“‘If you don’t calm down, I may need to call 911,’” Maharjan said, which escalated the situation. “He disconnected the phone and became more aggressive. When I called 911, he ran out of the classroom.” The student was in the throes of a mental health crisis.

Created by the National Council for Mental Wellbeing, the training empowers faculty members to recognize signs of mental disorders in students and to intervene in crisis situations until they can connect with professional help. While all CSU campuses provide vital Counseling and Psychological Services (CAPS) to students, faculty members are on the front line and are often the first to notice signs of trouble. Students may be reluctant to seek professional help due to the stigma surrounding mental health issues, confiding instead in a trusted faculty member.

That was the case for Gasior, who helped develop and deliver the training for Cal State Long Beach faculty as a Provost Leadership Fellow. In 2019, she received a CSU Faculty Innovation and Leadership Award recognizing her work. Ninety miles to the south at Cal State San Marcos, Strother, also concerned about student mental health, became certified and began conducting training sessions for faculty on her campus.

Data support a growing need for this critical training. Nationally, the suicide rate among persons ages 10-24 increased 57.4 percent between 2007 and 2018, according to the Centers for Disease Control. In 2019, suicide was the second leading cause of death for individuals in the same age range.

And a recent survey conducted by the Boston University School of Public Health reveals that a strong majority of faculty members – 87 percent – believe that student mental health has worsened or significantly worsened during the COVID-19 pandemic. Yet only about one in two – 51 percent – of faculty report that they “have a good idea of how to recognize that a student is in emotional or mental distress.”

Maharjan confirmed how difficult it can be to identify and respond to those distress signals. As a psychology professor, he notes, “I know the disorders, I know the symptoms,” he said. “But what if you’re a math instructor, a physics instructor or a history instructor? How do you talk to a student about a panic attack or suicidal ideation?”

MHFA training provides practical tools to do just that. The nine-hour course (two hours of pre-work followed by seven synchronous hours over two days) covers signs and symptoms and includes seven areas of mental health: anxiety, panic attack, substance use/overdose, suicide, psychosis and self-care; and a five-step framework to use when providing support to someone who may be in a crisis situation. The team facilitators — Gasior, Strother and Maharjan — also carve out time to talk about CAPS, the CSU Red Folder and other CSU-related resources.

And much like a first aid or CPR class, once training is complete, faculty members are equipped to intervene before symptoms escalate. “They can immediately apply the skills they’ve learned in the classroom, simply by changing their language, changing their approach from advising to listening nonjudgmentally,” Maharjan said.

Anya Iyengar, lecturer in communication studies at San Jose State, was able to apply those skills almost immediately. After completing the training in July 2021, she explained the MHFA training to her students. One student, an assault victim, “found the courage to confide in me … and I was able to guide and support her following her traumatic ordeal.” While afraid to be on campus, the student didn’t want to leave her community of friends, but her parents wanted her to transfer to a different school. “I would talk with her regularly for some time, via Zoom, phone or text,” Iyengar said. Eventually, the student began seeing a counselor, persuaded her parents to allow her to return to classes, now lives in an apartment with her friends and feels much safer, Iyengar said.

“The training helped me immensely,” she added. “I was so appreciative of the fact that this is available to students who have endured mental health concerns, particularly after the pandemic.”

Damien Wilson, Hamel Family Faculty Chair of Wine Business at Sonoma State University, completed the training in November 2021. “MHFA training made me aware of the signs of someone experiencing a mental health crisis,” he said. “Not only did MHFA training inform me of these indications, but I now feel confident that I can help someone experiencing a mental health crisis on campus to provide them with some of the supports to help themselves work through it.”

Strother points out that “the teaching faculty are not and should not be considered replacements nor stand-ins for our professional colleagues in CAPS. However, when working as part of a comprehensive team, we can support students in ways that best promote their well-being and success.”

Gasior agrees, noting that initially, some faculty were reluctant. “They would say, ‘We’re not counselors,’ to which I would reply, ‘We’re not asking you to be. Instead, consider the MHFA motto: ‘Listen, understand, and respond.’ If you walked into your classroom and a student was lying on the floor, would you stand back and say, ‘I’m not a doctor?’ No, you would approach that student and caringly ask, ‘Do you feel OK? Can I get you some water? What do you need? Where do you hurt?’” she said.

“Why is it that we are quick to intervene when someone is in physical distress but hesitate in mental distress situations?” Gasior said. “I suspect our own fears keep us from acting instinctually. MHFA training not only helps individuals with a mental health challenge, it also empowers us as allies. If you notice a student is having anxiety issues, it’s actually pretty easy to say, ‘Hey, I’m concerned about you. Let’s talk a little bit. What’s going on? How are you … really?’”

In early December 2021, faculty who had completed the training were invited to meet for a virtual refresher to review the five-step framework, learn how other faculty have used the training, share anecdotes and discuss possible steps they can take to affect change, including becoming MHFA instructors, on their own campuses, Gasior said. “I think faculty are very hungry and eager to talk about student mental health, about specific personal scenarios. They want input, they want advice, they want to talk about their experiences, all in the spirit of sharing and validation,” she continued. “The refresher was a powerful way for our Mental Health First Aiders to dialogue about student mental health beyond MHFA.”

Strother said she’s been surprised by how much faculty have been willing to reveal about themselves and some of their own mental health challenges (although the training doesn’t require anyone to divulge anything about themselves). “Being able to speak about mental health and mental illness in a supportive, stigma-free way is valuable to all human beings, faculty and students alike,” Gasior said.

Since its roll-out, demand for MHFA training has grown steadily. “Faculty have been so eager to get the MHFA training that the sessions have filled, with wait lists, almost immediately, each time we’ve launched a new one,” said Strother. Scaling up the MHFA will take time, however. Each training is capped at 30 faculty members when led by two facilitators; currently there are only three facilitators specifically trained to lead the faculty MHFA program in the CSU system.

Magruder, who has worked closely with Gasior and Strother to expand the program systemwide, said the current goal for the program is to continue building capacity by inviting those who have become certified in MHFA through the existing CSU trainings to become certified to facilitate trainings for more faculty.

“As we build capacity, we will continue to seek funding to expand the program, and we will consider whether to continue to offer this as a systemwide program or support campuses to develop their own programs, perhaps in collaboration with local (i.e., campus) counseling services and student affairs programs,” she added.

Strother, too, hopes to see the program expand. “From my own perspective, it would be ideal for each academic department on each campus in the CSU to have at least one person trained in Mental Health First Aid,” she noted. “In that way, students throughout the CSU would have ready access to someone with MHFA training, to serve as a resource and connect them with CAPS and other support services.”