First Face Training for Mental Health Support in Tribal Communities

Recruiting in Palo Alto (17 mi)

+8 other locations

Overseen by Martina Whelshula, PhD

Age: Any Age

Sex: Any

Travel: May Be Covered

Time Reimbursement: Varies

Trial Phase: Academic

Recruiting

Sponsor: Cambridge Health Alliance

Disqualifiers: Age 13 or younger, others

No Placebo Group

Approved in 1 Jurisdiction

Trial Summary

What is the purpose of this trial?

This trial evaluates a training program called 'First Face for Mental Health' designed for Tribal community members. The program teaches them how to recognize and help people experiencing mental health crises. The goal is to improve mental health support and reduce stigma within these communities. Mental Health First Aid (MHFA) aims to improve mental health literacy and support for those experiencing mental health issues.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the First Face Training Program for mental health support in Tribal communities?

The First Face Training Program is designed to strengthen informal mental health support networks in Tribal communities, similar to how Mental Health First Aid (MHFA) has been effective in improving mental health literacy and reducing stigma in other communities, like Bhutanese refugees. Additionally, community-driven programs, like the one in rural India, have shown success in improving mental health outcomes by involving community members in the care process. ^{1 2 3 4 5}

Is First Face Training for Mental Health Support safe for humans?

The available research does not provide specific safety data for First Face Training for Mental Health Support, but it emphasizes the importance of protecting trainees' physical safety, especially during COVID-19, and includes recommendations for self-care. ^{1 2 3 6 7}

How is the First Face Training Program treatment different from other mental health treatments?

The First Face Training Program is unique because it is a community-based intervention specifically designed for Tribal communities, focusing on strengthening informal support networks and creating pathways to formal mental health support, which is culturally tailored to fit the needs of Native adolescents. ^{1 2 3 6 8}

Research Team

Sarah E. Nelson, Ph.D.

Principal Investigator

Cambridge Health Alliance

Martina Whelshula, PhD

Principal Investigator

Healing Lodge of the Seven Nations

Eligibility Criteria

This trial is for individuals aged 14 or older who live or work in one of the seven Tribal Nations affiliated with the Healing Lodge of the Seven Nations in Northwestern U.S. It's not open to those younger than 14 or outside these tribal communities.

Inclusion Criteria

I am 14 years old or older.

Living or working in one of the seven Tribal Nations affiliated with the Healing Lodge of the Seven Nations, including Northwestern United States, including the Coeur d'Alene Tribe, the Confederated Tribes of the Colville Reservation, the Confederated Tribes of the Umatilla Indian Reservation, the Kalispel Tribe of Indians, the Kootenai Tribe of Idaho, the Nez Perce Tribe, and the Spokane Tribe of Indians

Exclusion Criteria

Not living or working in one of the seven Tribal Nations affiliated with the Healing Lodge of the Seven Nations, including Northwestern United States, including the Coeur d'Alene Tribe, the Confederated Tribes of the Colville Reservation, the Confederated Tribes of the Umatilla Indian Reservation, the Kalispel Tribe of Indians, the Kootenai Tribe of Idaho, the Nez Perce Tribe, and the Spokane Tribe of Indians

I am 13 years old or younger.

Trial Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Training

Initial training group receives the First Face training program and completes baseline and post-training surveys

0 months

Multiple training sessions (in-person)

Waitlist Control Training

Waitlist control group receives the First Face training program and completes baseline and post-training surveys

6 months

Multiple training sessions (in-person)

Follow-up

Participants are monitored for changes in mental health knowledge, ability to respond, and other outcomes

24 months

Online surveys at 6, 12, 18, and 24 months

Treatment Details

Interventions

• First Face Training Program (Behavioral Intervention)

Trial Overview The study tests a culturally tailored training program, First Face for Mental Health, designed to help Tribal community members respond effectively to mental health crises. The effectiveness will be measured through surveys before and after training, comparing immediate trainees with a waitlist group.

Participant Groups

Group I: Waitlist-control group Experimental Treatment 1 Intervention

Participants who are trained in the First Face training program 6 months after the initial training group

Group II: Initial training group Experimental Treatment 1 Intervention

Participants who are initially trained in the First Face training program

Who Is Running the Clinical Trial?

Cambridge Health Alliance

Lead Sponsor

Trials

65

Recruited

22,400+

Dr. Assaad Sayah

Cambridge Health Alliance

Chief Executive Officer since 2020

MD from the University of Massachusetts Medical Center

Dr. Jeffrey Hoffman

Cambridge Health Alliance

Chief Medical Officer since 2021

MD from Columbia University College of Physicians and Surgeons

Healing Lodge of the Seven Nations

Collaborator

Trials

1

Recruited

1,000+

National Institute of General Medical Sciences (NIGMS)

Collaborator

Trials

315

Recruited

251,000+

Findings from Research

The xaʔtus (First Face) for Mental Health program aims to enhance informal mental health support among Native adolescents, who often prefer peer support over professional services due to accessibility and cultural fit issues.

