The creation and growth of MHFA Australia since the first MHFA course in Canberra 20 years ago by Betty Kitchener, Founder and former CEO and Tony Jorm, Emeritus Professor, University of Melbourne.

The concept of Mental Health First Aid began one evening in 1997 when we were walking our dog “King”. Betty was working as a registered nurse at the Canberra Hospital and did some first aid instruction for Red Cross after hours. Tony was working as a mental health researcher at the Australian National University in Canberra. We had a discussion about why traditional first aid courses did not cover how to assist people with mental health problems, such as someone who is suicidal, having a panic attack or out of contact with reality. We knew these problems were much more common than many of the physical health emergencies addressed in traditional first aid courses. This seemed a major omission.

The need to provide first aid to people developing mental health problems also had a more personal meaning for us. Betty had had a serious episode of depression and a suicide attempt when she was 15. This was responded to with criticism rather than in a supportive way, and she received no professional help. Perhaps because of this lack of early help, Betty developed recurrent major depression, experiencing a number of episodes of depression throughout her life, including a period of hospitalization. She had also experienced discrimination in her workplace as a nurse after being hospitalized. Her supervisors felt that a nurse who had been a patient in the ‘psych ward’ was not suitable for working with patients who were acutely physically ill.

That evening on the dog walk, we resolved to do something about this situation. We decided that we would start up a ‘mental health first aid’ (MHFA) course as a community service activity in the city where we lived. We envisaged running 1-2 courses a year on our weekends, and never saw it going any further than that.

Over the next few years, we discussed what the course might cover on many occasions. However, the time pressures of work and family life meant that we did not get further than that. The big breakthrough for us was in 2000 when Betty decided to reduce her paid work at the hospital and to work as a volunteer on getting MHFA started. We also used volunteer help from a number of family members to make up for our lack of financial resources. For example, our daughter and son developed the Mental Health First Aid website, while Tony’s brother provided free legal advice. We have learnt over and over with the MHFA Program, that family members are a great source of support, skills and voluntary help.

By 2001, Betty was the sole MHFA instructor, running courses in Canberra for members of the public. At this point, Tony’s skill as a researcher became useful. From the very first courses taught, Betty began collecting data on the effects on participants. By 2002, we had an evaluation study published, showing benefits to participants’ knowledge, stigmatizing attitudes, and helping behaviours towards others.

In 2002, Betty trained a number of other instructors in Australia and the course began to spread across the country. By 2003, the Scottish government had seen the published evaluation study and Scotland became the first country outside Australia to adopt the MHFA course.

From that point, the expansion became very rapid across Australia and to other countries. In those early years, we also carried out a number of other evaluations, including two randomized controlled trials, showing beneficial effects.

An important milestone in the evolution of MHFA was the development of international MHFA Guidelines. We realized that we needed a better basis for the information in the course about the best way to provide MHFA. In 2005, we were successful in getting a small grant from Australian Rotary Health to employ Claire Kelly to begin the development of best practice MHFA guidelines, using the expert consensus of mental health professionals, consumers and carer-givers. These guidelines formed the basis of the 2nd edition MHFA courses, which were launched in Australia in 2010.

On that dog walk in 1997, we never imagined any more than a couple of MHFA courses a year in one city. However, our vision has grown. The MHFA Program has spread to over 25 countries and 4 million people globally have attended a MHFA course. We want a community where all people have the first aid skills to support people with mental health problems though the provision of high quality, evidence-based mental health first aid education to everyone.