Daryl Traylor1, Eboni Anderson2, Asia Hodges3, and Destiney Kirby4
1PhD, Adjunct Faculty, Department of Public Health, A.T. Still University College of Graduate Health Sciences, Mesa, United States
2PhD, DHEd, Associate Professor & Director of Community Oriented Primary Care, Department of Public Health & Research, A.T. Still University School of Osteopathic Medicine at Arizona, Mesa, United States
3MSc, Academic Coach, Department of Public Health, Eastern Washington University, Cheney, United States
4MD, Intern, Department of Family Medicine, Columbia University/New York-Presbyterian, New York, United States
Abstract
The mental health of medical students is a critical concern, with nearly 39% of medical students experiencing depression and over 66% reporting burnout. Untreated mental health issues can significantly impact patient care, leading to reduced empathy, impaired judgment, and increased medical errors. Mental Health First Aid (MHFA) training offers a solution by equipping individuals with the skills to identify, understand, and respond to signs of mental illnesses and substance use disorders. MHFA training, much like traditional first aid, emphasizes early intervention, which can prevent mental health crises from escalating and promote faster recovery. Incorporating MHFA into medical school curricula may foster a more supportive environment, reduce mental health stigma, and encourage open discussions about mental health. Strategies for integrating MHFA include embedding it into clinical rotations, interprofessional education, existing courses, elective modules, and online training. Partnerships with mental health organizations and support from professional medical associations can provide the necessary resources and credibility for successful implementation. Faculty training and ongoing professional development are crucial for sustaining MHFA initiatives. By prioritizing MHFA training, medical schools can enhance the well-being of future doctors and improve patient care outcomes, aligning with the growing emphasis on holistic healthcare. This approach ensures that mental health is given equal priority as physical health in medical education and practice, creating a healthier and more effective healthcare workforce.
Key Words: mental health, first aid, medical students, burnout, depression, medical education
Date submitted: 20-July-2024
Email: Daryl Traylor (daryltraylor@atsu.edu)
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Citation: Traylor D, Anderson E, Hodges A, and Kirby D. Integrating mental health first aid training into medical education. Educ Health 2025;38:82-87
Online access: www.educationforhealthjournal.org
DOI: 10.62694/efh.2025.136
Published by The Network: Towards Unity for Health
Imagine your future physician, deeply committed to your care, silently battling depression. This scenario is not hypothetical. Studies reveal that nearly 39% of medical students experience depression, and more than 66% report burnout.1 As the gatekeepers of our health, it’s imperative that physicians are equipped to handle their mental health, and that of their patients. Mental Health First Aid (MHFA) is a standardized program developed to improve mental health literacy of the public.2 We argue that medical schools should incorporate Mental Health First Aid training into their curriculum to equip future physicians with essential skills for addressing mental health crises, both in their patients and themselves.
The mental health crisis within medical schools is alarming. High rates of depression, anxiety, and burnout plague medical students.3 Research shows that approximately one in four medical students experiences symptoms of depression, and one in ten experiences suicidal thoughts.4 The pressures of medical training, coupled with the demanding nature of the profession, create a perfect storm for mental health issues.
These untreated mental health problems have a direct impact on patient care. Physicians suffering from mental health issues may exhibit reduced empathy, impaired judgment, and decreased productivity.5 Studies have shown that physician well-being is closely linked to patient outcomes.6 A distressed physician is more likely to make errors, affecting the quality of care and patient safety. Incorporating the topic of mental health in medical education is not just beneficial; it’s essential.
To address these challenges, some medical schools have implemented various interventions. For example, some institutions have introduced wellness programs, mindfulness training, and peer support groups.7 Others have focused on curriculum reforms to reduce academic stress and promote work-life balance.8 However, one strategy that shows promise in equipping future physicians with essential skills for addressing mental health crises is MHFA training.
