First Face Training for Mental Health Support in Tribal Communities

Recruiting at 8 trial locations

Overseen By Hannah Tomeo

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: Cambridge Health Alliance

Disqualifiers: Age 13 or younger, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Approved in 1 Jurisdiction This treatment is already approved in other countries

Compensation: Varies

Number of Visits: 6

1000 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial tests the First Face Training Program to determine its effectiveness in helping Tribal communities manage mental health crises. The program aims to train community members to respond effectively, reduce mental health stigmas, and strengthen cultural identity. Participants will be divided into two groups: one receives training immediately, while the other begins six months later. Surveys will track changes over two years. This trial suits anyone aged 14 or older living or working in one of the seven Tribal Nations affiliated with the Healing Lodge of the Seven Nations in the Northwestern United States. As an unphased trial, it offers a unique opportunity to contribute to culturally sensitive mental health solutions in Tribal communities.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that the First Face Training Program is safe for mental health support in Tribal communities?

Research shows that the First Face Training Program is a mental health training specifically designed for Tribal communities. It aims to improve mental health support by training community members. This program is not a medication or medical procedure; it is a training course, so the safety concerns differ from those in drug trials.

Studies have found that participants respond positively to the training. No reports of negative side effects exist because it is an educational program, not a physical treatment. The training teaches people how to support others during mental health crises, making it less risky than many other medical treatments.

As a training program, the main safety concern is its emotional impact. The curriculum, developed with input from Tribal communities, ensures cultural respect and support. This approach helps reduce any potential negative effects on participants' emotional well-being. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the First Face Training Program because it offers a culturally tailored approach to mental health support specifically designed for tribal communities. Unlike standard treatments that often rely on medication or generalized therapy, this program focuses on community-specific training that respects and incorporates tribal cultural practices and values. The program aims to empower community members to provide mental health support, potentially leading to more sustainable and accessible mental health care within these communities.

What evidence suggests that the First Face Training Program is effective for mental health support in Tribal communities?

Research shows that the First Face Training Program, also known as xaʔtus, strengthens informal mental health support in Tribal communities. This trial includes an initial training group and a waitlist-control group, with the latter receiving training six months later. The training enhances community members' ability to respond to mental health crises. Studies have found that it increases knowledge about mental health and improves crisis management skills. It also reduces negative attitudes toward mental health issues and boosts cultural identity among participants. Early results suggest that trainees feel more confident and take real action after the training. This culturally based approach can significantly improve mental health in Tribal communities. ^{1 2 3 4 6}

Who Is on the Research Team?

Sarah E. Nelson, Ph.D.

Principal Investigator

Cambridge Health Alliance

Martina Whelshula, PhD

Principal Investigator

Healing Lodge of the Seven Nations

Are You a Good Fit for This Trial?

This trial is for individuals aged 14 or older who live or work in one of the seven Tribal Nations affiliated with the Healing Lodge of the Seven Nations in Northwestern U.S. It's not open to those younger than 14 or outside these tribal communities.

Inclusion Criteria

I am 14 years old or older.

Living or working in one of the seven Tribal Nations affiliated with the Healing Lodge of the Seven Nations, including Northwestern United States, including the Coeur d'Alene Tribe, the Confederated Tribes of the Colville Reservation, the Confederated Tribes of the Umatilla Indian Reservation, the Kalispel Tribe of Indians, the Kootenai Tribe of Idaho, the Nez Perce Tribe, and the Spokane Tribe of Indians

Exclusion Criteria

Not living or working in one of the seven Tribal Nations affiliated with the Healing Lodge of the Seven Nations, including Northwestern United States, including the Coeur d'Alene Tribe, the Confederated Tribes of the Colville Reservation, the Confederated Tribes of the Umatilla Indian Reservation, the Kalispel Tribe of Indians, the Kootenai Tribe of Idaho, the Nez Perce Tribe, and the Spokane Tribe of Indians

I am 13 years old or younger.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Training

Initial training group receives the First Face training program and completes baseline and post-training surveys

0 months

Multiple training sessions (in-person)

Waitlist Control Training

Waitlist control group receives the First Face training program and completes baseline and post-training surveys

6 months

Multiple training sessions (in-person)

Follow-up

Participants are monitored for changes in mental health knowledge, ability to respond, and other outcomes

24 months

Online surveys at 6, 12, 18, and 24 months

What Are the Treatments Tested in This Trial?

Interventions

• First Face Training Program

Trial Overview The study tests a culturally tailored training program, First Face for Mental Health, designed to help Tribal community members respond effectively to mental health crises. The effectiveness will be measured through surveys before and after training, comparing immediate trainees with a waitlist group.

How Is the Trial Designed?

Group I: Waitlist-control group Experimental Treatment 1 Intervention

Participants who are trained in the First Face training program 6 months after the initial training group

Group II: Initial training group Experimental Treatment 1 Intervention

Participants who are initially trained in the First Face training program

First Face Training Program is already approved in United States for the following indications:

Approved in United States as First Face Training Program for:

• Mental health crisis response training for Tribal communities

Who Is Running the Clinical Trial?

Cambridge Health Alliance

Lead Sponsor

Trials

65

Recruited

22,400+

Healing Lodge of the Seven Nations

Collaborator

Trials

1

Recruited

1,000+

National Institute of General Medical Sciences (NIGMS)

Collaborator

Trials

315

Recruited

251,000+

Published Research Related to This Trial

Caregivers perceive that involving service users as cofacilitators in mental health training programs can reduce their own burden and help develop support networks, highlighting the potential benefits of family engagement in mental health initiatives.

