More than 155,000 New Yorkers were trained in Mental Health First Aid (MHFA) between 2016 and 2020. The authors conducted a mixed-methods study that included a web-based survey of past trainees and a series of focus groups to assess the impact of the MHFA trainings and needs for continued training in the future.

Evaluation of Mental Health First Aid in New York City

Eunice C. Wong, Michael S. Dunbar, Daniel Siconolfi, Anthony Rodriguez, Chester Jean, Vanessa N. Torres, Rosemary Li, Michele Abbott, Ingrid Estrada-Darley, Lu Dong, et al.

ResearchPublished Feb 7, 2023

Cover: Evaluation of Mental Health First Aid in New York City
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More than 155,000 New Yorkers were trained in Mental Health First Aid (MHFA) between 2016 and 2020. Free citywide trainings were made available to all New Yorkers and were disseminated through city agencies and community-based settings. RAND Corporation researchers conducted a mixed-methods study that included a web-based survey of past trainees and a series of focus groups with leaders of community-based organizations and city agency staff to assess the impact of the MHFA trainings and needs for future training. In this report, the authors describe the evaluation activities that took place; the methods behind them; and the results at the individual, agency, and community levels. They also offer recommendations for ways to improve future mental health education efforts.

Respondents applied MHFA skills extensively and broadly across their social networks. Nine in ten respondents had contact with an individual with a mental health problem in the past six months. Among those who had contact, 84 percent indicated using their MHFA skills to help a friend or family member, and nearly half reported applying skills with a co-worker, neighbor, or acquaintance. Because MHFA was offered through city agency workplaces and community-based settings, tens of thousands of New Yorkers were given tools to come to the aid of individuals in their personal and professional lives. MHFA may be a promising approach to building supportive social networks, organizations, and communities that are primed to recognize and assist those experiencing mental health challenges.

Key Findings

At the individual level, most survey respondents (90 percent) had contact with a person with a mental health problem in the past six months, and nearly all applied key MHFA skills

  • Respondents scored on average 50 percent correct on a mental health knowledge test.
  • One in five respondents expressed little to no confidence in assisting someone with a mental health problem even after having completed MHFA training.
  • More than 80 percent of respondents reported using MHFA skills to support their own well-being; in fact, 40 percent indicated obtaining counseling as a result of MHFA training.

At the city agency level, more than half of city agency survey respondents indicated that they would feel comfortable discussing mental health with coworkers (65 percent) and supervisors (58 percent)

  • City agency employees were significantly more likely to have recently used MHFA skills with a client than community-based respondents were.
  • Nearly a third of city agency employee respondents expressed discomfort with using mental health services through their employer.
  • One in ten feared retaliation or being fired for seeking mental health care.

At the community level, most survey respondents (84 percent) reported frequently or occasionally correcting misperceptions about mental health and mental illness

  • About half of respondents agreed that their community thinks less of someone with a history of mental health problems and that seeking treatment is seen as a sign of personal weakness.
  • Compared with non-Hispanic White respondents, racial/ethnic minority respondents were more likely to report needing additional training to apply MHFA skills in their communities.

Recommendations

  • Future mental health trainings could help to address identified needs and to fortify helping behaviors. Mental health literacy is a potential area in need of targeting.
  • Whether trainee well-being can be addressed by MHFA or similar trainings could be explored.
  • City agency employees are more likely to use MHFA to support their coworkers and clients, but workplace mental health climate can still be improved.
  • MHFA could potentially strengthen social support networks and community members at large to serve as first-line supports to individuals experiencing mental health challenges.
  • Future implementations of MHFA or similar trainings should consider the impact of community stigma.
  • Future trainings could assess and address the additional training needs that racial/ethnic minorities have identified as necessary to better apply MHFA within their communities.
  • Trade-offs between the selection and delivery method of mental health programming and desired outcomes should be weighed carefully.

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RAND Style Manual
Wong, Eunice C., Michael S. Dunbar, Daniel Siconolfi, Anthony Rodriguez, Chester Jean, Vanessa N. Torres, Rosemary Li, Michele Abbott, Ingrid Estrada-Darley, Lu Dong, and Rebecca Weir, Evaluation of Mental Health First Aid in New York City, RAND Corporation, RR-A1818-1, 2023. As of September 13, 2024: https://www.rand.org/pubs/research_reports/RRA1818-1.html
Chicago Manual of Style
Wong, Eunice C., Michael S. Dunbar, Daniel Siconolfi, Anthony Rodriguez, Chester Jean, Vanessa N. Torres, Rosemary Li, Michele Abbott, Ingrid Estrada-Darley, Lu Dong, and Rebecca Weir, Evaluation of Mental Health First Aid in New York City. Santa Monica, CA: RAND Corporation, 2023. https://www.rand.org/pubs/research_reports/RRA1818-1.html.
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The research described in this report was the Mayor's Office for Economic Opportunity and conducted in the Social and Behavioral Policy Program within RAND Social and Economic Well-Being.

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