Thursday, December 21, 2023

Evidence Against Mental Health First Aid - Not Helpful, Frequently Harmful

Article and literature review gallery about the problematic and harmful Mental Health First Aid mental health training course. 

The Problem with ‘Mental Health First Aid’

According to the Mental Health First Aid website it is an eight hour course that “teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders in your community.” It is geared particularly toward first responders, family, and others in the community who don’t typically offer support to people in distress for a living.

On the surface that doesn’t sound so bad. However, Mental Health First Aid is rife with problems. First, it is yet another approach that is largely absent any input from people who actually have psychiatric histories themselves. ... Mental Health First Aid does not do a good job of promoting genuine connection, listening, or supporting someone to make meaning of their experiences. It prioritizes referral into clinical services over all else*. Although, as with any approach, a participant’s experience may vary substantially based on the trainers and what they’ve decided to do with the material, it appears to be a tool to further entrench a medical model way of thinking about emotional distress, regardless of an individual’s personal beliefs, culture, or knowledge of what works for them. 

Unfortunately, Mental Health First Aid isn’t going anywhere soon. It is heavily funded, and has been promoted by both the Substance Abuse and Mental Health Services Administration (SAMHSA) and the National Council on Behavioral Health. Nonetheless, it is important that we determine for ourselves how we want to approach each other during times of struggle. We can (and need to) do better.

Inventing Mental Health First Aid: The Problem of Psychocentrism

The concept of psychocentrism, adopted as an analytical tool, critiques the problematic nature of MHFA premises and practices that automate, expedite, enforce, and normalize the global movement to psychiatrize human distress. Contesting MHFA’s international image as a benevolent, individual crisis intervention model, this essay discusses MHFA as a technique of neoliberal governance, moral surveillance, and social control, responsible for reinvigorating the psychiatric profession while dividing and demoting the populace.

Mental Health First Aid training: widely adopted, but is it evidence-based?

MHFA Australia estimates that over six million people worldwide have been trained, and that over 25 countries have now adopted MHFA training.

We found 21 studies including over 22,500 people that were relevant to our questions. Researchers worldwide had trialled MHFA in all sorts of settings, including schools, workplaces, and colleges. Disappointingly we only found five studies that had actually measured whether MHFA training improved mental health.

Our overall finding was that MHFA may result in little to no difference in the mental health of people in organizations that have adopted this training, but we had very little confidence in this result due to the problems with the evidence.

It is striking that a training program that has been so widely adopted is not better supported by solid evidence that it is effective in improving mental health. ... It is also concerning that there is no reliable evidence about whether it causes harm. 

Mental Health First Aid: Your Friendly Neighborhood Mental Illness Maker

It hit all the most stereotypical marks including a nod to the ‘chemical imbalance’ myth (absent the mentioning of the myth part, of course), ignored most environmental factors (homelessness, racism, poverty, and so on), and offered plentiful references to the value of psychiatric drugs (including some solid reassurances that at least the ‘anti-anxiety’ variety has supposedly “minimal side-effects”).

In fact, I might argue that it’s the guise of ‘teaching compassion’ (along with the few other benefits it might genuinely purport) that is precisely what makes it so dangerous for all the masked misinformation those benefits allow it to slip in unnoticed.  Haven’t we yet learned that teaching people that so much human distress boils down into illness does nothing to reduce ‘stigma,’ and in fact, makes discrimination worse?

Drug companies prey on children

Youth Mental Health First Training, sponsored by the National Council for Behavioral Health, is intended to enable teachers, parents and others in contact with young people to identify potential “mental illnesses” in order to facilitate early detection and treatment by our mental health care system.

Parents, teachers and other caretakers have been helping young people learn to cope with life’s vicissitudes since time immemorial. Why do they need help from the pharmaceutical companies to do this? Today, toddlers who throw temper tantrums are diagnosed with “bipolar disorder” and prescribed major tranquilizers, a process psychiatrist David Healy has likened to giving cancer chemotherapy to a child with a cold.

*Gallery Editor Note

Regarding the first article's statement that MHFA exists as "a tool to funnel more people into the mental health system without regard for efficacy" - many emotionally distressed individuals greatly disapprove of most to all mainstream mental health system resources. They are unhelpful to many. They actively harm many of us. These stories are widely suppressed but the voice of the failed grows louder every year, even while being wholesale ignored by the entities offering so-called "services". More on that topic can be found throughout this website's article archive and across the broader psychiatric survivor and mad justice community. 

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