Effects of a mental health first aid training on the attitudes of medical students: A mixed, non-randomized controlled study

Introduction. - Several studies have shown that medical students tend to have increasingly unfavorable attitudes towards people with mental disorders during their education, but there is little data on the effectiveness of programs aimed at improving these attitudes. Mental Health First Aid (MHFA) programs have been shown to bring mental health knowledge to the general population and to reduce stigmatizing attitudes towards individuals with mental disorders. In addition, it increases confidence in one's abilities and self-confidence to help an individual with a mental disorder. It therefore seems essential to evaluate the effects of MHFA-type programs in medical students. Objectives. - The aim of our study was to evaluate the effects of a MHFA-type program implemented in a French medical school on the attitudes of second-year medical students towards people with mental disorders. Method. - We used a mixed methodology including the collection of quantitative and qualitative data, involving comparative measurement of changes in social distance and stigma towards people with mental disorders between a control group and an intervention group that received the MHFA-type program. The quantitative data were collected using a self-administered questionnaire written, translated and adapted from English. This questionnaire is used to assess the impact of MHFA programs, using a Likert scale from 1to 5 and open-ended questions. The questionnaire was divided into four parts: 1) sociodemographic characteristics, 2) self-confidence in the ability to help someone with mental health problems, 3) social distance and personal stigma toward people with mental disorders, and 4) satisfaction toward the MHFA program. The qualitative part of the study comprised semi-structured interviews with second-year medical students who received the MHFA program. Results. - Our MHFA-type program significantly reduced social distance and stigmatization towards people with mental disorders (depression: P < 0.001 and P < .01; psychosis: P < 0.01 and P < .01). It also led to a significant increase in the confidence of students who received the intervention in providing help to this population (P < .001). Medical students reported a high level of satisfaction with the training and a greater interest in mental health. The semi-structured interviews highlighted the three following themes: a) the benefits of the program, b) perception of the program and c) interest in mental health. Through these themes, social representations were found to play a predominant role in the stigmatization of people with mental disorders by medical students, which differs depending on mental disorders. Conclusion. - Our study demonstrated the positive impact of a MHFA program on French second-year medical students' attitudes towards people with mental disorders. Our results are consistent with the international literature on MHFA programs showing positive effects on social distance and stigma toward people with mental disorders. According to our results, implementing MHFA programs in the early stage of medical education could be helpful to reduce stigmatization and unfavorable attitudes toward people with mental disorders in medical students. However, our monocentric study was performed in France and used a non-randomized design. Thus, our results need to be replicated in other contexts, including assessment of the long-term effects of MHFA programs. (c) 2024 Elsevier Masson SAS. All rights are reserved, including those for text and data mining, AI training, and similar technologies.