MHFA is a comprehensive program designed to teach lay individuals how to identify, understand, and respond to signs of mental health challenges.9 By incorporating MHFA into medical school curricula, institutions can provide students with practical tools to support both their own mental health and those of their peers and their future patients. This training can complement existing interventions and contribute to a more holistic approach to addressing mental health needs in medical education.
MHFA is a training program designed to help individuals identify, understand, and respond to signs of mental illnesses.10 It provides the practical skills necessary to reach out and provide initial support to someone who may be developing a mental health problem or experiencing a crisis. Much like traditional first aid, which equips individuals to address physical injuries, MHFA teaches participants to provide early intervention for mental health crises. This early intervention can prevent a crisis from escalating and promote faster recovery, underscoring the critical need for such training in the medical field.
Medical students and professionals trained in MHFA are better prepared to identify early signs of mental health problems, both in their patients and themselves. Case studies and testimonials from healthcare professionals who have undergone MHFA training highlight its effectiveness in improving their ability to manage mental health crises.11
While MHFA offers a promising approach to addressing mental health challenges in medical students, it is not the only strategy being implemented in medical education. Wellness programs, for example, are widely adopted and focus on promoting holistic well-being through activities such as yoga, mindfulness meditation, and time management workshops.6,7 These initiatives aim to mitigate stress and foster resilience but often lack the actionable crisis-intervention skills that MHFA provides.12 Similarly, peer support groups have gained traction, offering students a safe space to share experiences and build a sense of community.6,7 While these groups excel at fostering emotional support and reducing isolation, they may not provide participants with the tools to recognize or respond to acute mental health crises.
In contrast, MHFA is a structured program that equips students with specific evidence-based strategies for identifying and addressing mental health challenges. Unlike wellness programs and peer support initiatives, MHFA focuses on intervention rather than prevention or emotional support alone. However, MHFA may benefit from supplementation with other strategies, such as mindfulness training, to address the full spectrum of mental health needs in medical students.12 Tailoring MHFA to the unique demands of medical education, for example, integrating case studies relevant to clinical settings, may further enhance its effectiveness. Together, these strategies provide a comprehensive approach to addressing mental health challenges, with MHFA serving as a critical component of a broader framework.
A meta-analysis of MHFA programs highlights that while the intervention’s evidence base is strongest for improving participants’ knowledge, confidence, and willingness to help others in the short term,13 there is limited evidence regarding its long-term impact on the mental health outcomes of those who receive aid.14 This gap is particularly relevant in medical education, where students face chronic stressors over several years, requiring sustained support and ongoing mental health education.
Additionally, MHFA does not replace professional mental health services or comprehensive behavioral health support programs. It is primarily designed for early intervention and crisis response, leaving gaps in areas such as long-term treatment and addressing systemic issues like academic stress and burnout culture. There are also concerns about the variability in training quality and the potential for participants to overestimate their ability to address complex mental health issues, which underscores the need for robust faculty support and supervision. Finally, tailoring MHFA specifically for medical students remains an ongoing challenge, as the current program is designed for general populations rather than people experiencing the unique pressures and environments of medical training. Recognizing these limitations is crucial to positioning MHFA as a tool to improve mental health in medical education.
Incorporating MHFA into medical school curricula may foster a more supportive and empathetic environment among students and staff. It would help promote more open discussions about mental health, reducing stigma, and encouraging those in need to seek help. Having a supportive culture is crucial for the well-being of medical students.
MHFA skills are transferable across various medical specialties and may enhance overall professional development. With a growing emphasis on holistic patient care, integrating mental health into primary care is becoming increasingly important.15 MHFA training aligns with this trend, preparing future doctors to provide comprehensive care.
