Background Mental health stigma-reducing and awareness trainings encourage trainees to talk about mental health with the hope that increased discussions will lead to reduced stigma and increased access to mental health services. This survey study aimed to examine the current levels of confidence among participants, or “first aiders” who completed the Youth Mental Health First Aid (YMHFA) training in their ability to demonstrate the skills that were taught in the training. Additionally, this study examined the difference in levels of confidence between the YMHFA instructors and first aiders in the ability of the first aiders to demonstrate the skills that were taught in the training. We examined differences in levels of confidence among first aiders according to their socio-demographic and personal characteristics. Finally, we explored the ways in which first aiders who completed the course used their knowledge and skills after the training. Methods Seven hundred fifty-seven first aider participants were surveyed post-training and 129 first aider participants were surveyed at follow-up. Fourteen YMHFA instructors were surveyed. Results The data indicated that there was a significant decrease in confidence among first aiders between post-training and follow-up. With the exception of age, there were no statistically significant differences in levels of confidence among first aiders according to the following sociodemographic and personal characteristics: a.) gender; b.) race; c.) reason for attendance; d.) role of use. Survey data also indicated the various ways in which first aiders are currently using their training. Conclusions First aiders’ confidence declined after follow-up even though they reported various ways in which they are using their training. Instructors reported positive perceptions of the training and reported a high level of confidence in the ability of their trained first aiders to demonstrate the taught skills.

To address the concern of school violence and mental health, the state of Florida implemented a statewide mandate requiring school personnel to be trained in strategies to identify and respond to the mental health needs of students. Existing research supports the effectiveness of Youth Mental Health First Aid (YMHFA), the training program selected by the Florida Department of Education to implement in public schools. To date, limited research has explored the implementation experiences of YMHFA trainers. This qualitative descriptive study explored trainers’ experiences implementing YMHFA within school settings. Semi-structured interviews were conducted with 18 YMHFA trainers employed in Florida public schools to explore how individual characteristics and system and organizational level supports and resources influenced the implementation of YMHFA training. Member checking was conducted with 22% (or n =4) of participants to verify shared experiences and perspectives. Two overarching themes were identified using a deductive thematic analysis approach guided by the Exploration, Preparation, Implementation, and Sustainment (EPIS) conceptual framework. In general, changes in the training certification process, lack of fidelity monitoring protocols, abrupt changes to training curriculum, limited guidelines on state mandate requirements, and the lack of communication, resources, and supports were perceived as barriers to implementation (Theme 1). Conversely, positive trainer attitudes, opportunities to practice skills learned, adequate resources, pro-mental health perceptions, and supportive working environments served as facilitators to YMHFA implementation (Theme 2). Study implications and future directions for research are discussed.