Mental Health First Aid Tuition Scholarship Application A scholarship to attend the Mental Health First Aid instructor training is a significant investment in the successful applicant. The tuition to become a certified instructor is $1,850 and requires a 5-day commitment to the training course. There are limited funds available for scholarship opportunities to assist in making MHFA available to areas via Instructor training. Transportation, meals not provided during the training, and lodging are the responsibility of the individual and/or the sponsoring agency/institution. Please note that upon completion of Mental Health First Aid (MHFA) instructor training you will be in a partnership with MHFA-USA that is dedicated to improving mental health literacy, reducing the stigma associated with mental health problems, and increasing the help available to the public. We expect a commitment from you as part of this process. In order to demonstrate that commitment you will be required to: Teach your first MHFA course within 6 months of training and teach at least three MHFA-USA courses per year. List ALL scheduled classes, even those that are closed to the public, on the MHFA-USA website. Present the current program in accordance with the course outline, objectives, and key messages, and materials provided upon certification: While instructors should add local resources, contact information, and examples, they cannot otherwise alter course materials in delivering MHFA to public audiences. MHFA-USA welcomes any questions or concerns relating to the fidelity of the program in community presentations. Use the online evaluation method or collect printed evaluations from each course participant to whom a certificate is issued. In order to standardize evaluations nationwide, instructors must use the standard course evaluation form provided in the teaching kit and on the Technical Assistance site. Instructors should maintain copies of all printed evaluations for one year. Report this evaluation information to MHFA-USA to ensure you are delivering the program on a regular basis and maintaining acceptable evaluations from participants, thus helping to evaluate how the program is received nationwide. Respect the privacy of course participants, colleagues, and others, including the responsibility to protect personal information when gathering information on registration forms or in submitting evaluations; or in gaining permission prior to sharing personal stories or experiences of others. 1 Mental Health First Aid Tuition Scholarship Application All items must be completed: Applicant Name: _____________________ ________________________________________________ Address (city, state, zip): _______________________________________________________________ Phone number: _______________________________________________________________________ Email address: ________________________________________________________________________ Please respond to the following questions. A detailed response is important as you will be competing with others for the funding: 1. Why do you need a scholarship to attend the MHFA Instructor training? 2. What are the demographics of your population to be served? 3. Have there been incidents within the past 12 months that present a case for MHFA implementation? 4. How does MHFA fit with other initiatives in your workplace/school/church/youth organization? 5. What is unique about your situation that will enhance your involvement in MHFA? 6. A MHFA class can serve from 15-30 participants. At the ends of your first year, how many individuals will you have trained in MHFA? How many will have been trained at the end of three years? 7. Each course participant that you instruct will need a MHFA manual and you will have printing and other training expenses. How will this be funded? 8. How will your workplace/school/church/youth organization expand MHFA over time? 9. What kind of administrative/leadership support will you have as a MHFA instructor? 10. What kind of peer support will you have for implementing MHFA? 2 Mental Health First Aid Tuition Scholarship Application 11. You must submit a detailed implementation plan for your first three trainings after completing the MHFA instructor training and a statement of how you will continue to promote MHFA training in your community. We recommend that you obtain tentative approval from civic groups, schools, youth-serving organizations, churches, and other social groups to establish a first-year schedule: (you may use the table below or provide in narrative form). a. Failure to offer the required three classes per year may result in action for repayment of any scholarship funds. b. Failure to complete three MHFA-USA courses per year (anniversary date) will cause decertification of your MHFA instructor status. Year One Implementation Plan Group or organization Location Potential dates Finally, feel free to include any additional information that will aid our understanding of how you will use MHFA to make a difference: Submission guidelines: In order to meet the deadline for approval, please submit the completed scholarship application along with your application to become a MHFA instructor or you may submit the scholarship application only to: MHFirst.Aid@dmh.mo.gov. For questions please contact Vickie Epple, Missouri Department of Mental Health, Division of Behavioral Health; 573-751-4942 or 800-575-7480 or Vickie.epple@dmh.mo.gov. 3