Discussion: The Role Of The RN/APRN In Policy Evaluation

 

This program is a course that provides educational information in identifying, understanding and how to respond to signs of mental health problems and substance use disorders. This will train and equip you with knowledge and skills. By knowing the signs of mental illness, approach the person, provide support, know what is helpful for the situation, encourage to seek help. It is created to disseminate and emphasize an open and accessible program for the non-mental health professional. Training participants include teachers, professors, coaches, healthcare professionals, resident advisors, and family members of the patient who have mental health issues. This is an 8–12-hour training course and is either focused on young people or adults.

The program has been evaluated and there are levels of evidence which are stated below:

• Level I: is the systematic review of randomized controlled trials. The researchers explore all different areas and pool the statistics to look for consistency of the result. Study shows that participants are confident and skilled with better knowledge and attitude towards mental health problems.
• Level II: it is a randomized controlled trial where the researchers made sure that it is the interventions that makes it difference. One group was scheduled to train but not sure whether they will be able to get in the training right away or 12 months later (waitlist control). Everyone would get the training, and if the groups had similar improvements at different times, it would indicate the effectiveness of the training.
• Level III-1: the result is from a well-designed trial where participants are randomized.
• Level III-2: there are two pre-existing groups who received different interventions at the same time and the outcomes were compared.
• Level III-3: it is from comparative studies that includes historical control where old and new data are being compared. Two or more studies that do not have no control group but recruit people with similar characteristics and measures differences before and after interventions are given.
• Level IV: the evidence is from case studies with both pre and post-test outcomes. In post-test study, a group of people who received MHFA training might provide data on using their skills and knowledge onto someone. In pre-tests, people’s skills and knowledge were measured prior to receiving the training.

One approach they use is meta-analysis that provides rigorous systematic process to quantify the overall result of the treatment to summarize independent studies (Wong et al., 2015). There were 15 studies that resulted in improvement of mental health knowledge, reduces stigma, and increases helping behaviors, increases confidence, in approaching with mental health issues.

The MHFA implementation resulted 68%-88% of trained mental health first aiders used their skill when on contact with someone who is experiencing mental health illness, and it raises awareness of mental health.

Social determinants are about understanding how certain circumstances of their lives and work shape their health outcomes and it gives direct and indirect impact to mental health. These circumstances are world health inequalities including lower life expectancy, increase child mortality, burden of diseases among disadvantaged population. They found out that poor and disadvantaged populations are most affected by mental disorders with low socioeconomic status from anxiety, stress, unsecure and unpredictable living conditions. There are a lot of factors that are associated with mental health problems such as discrimination, familial relationships, and many others. Mental illness can also impact social determinants, including homelessness, school dropout, marital instability, and economic insecurity. Having mental health problems can affect educational performance, employment capacity, and justice that can limit opportunities. Also, a barrier to socioeconomic improvement, and increase mental health disorder risk (AlegriA et al., 2018)

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