Mental Health First Aid for NEMT drivers: the course, the cost, and the programs that ask for it

Mental Health First Aid (MHFA) is a course from the National Council for Mental Wellbeing that teaches ordinary people a five-step plan for supporting someone in distress until the right kind of help is available. Drivers carry riders to therapy, psychiatric visits, and treatment programs, and a few programs name this course for the crews who do it. The certification lasts three years. The driver training lists in Louisiana’s Medicaid manual, the Texas health plan handbook, and CareOregon’s manual do not include it, and Virginia’s fee-for-service requirements leave the course list to the broker. This guide covers the course, what it costs, and the rules that do ask for it. Ride types and secure transport licenses are in behavioral health rides, and the rest of a typical course list is in the driver training guide.

What does Mental Health First Aid teach a driver?

It teaches a five-step plan, called ALGEE, for noticing signs of a mental health or substance use challenge, giving first-level support, and connecting the person with professional help. For someone who is not in crisis, the steps can be used in any order.

• Approach and assess for risk of suicide or harm. Find a suitable time and place to start the conversation, keeping the person’s privacy and confidentiality in mind.
• Listen nonjudgmentally. Let the person share without interrupting, and be accepting even when you do not agree.
• Give reassurance and information. After the person has talked, offer hope and useful facts.
• Encourage appropriate professional help. Earlier help improves the chance of recovery, so offer to help the person learn the options.
• Encourage self-help and other support strategies. Help the person name their support network, community programs, and a self-care plan.

The limits are as important as the steps. MHFA says the course is not a replacement for professional help, that a First Aider does not diagnose or provide therapy, and that it is not a substance use recovery program. Its own guidance says the First Aider’s role is to give support and information, not to solve the problem.

Which version of the course fits NEMT crews?

Adult MHFA fits drivers and dispatchers who work with adult riders, and Youth MHFA fits crews who carry teenagers. Colorado’s rule below names both.

• Adult MHFA. A full-day course on helping people 18 and older. Topics include anxiety, depression, psychosis, and substance use.
• Youth MHFA. A full-day course for adults on helping young people aged 12 to 18. Topics include anxiety, depression, eating disorders, bullying, social media, substance use, and ADHD. MHFA lists health and human services workers among the people it is for.
• Older adults. A full-day Adult MHFA version for people who work with or care for older adults, including caregivers and nursing home workers.
• MHFA at Work. A separate set of company courses. Its Certification course runs four hours and is aimed at recognizing and helping coworkers, and participants leave as Mental Health First Aiders. The programs below name the Adult and Youth courses or an equivalent, so confirm with the program before substituting this one.

MHFA also lists versions for public safety, fire and EMS, corrections, and other groups. None is written for passenger transportation.

How long is the course, and what does it cost?

The course takes a full day in person, or two hours of self-paced online work plus a half day with an instructor, held online or in person. Prices are set by the instructor who teaches it, not by one national fee.

• Price. MHFA does not employ its instructors, and each one sets fees. They vary with the course type, the instructor’s qualifications, the venue, the location, and catering. Community grants can lower them.
• Groups. MHFA certifies 6 to 30 people at a time through private training, quoted individually. For companies with 1 to 250 employees, on-demand and live employee trainings start at $29.95 per person.
• Recertification. $30.95 per person, online, in under 60 minutes. The certification is valid for three years, and MHFA emails the First Aider when it expires. Retaking the full course is the other option.

Which programs name Mental Health First Aid?

Colorado, Minnesota, and Tennessee name it for crews on specific kinds of trips, and Minnesota’s general special transportation rule puts the topic inside its first aid course.

• Colorado secure transportation. Rule 6 CCR 1011-4, section 7.7, effective August 14, 2022, has counties set training for all staff with direct client contact. Staff who provide direct client support also complete “Adult and Youth Mental Health First Aid as offered by educational institutions or by professional organizations such as mentalhealthfirstaid.org, or the equivalent,” along with first aid, CPR, and training on caring for clients with substance use disorders. All of it comes before the person provides service and repeats annually “or as recommended by the relevant training organizations.” The service records each person’s compliance and makes it available to the county on request.
• Minnesota protected transportation. The state human services department’s standard, revised April 18, 2025, says drivers and attendants need at least six hours of training from the options it lists: a Crisis Intervention Team course, Mental Health First Aid, or another formal program in de-escalation. A mental health crisis team member who completes the 40 hours of annual training required of that role has met the standard. The protected transport entry covers the vehicle rules.
• Minnesota special transportation service. Rule 8840.5910, subpart 4, requires a first aid or emergency-care course of at least four hours for every driver and attendant. The course must include “mental health first aid, including recognizing signs of a mental health emergency or panic attack,” and the three-year refresher repeats it (subpart 9). The rule asks for the topic inside a first aid course, not for the MHFA certification.
• Tennessee mental health transport. The state’s grant manual covers sheriffs who subcontract the transport of people in mental health crisis. A third-party agency’s staff who deal with patients must maintain proof of completion of Mental Health First Aid, and Crisis Intervention Training is highly recommended. These are not routine Medicaid rides.

Your broker’s own driver training list is the other place to check. Louisiana’s manual lists defensive driving, CPR, child restraints, wheelchair securement with PASS, and HIPAA. The Texas handbook lists passenger assistance, passenger safety, assistive devices, defensive driving, and sensitivity training. CareOregon lists first aid, CPR, defensive driving, and a passenger service course. Virginia’s fee-for-service requirements point to the broker’s own training program. None names a mental health course.

What should a driver do when a rider talks about hurting themselves?

Call 911 when the rider may harm themself or others. MHFA’s guidance is to call 911 immediately if the person is thinking about harming themself or others or is acting erratically, and to tell the dispatcher that responders with training in mental health or crisis de-escalation are needed.

For a rider in distress who is not in immediate danger, the 988 Suicide and Crisis Lifeline gives 24-hour support by call, text, or chat, according to the federal Substance Abuse and Mental Health Services Administration. A driver is not a clinician. The role the course teaches is to listen, stay calm, and help the person reach professional help.

The order of calls to dispatch, the incident report, and how to end a ride safely are in the guide to difficult and unsafe riders. Keeping a rider’s information private on the radio and in the van is covered in HIPAA for NEMT providers.

Keeping proof of the training

Keep each driver’s certificate of completion in the driver file with the three-year expiration date. MHFA issues a new Certificate of Completion after the online recertification course. Colorado expects the service to record every staff member’s compliance and show it to the county on request, and Tennessee’s manual says staff must maintain proof of completion. A training log holds the course, date, and instructor in one place.

Tracking the course in HealthRide

Add Mental Health First Aid to each driver’s record as a certification with its three-year expiration date. A reminder goes out ahead of the date, and a lapsed certification is flagged to dispatch before that driver is given a trip. Certifications sit with each driver in fleet and credentials.