Quick Take: Mental Health First Aid, giving first care

Mental Health First Aid is an eight-hour course that teaches how to help someone who is developing a mental health problem or experiencing a mental health crisis


By Dr. Judy Riffle

According to the National Alliance on Mental Illness (NAMI), the economic impact of serious mental health illness is a loss of $193.2 billion each year in the U.S. A Mental Health First Aid USA training on June 14, 2019 in Phoenix, Arizona, addressed the stigma of mental health disorders through interactive activities, videos and lecture and provided training in how to assist those suffering from mental illness.

“The Wall Street Journal calls Mental Health First Aid a fast-growing program that trains people to understand and respond to people in distress. Mental Health First Aid teaches about recovery and resiliency — the belief that individuals experiencing these challenges can and do get better, and use their strengths to stay well.”

Mental Health First Aid prepares participants to provide initial help to those experiencing depression, suicidal thoughts, self-injury, anxiety disorder, panic attacks, aggressive behaviors, psychosis, substance use disorders and eating disorders. (Photo/Judy Riffle)
Mental Health First Aid prepares participants to provide initial help to those experiencing depression, suicidal thoughts, self-injury, anxiety disorder, panic attacks, aggressive behaviors, psychosis, substance use disorders and eating disorders. (Photo/Judy Riffle)

More than 1.7 million Americans have been trained through this eight-hour course. Mental Health First Aid prepares participants to provide initial help to those experiencing depression, suicidal thoughts, self-injury, anxiety disorder, panic attacks, aggressive behaviors, psychosis, substance use disorders and eating disorders. The course was developed by Australians Betty Kitchener and Anthony Jorm in 2001. Participants receive a course handbook and a three-year certification.

Mental Health First Aid is helpful to first responders, government agents, educators, medical professionals and anyone who interacts with the public daily. This recent training was sponsored by the Arizona Department of Education and the Crisis Response Network and provided to education professionals and others under a 2019 Substance Abuse and Mental Health Services Administration (SAMHSA) grant.

Course goals for workplaces are:

  • Recognize signs of someone who may be struggling with a mental health or substance use challenge.
  • Reach out to someone who may be dealing with a mental health or substance use challenge.
  • Connect a distressed person with the appropriate resources in accordance with company policies.
  • Create a culture of health in the workplace.

Here are three key takeaways from Mental Health First Aid:

#1 Lesson one is understanding what it is like to have a mental health disorder

According to Crisis Response Network mental health first aid trainers, Shelby Graves and Beth Brady, “a mental health disorder affects a person’s ability to live, love, and laugh.”

"Research shows that when employees succeed in life, they succeed in their jobs. They are more productive, engaged, loyal and goal oriented."

Some of the course activities focused on eliminating mental illness stigmas/myths and on helping participants build compassion for those experiencing mental illness. For example, role playing involved talking with another person while a third person whispered things in your ear (i.e. “Don’t trust her”). Participants shared sad stories regarding family members or friends, and the course included videos portraying actors experiencing mental illness, which assisted in building compassion.

Instructors told participants to follow the “Vegas Rule” — all relayed stories stay in the classroom. This rule helped to ensure a comfortable, safe environment for sharing and learning. In addition, participants were encouraged to abstain from any activities that made them feel uncomfortable or upset.

#2 Follow the ALGEE Mental Health First Aid Action Plan

First aid courses generally provide an action plan and mnemonic such as CPR (chest compressions, airways, breathing) to help participants understand what to do for people during a medical crisis. Similarly, participants practice the Mental Health First Aid Action Plan through role play and other activities, represented by the acronym ALGEE as shown below in five actions. The ALGEE plan is evidence-based, along with all parts of the course and handbook.

  • Assess for risk of suicide and harm
  • Listen nonjudgmentally
  • Give reassurance and information
  • Encourage appropriate professional help
  • Encourage self-help and other support strategies

Instructors led participants in understanding how to use the ALGEE action plan through quizzes, illustrations, videos, scenarios and group practice activities. They reinforced important tips such as “It is best not to try to reason with people having delusions.”

For example, if a person is insisting aliens from outer space or police officers are after them, don’t judge them nor tell them that their thoughts are ridiculous. Keep following the above steps, stay calm, show compassion and help the person trust you.

Do use statements such as “You must be so scared” or “I’m concerned about you” to demonstrate compassion.

Don’t say things like “You’ll feel differently tomorrow” because you have no proof of that. “Pull yourself together” is also not helpful to tell someone experiencing a mental health crisis; that statement does not provide any solution or resource for them.

Of note, when assessing for risk of suicide and harm, a lay person is not equipped to distinguish between a panic attack and a heart attack under ALGEE. Since these two conditions exhibit similar symptoms, it is required that a medical or mental health professional distinguish between the two. A mental health first aid trainee assists the victim with initial care until professional help is available.

#3 Familiarize yourself with your community’s risks

Course instructors asked participants, “What do you see in the community that makes it important to take this course?” Participants responded that they see increases in suicide and depression rates in the youth they serve. Instructors encouraged participants to review their community mental health data, complete a comprehensive needs assessment and refer to the course handbook for more information and resources.

They offered the following statistics and tips to help participants understand common community health risks:

  • Death by suicide is more common for men, but women attempt suicide more often.
  • Mental health professionals advise not to use terminology such as “committed suicide” or “successful suicide.” There is nothing successful about suicide. Instead, use terminology such as “died by suicide.”
  • Anxiety disorder is the most common mental health disorder; 18.1% of adults suffer from it.
  • Anxiety disorders include posttraumatic stress disorder (PTSD), obsessive-compulsive disorder and phobias (source: NAMI).
  • Fifty percent of people experience one episode of anxiety or depression, and 50% have recurring episodes in their lives.
  • Physical symptoms of depression include headaches, nausea, weakness, heart palpitations, chest pain and shortness of breath. These symptoms are often reported to medical professionals first before any behavioral or psychological symptoms.
  • Victims of psychosis are much more likely to be victims of crime than they are to commit a crime.

About the author

Dr. Judy Riffle owns Santa Cruz Grants & Consulting, LLC, and has raised over 18 million dollars for various schools, school districts, and nonprofits. Funded and managed grants include school formula grants such as Title I, Title IV, IDEA Basic, and Title III LEP. Funded competitive grants include: McKinney-Vento Supplemental Education for Homeless Children & Youth, State Tutoring, 21st Century Community Learning Centers, school improvement, CA Community Colleges Basic Skills and Student Outcomes Transformation, New York Learning Technology, Arizona Pilot Program on School Emergency Readiness, USDA Fresh Fruit & Vegetable Program, USDA Distance Learning & Telemedicine Program, Baptist Community Ministries, Safeway Foundation, Tucson Electric Power, Cox Charities, Del E. Webb Foundation, and Arizona Disabled Veteran Foundation. Dr. Riffle is a former teacher, education specialist, new teacher mentor, and administrator with degrees in special education, Deaf education, and educational leadership. Besides being a member of the Grant Professionals Association, she also serves as Vice-President for the Green Valley Sahuarita Chamber of Commerce Foundation and has a special interest in school safety and mental health.

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