When Evanston resident Kate Schwartz saw a woman pacing around and talking to herself at the library, she walked right over to ask her if she would like a listening ear.
Just the day before, Schwartz had completed a training program on how to support people in mental health crises throughout the city. Now, she was using what she learned to help someone in need.
The woman immediately responded with “Boy, do I ever,” and Schwartz listened attentively as she sat down and talked for a while. Once she noticed the woman had calmed down, Schwartz asked if she would like to speak with someone regularly, handed her a card for the library’s social worker and encouraged her to call.
“I know I’m going to see (that woman) again,” Schwartz said. “I told her, ‘I’m going to tease you until I see that you’re doing something good for yourself.’”
Mental Health First Aid comes to Evanston
Across the United States, rates of mental health challenges like anxiety and depression among youth and adults have continued to rise, and Evanston is no exception. According to a 2022 survey from the Centers for Disease Control and Prevention, one in seven adult Evanston residents reported experiencing poor mental health.
To address these challenges, Evanston has offered Mental Health First Aid training for free to residents and anyone connected to the city since March, in partnership with Chicago-based mental health non-profit, Naomi Ruth Cohen Institute. The program is funded by the city’s pandemic recovery funds.
During a 2022 participatory budgeting process, 3,400 Evanston community members voted for the proposal to implement MHFA training, receiving the most votes out of all proposals.
The program teaches individuals how to provide initial assistance to someone experiencing mental health challenges. To date, the city has hosted 14 trainings, which each accommodate 10-30 participants.
Kristin Meyer, a management analyst for Evanston’s Public Health Services department, organizes the city’s program. MFHA is an international public education program that began in Australia in 2000 and has since expanded to nearly 30 countries, including the U.S.
“I think there’s a really wide, broad swatch of community members who are interested in this because what we know is that mental health challenges are growing both in Evanston and across the nation,” Meyer said.
She added that 50% of participants in Evanston’s MHFA training have reported supporting someone in their life with mental health challenges, and about a third have shared that they have struggled with their mental health in the past.
The training process
To become a certified “Mental Health First Aider,” participants complete a two-hour online webinar, a seven-hour in-person instructor-led training session and a post-training evaluation check. Certifications must be renewed every three years. Participants are not qualified to provide a diagnosis.
In-person sessions are offered on Saturdays or split across two weekday evenings at locations such as the Evanston Public Library and Levy Senior Center.
During the training, participants learn to use the MHFA action plan, which has five steps: approach and assess for risk of suicide or harm, listen nonjudgmentally, give reassurance and information, encourage appropriate professional help and promote self-help and other support strategies.
Tracy Levine, NRCI Executive Director and MHFA instructor, has worked closely with the city to implement this program.
She said an important element of the training is sharing mental health resources available within the city with participants so they can share those support options with those they encounter.
“Even though I’m an Evanston resident and I’ve been doing these trainings, and I feel pretty well versed in what’s available, I frequently learn from somebody else,” Levine said.
Participants also learn how to respond effectively in crisis situations, use supportive language that reduces stigma around mental health and practice their new skills with hypothetical scenarios. The in-person sessions combine lectures and group discussions with small-group activities.
During her own training session, Schwartz said she was shocked by how many people didn’t fully understand what mental illness really is, and she appreciated that the training gave people a chance to express that without shame or embarrassment.
“What impressed me the most is that it allowed people to say, ‘I didn’t know, and now I do,’ and to take what you learned with you, to work, to the community,” Schwartz said.
An evidence-based approach
MHFA utilizes an evidence-based approach, and researchers have been studying the process and impact for nearly 15 years in over 90 published peer-reviewed studies.
“An ‘evidence-based’ approach means that (MHFA) methods and outcomes have been tested, measured and proven effective through years of research and evaluation,” MHFA Research & Evaluation Strategist Sanjana Bhakta wrote in an email to The Daily.
Based on nearly 50 peer-reviewed studies, including responses from 700,000 training participants across all 50 states, the findings demonstrate that trainees can identify knowledge of signs, symptoms and risk factors of mental health while showing greater empathy and less stigma for mental health challenges.
Bhakta stated the MHFA team continues to actively implement recommendations from research findings to improve the training process.
Community response
Data from the first 11 training sessions in Evanston, involving 169 participants, show improvements in knowledge and confidence related to mental health and substance use support, according to survey results provided by Levine.
Before the training, 70% participants reported having the knowledge to “recognize the signs and symptoms of mental health or substance use challenges that may impact adults.” After training, that figure rose to 98%.
Almost 75% also reported feeling confident asking someone directly about suicidal intentions and responding to someone in a substance-use crisis, and 99% said they are likely to have a supportive conversation with an adult experiencing a mental health or substance-use challenge.
Felicia Bloom, a participant of an August session, said the program was very thorough and comprehensive. While she has not yet assisted anyone specifically, she said the training made her more observant, a better listener and more confident in helping someone in the future.
“It was very important for me to go through this training and to get the practical tools and skill set to be available, like a good citizen should be available to contribute positively to their community,” Bloom said.
MHFA on college campuses
MHFA training is also offered on many college campuses, including Roosevelt University in Chicago, in partnership with Levine at NRCI. The school held two sessions in 2023 and offered two more before their fall semester this year, with about 40 attendees. Sessions are open to administrators and staff, and this year, student resident assistants were eligible.
“It offers a little bit of background on what the students may be experiencing,” said Mayra Salgado, a social worker at Roosevelt University, who organized this year’s training sessions.
She added that the training helps administrators “offer empathy” in conversations with students.
Other Illinois colleges offering the program include the University of Illinois Urbana-Champaign and Oakton College. Northwestern has offered voluntary virtual MHFA training opportunities for its employees, but the program has not been extended to students.
Levine said the NRCI would welcome a future partnership with NU to implement MHFA training.
Program limitations
The training does come with some barriers, according to MHFA researchers, organizers and participants. Completing the seven-hour course is required for certification, but the length of the training can be a challenge for some.
For Evanston’s program, Meyer said it can be difficult for community members to “set aside that time to receive the training.” The city has looked for ways to accommodate these schedules.
“We’re trying our best to provide training in evenings, on weekends, to give folks a variety of options to help them find a time that they can do the course if they’re interested,” Meyer said.
Another challenge is connecting individuals to professional mental health resources.
Pamela Valera, a Rutgers University School of Public Health assistant professor, is a MHFA instructor and research advisor. She said the training prepares people to identify signs and symptoms of mental health challenges.
But, the next step — linking them to professional help — depends on broader community and institutional support.
“Do we now have the resources, which is where the community and institutions come in, to support people that need a lot of help and support?” Valera said. “That’s a gap I would say we’re trying to bridge.”
Despite these limits, many participants and researchers note how MHFA training is encouraging more open discussions of mental health.
Sara Geierstanger, the academic program management officer for the Institute for Health Policy Studies at the University of California, San Francisco, said she has observed how the training combats mental health stigma from studying the impact of youth-focused MHFA training.
“Trainings like Youth (MHFA) and other school-wide awareness campaigns are helping to bring awareness to the importance and the acceptability of talking about mental health problems,“ Geierstanger said.
Evanston will continue to offer MHFA training through 2026, until the funding runs out. Meyer said she hopes to continue seeing strong interest and participation.
She added that for every community member who completes the training, the city expands its capacity to “respond with confidence and compassion” to the growing mental health crisis.
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