Exploring Implementation Facilitators and Barriers in Youth Mental Health First Aid Training of Adults Working in Texas High Schools: A Community-Based Participatory Research Study

Background School staff are in a unique position to support student well-being. This study examined the facilitating factors and barriers to implementing Youth Mental Health First Aid (YMHFA), an evidence-based, one-day mental health awareness training intervention for all Texas high school staff, from the perspective of school decision-makers. Methods Using a community-based participatory research approach, academic researchers, community partners, and a community advisory board collaborated to co-design the study. Through semi-structured, in-depth interviews, we video-interviewed 11 key informants, who are school decision-makers responsible for staff mental health awareness training in nine Texas school districts spanning six regions. Thematic analysis was conducted using ATLAS.ti.(25). Results: All participants’ high schools had begun implementing YMHFA at the time of the interview. Two key facilitators for the implementation of YMHFA included having community partner support for funding and coordination to meet the legislative mandate. It was also stated that YMHFA is a well-known and respected EBI with several options for its course delivery. Two barriers identified relate to scheduling and logistical challenges for a large professional training, as well as the length and depth of the YMHFA EBI. Conclusion State funding and mandates facilitate the implementation of evidence-based, well-respected mental health awareness interventions, such as YMHFA. However, further implementation requires stronger coordination and innovation between community partners and educators within Texas high schools. More resources are needed in schools and communities to fully implement YMHFA training and promote mental health for students overall.