To integrate MHFA training into existing medical school curricula, schools can consider workshops, mandatory courses, online training modules, or elective modules. Some medical schools have successfully implemented MHFA training, serving as models for others. For example, the University of Sydney has incorporated MHFA into its medical program, resulting in positive feedback from students.16
Partnering with mental health organizations can provide expert training and resources that are crucial for the effective implementation of MHFA programs in medical schools. These organizations have extensive experience and specialized knowledge in mental health care, which can greatly enhance the quality and credibility of MHFA training. By collaborating with mental health organizations, medical schools can ensure that their MHFA programs are grounded in the latest evidence-based practices and tailored to meet the specific needs of medical students and professionals.
These partnerships can also offer funding opportunities that are essential for the development and sustainability of MHFA training initiatives. Mental health organizations often have access to grants and funding sources that can be utilized to support MHFA programs. This financial support can cover various aspects of the training, such as curriculum development, training materials, instructor fees, and ongoing professional development for faculty. Additionally, funding can be used to create and maintain support services for students and staff, such as counseling and peer support networks, which are integral components of a comprehensive mental health strategy.
Moreover, partnerships with mental health organizations can provide access to a wealth of resources, including expert trainers, educational materials, and best practice guidelines. These resources can be used to enhance the MHFA curriculum and ensure that it is both comprehensive and practical. Expert trainers from mental health organizations can bring real-world experience and insights to the training sessions, making the learning experience more engaging and relevant for medical students and professionals.
Support from professional medical associations can further facilitate the implementation of MHFA training. These associations can endorse the MHFA programs, lending their credibility and influence to promote the importance of mental health education within the medical community. They can also advocate for policy changes and institutional support that prioritize mental health training in medical education. Additionally, professional medical associations can provide platforms for sharing success stories, research findings, and best practices related to MHFA, fostering a community of learning and improvement.
Integrating MHFA training into medical curricula, while challenging, has proven to be both feasible and impactful when strategically embedded into existing structures. Medical schools often face constraints with packed curricula, yet evidence demonstrates that MHFA training enhances mental health literacy, reduces stigma, and increases confidence in addressing mental health crises among students. These outcomes benefit both students and their future patients, illustrating the importance of incorporating MHFA training into healthcare education.
Several institutions have successfully integrated MHFA training, offering insights into effective implementation strategies. At the University of Nottingham in the United Kingdom, a pilot randomized controlled trial evaluated the MHFA eLearning course among 55 medical students. The training improved mental health first aid intentions, reduced stigmatizing attitudes, and increased confidence in supporting peers. Students found the course flexible, impactful, and applicable to their professional development, with many reporting more frequent mental health first aid actions post-training. 17
Similarly, in Australia, MHFA training was incorporated into medical, nursing, and pharmacy programs across multiple universities.16,18 These programs, which used both face-to-face and online delivery formats, demonstrated significant improvements in students’ mental health literacy, confidence in providing help, and attitudes toward mental illness. A study involving 434 students highlighted a reduction in stigma and enhanced mental health first aid skills, underscoring the value of tailored MHFA content.18
Additionally, Bristol Medical School implemented a peer-led MHFA program that utilized discussion-based workshops for first-year medical students. The program resulted in a 24% improvement in understanding mental health challenges, an 18% increase in confidence when supporting peers, and a 21% improvement in handling acute situations. Students praised the peer-led approach for fostering an open and supportive environment.19
These examples highlight that medical schools can integrate MHFA training into their existing curricular structures and that students find the training useful. Embedding MHFA into clinical rotations is another possible solution, as these hands-on experiences allow students to apply MHFA principles in real-life scenarios. Psychiatry, primary care, or emergency medicine rotations provide ideal opportunities for targeted training, emphasizing symptom recognition, initial support, and referral processes. This ensures that MHFA skills are contextually applied, reinforcing both relevance and retention.
Interprofessional education (IPE) presents another valuable platform, enabling students from various healthcare disciplines to learn MHFA collaboratively. This multidisciplinary approach fosters teamwork and mirrors real-world healthcare settings, preparing students to deliver integrated mental health care.
