Adolescence is often an age of storm and stress. As adolescents grapple with physical, social and emotional changes, they become more vulnerable to mental health issues. While adolescents prefer to seek help from peers, their peers tend to be ill-equipped in providing support to someone with a mental health problem. In addition, adolescents do not usually encourage their peers to seek help from adults. This dual problem highlights a critical gap in providing effective mental health assistance to the adolescents in our society.

The Current Study

Background

Hart et.al (2018) believed that depression, anxiety and other mental health issues can be addressed by creating an effective pathway for adolescents to provide social support to their peers and encourage their peers to seek help from adults or professionals. The authors saw that this could be done by training adolescents to provide mental health first aid to their peers and educating adolescents about the importance of professional help.

What is mental health first aid?

Mental health first aid is the provision of relief to a person who is developing a mental health problem or experiencing a mental health crisis, until the crisis is resolved or the person is seen a professional (e.g.counsellor or psychologist). It is commonly known as psychological first aid.

Method

In this study, the effectiveness of teen Mental Health First Aid (tMFA) training was tested in four Australian schools. Students were either allocated to a treatment condition where they received mental health first aid training or a control condition where they received physical first aid training (PFA). Students underwent three 75-minute training sessions with professional instructors. In particular, the core message of tMFA training was to seek help from a trusted adult when a peer is experiencing psychological distress.

Findings

Two fictional characters were described to the students. One was an adolescent with depression and suicidality, while the other was an adolescent with social anxiety and phobia. The authors measured (1) quality of intentions (2) confidence in providing help (3) mental health literacy (4) stigmatizing beliefs towards these two characters, before and after the trainings were conducted.

*Note: Measures of mental health literacy comprised of subcomponents including problem recognition and beliefs of adult helpfulness. Measures of stigmatizing beliefs comprised of subcomponents including desire for social distance, weak-not-sick beliefs and beliefs of danger.

Prior to receiving training, the students had already reported a high level of problem recognition and low stigmatizing beliefs. Thus, tMFA training did not produce significant changes in these measures. However, the student's quality of intentions and confidence improved after tMFA training.

The evaluation of mental health training effectiveness was done by comparing outcome measures of students who underwent tMFA training against those who underwent PFA training. In comparison, students who received tMFA training scored better on outcome measures than students who received PFA training. In sum, students who completed tMFA training were more likely to have helpful first aid intentions, greater confidence in providing help and improved beliefs about adult helpfulness.

The authors highlighted two findings in particular. Firstly, tMFA training was associated with reductions in desires for social distance. Secondly, tMFA training led to increases in ratings of adult helpfulness. These findings point to how students would be more likely to provide effective support to their peers in the future.

Conclusion

This study shed light on a crucial problem underlying adolescent mental health and provided evidence for the usefulness of training adolescents in mental health first aid. The implications of this study are especially relevant for Singapore, where suicide is the leading cause of death in adolescents. Although the rates are unknown, many teenagers in Singapore struggle with depression and anxiety alone because they fear the possible response from their parents and schools if their condition were made known (Mahmud, 2018)

For many years, mental health first aid training was primarily catered to school counsellors and teachers in Singapore. Only in recent years, a handful of junior colleges and universities set up peer helper initiatives on their campuses, where a selected group of students are trained in basic counselling skills to provide support to their peers in school. While this is a positive direction, it would be beneficial to equip more of our youths and adults with this important life skill. Mental health first aid is a useful resource that can be used to integrate our youths into the safety net against suicide. While adolescents may easily identify a friend in need, not knowing what to do is a significant barrier that prevents help from being extended. With training, youths can be empowered to identify signs of psychological distress and provide effective socioemotional support to their peers. All in all, the social bond between youths can potentially serve as a unique protective factor against youth suicide.

If you are a youth, parent or teacher, you have an important role to play in ensuring the mental health of our youth today. Even if you are just a friend, you too can play a part. If you are interested in learning Mental Health First Aid, there are courses provided by Singapore Red Cross and Singapore Emergency Responder Academy.

References

Hart, L. M., Morgan, A. J., Rossetto, A., Kelly, C. M., Mackinnon, A., & Jorm, A. F. (2018). Helping adolescents to better support their peers with a mental health problem: A cluster-randomised crossover trial of teen Mental Health First Aid. Australian & New Zealand Journal of Psychiatry,52(7), 638-651. doi:10.1177/0004867417753552

Mahmud, A.H. (2018). Some teens, wary of being dismissed, seek mental help without parent's knowledge. Retrieved from https://www.channelnewsasia.com/news/singapore/teens-wary-dismissed-mental-health-help-without-parents-knowing-10752012

Article written with Tay Shi Ying. Shi Ying is a psychology undergraduate at the Nanyang Technological University (NTU) and aspiring clinical psychologist who has completed an internship with ImPossible Psychological Services. She is supervised by our senior clinical psychologist, Haikal.