Focus groups with teens, clinical staff, and community members provided valuable insights for optimizing the program, emphasizing the need for convenient training times, engaging delivery methods, and addressing the personal relevance of the training to encourage participation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recommendations for Optimizing xaʔtus (First Face) for Mental Health Training: Insights from Key Informants. Gray, HM., Beu Rae, M., Anderson, C., et al.[2023]

Mental Health First Aid (MHFA) training significantly improved mental health literacy among Bhutanese refugees, particularly for recognizing and responding to conditions like schizophrenia and depression, especially when combined with culturally-appropriate orientation materials.

Participants who received the orientation showed greater improvements in their understanding of mental health concepts compared to those who did not, highlighting the importance of culturally relevant training in enhancing the effectiveness of mental health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Culturally-Appropriate Orientation Increases the Effectiveness of Mental Health First Aid Training for Bhutanese Refugees: Results from a Multi-state Program Evaluation. Gurung, A., Subedi, P., Zhang, M., et al.[2023]

Mental Health First Aid (MHFA) training significantly improved Bhutanese refugee community leaders' ability to recognize symptoms of depression and their understanding of treatment options, as shown by pre- and post-test results from 58 participants.

Despite the knowledge gains, the training did not lead to a reduction in negative attitudes towards individuals with mental illness, suggesting that further adaptations to the program may be needed to address stigma in this community.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mental health first aid training for the Bhutanese refugee community in the United States. Subedi, P., Li, C., Gurung, A., et al.[2020]

Caregivers perceive that involving service users as cofacilitators in mental health training programs can reduce their own burden and help develop support networks, highlighting the potential benefits of family engagement in mental health initiatives.

However, barriers such as fear of stigma, lack of trust, and time management issues can hinder participation, suggesting that addressing these concerns through better orientation and support from health workers is crucial for successful program implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A service user co-facilitated intervention to reduce mental illness stigma among primary healthcare workers: Utilizing perspectives of family members and caregivers. Rai, S., Gurung, D., Kaiser, BN., et al.[2019]

A community-driven psychiatric 'task shifting' program in a rural South Indian tribal community led to significant improvements in daily functioning for treated patients, demonstrating the program's efficacy in addressing mental health issues.

The program increased community knowledge and acceptance of mental illness, with self-referrals rising from 27% to 57% over three years, all at a low annual cost of approximately 122.53 Indian Rupees (USD 1.61) per person.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A task shifting mental health program for an impoverished rural Indian community. Nimgaonkar, AU., Menon, SD.[2022]

The Australian Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA) course was successfully adapted and implemented, training 199 Aboriginal people as Instructors who then conducted community courses, indicating strong uptake and engagement.

Qualitative feedback highlighted that the AMHFA course is culturally appropriate and empowering, providing relevant information for assisting Aboriginal individuals with mental health issues, though further refinements and impact evaluations are needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation. Kanowski, LG., Jorm, AF., Hart, LM.[2022]

A systematic review of 21 studies involving 22,604 participants found that Mental Health First Aid (MHFA) training may have little to no effect on individual mental health outcomes at six to twelve months, but the evidence is uncertain due to high risk of bias in the studies.

There is insufficient quality evidence to determine the impact of MHFA training on mental health service usage or adverse effects, highlighting the need for more rigorous research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mental Health First Aid as a tool for improving mental health and well-being. Richardson, R., Dale, HE., Robertson, L., et al.[2023]

A 90-minute training program was developed to enhance the knowledge and empathy of mental health professionals regarding Indigenous cultures, addressing the significant mental health disparities faced by Indigenous people in the U.S.

The training, which focuses on cultural competency, humility, and decolonialism, has been positively received across various settings, indicating its effectiveness in improving mental health services for Indigenous patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Decolonizing Mental Health Services for Indigenous Clients: A Training Program for Mental Health Professionals. Lewis, ME., Hartwell, EE., Myhra, LL.[2019]

References

1. United States pubmed.ncbi.nlm.nih.gov

Recommendations for Optimizing xaʔtus (First Face) for Mental Health Training: Insights from Key Informants. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Culturally-Appropriate Orientation Increases the Effectiveness of Mental Health First Aid Training for Bhutanese Refugees: Results from a Multi-state Program Evaluation. [2023]

3. England pubmed.ncbi.nlm.nih.gov

Mental health first aid training for the Bhutanese refugee community in the United States. [2020]

4. United States pubmed.ncbi.nlm.nih.gov

A service user co-facilitated intervention to reduce mental illness stigma among primary healthcare workers: Utilizing perspectives of family members and caregivers. [2019]

5. Netherlands pubmed.ncbi.nlm.nih.gov

A task shifting mental health program for an impoverished rural Indian community. [2022]

6. England pubmed.ncbi.nlm.nih.gov

A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation. [2022]

7. England pubmed.ncbi.nlm.nih.gov

Mental Health First Aid as a tool for improving mental health and well-being. [2023]

8. England pubmed.ncbi.nlm.nih.gov

Decolonizing Mental Health Services for Indigenous Clients: A Training Program for Mental Health Professionals. [2019]