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Case Studies

Missouri Department of Mental Health

Brief description: The Missouri Department of Mental Health (MDMH) is dedicated to combating stigma associated with mental illness, developmental disabilities, and substance addiction. Since 2006, when MDMH began offering Mental Health First Aid (MHFA), the state has successfully trained over 37,000 first aiders.
Transforming mental health in Missouri
In 2006, as a part of the Substance Abuse and Mental Health Services Administration’s (SAMSHA) Mental Health Transformation Grant program, MDMH received funding to help transform the mental health system in Missouri. After receiving this grant, MDMH’s leadership team began searching for an educational and stigma-reducing initiative to invest in. Late Missouri State Senator, Betty Sims, became aware of MHFA, and strongly recommended that MDMH invest in it. During the grant period, MDMH established a relationship with the National Council for Behavioral Health (NCBH), who played a vital role in spearheading this effort. After the grant ended, MDMH was able to take advantage of state funding to drive this initiative forward.
Mark Stringer, Director of MDMH, worked closely on Missouri’s MHFA effort and described the value of the simplicity of the program, saying, “The concept is elegantly simple. It makes immediate sense to people. And that was valuable.” Regarding the public value of the program, Stringer added, “A lot of us have had physical first aid training, but not behavioral first aid training. MHFA makes a lot of sense in this day and age.”
In an effort to establish the presence of MHFA throughout the state, MDMH developed contracts with ten mental health centers in its Prevention Resource Network, which each have certified instructors offering MHFA to the community. Angie Stuckenschneider, Director of Prevention and Mental Health Promotion at MDMH, mentioned that each year, MDMH targets a specific population to train in MHFA while continuing to meet the general demand across the state. MDMH previously has focused on serving veterans. A target population last year was public safety workers, which led to the state taking the One Mind pledge, a national campaign led by the International Association of Chiefs of Police (IACP) that seeks to ensure successful interactions between police officers and people affected by mental illness, and encourages participating departments to train all staff in MHFA. MDMH is now focusing on better serving the homeless population by training public housing authorities and other agencies who work with the homeless.
The Missouri Institute of Mental Health at the University of Missouri St. Louis (MIMH) has been instrumental in the success of Missouri’s MHFA initiative. MIMH has been particularly involved in bolstering Missouri’s instructor workforce. MIMH visits MHFA instructors periodically to ensure the quality and fidelity of their classes. In addition, MIMH keeps track of the number of classes each instructor teaches, to make sure instructors are fulfilling their requirement of teaching three classes per year. Lastly, MIMH holds instructor summits twice per year, which provide instructors with opportunities to ask questions and collaborate with others.
Jay Nixon served as the Governor of Missouri from 2009 to 2017, and was highly supportive of Missouri’s MHFA effort, which helped raise awareness of the program in the state. Nixon spoke of the public safety value of MHFA by saying, “By investing in proven tools like MHFA and expanding access to services through our mental health liaisons, we have taken great strides to make our communities safer, healthier, and stronger.”1
Results of MHFA
Since 2006, Missouri has trained over 37,000 first aiders and certified almost 300 instructors, a result of MDMH offering five instructor trainings per year (in part, through the ten Prevention Resource centers). In 2016, Missouri ranked 1st in the nation in first aiders trained per capita and 5th in total first aiders trained per state.12 Beyond the number of people trained, Stringer emphasized that the training has had on impact on people’s lives, saying, “We’ve only heard positive things from people who have taken the course. There are so many stories of people who have been able to use the training in their day-to-day life.”
In addition to the success that MHFA has had state-wide, the Missouri Crisis Intervention Team (CIT) Council has recommended that all of Missouri’s police officers receive MHFA training as a complement to higher-intensity CIT training, which is given to a subset of officers. St. Louis County Sergeant Jeremy Romo, who is also a Team Coordinator at Missouri’s CIT Council, has been certified as a national MHFA trainer and has trained instructors in other states.
Future direction of MHFA
When asked about the future of MHFA in Missouri, Stringer says, “There are a lot more people to train and there’s no shortage of requests for this training in Missouri.” Beyond training more first aiders, MDMH is interested in improving the delivery of MHFA to teachers and staff within public school districts.