Mental Health Crisis
Conditions
Keywords
Crisis Intervention Training, Mental Health Crisis, Behavioral Emergency, Firefighters, Emergency Medical Services, Public Health Personnel, De-escalation Training, Mental Health Stigma, Substance Use Stigma, Self-Efficacy, Interprofessional Education, Pre-Post Study
Brief summary
This study evaluated whether a mental health crisis response training course improved the knowledge, confidence, and attitudes of police officers, firefighters, emergency medical personnel, and public health staff who may encounter people experiencing mental health or substance use crises. Participants attended a four-hour training course covering mental health laws, recognition and assessment of behavioral emergencies, crisis identification, the escalation of violent behavior, communication, and de-escalation techniques. Participants voluntarily completed an online questionnaire immediately before and after the course. The study compared participants' responses before and after training to determine whether the course improved their understanding of mental health crises, confidence in responding to these situations, and attitudes toward people with mental health conditions or substance use problems.
Detailed description
This was an observational, single-group pre-post study conducted among personnel attending a mental health crisis response training program organized in New Taipei City, Taiwan. Eligible attendees included police officers, firefighters, emergency medical personnel, public health personnel, and other frontline staff involved in responding to mental health or behavioral emergencies. Participation in the research questionnaires was voluntary and was separate from participation in the training course. The study did not assign participants to receive the training or to a comparison group. Before the course, participants who agreed to participate scanned a QR code and completed an online 32-item questionnaire. The questionnaire assessed knowledge and understanding of mental health crises, perceived confidence and self-efficacy in responding to behavioral emergencies, attitudes toward people with mental health conditions, and attitudes toward people with substance use problems. The four-hour course included mental health legislation, initial and secondary assessment of behavioral emergencies, identification of mental health crises, recognition of the escalation of potentially violent behavior, personal and scene safety, communication strategies, and verbal de-escalation techniques. Immediately after completing the course, participants completed the corresponding online post-training questionnaire. No personally identifying information was collected. Pre-training and post-training responses were compared to evaluate changes associated with participation in the course. Analyses included descriptive statistics and appropriate comparisons of pre-training and post-training measures according to the distribution and measurement level of each variable. Additional analyses examined whether participant characteristics were associated with training outcomes.
Interventions
BEHAVIORALMental Health Crisis Response Training
A four-hour instructor-led training course covering mental health legislation, initial and secondary assessment of behavioral emergencies, recognition of mental health crises, escalation of potentially violent behavior, personal and scene safety, communication strategies, and verbal de-escalation techniques.
Sponsors
Far Eastern Memorial Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Healthy volunteers
Yes
Inclusion criteria
* Police officers, firefighters, emergency medical personnel, mental health personnel, public health personnel, or other frontline staff attending the mental health crisis response training program organized in New Taipei City. * Willing to participate voluntarily after reading the questionnaire information and participant rights statement. * Willing to complete the online study questionnaire before and/or immediately after the training course.
Exclusion criteria
\- No protocol-specified
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Self-Efficacy for Managing Mental Health Crises and Behavioral Emergencies | Immediately before the training session and immediately after completion of the 4-hour training session | Self-efficacy was assessed using the mean score of eight items from the study-specific questionnaire (items 6-13). Each item was rated on a 5-point confidence scale. The overall mean score ranged from 1 to 5, with higher scores indicating greater confidence in recognizing, assessing, communicating with, and responding to individuals experiencing mental health crises or behavioral emergencies. Change was calculated as the post-training mean score minus the pre-training mean score. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Change in Cognition Toward Behavioral Emergencies | Immediately before the training session and immediately after completion of the 4-hour training session | Cognition toward behavioral emergencies was assessed using the mean score of six items from the study-specific questionnaire (items 15-20). Each item was rated on a 5-point agreement scale. Item 20 was reverse-coded because agreement with routine use of force represented less favorable cognition. The mean score ranged from 1 to 5, with higher scores indicating more favorable understanding and attitudes regarding behavioral emergency response. Change was calculated as the post-training score minus the pre-training score. |
| Change in Stigma Toward People Experiencing Behavioral Emergencies | Immediately before the training session and immediately after completion of the 4-hour training session | Stigma toward people experiencing behavioral emergencies was assessed using the mean score of six dichotomous items from the study-specific questionnaire (items 21-26). Positive recovery-oriented or interaction-related items were reverse-coded so that higher scores consistently represented greater stigma. The mean score ranged from 0 to 1, with higher scores indicating greater stigma. Change was calculated as the post-training score minus the pre-training score; a negative change indicated reduced stigma. |
| Change in Stigma Toward People With Substance Use Problems | Immediately before the training session and immediately after completion of the 4-hour training session | Stigma toward people with substance use problems was assessed using the mean score of six dichotomous items from the study-specific questionnaire (items 27-32). Positive recovery-oriented or interaction-related items were reverse-coded so that higher scores consistently represented greater stigma. The mean score ranged from 0 to 1, with higher scores indicating greater stigma. Change was calculated as the post-training score minus the pre-training score; a negative change indicated reduced stigma. |
| Post-Training Satisfaction With the Mental Health Crisis Response Training | Immediately after completion of the 4-hour training session | Training satisfaction was assessed using five items from the post-training questionnaire (items 33-37). Items evaluated the perceived usefulness of the course for participants' work, satisfaction with the instructor and course content, usefulness of practical exercises, course flow, and overall course satisfaction. Each item was rated on a 5-point Likert scale ranging from 1 to 5. The mean satisfaction score ranged from 1 to 5, with higher scores indicating greater satisfaction with the training course. |
Countries
Taiwan
Outcome results
None listed