Evaluation of Mental Health First Aid within a workplace context.

Background: Evidence suggests that Mental Health First Aid (MHFA) benefits organisations and employees. However, there has been no systematic investigation of the impact of MHFA on direct recipients and the organisations that adopt MHFA. Aims of thesis: The thesis aims to [1] evaluate the effectiveness of MHFA on help-seeking behaviour amongst employees and direct recipients, [2] explore participants’ experience and the impact of MHFA on workplace culture and relationships, [3] understand the active ingredients and mechanisms of action in MHFA that improves help-seeking behaviour for mental health difficulties. Methods Design: An embedded mixed methods design comprising a two-arm clustered Randomised Controlled Trial (RCT) comparing MHFA and usual practice, a qualitative evaluation, and theoretical mapping of MHFA onto the Behavioural Change Wheel (BCW). Sample: The participants were mental health first-aiders and other employees who have received MHFA directly or indirectly, working in randomly allocated UK clusters. Measures: Standard measures of participants’ help-seeking behaviour, helpseeking intentions, mental health and well-being, self-efficacy levels, and use of health and social services were used to assess the impact of MHFA. Procedure: Employees within these organisations were assessed via online completion of measures at baseline and 6 months post-intervention. A purposive selection of participants was interviewed. In addition, a consensus approach was taken to retrospectively map the MHFA intervention to the associated elements of the BCW. Results & Discussions: The study found that MHFA does not encourage formal help-seeking behaviour and identifies contributing factors to a preference for informal help-seeking avenues outside the workplace through qualitative interviews. Also, the thesis identified key components of health behaviour change, such as problem-solving, action planning, and social support as active ingredients in MHFA. However, there were inconsistencies in the practical 2 application of the MHFA interventions. The study suggests that more research is needed to determine the effectiveness of MHFA interventions on direct recipients and to explore the factors that contribute to mental health help-seeking. Utilising the COM-B model and TDF in future studies can help identify the changes required to facilitate actual help-seeking behaviour in a bid to improve MHFA intervention.