Background
Methods
Selection criteria
Searches
Study selection and data collection
Risk of bias (quality) assessment
Strategy for data synthesis
Results
Study | Study design | Training evaluated | Participants | Comparator | Number of participants in study | Number of participants in analysis |
---|---|---|---|---|---|---|
Country | Type of evaluation | Number of clusters | ||||
Police officers: Interventions with a broad mental health focus | ||||||
Compton (2008) [13] | Systematic review |
Crisis Intervention Team programs (CIT)
| Police officers | No comparators specified however the broad scope was “research on CIT” | 12 studies were included in the review | Unclear. No summary table of studies provided. The studies are presented in a narrative synthesis. Some studies reported number of participating police officers and others number of incidents (n = 929 police officers for the 6 studies of officer level outcomes) |
USA | Provide a systematic summary and critical analysis of research on crisis intervention teams | Evaluations, surveys, or outcome studies conducted to examine specific questions or test hypotheses were included | ||||
Reports of descriptive statistics were excluded | ||||||
Searches included: databases (MEDLINE, PsycINFO, and databases of criminal justice, criminology and sociology abstracts), grey literature searches, and reference checking | ||||||
Forni et al. (2009) [29] | Non-comparative study |
Mental health awareness training to improve communication and understanding; explore common problems and solutions; understand how the Mental Health Unit functions; how MH staff handle violence and aggression; understand common MH problems | Police officers | Not applicable | 364 received training | 280 returned evaluation forms |
England | Post training evaluation form | |||||
Hansson & Markstrom (2014) [27] | Prospective non-RCT | An anti-stigma intervention aimed at improving knowledge behaviour and attitudes towards people with mental illness | Police officers | No training | 120 | 105 (46 intervention 59 control) |
Pre and post intervention questionnaire. 6 month follow up of intervention group | ||||||
Sweden | ||||||
Herrington & Pope (2013) [28] | Prospective non-RCT |
Mental Health Intervention Team (MHIT): training uniformed officers as specialists to respond to individuals with an apparent MH concern | Front line police officers (constables, senior constables, sergeants) | No training | 185 | Unclear |
Training group: pre, 2 months and 18 months post intervention questionnaires | ||||||
Australia | ||||||
Control group: questionnaire at 18 months only. Routinely collected data, semi-structured interviews, observational data, focus groups | ||||||
Norris & Cooke (2000) [30] | Non-comparative study | Training package developed by MH professionals. Aims to provide police officers with understanding, skills and awareness, and aid the management of mental disorder or mental illness | Police officers | Not applicable | 132 officers trained | 57 responses (43%) |
England | Immediate post training evaluation and retrospective survey | |||||
Pinfold et al. (2003) [31] | Non-comparative study |
Mental health awareness training developed in house. Aim to reduce negative stereo-typing and discriminatory actions | Police officers | Not applicable | 232 were eligible to take part; 163 were trained | 119 provided follow-up data |
England | Pre and 4 weeks post training surveys | |||||
Rafacz (2012) [17] | RCT | Online anti-stigma video aimed at changing attitudes, reduce stigma and increase empathy | Campus police officers | Alternative training | 91 | 91d
|
USA | Multiple pre and post intervention surveys. | |||||
Police officers: Interventions with a specific mental health focus | ||||||
Bailey et al. (2001) [26] | Prospective non-RCT | Awareness raising training on intellectual disabilities in general | Police officer trainees | No training | 62 | 57 |
(27 intervention 30 control) | ||||||
Northern Ireland | Pre and post intervention questionnaire | |||||
Teagardin et al. (2012) [15] | Cluster RCT |
Law Enforcement: Your Piece to the Autism Puzzle. Aims to help the recognition and identification of and attitudes towards people with Autism Spectrum Disorders (ASD) | “in the field” law enforcement officers (e.g. a patrol officer or detective) | Waiting list | 82 | 81e
|
Unclear | ||||||
USA | Pre and post intervention survey | |||||
Other non-mental health trained professionals: Interventions with a broad mental health focus | ||||||
Dorsey et al. (2012) [25] | Cluster RCT |
Project Focus: training and consultation model to improve knowledge of evidence based practices and ability to classify MH problems and referral options | Child welfare caseworkers | Waiting list | 67 | 44 |
USA | Questionnaire and a vignette based knowledge test pre and post intervention | 4 offices | ||||
