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Exploring the impact of mental health first aid on nursing students’ knowledge and attitude: A pilot randomised controlled trial

Mak, Wai Yee


Wai Yee Mak


Objective: This study aimed to: explore the impact of providing Mental Health First Aid (MHFA) training to general nursing students; and evaluate their mental health literacy (MHL) and attitudes towards mental illness.
Methods: This study was a single-site, parallel pilot randomised controlled trial (RCT). Seventy students were randomly assigned to intervention (MHFA plus Usual Education Practice (UEP). MHFA is education programme; UEP is clinical placement. Primary outcome variables were the vignette questionnaire in MHL (i.e., problem recognition, beliefs about treatment, first-aid intentions and beliefs), and secondary outcome was attitude. Assessments were conducted at baseline, post-intervention, and six-month follow-up. Intention to treat (ITT) and mixed methods were performed.
Results: Repeated measures analysis of variance (ANOVA) results suggested a strong time effect for the MHFA group with partial eta-squared = 0.14 from baseline to post-intervention and significant time effect from post-intervention to six-month follow-up for attitude. Friedman tests indicated that order effects may influence three vignette responses. The ANOVA results also supported the attribution model of controllability and dangerousness. In beliefs about treatment, six categories were grouped as seeking professional help, pharmacological intervention, psychiatric assessment, therapeutic communication, problem-solving skills, and psychosocial intervention. While both quantitative and qualitative data revealed the primary outcome variables were statistically non-significant, this may be due to random error.
Conclusion: This study was the first pilot RCT for MHFA for general nursing students in Hong Kong. The significance tests may indicate Type I and Type II errors, but using p value of 0.01 and mixed methods are effective in reducing these errors. Although there are non-significant results in primary outcome, they are clinically meaningful. The limitation for this pilot was high attrition rate. Protocol amendments to expand the age range and use a validated tool are recommended for future research.


Mak, W. Y. Exploring the impact of mental health first aid on nursing students’ knowledge and attitude: A pilot randomised controlled trial. (Thesis). University of the West of England. Retrieved from

Thesis Type Thesis
Publicly Available Date Jun 7, 2019
Keywords Nursing students, MHL, MHFA, attitude, RCT
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