Mental Health First Aid Training for Advisory Agents Working with Farmers A/Prof Don Gorman Dr Delwar Hossain Dr Rob Eley Dr Jeff Coutts

Farming-- used to be…. 28/11/2018

Long Term Drought in Australia 28/11/2018

Impact 28/11/2018

The Study Advisory Agents (AAs) lacked confidence to assist farmers with mental health problems The study (Funded by a Foster Community Grant) aimed to provide Mental health First Aid (MHFA) training 28/11/2018

Objectives of the study Increase MHFA knowledge and skills of AAs: Symptom recognition Knowledge, confidence and empathy referral to professional help 28/11/2018

Farming & Mental Health Depression, Stress, Anxiety, Frustration, Fear, Anger, Agitation, Lack of Confidence, Indecision, Loneliness, Nervousness, Feelings of Worthlessness (Sartore et al. 2008) Drought, ↓production, ↓Govt Assistance, ↓Credit, Relationship breakdown, Ageing Farmers, Reduced Workforce etc Risk of Suicide and/or Mental Illness 28/11/2018

Possible Impact or AAs Risk of Suicide and/or Mental Illness Depression, Stress, Anxiety, Frustration, Fear, Anger, Agitation, Lack of Confidence, Indecision, Loneliness, Nervousness, Feelings of Worthlessness (Sartore et al. 2008) Education, Support, Resilience, Prevention Drought, ↓production, ↓Govt Assistance, ↓Credit, Relationship breakdown, Ageing Farmers, Reduced Workforce etc Referral, Early Intervention AAs + Training Symptom identification, Support, Communication, Empathy, Referral Risk of Suicide and/or Mental Illness 28/11/2018

Phase 1: Focus groups Farmers' representatives, Health professionals, and Agencies (Dept Primary Ind & Fisheries, Dept National Resources and Water, Qld Murray Darling Committee, Condamine Alliance, AgForce) 28/11/2018

Outcomes of Focus Groups Issues Raised pressure on rural landholders and their families incidence and significance of mental health issues impact on AAs and other staff initiatives to deal with mental health issues in rural communities and/or staff potential benefits and outcomes of training field staff Training should include latest data on suicide in rural and urban communities case studies Rural and urban differences in drug and alcohol use interpersonal communication empathy skills 28/11/2018

Phase 2: Training Selection of Advisory & Extension Agents Extension officers Landcare officers Financial counsellors Farming systems officers, etc Received 43 nominations from agencies 2 Groups: Group 1 (Experimental) Group 2 (Control) 28/11/2018

Training- MHFA course Sept 2007 March 2008 Sept 2008 Group 1 Pre assessment & Training Six month assessment Group 2 28/11/2018

Demographic profile Brief Info Group1 Group2 n % Sex- 8 9 47 53 4 11 Male Female 8 9 47 53 4 11 27 73 Age- below 25 25-34 35-44 45 and above 6 3 23 36 18 5 7 33 20 Work Experience- 5yrs > 5yrs 13 77 12 80 Exp Mental Health Problem Yes No 35 65 2 87 28/11/2018

Findings: Confidence in helping mentally ill people Group Pre Training Six month Confidence G1 2.53 3.18 t=-2.34, =.02 G2 2.40 3.22 T=-3.02, =.006 Combined G1&G2 2.47 3.19 t=-3.74, =.001 28/11/2018

Findings: Mental Health Knowledge (mean) Group Pre Training Six month Knowledge G1 5.94 10.06 t=-4.47, =.001 G2 6.16 10.33 t= -3.89, =.001 Combined G1&G2 6.03 10.15 t=-6.04, =.001 28/11/2018

Findings: Stigmatizing attitudes Group Pre Training Six month Stigmatized attitude G1 2.74 3.38 t=-7.302, =.001 G2 3.55 3.81 t=-.891, =.38 Combined G1&G2 3.22 t=-2.38, =.02 28/11/2018

Findings: Effect of age, sex work experience, prior experience to mental health Effect of age, sex and work experience Comparison by age (up to 40 and over 40 years) showed no differences (all  > .08) in any parameters Similarly there were no differences (all  > .10) according to sex or work experience (5 year or less or more than 5 years; all  > .20) Effect of prior experience to mental health Who had prior experience in mental health problem differed significantly at pre training in knowledge (t=2.92, =.007) and personal attitudes (t=-2.38, =.02) than those who indicated that they had no prior experience Post-training there were no significant effects 28/11/2018

Discussion Increased confidence in providing help to someone with mentally ill Improved the ability to recognise a mental disorder of people Increased knowledge about treatment –who to refer people to for help (seeking help, taking action and medication) Age, sex and work experience did not have any effect. Results are consistent with previous studies 28/11/2018

Conclusions The MHFA training is effective in enhancing mental health knowledge and skills of Advisory and Extension Agents. The agents who are a main line of contact of farmers are able to recognise mental disorders of people. They are more willing to work with a stigmatized people and know who to refer people to for help. 28/11/2018