Jorm et al. (2010) [23] | Cluster RCT | A modified version of the Youth Mental Health First Aid course. Aims to improve knowledge, attitudes, confidence and behaviour for dealing with students MH problems | Teachers | Waiting list | 327 | 327 |
Australia | Pre and post intervention and 6-month follow up questionnaire | |||||
14 schools | ||||||
Lipson et al. (2014) [21] | Cluster RCT |
Mental Health First Aid. Aims to improve attitudes and increase knowledge and self-efficacy to manage MH issues | Resident advisors | Usual practice | 254 | 2543 |
32 colleges and universities | ||||||
USA | Surveys 2–3 months pre and post training | |||||
Svensson & Hansson (2014) [16] | RCT |
Mental Health First Aid (translated and modified) To improve MH literacy and give skills to provide help to people with MH problems | Public sector staff | Waiting list | 406 | 406 |
Questionnaires and vignette 1 month pre intervention; 6 months post intervention and 2 year follow-up | ||||||
Sweden | ||||||
Thombs et al. (2015) [14] | Cluster RCT |
Peer Hero Training Programme. Aims to improve skills, knowledge & confidence in managing responses to MH and other situations | Resident assistants | Usual practice | 652 | 566c
|
USA | On-line survey at baseline, follow-ups at 3, 7 and 9 months | 8 campuses | ||||
Other non-mental health trained professionals: Interventions with a specific mental health focus | ||||||
Hart & More (2013) [24] | RCT | Audio-visual synchronous podcast of information related to Autism Spectrum Disorder (ASD) with the aim of improving knowledge | Trainee teachers | Alternative training | 79 | 79 |
USA | Pre and post intervention survey | |||||
Kolko et al. (2012) [22] | RCT |
Alternatives for Families: A Cognitive–Behavioral Therapy (AF-CBT). Aims to provide skills to use AF-CBT when working with families with physical forces, aggression or abuse of children | Community practitioners | Usual practice | 182 | 128 |
USA | Questionnaires completed at baseline, 6, 12 and 18 months | |||||
McVey et al. (2008) [20] | Cluster RCT |
The student body: promoting health at any size an online programme.” Aims to help prevent the onset of disordered eating through the promotion of positive body image | Teachers and public health professionals | Waiting list | 167 | 85b
|
Canada | Pre and 60 days post intervention questionnaire | 37 schools and their public health agencies (number unclear) | ||||
Moor et al. (2007) [19] | RCT | Educational package on recognition, identification and attitudes towards adolescent depression | Teachers | Waiting list | 151 | 151 |
Scotland | Pre and post training questionnaire | |||||
Ostberg & Rydell (2012) [18] | RCT | A modified version of Barkley’s parent training programme. Aims to provide tools and strategies to help children with Attention Deficit Hyperactivity Disorder (ADHD) | Parents and teachers | Waiting list | 147 | 129a
|
Sweden | Pre and post intervention and 3-month follow up questionnaire |
Evaluation of outcomes
Primary outcomes | Secondary outcomes | ||||||
---|---|---|---|---|---|---|---|
Study | Change in practice | Change in outcomes for the groups of people the trainees come into contact with | Satisfaction with training: | Change in attitude towards the importance of mental health | Change in confidence | Change in knowledge: | Change in skills - change in behaviour/ application of skills: |
Police officers: Interventions with a broad mental health focus
| |||||||
Forni et al. (2009) [29] | Not measured | Not measured | Feedback form evaluated quality of presentation and content | Form evaluated quality of presentation and content | Not measured | Form evaluated quality of presentation and content | Form evaluated quality of presentation and content |
Hansson & Markstrom (2014) [27] | Not measured | Not measured | Not measured | Attitudes: Community Attitudes towards Mental Illness. Validated. 20 items. Score: 6-point Likert scale. | Not measured | Mental Health Knowledge Scale. Validated 12 items, scored on 1–5 scale | Not measured |
Behaviour: Reported and Intentional Behaviour Scale: Validated. 8 items: 4 scored Yes/No and 4 on 1–5 scale | |||||||
Herrington & Pope (2013) [28] | Surveys. Number of items and validation not reported | Surveys. Number of items and validation not reported | Surveys. Number of items and validation not reported | Not measured | No comparative data reported | Not measured | Surveys. Number of items and validation not reported |
Norris & Cooke (2000) [30] | Questionnaire developed by study team | Not measured | Not measured | Not measured | Not measured | Not measured | Not measured |
Pinfold et al. (2003) [31] | Modified Community Attitudes towards Mental Illness (CAMI) and World Psychiatric Association (WPA 2000) questionnaires. Scored on 5 point likert scale | Not measured | One page feedback form | Modified CAMI and WPA 2000 questionnaires. Scored on 5 point likert scale | Modified CAMI and WPA 2000 questionnaires. Scored on 5 point likert scale | Modified CAMI and WPA 2000 questionnaires. Scored on 5 point likert scale | Modified CAMI and WPA 2000 questionnaires. Scored on 5 point likert scale |
