**2. Methods**

#### **2.1 Indima Yethu's pilot project**

Despite its growing popularity as a method of improving mental literacy and wellbeing, national uptake of MHFA in South Africa has been slow, as with other mental health related policies in the country. In the absence of a well-coordinated national MHFA strategy, guidelines, and agenda, the responsibility for mental health literacy has fallen on civil societies and communities. These organizations and communities design and pilot adapted MHFA training nationally, based on assumptions that are drawn from international research from the Global North, which leaves gaps in perceptions and understanding of the cultural appropriateness of MHFA training in South Africa. This paper examines the outcome of a culturally adapted version of MHFA in South Africa (which included spirituality and ubuntu values), implemented by a nonprofit organization, Indima Yethu. The current assessment of outcomes form part of a wider effort at building an evidence base of the utilization of YMHFA in South Africa, through a post-training feedback interview of MHFA participants in Cape Town.

#### *Mental Health – Preventive Strategies*

Since 2018, Indima Yethu has been working with children and young people (CYP) in providing participatory health promotion interventions and culturally adapted MHFA training. In view of the complex mental health issues facing the South African youth during and post-lockdown, the NPO developed a 13-week YMHFA program, for over 863 young people aged 18–34 years, across the Western Cape province in South Africa, to enable them serve as first responders to their peers who were in crisis.

The foundation to Indima Yethu's Youth MHFA program was laid for the first time by a needs assessment survey which revealed that a number of factors put students and young people at risk of writing – anxiety, panic attacks, paranoia, and depression. Among these factors are mismatched expectations, poor socioeconomic status, and uneven ratio of psychologists to students at various universities in South Africa.

Based on these, the goal of Indima Yethu's MHFA training program is to create an informal peer mentoring and mental health support group to fill the gaps.

Thus, working from an asset-based theoretical and a participatory health research framework, the MHFA training program provides a space where students and other participants are able to improve their writing skills and manage their mental health and that of their peers who have no access to professional support through shared narrative therapy or mental health first aid. The methods and intervention tools utilized by Indima Yethu are underpinned by research-backed philosophy that writing, journaling, and narrative therapy give coherence and increase mindfulness, while peer support is cathartic and eases anxiety. Thus, Indima Yethu's MHFA trainings were held online and offline (onsite at their Cape Town office) once a week for 2 hours each, over a 13-week period per session. The broader goals were summarized thus:

