To provide an up-to-date assessment of the effectiveness of the Mental Health First Aid (MHFA) training program on improving mental health knowledge, stigma and helping behaviour. Systematic review and meta-analysis. A systematic search of electronic databases was conducted in October 2017 to identify randomised controlled trials or controlled trials of the MHFA program. Eligible trials were in adults, used any comparison condition, and assessed one or more of the following outcomes: mental health first aid knowledge; recognition of mental disorders; treatment knowledge; stigma and social distance; confidence in or intentions to provide mental health first aid; provision of mental health first aid; mental health of trainees or recipients of mental health first aid. Risk of bias was assessed and effect sizes (Cohen’s d) were pooled using a random effects model. Separate meta-analyses examined effects at post-training, up to 6 months post-training, and greater than 6 months post-training. A total of 18 trials (5936 participants) were included. Overall, effects were generally small-to-moderate post-training and up to 6 months later, with effects up to 12-months later unclear. MHFA training led to improved mental health first aid knowledge (ds 0.31–0.72), recognition of mental disorders (ds 0.22–0.52) and beliefs about effective treatments (ds 0.19–0.45). There were also small reductions in stigma (ds 0.08–0.14). Improvements were also observed in confidence in helping a person with a mental health problem (ds 0.21–0.58) and intentions to provide first aid (ds 0.26–0.75). There were small improvements in the amount of help provided to a person with a mental health problem at follow-up (d = 0.23) but changes in the quality of behaviours offered were unclear. This review supports the effectiveness of MHFA training in improving mental health literacy and appropriate support for those with mental health problems up to 6 months after training. PROSPERO (CRD42017060596)

Objective:  To determine the mental health first‐aid knowledge and beliefs of young people and their parents.Methods:  A national telephone survey was carried out with 3746 people aged 12–25 years. Interviews were also carried out with 2005 co‐resident parents. First‐aid knowledge was assessed in response to one of four randomly presented vignettes covering depression, depression with alcohol misuse, social phobia and psychosis (schizophrenia). Young people were asked about first aid in relation to a peer and parents in relation to a child.Results:  The potential value of encouraging professional help‐seeking was not universally recognized by either young people or adults. In general, positive social interactions were endorsed as likely to be helpful and negative ones as not, but again there is considerable room for improvement. Adolescents had less sophisticated first‐aid knowledge and beliefs than young adults, but were paradoxically more confident about providing help to a peer.Conclusions:  These findings show that there is a continuing need for further community education about the potential benefits of early professional treatment of young people developing mental disorders.

Objective: To determine the intentions that young people have for seeking help if they were to develop a mental disorder. Design, participants and setting: National telephone survey of 3746 Australia...

Background. There has been ethical concern that participants in psychiatric research will become distressed and their mental state might worsen.Method. A systematic search was carried out for studies that examined distress following participation in research that involved the assessment of psychiatric state or associated risk factors. There were 46 relevant studies.Results. A minority of participants become distressed immediately after participation, with distress more likely in studies of traumatic experiences. There is limited evidence on longer-term effects, but what there is suggests no adverse impact. Positive reactions to participation show little association with distress and these are more common than negative reactions. Very few studies of distress in research have used control groups to establish causal associations. However, what evidence there is suggests no causal role, including for research on suicidality. Researchers in this area have made a range of suggestions about ethical practice.Conclusions. A minority of participants in psychiatric research become distressed, but there is no evidence of longer-term harm. Nevertheless, researchers need to take account of ethical concerns in designing studies. Future research in the area needs to be carried out with stronger designs involving control groups.