Rafacz (2012) [17] | Not measured | Not measured | Not measured | Modified Attribution Questionnaire. 31 questions, response on a 5-point Likert scale | Not measured | Not measured | Not measured |
Police officers: Interventions with a specific mental health focus | |||||||
Bailey et al. (2001) [26] | Not measured | Not measured | Not measured | Attitudes towards Mental Retardation and Eugenics questionnaire. Validated. 32 items measured on a Likert scale. Score range 32–192 | Not measured | Not measured | Not measured |
Teagardin et al. (2012) [15] | Not measured | Not measured | Not measured | Not measured | 2 of a 12 item questionnaire developed by study team: scored on Likert scale | 10 of a 12 item questionnaire developed by study team: scored on Likert scale | Not measured |
Other non-mental health trained professionals: Interventions with a broad mental health focus | |||||||
Dorsey et al. (2012) [25] | 54 item questionnaire developed by study team | Not measured | Not measured | Not measured | Not measured | Vignette-based knowledge test developed by study team | Vignette-based knowledge test developed by study team |
Jorm et al. (2010) [23] | Not measured | Strengths & Difficulties Questionnaire: validated measure of 25 items: score range 0–3 | Not measured | Vignette-based knowledge test developed by study team. Non-validated | Two item questionnaire developed by the study team. Non-validated. Score range 0–5 | 21 item questionnaire developed by the study team. Non-validated. Score range 0–3 | 4 item questionnaire developed by the study team. Non-validated. Score range 0–4 |
Lipson et al. (2014) [21] | Study team produced categorical measure of the number of residents with whom Resident Advisors discussed mental health issues (0, 1, 2–3, or 4+); | The K6 scale for psychological distress. Validated scale. Score range: 0 to 24 | Not measured | 3 item measure of personal stigma adapted from the existing Discrimination-Devaluation Scale. Score range: 0–5 | Measure used was not clearly reported | Non-validated question developed by the researchers. 5 response categories | Non-validated 6 items related to self-perceived gatekeeper skills. |
Svensson & Hansson (2014) [16] | Pre-existing Questionnaires with vignettes. Vignettes scored max. 5 or 6 | Not measured | Not measured | Pre-existing Social distance scale. 6 items, scored on a 1–3 scale. | Pre-existing Questionnaires with vignettes. Vignettes scored max. 5 or 6 | Non-validated Questionnaire developed by study team. 16 items, response scale 0–2. Score range 0–16 | Pre-existing Questionnaires with vignettes. Vignettes scored max. 5 or 6 |
Thombs et al. (2015) [14] | 12 item survey developed by study team measured the number of first aid efforts made over the previous 30 days | Not measured | Not measured | Not measured | Referral efficacy, scored on a 5-point Likert scale | Not measured | Not measured |
Other non-mental health trained professionals: Interventions with a specific mental health focus | |||||||
Hart & More (2013) [24] | Not measured | Not measured | Not measured | Not measured | Not measured | Non-validated questionnaire, with ten open-ended questions: score range 0–3 | Not measured |
Kolko et al. (2012) [22] | 35 item AF-CBT implementation measure (AIM). Scores rated on a 5-point Likert-type scale | Not measured | 13-item training evaluation developed by The National Child Trauma Stress Network. 11 Items scored on a 1–5 Likert-type scale; 2 items open ended | Not measured | Not measured | 25-item CBT Knowledge Questionnaire. Multiple-choice: 4 or 5 response choices. | 35 item AF-CBT implementation measure (AIM). Scores rated on a 5-point Likert-type scale |
McVey et al. (2008) [20] | Not measured | Not measured | A 24 item non-validated questionnaire developed by study team. a 4-point, forced-choice scale | 6-item questionnaire developed by study team, rated on a 4-point Likert scale | 6-item subscale from existing validated “Free to Be Me” survey, adapted for teachers. Score: 4-point Likert scale | Validated survey “Free to Be Me” (modified); in-house survey; items, from Perceived Media Influences Sub-Scale. Scored on a 4/5-point Likert scale | 6-item subscale from existing validated “Free to Be Me” survey, adapted for teachers. Score: 4-point Likert scale |
Moor et al. (2007) [19] | Percentage of pupils reported as depressed by teachers, using lists of class cohort | Not measured | Not measured | Not measured | Attitudes Questionnaire designed by the research team. This was piloted however unclear to what extent it was validated. 30mins to complete | Not measured | Lists of class cohort |
Ostberg & Rydell (2012) [18] | Not measured | ADHD Rating Scale 0–4; DSM-IV scale 0–4; Strengths and Difficulties Questionnaire validated, 20-items, scale 1–5 | Described by authors as measured, but how was not reported | Not measured | Not measured | Not measured | Not measured |
