Mental Health and Migration: The Applicability of the Mental Health First Aid Program

This article reviews the establishment of a mental health literacy program – Mental Health First Aid – and its introduction among ethnic minorities and migrants. The text focuses on the program adaptations toward culturally more sensitive content and approaches. Based on the evaluation of the program by its users, the article summarizes their suggestions for further adaptations to their “cultural needs.” In line with the evaluations, the article discusses the shift from considering “only” the cultural dimensions of mental health toward reflecting structural vulnerabilities that affect lived experiences of migrants, including the contestable use of the literacy concept itself.
KEYWORDS: migration, mental health, mental health literacy, Mental Health First Aid, cultural dimension

This article discusses the establishment of the mental health literacy program Mental Health First Aid, initially designed in Australia and later transformed for the needs of ethnic minorities and immigrants. In shaping the program, its authors referred to health evidence about the poor mental health of certain social groups on the one hand, and the results of studies that confirmed that not seeking professional help and poor mental health literacy were the main reasons for their poor mental health and well-being. Since the Mental Health First Aid program is grounded in particular Western medical knowledge, the research question reads: What kind of knowledge is preferred to improve the literacy of people with mental health difficulties, including immigrants?
In this line, the article first shortly summarizes the circumstances of the Mental Health First Aid program’s establishment in Australia, which was designed to improve participants’ knowledge of mental health, certain common disorders (e.g., depres­sion, anxiety, substance abuse, self-harm, suicidal behaviors), and available treatment options. Further, the article focuses on the Mental Health First Aid program’s introduction in Aboriginal and immigrant communities. It soon became apparent that the general “one size fits all” approach was not appropriate. Therefore, the program was redesigned in terms of cultural relevancy, competence, and safety. Moreover, evaluation studies of such culturally sensitive programs implied that further adaptations of educational content and approaches were necessary to meet the particular cultural needs of these groups. These endeavors are illustrated by examples of the culturally adapted Mental Health First Aid for Aboriginal people and immigrants in various countries. Besides considering the importance of the cultural dimension of mental health in such programs, the article discusses historical and contemporary vulnerabilities that significantly affect the lived experiences of “culturally different” people with mental health difficulties. In this view, a culture is not only an observable circumstance of the program users but the program providers as well. Finally, such program adaptations question the concept of literacy itself, considering the practice of equal knowledge of the mental health of both the users and providers instead.