The mental health issues impacting young people are broad and complex. Reaching and supporting all young people can be a challenge, particularly when social isolation and limited resources create barriers. While some communities of young people are inherently more vulnerable, reaching whole-of-school populations with preventive education is important. This gives every young person the best chance to thrive. Building the capacity for teachers, well-being staff, school nurses and frontline youth workers to deliver Mental Health First Aid® (MHFA™) training, is a practical solution. Further, empowering young people to provide support to their peers builds protective factors, and fosters community connection and inclusion.
The East Gippsland Drug and Alcohol Alliance (DAPA), through their role as a Local Drug Action Team (LDAT), demonstrate this approach in action. They have shared with Mental Health First Aid Australia details of their process, challenges and lessons learned in the hopes that it will strengthen protective factors across communities to reduce youth mental ill-health and alcohol and other drug related problems.
“We had a diverse range of issues impacting young people across several domains, including higher than average rates of housing insecurity, unemployment, disability, family violence, school readiness issues, and bullying. We also had specific concerns about the harms of drug and alcohol usage that needed to be addressed. We saw an opportunity for cooperation between schools, government and non-government services, and other local agencies, to work together on practical, evidence-based strategies to increase protective factors in communities and prevent harm in young people”
Glenn Bury, Partnership Facilitator of the East Gippsland Primary Care Partnership.
MHFA training has become an integral part of these evidence-based strategies; reaching young people and the adults who support them for better well-being.
Community driven needs and strengths
East Gippsland is a large geographical region of Victoria with a diverse population. The region includes some of Victoria’s most remote pockets, alongside urban areas. It has a high Indigenous population comparative to other regions of Victoria, and a mix between wealthy and low-socio-economic areas. Young people living across these communities have vastly different environments and experiences, which can impact mental health differently. Their support networks at home, school and in the community can also differ.
An area of particular concern for the community has been youth alcohol and other drug use. A plan for action to prevent ‘first use of alcohol and other drugs’ in young people was formulated in 2015 by DAPA. This alliance comprises of 20 local health, Government and non-Government agencies facilitated by the East Gippsland Primary Care Partnership (EGPCP). As a Local Drug Action Team they became active in the implementation of evidence-based interventions to minimise the harms caused to community by alcohol and other drugs.
Harm prevention and equipping young people with protective knowledge, attitudes and behaviours was a key focus, and an important element of this has been the delivery of Teen MHFA courses.
“Teen MHFA has long been viewed as a highly regarded and evidence based mental health training program, so it became our program of choice,” says Glenn.
East Gippsland secondary schools became the primary target audience, and the program was well received by students, education staff and broader communities. However, the delivery of courses was impacted by a reliance on small local grants to fund annual delivery, and reduced access to local and available Instructors of the Teen MHFA course.
As a result of these challenges, a train-the-Instructor model was adopted. The intention was to build local area capacity, by training those who work with young people as Teen MHFA Instructors. This approach embraces local knowledge and networks, and has become a driving success around the program’s impact and longevity.
“We hoped that this new approach would embed skills locally and build workforce capacity. By alleviating the concerns around resourcing and funding, the model could provide long term sustainable benefits to schools and community into the future,” says Glenn.
The train-the-Instructor model is a key strategy for the mobilisation of Mental Health First Aid in communities of all types across Australia and around the world. By equipping local people who have a vested interest in positive change with the skills to train others in their community, the barriers for participation can be reduced. This model also harnesses local-area knowledge as Instructors have a strong understanding of local issues, needs, strengths and networks.
Participants from a Teen MHFA Instructor Training Course, delivered as part of this initiative in 2021.
Building workforce capacity to support young people
Guided by this newly embraced model of delivery, a project was established by the East Gippsland Drug and Alcohol Prevention Alliance (DAPA) to train selected staff from schools and key community agencies in the East Gippsland and Wellington municipalities and shires as Teen MHFA Instructors. Staff targeted for training included school nurses and well-being support staff, as well as key staff from relevant agencies such as community health, Headspace, Victoria Police, and regional health services.
This train-the-Instructor approach in these regions will expand the delivery of Teen MHFA training, in which young people learn the knowledge and skills for age-appropriate responses to developing, worsening or crisis-point mental health problems. This training empowers young people to provide mental health first aid to a friend, or other young person in their community, and also builds their own protective factors for safety and well-being.
The key aims of the train-the-Instructor project included:
- Encourage broader saturation of Teen MHFA training across schools and community.
- Provide students with a sound knowledge of mental health first aid.
- Build understanding of the links between poor mental health and the uptake of alcohol and other drugs.
- Build workforce capacity for staff in schools and agencies to provide training.
- Alleviate the need to seek funding for delivery.
- Enhance mental well-being outcomes in the community.
- Place downward pressure on early uptake of alcohol and other drugs, depressive symptomatology, and stigma associated with poor mental health.
Achieving impact despite barriers
The Teen MHFA train-the-Instructor initiative was given the green light in 2019 with the aim of training a minimum of 12 local-area Instructors. These people would then go on to deliver Teen MHFA courses to young people, with a target reach of 800 students in the first phase. In 2020 expressions of interest for suitable candidates were identified through alliance members.
This coincided with the emergence and then ongoing nature of COVID-19. Unfortunately this stretched out timeframes and created additional barriers for the delivery of training due to health directives, school shutdowns and social isolation restrictions. The municipalities of East Gippsland and Wellington had already experienced significant community disadvantages from crises such as prolonged drought in rural communities over former years, and catastrophic bushfires and weather events. These challenges only further highlighted the need for preventative and interventional mental health strategies for young people going through tough times.
Despite the emergence of these additional barriers, 15 new staff were trained as Teen MHFA Instructors in early 2021 – exceeding initial targets. These Instructors now have a unique skillset that collectively has the potential to reach thousands of students into the future. To date, 137 students from six schools have received Teen MHFA training across the school year, and their work continues to build from this solid foundation.
The success of this initiative during unprecedented times of interruption and uncertainty, demonstrates the applicability and flexibility of MHFA training.
“The delivery into schools has been significantly disrupted by COVID-19, but despite this we have had overwhelmingly positive support from school staff, partner agencies and government departments. This bodes well for the future, as our training of young people resumes.“ says Glenn.
From lessons learned to a sustainable future
The various community partners engaged with this initiative have experienced collective learnings that they happily now share, not only for their own growth, but as a case study for other schools, organisations and communities who are looking to implement MHFA training and other well-being strategies.
They have highlighted the importance of shared measurement outcomes. Not only does this maintain buy-in and commitment of partners, but it also becomes a selling point for schools who are less ready to embrace the program. Periodically, there is a need to review these measures against an ever-changing landscape with multiple partners. This helps with the identification and selection of new prevention activities and the ability to measure long-term change across the communities.
The Drug and Alcohol Prevention Alliance continue to explore other strategies that will contribute to the prevention of alcohol and other drug use, and which will enhance youth mental health and well-being holistically. DAPA is currently working on aligning its work and outcome areas, improving measures, bolstering resources, and the development of a new iteration of the East Gippsland Municipal Public Health and Wellbeing Plan. They are practicing what they preach in terms of capacity development for long-term youth well-being.
Mental Health First Aid Australia are proud to continue their work with DAPA and East Gippsland communities, contributing to a sustainable impact on the life trajectory of young people in regional Australia.