Risk of bias within studies
Training interventions
Study | Type of training intervention | Aims of training | Target audience | Details of course content | Trainer details | Course materials |
---|---|---|---|---|---|---|
Where delivered | ||||||
Study design | Mode of delivery | Length of training | ||||
Police officers: Interventions with a broad mental health focus | ||||||
Compton et al. (2008) [13] | Crisis Intervention Team programs (CIT) | The CIT model is a specialised police-based program intended to enhance officers’ interactions with individuals with mental illnesses and improve the safety of all | No details or table of characteristics presented. | Not reported in this paper. Reference is made to other reports and reviews that explain the CIT model (Dupont and Cochran 2000; Cochran, Deane and Borum 2000; Munertz et al., 2006; Oliva et al., 2006; Oliva and Compton 2008) | No details or table of characteristics presented. | No details or table of characteristics presented. |
MH providers, family advocates and MH consumer groups (Cochran, Deane and Borum, 2000) | ||||||
40 h (Cochran, Deane and Borum, 2000) | ||||||
Systematic review | Face-to-face | Parties involved in MH crises. Self-selected officers (usually volunteers selected after a review by a CIT coordinator or other senior officer) receive 40 h classroom and experiential de-escalation training in handling crises. | Cochran, Deane and Borum (2000) describe the program as teaching officers about mental illness, substance abuse, psychotropic medication, treatment modalities, patients’ rights, civil commitment law and techniques for intervening in crisis. It is also reported that ‘advocates of CIT’ state that the program promotes a philosophy of responsibility and accountability to consumers of MH services, their relatives and the community. | |||
Team based | ||||||
Mixed | ||||||
Forni et al. (2009) [29] Non-comparative study | MH awareness training: developed in house. | To improve police officers’ knowledge and awareness of MH. Objectives included: improve overall communication; understand others roles and perspectives; explore common problems and discuss ways to overcome them; understand how the Unit functions; how MH staff handle violence and aggression and for Police to understand common MH problems. | Every police officer in the borough. | Tour of unit by MH Professionals explaining their work and answering questions. | Borough police officer for MH liaison and clinicians: two police trainers responsible for teaching section 136 procedures and prosecuting offenders with MH problems | Not reported |
The Ladywell Mental Health Unit, South London and Maudsley NHS Foundation Trust, Lewisham | Assessing a mental state | |||||
‘Hearing voices’ | ||||||
Assaults by patients with MH problems | ||||||
Face-to-face | Section 136 procedures | |||||
Team based | ||||||
Mixed | ||||||
One day training | ||||||
Delivered over 4 months – groups of 12 to 20 each day | ||||||
Hansson & Markstrom (2014) [27] | An anti-stigma course added on to the regular psychiatry course as part of officer training | To improve knowledge, behaviour and attitudes towards people with mental illness | Student police officers | The programme comprised of: an introductory lecture on attitudes towards people with mental illness; a video of people with lived experience telling their story (2 h); two lectures by people with mental health problems (schizophrenia and bipolar disorder) (2 h); six videotapes of people with MH problems including psychosis, anxiety disorder, depression, bipolar disorder, suicide, and children in families with a parent with mental illness (4 h); practical in vivo training module where feedback was provided on how best to respond to specific situations (4 h). The psychiatry course consisted of 14 h of lectures on causes, diagnosis and types of mental illnesses, legislation and a case study presented at a 2 h seminar. | Two lecturers with experience of MH problems | Lectures, videos, role play with professional actors |
University | ||||||
3 weeks full-time | ||||||
Non-RCT | ||||||
Face-to-face | ||||||
Team-based | ||||||
Mixed | ||||||
Herrington & Pope (2013) [28] | Mental Health Intervention Team (MHIT) | To train uniformed officers to be specialist responders to individuals with an apparent MH concern | Front line police officers (constables, senior constables, sergeants) | Not reported in this paper. Reference is made to Crisis Intervention Teams developed in Memphis (Compton et al. 2008 and Canada et al. 2010) which MHIT is based on. | A central project team was responsible for the development and delivery of training, headed by a superintendent (commander) supported by an Education Development Officer, an analyst, and a Clinical Nurse Consultant | Not reported |
Non-RCT | Not reported | |||||
Not reported | ||||||
