New Report Evaluates Mental Health First Aid (MHFA)

New York, NY – Recent mass shootings have prompted broader conversations about serious mental illness and policy devices for addressing it. For decades, the prevailing policy approach has treated mental illness as a “public health” matter, prioritizing prevention over treatment, with educational programs such as Mental Health First Aid (MHFA) as representative examples. In the latest Manhattan Institute report, adjunct fellow Carolyn D. Gorman argues that this strategy is ineffective for averting crises related to mental illness. Instead, the focus should shift to facilitating treatment and producing demonstrable improved outcomes for the mentally ill.   

Specifically, Gorman assesses MHFA, a publicly funded program that trains ordinary citizens to recognize the signs and symptoms of mental illness. Two decades of data demonstrate that MHFA has not helped mentally ill people get adequate professional help. Gorman argues that this failure stems from the flawed assumption that mental illness can be effectively prevented “upstream” by educating the general population on its existence. Reducing the social stigma attached to mental illness — a common priority of those who support a public health approach – has not increased access to treatment. 

What will work to help prevent tragedies, Gorman argues, is promoting treatment access and continuity for the most seriously mentally ill, who are at highest risk of crises. Currently, professional treatment for mental illness is limited: over half of all U.S. counties lack a practicing psychiatrist, there is a shortage of psychiatric hospital beds, Medicaid discriminates against some inpatient coverage for mental illness treatment, and the remunerative incentives for doctors to practice psychiatry over other specialties are minimal. In response to these limited resources and barriers to treatment, Gorman makes policy recommendations: 

• Public mental health funding should be spent on programs that demonstrate improved outcomes related to mental illness. Relevant outcomes include greater access to high-quality treatment (and services that facilitate it) for the seriously mentally ill, and fewer incidences of violence, homelessness, and incarceration among the mentally ill.  

• Building infrastructure for psychiatric treatment, such as inpatient bed capacity, could be encouraged by providing financial incentives to do so. A severe shortage of inpatient psychiatric beds exists nationwide because financial disincentives for maintaining capacity exist in provider payment systems. Lessening these disincentives for standalone specialty psychiatric hospitals and general hospital psychiatric units would allow more timely access for individuals in need. 

Click here to view the full report.