Effects of Youth Mental Health First Aid (YMHFA) on South Asian American Adults Working With South Asian American Youth

The Mental Health Literacy Scale (MHLS) is a 35-item tool that assesses knowledge across a variety of domains related to mental health, including attitudes toward mental health and help-seeking behaviors. Items 1 to 10 and 13 to 15 are rated on a 4-point Likert scale from 1 (very unlikely) to 4 (very likely). Items 11 to 12 are rated on 4-point Likert scale ranging from 1 (very unhelpful) to 4 (very helpful). Additionally, items 16 to 28 are rated on 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree), with items 29 to 35 also rated on 5-point Likert scale ranging from 1 (definitely unwilling) to 4 (definitely willing). Overall, higher total scores indicate greater mental health literacy (better outcome).

The "Confidence in Helping Skills" 5-item measure will assess adults' confidence in applying the ALGEE steps (part of YMHFA training). Participants will indicate their level of agreement with each statement on a 5-point Likert scale ranging from 1 (strongly disagree) to 5 (strongly agree). Overall, higher scores indicate higher confidence in applying the ALGEE steps (better outcome).

Participants' intentions to engage in ALGEE will be measured using responses to two vignettes featuring a youth with depression and another with schizophrenia.

The responses will be coded using a checklist that scores each ALGEE action step using a 3-point scale from 0 (no mention or inadequate response) to 2 (specific details/actions). Overall, higher scores indicate greater intentions to engage in ALGEE (better outcome).

The Mental Health Service Use (MHSU) questionnaire will assess participants' utilization of mental health services within the past month, gauging the frequency of accessing these services for themselves and/or a family member. This scale consists of 9 items on a 6-point Likert scale ranging from 0 days accessing services to more than 10 days accessing services. Overall, the higher the score, the more services that have been accessed by participants (better outcome).

Engagement in actual MHFA behaviors (ALGEE) will be assessed through participants rating the frequency of their engagement in each ALGEE behavior on a 4-point Likert scale from 1 (never) to 4 (many times). Overall, higher the score indicates participants have engaged in ALGEE behaviors more often (better outcome).

Depression Anxiety Stress Scale (DASS-21) consists of 21 items across three subscales that measure symptoms of depression, anxiety, and stress. Participants rate the extent to which they experienced these symptoms over the past week on a scale from 0 (did not apply to me at all) to 3 (applied to me very much or most of the time). Overall, higher the score indicates greater symptom severity for participants (worse outcome).

The Barriers to Access to Care Evaluation (BACE v3) will assess barriers to mental health service utilization. The 30-item measure examines three categories of barriers; however, this study will focus on two categories of barriers (22 items): (1) stigma-related barriers and (2) attitudinal barriers. Each item represents a specific barrier that may have prevented, delayed, or discouraged individuals from seeking professional mental health care. Responses are rated on a 4-point Likert scale ranging from 0 (not at all) to 3 (a lot), with six items including an additional "not applicable" option. Overall, higher scores indicate the more barriers participants faced that may have prevented, delayed, or discouraged them from seeking professional mental health care (worse outcome).

Satisfaction with the YMHFA training will be assessed using a five-item intervention acceptability scale. Participants will rate these items on a 5-point Likert scale from 1 (strongly disagree) to 5 (strongly agree). Overall, higher the score indicates a greater acceptability of the training (better outcome).