Not reported | ||||||
Norris & Cooke (2000) [30] | MH awareness training: developed in house. | To acquire awareness, understanding and skills in order to aid management of mental disorder or mental illness and thereby assist police officers in their duties. | Police officers | Morning: Legal responsibilities of police. Tour of unit by MH Professionals explaining their work and answering questions. | MH professionals at the Hutton Centre and the Cleveland police training officer | Not reported |
The Hutton Centre, Middlesborough, a medium secure unit | ||||||
Afternoon: Assessing a mental state, emphasis on increasing awareness of signs and symptoms of MH problems rather than clinical diagnosis. Discussion of personal and professional experiences and interactive role plays and teaching. | ||||||
Non-comparative study | ||||||
Face-to-face | ||||||
One day training | ||||||
Has been delivered over last five years – 132 officers trained. | ||||||
Team based | The training emphasised the “distinction between a ‘criminal’ and a ‘mentally disordered offender’”, and the “need for care and treatment as opposed to incarceration and punishment” | |||||
Mixed | ||||||
Pinfold et al. (2003) [31] | Reducing psychiatric stigma and discrimination: developed in house | To communicate the ordinariness of mental ill-health and to address fear and misunderstanding surrounding experiences labelled ‘severe mental illness’. Raising participant awareness; increasing level of knowledge; changing views and affecting behaviour. | Police officers | Workshop 1: ‘What are MH problems?’ Including hearing voices simulation exercise a session on recovery and talks by an individual explaining what it feels to be psychotic. | Developed by project team, police force, Rethink severe mental illness trainers. | Workshops supported by information packs |
Two police areas in Kent | ||||||
Non-comparative study | ||||||
2 × 2 h workshops over 6 month period. | ||||||
Workshop 2: ‘How can the police support people with MH problems?’ including case studies and talks from carers and service users highlighting best practice principles. Additionally, workshop two reviewed mental health act 1983 legislation, local service provision and officers own MH needs | Delivered by: service users, carers, social workers, voluntary sector staff | |||||
Face-to-face | ||||||
Team based | ||||||
Mixed | ||||||
Rafacz (2012) [17] | An on-line anti-stigma program delivered in two different ways: personal experience vs information giving | The control condition aimed to increase general knowledge of specific MH conditions. The intervention condition aimed to change attitudes (reduced stigma and increased empathy) | Campus police officers | A 17 min long video in which the presenter disclosed his mental illness (schizo-affective disorder), and shared his initial experiences of the illness and treatment before discussing t where he is now and his successes, hopes and dreams for the future. He also discussed the interaction he had with police officers and their effect on the outcomes of his illness. | Videos presented by men with similar attributes to each other, however in the intervention group the presenter disclosed having a diagnosis of schizo-affective disorder | Video presentation delivered online |
RCT | ||||||
Online | ||||||
17 min | ||||||
Online/web-based | ||||||
Self-directed | ||||||
Didactic | ||||||
Police officers: Interventions with a specific mental health focus | ||||||
Bailey et al. (2001) [26] | Awareness training on intellectual disabilities | Training aimed to raise the awareness of police officers to people with intellectual disabilities in general | Trainee Police officers (post foundation training) | Involved a role-played exercise where residents from a group home on a local housing estate attended a community meeting relating to a drug problem on the estate. Police officers within the treatment group were allocated a number of roles, including that of a person with intellectual disability resident in a group home. This was followed by a debrief session and exploration of stereotyped views held about people with intellectual disability. | One of the co-authors, a professional with a background in intellectual disability services. | Briefing, role play, plenary group. Other course materials not reported |
Non-RCT | ||||||
Not stated | ||||||
Face-to-face Team-based Interactive | ||||||
Not stated but appeared to be a single session | ||||||
Teagardin et al. (2012) [15] | “Law Enforcement: Your Piece to the Autism Puzzle”: a video to educate law officers about Autism Spectrum Disorders (ASD) | To help the recognition and identification of and attitudes towards people with ASD. | ‘In the field’ law enforcement officers. | The video covers topics included what is ASD, how to recognize persons with ASD, and how to respond to persons with ASD. | No trainer present, video only. | Video presentation |
