Mental Health First Aid, as the National Council for Behavioral Health defines it, “is a public education program that can help individuals across the community understand mental illnesses, support timely intervention and save lives.” It is a skills-based training course that teaches participants about mental health and substance-use issues and the skills to help someone who they’re concerned about. The goal is to have a world where everyone has the first aid skills to support people with mental health problems. Since it began in 2000, it has evolved into a global movement. Mental Health First Aid courses are now available in over 25 countries, including the USA, UK, Australia, and India. Thus far, over 3 million people have been trained globally.
Why Mental Health First Aid?
Globally, 3 of the 6 leading disabilities are due to mental illness (depression, schizophrenia, and bipolar disorder). Mental illnesses are becoming increasingly common, and in countries like the USA and Australia as many as one in five persons has a mental illness or substance use disorder. Mental illness affects everyone across age, sex, and race. Up to 90% of people
being treated recover. Yet, nearly 70% go without treatment because they do not seek help, mostly because they don’t understand they have an illness or they simply don’t know where to turn for care and also because of the stigma associated with mental illnesses. Recognizing mental health and substance use challenges is not easy; hence it is important for everyone to understand the warning signs and risk factors. All too often, those in need of mental health services do not get them until it is too late (National Council for Behavioral Health, n.d.).
Family members, friends, and co-workers are the people most likely to notice when an individual’s behavior changes, but they usually don’t know what those changes mean or how to get help. Mental Health First Aid puts that information into their hands (Dayak & Cobb, 2013).
In mental health crises, such as a person feeling suicidal, deliberately harming themselves, having a panic attack or being acutely psychotic, someone with appropriate mental health first aid skills can reduce the risk of the person coming to harm. Mental Health First Aid gives people from all walks of life the confidence and skills to help a person in crisis.
There is also stigma and discrimination against people with mental health problems, which may be reduced by improving public understanding of their experiences.
Origins of Mental Health First Aid (Dayak & Cobb, 2013)
The Mental Health First Aid Program was developed in Australia by Betty Kitchener and Anthony Jorm in 2000. In 1997, Betty was working as a nurse and did first aid instruction for Red Cross after hours. Tony was working as a mental health researcher at the Australian National University in Canberra. The two often discussed why traditional first aid courses did not cover how to help people with mental health problems such as someone who is suicidal, having a panic attack, or out of contact with reality. They knew these problems were much more common than many of the physical health emergencies addressed in traditional first aid courses. This seemed a major omission.
Then one evening in 1997, they resolved to do something about this situation. They decided to start up a “mental health first aid” course as a community service activity in the city where they lived. They envisioned running one or two courses a year on weekends, and never saw it going any further than that. During the next few years, they discussed what the course might cover on many occasions. However, the time pressures of work and family life meant that they did not get further than that. The big breakthrough came in 2000 when Betty decided to reduce her paid work at the hospital and to work as a volunteer on getting Mental Health First Aid started. The rest, as they say, is history.
What is Mental Health First Aid?
Mental Health First Aid is an 8-hour course that teaches how to identify, understand and respond to signs of mental illnesses and substance use disorders. It explains about risk factors and warning signs of mental health concerns, makes one understand their impact and provides an overview of common treatments. Through role-playing and simulations, it demonstrates how to assess a mental health crisis; select interventions; provide initial help; and connect people to professional, peer and social supports as well as self-help resources.
Like traditional first aid, Mental Health First Aid does not teach people to treat or diagnose mental health or substance use conditions. Instead, the training teaches people how to offer initial support until appropriate professional help is received or until the crisis resolves.
Mental Health First Aid encourages early detection and intervention by teaching participants about the signs and symptoms of specific illnesses like anxiety, depression, schizophrenia, bipolar disorder, eating disorders and addictions.
Key Elements of Mental Health First Aid Course (Dayak & Cobb, 2013)
Mental Health First Aid course or program teaches participants to implement a five-step action plan, ALGEE, to support someone developing signs and symptoms of mental illness or in an emotional crisis:
- Assess for risk of suicide or harm—When helping a person in a mental health crisis, it is important to look for signs of suicidal thoughts and behaviors and/or nonsuicidal self-injury.
- Listen nonjudgmentally—The ability to listen nonjudgmentally and have a meaningful conversation with an individual requires skill and patience. Make the individual feel respected, accepted, and understood. The program teaches you to use a set of verbal and nonverbal skills to engage in appropriate conversations such as open body posture, comfortable eye contact, and other listening strategies.
- Give reassurance and information—Recognize that mental illnesses are real, treatable illnesses from which people can and do recover. Approach the conversation with respect and dignity for that individual and to not blame the individual for his or her symptoms. Mental Health First Aid teaches you helpful information and resources you can offer to someone to provide consistent emotional support and practical help.
- Encourage appropriate professional help—A variety of health and behavioral health professionals and interventions can help when someone is in crisis or may be experiencing the signs or symptoms of a mental illness.
- Encourage self-help and other support strategies—Individuals experiencing mental illness can use many strategies to contribute to their own recovery and wellness. These strategies may include exercise, relaxation, and meditation; participating in peer support groups; self-help books based on cognitive behavioral therapy; and engaging with family, friends, faith, and other social networks.
Mental Health First Aid instructors share information and conduct interactive exercises to help participants be prepared to act in the event of a psychiatric emergency. The course teaches participants how to interact with a person in crisis, how to protect themselves, and connect the person with professional help.
The program offers concrete tools and answers key questions like “What can I do?” and “Where can someone find help?” Participants are introduced to local mental health resources, national organizations, support groups, and online tools for mental health and addiction treatment and support.
Impact of Mental Health First Aid
As Wikipedia notes, a number of studies have shown that the people who are trained in mental health first aid showed improved knowledge, confidence, attitudes and helping behavior. A meta-analysis of data from 15 evaluation studies concluded that mental health first aid training “increases participants’ knowledge regarding mental health, decreases their negative attitudes, and increases supportive behaviors toward individuals with mental health problems”.
It is a low-cost, high-impact program that generates tremendous community awareness and support. Mental health first aid training has been included in the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidence-based Programs and Practices.
Mental Health First Aid is helping to change the dialogue—by demystifying mental illness; by helping us understand that mental illnesses are real, common, and treatable; and by showing people how to help people (Dayak & Cobb, 2013).
Dayak, M. & Cobb, H. eds., 2013. Mental Health First Aid, Special 5th Anniversary Issue. Washington, DC: National Council for Community Behavioral Healthcare.
National Council for Behavioral Health, n.d. Mental Health First Aid. [Online]
Available at: https://www.thenationalcouncil.org/about/mental-health-first-aid/
[Accessed 7 Oct 2019].