In-Person Versus Virtual Mental Health First Aid: A Retrospective Compartive Outcomes Analysis of Post-training Helping Behavior Characteristics

Background: Evidence regarding Mental Health First Aid (MHFA) training participants’ post training helping behavior and comparisons between in-person and virtual training modalities is limited. Objective: This study aimed to compare post-training helping behavior outcomes among in-person Adult MHFA (iAMHFA), virtual Adult MHFA (vAMHFA), and virtual Youth MHFA (vYMHFA) participants. Methods: We used a retrospective comparative outcomes analysis with a mixed-methods approach. Following in-person and virtual MHFA training of 252 U.S. community members, responses to a 1-month follow-up survey were analyzed to assess helping behavior outcomes related to help frequency, help recipients, skills used, and context for help. Results: Of 102 respondents (response rate: 40.5%), 58.0% (n=59) reported helping behavior. Helping behavior was significantly more common among iAMHFA than vAMHFA participants (67.9% vs 43.3%; p = 0.033, d = 0.51). vAMHFA participants were significantly more likely to help family members than iAMHFA participants (61.5% vs 25%; p = 0.032, d = 0.80), while iAMHFA participants were significantly more likely to help strangers (16.7% vs 0%, p = 0.012, d = 0.51). vYMHFA participants assessed for risk of suicide or harm significantly more than both iAMHFA (80% vs 38.9%, p = 0.018, d = 0.86) and vAMHFA participants (80% vs 38.5%, p = 0.044, d = 0.88). vAMHFA participants also reported listening nonjudgmentally significantly more than iAMHFA participants (100% vs 83.3%, p = 0.012, d = 0.51). Conclusion: Lockdowns and other risk mitigation measures during the COVID-19 pandemic may have influenced the observed intergroup differences. However, comparison of effectiveness across groups remains inconclusive due to limited statistical power. These findings offer valuable insights into current evidence gaps by exploring real-world helping behavior outcomes following in-person and virtual MHFA training. Future studies with larger sample sizes and new curriculum are needed to validate and expand on these results, and to support evidence-based implementation decisions.