Date of Award

Spring 2026

Abstract

BACKGROUND: Paraprofessional staff in outpatient mental health clinics play a critical role in monitoring clients with serious mental illness (SMI) and supporting continuity of care in community-based settings. However, the absence of standardized training contributes to variability in staff knowledge, confidence, and ability to recognize early signs of mental health deterioration. Mental Health First Aid (MHFA) is an evidence-based training designed to improve mental health literacy and crisis response skills among frontline workers.

METHODS: This quality improvement project utilized a pre-post design within a Plan-DoStudy-Act (PDSA) framework at an outpatient mental health clinic. Paraprofessional staff completed the Mental Health Literacy Scale (MHLS) before and after MHFA training. A 30-day follow-up assessed changes in client appointment adherence. Descriptive statistics and a Wilcoxon signed-rank test were used to evaluate changes in MHLS scores, and qualitative feedback was analyzed using content analysis.

INTERVENTION: Paraprofessional staff participated in an MHFA training consisting of an 8- hour instructor-led session. A structured client check-in guide was introduced to reinforce application of MHFA principles during routine client interactions.

RESULTS: Of 25 paraprofessional workers, 10 completed the training, and 8 completed matched pre-post assessments. Mean MHLS scores increased from 115 (SD = 14.88) pre-intervention to 121.25 (SD = 15.11) post-intervention, reflecting an average increase of 6.25 points. Although improvements approached statistical significance (W = 5, p = .069), results were not statistically significant, likely due to the small number of participants. Appointment adherence showed mixed changes following the intervention, with completed visit rates remaining unchanged (80% to 81%) and no-show rates showing a statistically significant reduction (12% to 9%; p = 0.0014). Qualitative findings indicated increased staff confidence, improved communication, and enhanced recognition of mental health warning signs.

CONCLUSION: MHFA training was associated with improvements in paraprofessional staff mental health literacy and showed promising improvements in client appointment adherence. While findings were limited by the number of participants and short follow-up, results support the feasibility and potential effectiveness of structured training for paraprofessional staff in community mental health settings. Future work should examine long-term outcomes and scalability across similar programs.

Document Type

Clinical Doctorate

First Advisor

Marcy Doyle

College or School

CHHS

Department or Program

Nursing

Degree Name

Doctor of Nursing Practice

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