Rather than creating separate courses, MHFA content can be incorporated into existing courses such as patient communication, ethics, or public health-related courses. This method may align MHFA with broader training objectives by emphasizing its role in comprehensive patient care. Offering MHFA as elective modules or workshops further provides flexibility for students to opt into training based on their interests and schedules. Workshops can be scheduled during less intensive periods, while online modules offer accessible, self-paced options with interactive features like quizzes and case studies to enhance engagement. These formats allow continuous access to MHFA resources, enabling students to revisit material as needed.
Simulation-based learning, using controlled scenarios involving mental health crises, is another effective approach. Simulations provide hands-on practice, immediate feedback from instructors, and opportunities to build confidence in managing challenging situations. By employing these strategies, medical schools can successfully integrate MHFA training into their curricula, equipping future healthcare professionals with essential mental health competencies while promoting their own well-being and that of their peers.
Training faculty members to teach and support MHFA initiatives is essential for the successful integration of this program into medical school curricula. Faculty members are not only the primary facilitators of knowledge transfer but also role models in cultivating a supportive and empathetic learning environment. To achieve this, a well-structured faculty development plan is needed, focusing on both the theoretical foundations and practical application of MHFA.
The selection of faculty to lead MHFA training is a critical consideration. While general faculty can serve as facilitators, incorporating specialists such as psychiatrists, clinical psychologists, and behavioral health experts can provide deeper insights and expertise. These specialists can offer advanced guidance on managing complex mental health challenges, ensuring that the training aligns with evidence-based practices. For general faculty, collaboration with mental health professionals during the training process can bridge gaps in specialized knowledge and enhance the overall quality of MHFA instruction.
While MHFA is a generic program, its implementation in medical education may require customization to address the unique stressors and scenarios faced by medical students. Tailoring the training to include case studies relevant to clinical settings, discussions on burnout, and strategies for self-care can make the program more impactful. Faculty should also be trained to adapt MHFA principles to the specific needs of medical students, ensuring the curriculum is relatable and practical.
Comprehensive training programs should be designed to equip faculty with both foundational and advanced MHFA skills. These programs should include certification opportunities, workshops, and interactive seminars that emphasize practical skills such as de-escalation, active listening, and crisis response. Role-playing scenarios and peer-to-peer learning activities can further enhance faculty confidence and competence in delivering MHFA training. Additionally, ongoing professional development, including refresher courses and updates on changes to the MHFA curriculum, should be prioritized to maintain faculty proficiency and ensure alignment with the latest evidence and best practices in mental health care.
To ensure the effectiveness of faculty training, robust assessment and evaluation mechanisms must be established. Faculty competency can be assessed through pre- and post-training evaluations, peer reviews, and feedback from students. Simulated scenarios with standardized patients or actors can also be used to gauge faculty preparedness and identify areas for improvement. Institutions should collect longitudinal data on the impact of faculty training on student outcomes, such as changes in mental health knowledge, attitudes, and help-seeking behaviors among medical students.
Institutional support plays a pivotal role in the success of MHFA implementation. Medical schools should allocate resources such as funding for faculty development, access to mental health experts, and platforms for knowledge sharing. Creating collaborative spaces where faculty can discuss challenges, share successes, and exchange best practices can foster a community of continuous improvement. Recognizing and rewarding faculty contributions to MHFA training through incentives or professional accolades can further motivate and sustain engagement.
By addressing these areas—specialized faculty roles, program customization, robust training opportunities, and institutional support—medical schools can create a sustainable and effective framework for integrating MHFA into their curricula. This approach not only empowers faculty but also ensures that future physicians are equipped with the skills to navigate and address mental health challenges in their professional and personal lives.
Incorporating Mental Health First Aid training into medical school curricula is a crucial step towards improving the well-being of medical students and professionals, as well as the quality of patient care. By prioritizing MHFA training, medical schools can foster a more supportive environment, reduce stigma around mental health, and equip future doctors with the skills they need to address mental health crises
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Education for Health | Volume 38, No. 1, January-March 2025