RCT | Law enforcement training venue | |||||
13 min | ||||||
On-line/web based | ||||||
Self-directed | ||||||
Didactic | ||||||
Other non-mental health trained professionals: Interventions with a broad mental health focus | ||||||
Dorsey et al. (2012) [25] | Project Focus’ a caseworker training and consultation model. Training followed by case-specific consultation. | To enhance the skills of case-workers through training and case-based consultations to enable better recognition of MH needs and link youth with effective MH treatment (EBP). Project focus was designed to explore whether an increase in caseworker capacity to identify commonly occurring MH problems and to refer to EBPs improves child well-being. | Child Welfare Caseworkers. | The training involved: building awareness of available EBPs in the community; common MH needs for youths in foster care screening to identify needs. Three main classes of MH problems were covered: internalising (depression and anxiety), externalising (disruptive behaviour) and attention-related issues. Screening strategies were discussed. Classes of disorders rather than specific diagnosis were covered. Overviews of ‘name brand’ approaches available locally were provided; short video modelling and demonstration of EBPs; and engagement training to involve foster parents and collaborate with clinicians. Consultation sessions involved reviewing screening data and discussing the implications, treatment options and developing action plans for each case. | None stated for training. Consultation sessions were delivered by three PhD-level psychologists and one M-level social worker with 30+ years-experience in MH. | Lectures (PowerPoint), small group activity (vignette and discussion). Short modelling and video demonstrations of available EBPs |
RCT | Not specified. | |||||
Two 3-h training sessions and following training, caseworkers received 4 months of bi-weekly 1 h case specific consultation. | ||||||
Face-to-face | ||||||
Team based | ||||||
Mixed. | ||||||
Jorm et al. (2010) [23] | A modified version of the Youth MHFA course. | For teachers, to improve: knowledge and attitudes towards MH; confidence in helping students; knowledge of school policies and procedures for dealing with students with MH problems. Training also aimed to improve teachers ability to support colleagues with MH problems seek information about MH problems and their own MH | Teachers | How to apply the MHFA action plan “ALGEE”: Assess the risk of suicide or harm; Listen non-judgementally; Give reassurance and information; Encourage to get appropriate professional help; Encourage self-help strategies | MHFA trainers who had previously worked as teachers. Each course was taught by two instructors, one from the Department of Education and Children’s Services and the other from the Child and Adolescent Mental Health Service. Instructors got a one-week training program in how to conduct this modified Youth MHFA course. They were trained by two experienced trainers, including the person who devised the MHFA course | A lesson plan for each session, the existing Youth MHFA manual and a set of MH factsheets |
Participants’ school | ||||||
RCT | ||||||
Two parts, taught over two days, seven hours each day | ||||||
Face-to-face | ||||||
Part 1 (for all education staff) covered departmental policy on MH issues, common mental disorders in adolescents and how to use the MH action plan | ||||||
Team based | ||||||
Mixed | ||||||
Part 2 (for teachers with special responsibility for student welfare) provided information about first aid approaches for crises that require a more comprehensive response and about responses for less common MH problems | ||||||
For students to improve their MH and increase information provided about MH | ||||||
Lipson et al. (2014) [21] | MHFA | For Resident Advisors and Residents trained in MHFA to have improved attitudes, knowledge and self-efficacy to manage MH issues in their residential communities. This should lead to more contact with residents about MH issues, leading to increased knowledge and attitudes at the population level. Ultimately, training aimed to increase residents’ service utilization, so improving MH. | University Resident Advisors | The five course modules were on: depression, anxiety, psychosis, substance abuse and eating disorders. Each module had information about signs and symptoms, appropriate responses, and interactive activities. The cornerstone for MHFA is a five-step gatekeeper action plan ALGEE (as above). MHFA emphasises that self-help does not replace professional care in potential crises. | Instructors were certified by the National Council on Behavioral Healthcare. Most of the instructors (10 of 14) were behavioural health clinicians. | Slides, demonstrations, and case examples. |
RCT | Face-to-face | Not specified. | ||||
Team based | ||||||
Interactive | ||||||
12 h (since reduced to 8 h but still retaining breadth of content) | ||||||
