How IU Fort Wayne is enhancing its mental health education for student nurses and their patients

Mental health illnesses are some of the most common health conditions in the United States. In 2021 it was estimated that 1 in 5 adults, approximately 57 million people, live with a mental illness. This issue is not limited to adults and greatly affects children too. According to the National Mental Health Alliance, “1 in 6 youth, ages 6-17 experience a mental health disorder each year.”   

As the mental health epidemic continues to grow new tools are needed to support the community. In some places, like the Indiana University Fort Wayne School of Nursing, Mental Health First Aid Training (MHFA) is being added to the curriculum to help future healthcare workers recognize and respond to the signs of mental health or substance use challenges. 

MHFA is an evidence-based, early intervention program that can be taught to anyone. Betty Kitchener, nurse and educator, and her husband, Anthony Jorm, a mental health literacy professor created the MHFA framework and began teaching it in Australia in 2001. Then, they formed a nonprofit, Mental Health First Aid Australia, to support the work. According to their website, the course was developed to fill a need for practical mental health training, which was similar to the first-aid training provided for physical health.

Within five years the program grew and was being taught across Australia. Since then twenty-five countries have embraced MHFA, with over six million people internationally now trained and certified. 

In the United States, MHFA is overseen by the National Council for Wellbeing. Since its implementation in the U.S. over three million people have been certified. According to the National Council for Mental Health Wellbeing, the program is proven to increase empathy and mental health literacy while reducing any stigma participants may hold.

As a professor at Indiana University Fort Wayne School of Nursing with a certification in psychiatric mental health, Adaline Cunningham is passionate about raising awareness of mental health needs and addressing incorrect stigmas around mental health. She recognizes the increasing need for mental health training in medical professionals. She pilots the MHFA program at IU Fort Wayne.

Student nurses at IU Fort Wayne now receive Mental Health First Aid Training (MHFA) as part of their curriculum.The program itself is not designed to diagnose but rather equip participants to recognize and respond to a mental health crisis. It gives its participants the knowledge, confidence, and proper language to discuss mental health issues with anyone, which Cunningham believes are important skills for future nurses. 

Nurses are often trained to focus on total patient care, which means even when patients aren’t being seen in a mental health setting, it’s still important for their nurses to be trained to help with mental health crises. Cunningham says the MHFA training prepares her students for both their clinical experiences and their future professional practice.

Instructor certification for MHFA is open to anyone who completes the three-day course and training program. To maintain certification an instructor must teach the course at least three times per year Instructors can also become dual-certified in multiple MHFA programs. The training is comprehensive and is constantly being updated based on evidence-based research.

To become MHFA certified, participants must go through eight hours of instruction time, which can be taught in one or more sessions. At IU Fort Wayne, nursing students learn the material throughout one, eight-hour session and receive their MHFA certification at the end of the day. Cunningham says the training is incorporated into the mental health classes and clinical teachings.

The course students at IU Fort Wayne take is divided into four segments. The first section gives participants an overview of mental health, including the most common health issues such as anxiety, panic attacks, substance usage, and violence.

The second portion reviews the MHFA Action Plan, which is explained via the acronym ALGEE and teaches students the basic steps of MHFA. A is for “Assessing for risk of suicide or self-harm.” Participants are taught the signs of self-harm, suicidal thoughts, and behaviors. L represents “Listening non-judgementally.” Students are taught how to have a meaningful conversation, helping the individual to feel heard and understood. G is for “Giving reassurance and information.” Participants learn the proper language to help individuals in crisis know there is help available and their symptoms are treatable. E stands for “Encouraging appropriate professional help.” Students are trained to walk patients through the different types of help available such as doctors, social workers, counselors, medications, and other treatments. The last E represents “Encouraging self-help and other support strategies.” In this final step, participants are taught methods through which those with mental health issues can help themselves. Examples of these strategies include exercise, meditation, support groups, therapies, and engaging with others. 

Throughout the teaching of ALGEE participants are educated on proper terminology, stigmas, and statistics. Students are also equipped with skills to set appropriate boundaries and maintain safety for themselves and the person in crisis.

The third portion of the program builds scenarios with the students, allowing them to work on applying ALGEE. They begin with the early stages of mental health concerns and discuss what behaviors and symptoms you may see. They then run through a worsening case and work up to a full mental health crisis. The crisis scenario includes responding to suicide, psychosis, violence, substance abuse, and advanced verbal and physical abuse.  

In the fourth and final section, students are taught about self-care; and healthy ways to process the trauma they have experienced. 

Student nurses at IU Fort Wayne now receive Mental Health First Aid Training (MHFA) as part of their curriculum.“Various research indicates that most healthcare professionals have experienced events classified as traumatic,” Cunningham explains. “Whether or not a person is consciously aware of this or not, this reality influences the individual's personal and professional reality.”

Cunningham says educational institutions have previously overlooked the need for this.

“A critical and historically neglected element of helping nurses develop professionally is self-awareness and self-care,” she says.

Nursing students are taught several ways to care for others, but they also need to learn how to care for themselves. Cunningham says the ability to care for ones self creates better healthcare professionals.

“Students who make self-care a priority then have the resources and the resilience to show up as their best selves for care for others,” she explains. “Self-care then empowers other care.”

IU nursing students can then take the all skills they learned in the Mental Health First Aid course and immediately apply them to their mental health clinicals for school. Cunningham says the program gives the students more confidence to approach specific scenarios, handle patients who may currently be in crisis, and set appropriate boundaries for the safety of everyone involved. 

“Students are more prepared, have better mental health communication skills, and are overall more confident going into mental health facilities,” Cunningham says.

Mental Health First Aid was incorporated into the nursing program at IU Fort Wayne in the fall of 2021. Since its implementation, the IU Fort Wayne nursing program has trained almost 300 students and close to 30 faculty members.

The benefits of the program were seen almost immediately by the school’s clinical partners. In a letter to Cunningham, the inpatient director of Northeastern Center reported that IU Nursing students “exhibited more confidence in the mental health units, were quicker to engage clients in conversation and/or activities, and were more skilled in communication.”

The Inpatient Director of North Eastern Center reported in a letter to Cunningham that “students exhibited more confidence in the mental health units, were quicker to engage clients in conversation and/or activities, and were more skilled in communication.” 

They also reported that students trained in MHFA helped respond to a menthol health crisis that occurred during their clinical, which was a change from previous students who were not trained in MHFA.

Cunningham says her students report feeling more confident in their understanding of mental health, therapeutic communication, and assessment skills. She says these improvements are also measured objectively in clinical measures of grading student performance.

IU Fort Wayne School of NursingAdditionally, IU nursing students have said the program helped them process their own personal mental health struggles.

MHFA also offers different types of training programs for other professions. These programs are designed to train specific fields/audiences. Adult courses include Fire/EMS, Higher Education, Corrections Professionals, Older Adults, Public Safety, and others. Mental Health First Aid can be taught in schools and the workplace. MHFA offers programs directed specifically at youth, tribal communities, and in several languages.

To find more information about a course near you visit
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