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Rural Health Information Hub

Formerly the
Rural Assistance Center

Mental Health First Aid

  • Need: Rural areas face challenges in access to mental health services, including shortages of mental health providers.
  • Intervention: This 8-hour course trains rural community members to recognize mental health and substance abuse issues and learn how to help connect those in need to mental health resources.
  • Results: Numerous studies of this method have found that course participants are better able and more likely to help others regarding mental health issues.
Promising (About evidence-level criteria)

Mental Health First Aid is an early intervention public education program that teaches the public how to assist someone experiencing a behavioral health crisis. Mental Health First Aid teaches the skills needed to identify, understand, and respond to individuals who may be experiencing signs of a mental illness or substance use disorder. First Aid is administered until appropriate support is received or until the crisis is resolved.

The training is especially useful in rural communities where access to mental health services may be limited. Rural Mental Health First Aid is a way to build community level capacity to identify mental health and substance abuse concerns early and for rural residents to increase their confidence to intervene and refer people to the resources that do exist. Mental Health First Aid is a way to increase the level of baseline knowledge about mental health and substance abuse and to decrease the negative perceptions often associated with these disorders.

Mental Health First Aid was created in Australia in 2001 and is managed in the United States by the National Council for Behavioral Health, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health. More information is available from Mental Health First Aid USA. Mental Health First Aid trains participants to recognize mental health and substance abuse issues and learn how to assist those in need in accessing available mental health resources. Audiences for this training include:

  • Law enforcement
  • First responders
  • Primary care providers
  • Nursing home staff
  • Schools and teachers
  • Faith-based organizations
  • Employers and the business community
  • Higher education staff and students
  • Military, veterans, and family members
  • Populations working with older adults
  • Policymakers
  • Mental health advocacy organizations
  • Shelter volunteers
  • Families
  • General public

The training program has been used successfully throughout Australia, including rural areas. It has been adapted in 23 other countries, including the United States.

A 2014 feature article in The Rural Monitor provides an overview of Rural Mental Health First Aid, with details on the implementations underway in New Mexico and Missouri:

Services offered

Mental Health First Aid training is offered through an 8-hour course where participants learn about:

  • Risk factors and warning signs for mental health issues
  • Prevalence of various mental health disorders
  • The need to reduce stigma
  • A 5-step action plan to assess a situation, identify appropriate interventions, and help those in need access mental health services
  • Resources available to help people experiencing a mental health issue or problem

Research studies examining this approach have found that participants of the Mental Health First Aid course have:

  • Improved knowledge of mental illnesses and treatments
  • Knowledge of appropriate strategies for helping others
  • Confidence to provide assistance regarding mental health issues

For more information on program results:

Jorm, A.F., Kitchener, B.A., O'Kearney, R., & Dear, K.B. (2004). Mental health first aid training of the public in a rural area: a cluster randomized trial. BMC Psychiatry, 4, 33. Article Abstract | Free Full-text

Kitchener, B.A. & Jorm, A.F. (2006). Mental health first aid training: review of evaluation studies. Australian and New Zealand Journal of Psychiatry, 40(1), 6-8. Article Abstract

A detailed list of evaluations and publications related to this approach is available from Mental Health First Aid Australia.

Mental Health First Aid USA summarizes the results  from Australian studies, as well as listing evaluations underway in the U.S.


This step-by-step guide is available to help you implement a rural Mental Health First Aid program in your rural community:

Mental Health First Aid USA offers a directory of courses and instructors, as well as information on how to become an instructor.  Instructors can obtain a rural training designation.  

Contact Information
Tramaine Stevenson
National Council for Behavioral Health
202.684.7457 x283
Mental health
States served
National/Multi-State, Maryland, Missouri
Date added
June 5, 2013
Date updated or reviewed
June 11, 2015

Please contact the models and innovations contact directly for the most complete and current information about this program. Summaries of models and innovations are provided by RHIhub for your convenience. The programs described are not endorsed by RHIhub or by the Federal Office of Rural Health Policy. Each rural community should consider whether a particular project or approach is a good match for their community’s needs and capacity. While it is sometimes possible to adapt program components to match your resources, keep in mind that changes to the program design may impact results.