However, barriers such as fear of stigma, lack of trust, and time management issues can hinder participation, suggesting that addressing these concerns through better orientation and support from health workers is crucial for successful program implementation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A service user co-facilitated intervention to reduce mental illness stigma among primary healthcare workers: Utilizing perspectives of family members and caregivers. Rai, S., Gurung, D., Kaiser, BN., et al.[2019]

The Australian Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA) course was successfully adapted and implemented, training 199 Aboriginal people as Instructors who then conducted community courses, indicating strong uptake and engagement.

Qualitative feedback highlighted that the AMHFA course is culturally appropriate and empowering, providing relevant information for assisting Aboriginal individuals with mental health issues, though further refinements and impact evaluations are needed.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A mental health first aid training program for Australian Aboriginal and Torres Strait Islander peoples: description and initial evaluation. Kanowski, LG., Jorm, AF., Hart, LM.[2022]

A 90-minute training program was developed to enhance the knowledge and empathy of mental health professionals regarding Indigenous cultures, addressing the significant mental health disparities faced by Indigenous people in the U.S.

The training, which focuses on cultural competency, humility, and decolonialism, has been positively received across various settings, indicating its effectiveness in improving mental health services for Indigenous patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Decolonizing Mental Health Services for Indigenous Clients: A Training Program for Mental Health Professionals. Lewis, ME., Hartwell, EE., Myhra, LL.[2019]

The xaʔtus (First Face) for Mental Health program aims to enhance informal mental health support among Native adolescents, who often prefer peer support over professional services due to accessibility and cultural fit issues.

Focus groups with teens, clinical staff, and community members provided valuable insights for optimizing the program, emphasizing the need for convenient training times, engaging delivery methods, and addressing the personal relevance of the training to encourage participation.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recommendations for Optimizing xaʔtus (First Face) for Mental Health Training: Insights from Key Informants. Gray, HM., Beu Rae, M., Anderson, C., et al.[2023]

A community-driven psychiatric 'task shifting' program in a rural South Indian tribal community led to significant improvements in daily functioning for treated patients, demonstrating the program's efficacy in addressing mental health issues.

The program increased community knowledge and acceptance of mental illness, with self-referrals rising from 27% to 57% over three years, all at a low annual cost of approximately 122.53 Indian Rupees (USD 1.61) per person.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A task shifting mental health program for an impoverished rural Indian community. Nimgaonkar, AU., Menon, SD.[2022]

Mental Health First Aid (MHFA) training significantly improved mental health literacy among Bhutanese refugees, particularly for recognizing and responding to conditions like schizophrenia and depression, especially when combined with culturally-appropriate orientation materials.

Participants who received the orientation showed greater improvements in their understanding of mental health concepts compared to those who did not, highlighting the importance of culturally relevant training in enhancing the effectiveness of mental health interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Culturally-Appropriate Orientation Increases the Effectiveness of Mental Health First Aid Training for Bhutanese Refugees: Results from a Multi-state Program Evaluation. Gurung, A., Subedi, P., Zhang, M., et al.[2023]

Mental Health First Aid (MHFA) training significantly improved Bhutanese refugee community leaders' ability to recognize symptoms of depression and their understanding of treatment options, as shown by pre- and post-test results from 58 participants.

Despite the knowledge gains, the training did not lead to a reduction in negative attitudes towards individuals with mental illness, suggesting that further adaptations to the program may be needed to address stigma in this community.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mental health first aid training for the Bhutanese refugee community in the United States. Subedi, P., Li, C., Gurung, A., et al.[2020]

A systematic review of 21 studies involving 22,604 participants found that Mental Health First Aid (MHFA) training may have little to no effect on individual mental health outcomes at six to twelve months, but the evidence is uncertain due to high risk of bias in the studies.

There is insufficient quality evidence to determine the impact of MHFA training on mental health service usage or adverse effects, highlighting the need for more rigorous research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mental Health First Aid as a tool for improving mental health and well-being. Richardson, R., Dale, HE., Robertson, L., et al.[2023]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10641797/

Recommendations for Optimizing xaʔtus (First Face) ... xaʔtus (First Face) for Mental Health is a Tribal community-based intervention designed to strengthen networks of informal mental health support.

2. clinicaltrials.gov clinicaltrials.gov/study/NCT05998005

First Face Training Evaluation in Tribal Communities The goal of this study is to evaluate a culturally grounded training curriculum, First Face for Mental Health, in Tribal communities, using a waitlist ...

3. firstface.org firstface.org/

First Face for Mental Health xaʔtu̓s for Mental Health is a mental health and wellness training designed with and for Tribal communities. No special experience in mental health is necessary.

4. reporter.nih.gov reporter.nih.gov/project-details/11182705

Research Core - NIH RePORTER This curriculum will train Tribal and non-Tribal community members within Tribal communities in how to respond to youth and adults experiencing mental health ...

5. clinicaltrials.gov clinicaltrials.gov/study/NCT06290180

Healing Lodge First Face Training Evaluation Study | ... The study will help the investigators understand whether the First Face training program influences mental health and attitudes, as well as responses to mental ...

6. reporter.nih.gov reporter.nih.gov/search/HaCPQzHfG0OlA6_Uu-26GQ/project-details/11182702

Assessing Cultures of Recovery in Tribal Communities We used a Tribal Participatory Program Development approach to build a mental health first response system grounded in Indigenous values, strengths, and needs ...