Svensson & Hansson (2014) [16] | MHFA translated and modified to suit the Swedish context | To improve MH literacy among the general public and give the public the skills to be able to provide initial help to people with MH problems. | Public sector staff (social insurance agencies, employment agencies, social services, schools, police departments, correctional treatment units, rescue services, recreation centres). | The course was taught in five steps (as in ALGEE above). The steps were then applied to depression, anxiety disorders, psychosis and substance use disorder. Attendees were taught how to help a suicidal person, a person having a panic attack, a person who has experienced a traumatic event and a psychotic person threatening violence. | An Australian team taught three Swedish main instructors, who then taught 18 instructors who implemented the training program. All the instructors had experience of MH work in some form, such as health care staff and volunteers in user organisations. | An MHFA manual in Swedish |
RCT | ||||||
Face-to-face | ||||||
Team based | ||||||
Interactive | ||||||
Training was given at worksites or local colleges localities in classes | ||||||
12 h (equally spread over 2 days) | ||||||
Thombs et al. (2015) [14] | Peer Hero Training Program: uses a story-based approach to emphasise Resident Assistants (RAs) need to show courage in carrying out their responsibilities as MH & alcohol/other drug first-aid providers. | Improve skills, knowledge and confidence in managing their ‘First-aid’ response in relation to MH and alcohol/other drug situations for students living in university residences. Address the RA’s four critical attitudes which affect their ability to manage these ‘first-aid’ situations: perceived referral barriers, referral self-efficacy, referral anticipatory anxiety, and perceived referral norms. | University RAs | Program has three components, all in video format. 1) 3 dramatisations of a situation which RAs may face relating to alcohol, other drug, MH, and academic problems and methods for referring students for help. Interactive decision points require the RA to select 1 of 4 answers. The actor RA then dramatises the selected answer before feedback is given about the selected answer. 2) two-part counselling session: a student referred by an RA meeting with a counsellor, the story line flows from videos above to illustrate what students referred to counselling may encounter. 3) a series of interviews with actual parents of students and senior residence life professionals on: what is expected of RAs; not ignoring or overlooking students’ needs; how to approach students with an observed behavioural problem; need for RAs to be sincere, empathic and maintain confidentiality. | Developed by team of campus residence professional staff, RA supervisors, RAs campus MH professionals, student affairs professionals and health behaviour researchers. | Interactive videos |
Not specified | ||||||
RCT | Three separate training sessions which each took between 15 and 25 min to complete. | |||||
Delivered on line. | ||||||
On-line/web-based | ||||||
Self-directed | ||||||
Interactive | ||||||
Other non-mental health trained professionals: Interventions with a specific mental health focus | ||||||
Hart & More (2013) [24] | Information relating to Autism Spectrum Disorder (ASD). | Improve knowledge of ASD by comparing two methods of information delivery. | Trainee teachers | The ASD-related content was based on information on the Centers for Disease Control website and the course text, included: early warning signs and current prevalence and definition of ASD. Content used reflected the local cultural and linguistic diversity and that seen in ASD: this focused on potential underservice of ethnic and linguistic minority populations and teacher strategies for developing cultural competence and collaborative relationships with families. | The content of the training was developed by the authors: no details provided. Delivery was online. | For both groups material was located on a university Blackboard Course Management Learning System which students were asked to log onto via a laptop. Those allocated to the podcast also used headphones. |
Classroom | ||||||
RCT | 20 min | |||||
On-line/web-based | ||||||
Self-directed | ||||||
Didactic | ||||||
