A Feasibility Trial of Mental Health First Aid First Nations: Acceptability, Cultural Adaptation, and Preliminary Outcomes

Abstract

The Mental Health First Aid First Nations course was adapted from Mental Health First Aid Basic to create a community‐based, culturally safe and relevant approach to promoting mental health literacy in First Nations contexts. Over 2.5 days, the course aims to build community capacity by teaching individuals to recognize and respond to mental health crises. This feasibility trial utilized mixed methods to evaluate the acceptability, cultural adaptation, and preliminary effectiveness of MHFAFN. Our approach was grounded in community‐based participatory research principles, emphasizing relationship‐driven procedures to collecting data and choice for how participants shared their voices. Data included participant interviews (n = 89), and surveys (n = 91) from 10 groups in four provinces. Surveys contained open‐ended questions, retrospective pre‐post ratings, and a scenario. We utilized data from nine facilitator interviews and 24 facilitator implementation surveys. The different lines of evidence converged to highlight strong acceptability, mixed reactions to the cultural adaptation, and gains in participants’ knowledge, mental health first aid skill application, awareness, and self‐efficacy, and reductions in stigma beliefs. Beyond promoting individual gains, the course served as a community‐wide prevention approach by situating mental health in a colonial context and highlighting local resources and cultural strengths for promoting mental well‐being.

Digital Health Solutions for Indigenous Mental Well-Being

“…E-learning has been adopted in mental health, including examples in emergency health providers in rural settings with increased self-efficacy reported among participants [24], and for suicide prevention and Mental Health First Aid training resulting in increased attendance of individuals in both urban and rural settings [25, 26]. Mental Health First Aid has been adapted specifically to Indigenous communities [27]; however we could not locate any examples of e-learning modules for Indigenous Mental Health First Aid. One noted pitfall of e-learning for Mental Health First Aid is the absence of face-to-face interaction among group members, with recent literature proposing a blend of both face-to-face training and e-learning [26].…”

Adapting evidence-informed population health interventions for new contexts: a scoping review of current practice

“…In their cultural adaptation of a mental health literacy intervention to the First Nations context, Crooks and colleagues describe modifications to foster community resilience by building upon specific healing resources of First Nations cultures [ 37 ]…”

“…A few studies also described advisory boards which comprised representatives of these different stakeholder groups overseeing and giving advice during all phases of adaptation [ 25 , 29 , 32 , 34 , 37 , 39 , 41 , 43 , 44 ]. For example, in the study on adaptation of a health behaviour intervention for people with impaired mobility, the 13-member national advisory board consisted of health professionals including rehabilitation physicians and occupational therapists, disability researchers specialising in weight loss, experts in human and organisational development, and representatives of community-based disability organisations [ 25 ].…”

“…Studies most frequently discussed the aims of adaptation to enhance cultural and contextual relevance [ 41 ]. Cultural and contextual insensitivity of an intervention was described as potentially contributing to null or negative intervention impacts and lack of acceptance and adherence to the intervention [ 37 , 43 ]. In contrast, taking this into account could affect engagement with the intervention, its acceptability, feasibility, and outcomes [ 24 – 28 , 31 – 43 , 47 ].…”

Evaluation of the Aboriginal and Torres Strait Islander Mental Health First Aid Program

“…This is a key consideration when assessing the adaptation or importation of program materials into cultural contexts 35 . Indeed, a key feature of the recent Canadian adaptation of MHFA for use in Indigenous communities by Crooks et al 36 was the embedding cultural activities and content within Western theories of mental illness and health. It is also important to note here that the recipients of AMHFA included those who identified as from both Indigenous and non‐Indigenous cultural backgrounds and came from remote communities as well as regional and metropolitan areas.…”