Journal of Nursing Education

Syllabus Selections: Innovative Learning Activities Free

Implementing Mental Health First Aid and Certification in the Nursing Program

DeAnna Gapp, PhD, RN

Throughout the nation, as mental health crises are affecting all populations and are increasing in occurrence and severity, schools of nursing can empower students to lead the charge in expanding support for those in crisis. Just as nursing students are trained for cardiac crises through cardiopulmonary resuscitation (CPR) certification, nursing students could be trained for mental health crises by being certified as Mental Health First Aid (MHFA) responders. MHFA is effective in increasing mental health literacy and supporting those with mental health issues for the general population (Morgan, Ross, & Reavley, 2018; National Council for Behavioral Health, 2019). Due to some nursing students embracing negative stereotypes and accepting societal stigmas of this vulnerable population (Chadwick & Porter, 2014), the MHFA training for nursing students may have a positive impact in their perceptions about caring for those with mental illness.

All nursing students at Washtenaw Community College receive MHFA Training and Certification, which is part of the list on the National Registry of Evidence-based Programs and Practices, as part of the nursing curriculum. Students are required to purchase the MHFA material as part of the required book list for NUR 138, the third nursing concept course that focuses on acute, critical concepts throughout the life span. The nursing faculty must be certified as MHFA trainers by passing a week-long training (conducted by the MHFA institution). The college administration covered the expense because of the mental health crisis in the community. The students are assigned to come to campus before any mental health clinical to take part in the training and to be certified in MHFA. The certification is valid for 3 years. This training is 8 hours in length and follows specific guidelines, similar to CPR certification.

The goals of MHFA are (a) nursing students will be able to assess a person for mental health distress; (b) nursing students will be able to assist a person in mental health distress by providing treatment; and (c) nursing students will self-evaluate for mental health bias. During the training using active learning exercises, students identify the warning signs of an emotional crisis, demonstrate caring support, and evaluate the symptoms of those in a mental crisis. The MHFA training counts toward fulfilling clinical hours because of the active learning exercise through role-playing and simulation. Fulfilling clinical hours is a great benefit to this nursing program because of the lack of quality mental health clinical placements in the area.

Postsurveys, containing 20 items on a 5-point Likert scale—ranging from strongly disagree to strongly agree—and six open ended questions were thoroughly evaluated. For the following semesters—fall 2016 (40 students), spring 2017 (52 students), fall 2017 (52 students), and spring 2018 (38 students), 92.3% to 100% of the students either strongly agreed or agreed in all the items. For example, these students felt more confident in working with a mentally distressed individuals, as well as in identifying their own views and misconceptions of mental health issues. The qualitative data was also positive:

  • Quite concise & informative—assumption was it would be quite remedial—on the contrary.
  • This course should be part of … any medical health profession.
  • I learned so much about mental health which I had little previous knowledge about.
  • I am happy we completed the MHFA before clinical started because now I am more confident.
  • I feel better prepared to talk to people with mental illness about substance use or suicide.

Because of the overwhelming positive feedback throughout these semesters, the nursing program has decided to expand MHFA to include pediatric training. The current fall 2018 students will be MHFA certified for the adult and pediatric population. Nursing students who are MHFA responders can positively impact the mental health crisis affecting the nation.

DeAnna Gapp, PhD, RN
Washtenaw Community College


  • Chadwick, L. & Porter, J. (2014). An evaluation of the effect of a mental health clinical placement on the mental health attitudes of student nurses. Nursing and Health, 2(3), 57–64.
  • Morgan, A.J., Ross, A. & Reavley, N.J. (2018). Systematic review and meta-analysis of Mental Health First Aid training: Effects on knowledge, stigma, and helping behaviour. PLoS One, 13, e0197102. doi:10.1371/journal.pone.0197102 [CrossRef]
  • National Council for Behavioral Health. (2019). Mental Health First Aid: Get involved and make a difference. Retrieved from

The author has disclosed no potential conflicts of interest, financial or otherwise.


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