Kolko et al. (2012) [22] | Alternatives for Families: A Cognitive–Behavioral Therapy (AF-CBT) | Provide practitioners with skills to use AF-CBT when working with families with physical forces, aggression or abuse of children. | Community practitioners (clinicians) | Initial training based on the AF-CBT Session Guide: included didactic and experiential activities, case examples, group discussion, videotape reviews, and behavioural rehearsal/ challenge exercises. The session guide provides clinicians with an outline and examples for presenting the three phases of AF-CBT: engagement and psycho-education, individual skill-building, and family applications. Follow-up training: Each consultation began with a review of one or more AF-CBT topics, followed by two case presentations, feedback from consultants and the group, and problem solving to address the needs of the presenting clinicians. Booster training: Sessions focused on case conceptualisation, review of a skill topic, exploration of treatment adaptations and use of handouts, and implementation challenges. | Three experienced, ‘second generation’ trainers either alone or in tandem (1 trainer to 8–15 practitioners). | Treatment book; AF-CBT session guide; clinician-friendly handouts; two children’s books |
RCT | ||||||
Initial training: conducted at the site of each participating agency, repeated for each cohort. Follow-up: at agency site; Booster: not stated. | ||||||
Face-to-face | Experienced AF-CBT clinicians, trainers, and developers generated the initial training content based on the AF-CBT Session Guide. | |||||
Team based | ||||||
Interactive | ||||||
Initial training: 4 × 8 h weekly workshops for 1 month; Followed by 10 × 90 mins bi-weekly group case consultations. | ||||||
Annual booster sessions offered (1.5–2 h) from 6 to 12 months after initial training. | ||||||
McVey et al. (2008) [20] | An online programme called “The student body: promoting health at any size an online programme” | Help teachers and public health practitioners prevent the onset of disordered eating through the promotion of positive body image in children before they reach adolescence. Inform adult role models about the various factors influencing children’s body image. | Teachers and public health professionals | Six modules: media and peer pressure, healthy eating, active living teasing, adult role models and school climate. Steps in each module for the facilitator: 1) a case study introducing the topic using an animated cartoon; 2) background information providing topic information and its significance to disordered eating prevention; 3) instructions on how to conduct a classroom activity with students; 4) topic-related supplementary resources. | Online | Case study script for role-play, PDF of background information, true or false game, comic strip with game answers, parents’ handout and an optional evaluation. Topic related resources |
RCT | ||||||
Online for participants – for delivery in classroom. | ||||||
Online-curriculum available for delivery to students during classroom time for 60 day period. | ||||||
On-line/web-based | ||||||
Self-directed | ||||||
Didactic | ||||||
Moor et al. (2007) [19] | Educational package on adolescent depression | Not explicitly specified but intervention designed to help the recognition, identification of and attitudes towards adolescent depression. | Teachers | The training was delivered in three parts. 1) An introduction to adolescent depression and the importance and challenges of early detection; emphasising the role of teachers. Followed by a video of actors on ways that the signs of depression may show in school settings and standardising information on the signs and symptoms of depression. 2) Case vignettes illustrating a range of difficulties that schools may encounter were presented to teachers in small groups for discussion. All depressive disorders in the community such as co-morbidity of depression with school refusal, drug and alcohol abuse and conduct disorder were included. Management strategies appropriate for teachers to use in school were covered, including problem solving approaches. 3). Discussion of issues specific to each staff group’s local triage procedures and referral of hypothetical at-risk pupils. | Each training session was delivered by the same pair of trainers-details of trainers not provided. | An educational video and case vignettes |
Not specified | ||||||
RCT | 2 h | |||||
Face-to-face | ||||||
Team based | ||||||
Mixed | ||||||
Ostberg & Rydell (2012) [18] | A modified version of Barkley’s parent training programme-adapted to setting and for use with teachers | To better equip teachers and parents with the ‘tools’ they need and “strategies in Everyday life” to help children with ADHD | Teachers and parents | Sessions from Barkley’s parent training included information about neuropsychiatric problems, teaching participants to use reinforcements, problem solving and communication with the children. Adaptations to the programme included: removal of ‘time-out’ for unwanted behaviour, home assignments were based on the problems parents and teachers experienced and reported on. Problem-solving aspect of the training was extended. A structure for co-operation between home and school was formed. | Two “well-trained” group-leaders per group | Home assignments based on problems reported by parents and teachers |
Child and adolescent psychiatry clinic. | ||||||
RCT | ||||||
Parents 10 weekly 2 h sessions, teachers 8 sessions. | ||||||
Face-to-face | ||||||
Team based | ||||||
Mixed |