This study evaluated whether a mental health crisis response training course improved the knowledge, confidence, and attitudes of police officers, firefighters, emergency medical personnel, and public health staff who may encounter people experiencing mental health or substance use crises.

Participants attended a four-hour training course covering mental health laws, recognition and assessment of behavioral emergencies, crisis identification, the escalation of violent behavior, communication, and de-escalation techniques. Participants voluntarily completed an online questionnaire immediately before and after the course.

The study compared participants' responses before and after training to determine whether the course improved their understanding of mental health crises, confidence in responding to these situations, and attitudes toward people with mental health conditions or substance use problems.

This was an observational, single-group pre-post study conducted among personnel attending a mental health crisis response training program organized in New Taipei City, Taiwan. Eligible attendees included police officers, firefighters, emergency medical personnel, public health personnel, and other frontline staff involved in responding to mental health or behavioral emergencies. Participation in the research questionnaires was voluntary and was separate from participation in the training course. The study did not assign participants to receive the training or to a comparison group.

Before the course, participants who agreed to participate scanned a QR code and completed an online 32-item questionnaire. The questionnaire assessed knowledge and understanding of mental health crises, perceived confidence and self-efficacy in responding to behavioral emergencies, attitudes toward people with mental health conditions, and attitudes toward people with substance use problems.

The four-hour course included mental health legislation, initial and secondary assessment of behavioral emergencies, identification of mental health crises, recognition of the escalation of potentially violent behavior, personal and scene safety, communication strategies, and verbal de-escalation techniques. Immediately after completing the course, participants completed the corresponding online post-training questionnaire.

No personally identifying information was collected. Pre-training and post-training responses were compared to evaluate changes associated with participation in the course. Analyses included descriptive statistics and appropriate comparisons of pre-training and post-training measures according to the distribution and measurement level of each variable. Additional analyses examined whether participant characteristics were associated with training outcomes.

Inclusion Criteria:

• Police officers, firefighters, emergency medical personnel, mental health personnel, public health personnel, or other frontline staff attending the mental health crisis response training program organized in New Taipei City.
• Willing to participate voluntarily after reading the questionnaire information and participant rights statement.
• Willing to complete the online study questionnaire before and/or immediately after the training course.

Exclusion Criteria:

- No protocol-specified exclusion criteria.

The study population consisted of police officers, firefighters, emergency medical personnel, mental health personnel, public health personnel, and other frontline staff who attended a four-hour mental health crisis response training program in New Taipei City, Taiwan. Course attendees were invited to voluntarily complete online questionnaires immediately before and after the training. Participation in the research questionnaires was voluntary and was not required for attendance at the training course.

Individual participant data will not be publicly shared because the study used anonymous questionnaire responses, and the participant information process did not include consent for unrestricted secondary use or public data sharing. Aggregate study results may be published. Deidentified summary data or study materials may be considered upon reasonable request, subject to approval by the principal investigator, the institution, and the relevant research ethics committee.