional information about training courses for those interested in becoming instructors or providers.

An evidence-based practice

The U.S. Substance Abuse and Mental Health Services Administration has determined that Mental Health First Aid improves behavioral health knowledge and skills of its trained caregivers and also benefits the recipients of mental health first aid.

A growing number of scientific studies that have met requirements for objectivity and sound research methods have demonstrated proof of these hypothesized effects.

The training demystifies mental health and increases the awareness of unhealthy behaviors. Several Australian studies that compared experimental and control groups found that Mental Health First Aid saved lives, but additional empirical testing elsewhere is needed to clarify the program’s role in saving lives.

A potential concern is that some people who complete the provider course may think they are able to identify and diagnose behavioral health problems, but this course does not qualify them for these responsibilities.

Only licensed medical professionals, such as physicians and licensed behavioral health professionals, can make diagnoses. The program screens prospective trainers and providers who might be prone to assume capacities for which they lack training and certification and who may be otherwise unsuited.

Mental Health First Aid is particularly suited for providers who wish to aid their peers and the public, such as law enforcement personnel, emergency medical technicians, school and college staff, veterans, employers and people who have a duty to care for others, such as family members of a person who experiences behavioral health problems.

The program focuses on prevention of self-harm. It is understandable why Mental Health First Aid was devised in Australia, a highly rural country with a greater rate of intentional self-harm among rural residents than among urban residents.

Like Australia, the U.S. and many countries have a higher rate of intentional self-harm resulting in death among rural than urban dwellers. Access to professional care may require traveling long distances; Mental Health First Aid providers can undertake the preliminary screening, stabilization of the person needing follow-up care, referral and transportation as necessary.

The program aims to detect persons in need of assistance and protection so as to prevent self-harm.

Farmers, ranchers and other rural residents are starting to take a look at Mental Health First Aid as a type of training and service that will particularly benefit their communities.

Mike Rosmann is a Harlan, Iowa, psychologist and farmer. To contact him, go to