Experiences of graduates of the Mental Health First Aid-USA course

Mental health distress is common, yet many people lack mental health literacy and skills to help themselves and others. In this qualitative study, we used semi-structured interviews to ask graduates of Mental Health First Aid (MHFA-USA), a mental health promotion program designed to address such needs, about its impact. Interviewees described gaining knowledge, skills and confidence to help someone in distress, empathy for people with mental illness, and developing a sense of responsibility and permission to try to help when needed. They gave varied examples of using MHFA-USA skills with strangers, acquaintances, coworkers, clients and family members, and to help themselves, in a range of situations. We integrate these results into a tentative change process diagram, and speculate on its effects for people in distress and community norms regarding emotional and psychiatric distress. We then discuss the implications for MHFA-USA outcomes research.