Traditional first aid courses are all about the body. Yet we’re more likely to encounter someone with a mental health problem than someone needing CPR.
Mention first aid and most of us think of resuscitation or dealing with injuries or burns. But what should you do if you encounter someone having a panic attack, behaving aggressively (perhaps because of alcohol or drugs), or appearing suicidal?
Mental health problems are very common, if not more common than a lot of the physical health problems people learn how to give help to. And there are wonderful things that can help. Once you know that, you really need to not just stand by.
Why mental health first aid?
1 in 3 adults will suffer from a mental health disorder in their lifetime.
Only 25% of people with a mental illness will seek treatment.
Psychiatric conditions rank as the leading cause after back problems of sick absenteeism and ill health retirement (more than 40% of ill health retirement).
Approximately 56% of people affected by HIV/AIDS are predisposed to mental health disorders. Prevalence of psychosocial distress amongst individuals affected by HIV/Aids is increasing.
Substance abuse including alcohol use among the teenagers is increasing.
The high levels of financial indebtedness and stress will make the situation worse as noted by increase in suicides.
How to help: some basics
- If you notice changes in a person’s mood, behaviour, energy, habits or personality, you should consider a mental illness being a possible reason for these changes.
- Let the person know you are concerned about them and are willing to help
- Use ‘I’ statements such as ‘I have noticed…. and feel concerned’ rather than ‘you’ statements.
What doesn’t help?
- Telling them to ‘snap out of it’ or ‘get over it’
- Being hostile or sarcastic
- Being over-involved or over-protective
- Nagging
- Trivialising a person’s experience by pressuring them to ‘put a smile on their face,’ to ‘get their act together’ etc.,
- Belittling or dismissing the person’s feelings by saying things like ‘You don’t seem that bad to me.’
- Speaking in a patronizing tone of voice
- Trying to cure the person or come up with answers to their problems
Dealing with a crisis
Mental health first aid doesn’t aim to teach people how to be counsellors or mental health professionals, but rather, like traditional first aid, how to keep others safe in some common crisis situations – either until professional help can be found or until the crisis is resolved.
Scenarios covered include what to do when someone:
- may be having a panic attack
- is severely affected by alcohol or drugs
- is in a severely psychotic state (has severe disturbances in thinking, emotion and behaviour)
- has had a traumatic event, such as being involved in an accident, assault, robbery or family violence
- is acting aggressively
- is having suicidal thoughts and behaviours
- is injuring themselves in a non-suicidal way
The guidelines taught for each scenario are developed by expert panels of professionals and consumer advocates, based on a rigorous analysis of research, and are regularly updated.
Reducing the burden
Research shows fewer than 50 per cent of people with mental health problems seek professional help. And of those that do, often it’s only because someone else suggested it to them. So mental health first aid has potential to significantly reduce the burden of mental illness on society.
Research suggests the training is having an impact – improving people’s knowledge and attitudes to mental health problems as well as the likelihood they would step in and offer help to someone in need.
Remembering what to do
In any first aid course, participants learn an action plan for the best way to help.
In First Aid for physical illness and injury, the mnemonic is DR ABC(D) – which stands for Danger, Response, Airway, Breathing and Compressions (Defibrillation). If the first aider determines the person is not fully conscious, the subsequent actions of ABC(D) need to be performed in that order.
Similarly, Mental Health First Aid has the acronym ALGEE to remind people of the action plan for someone in a mental health crisis or developing a mental health problem.
A: approach, assess and assist with any crisis the person is experiencing
When helping a person going through a mental health crisis, it is important to look for signs of suicidal thoughts and behaviors, non-suicidal self-injury, or other harm. Some warning signs of suicide include:
- Threatening to hurt or kill oneself
- Seeking access to means to hurt or kill oneself
- Talking or writing about death, dying, or suicide
- Feeling hopeless
- Acting recklessly or engaging in risky activities
- Increased use of alcohol or drugs
- Withdrawing from family, friends, or society
- Appearing agitated or angry
- Having a dramatic change in mood
L: listen non-judgmentally
It may seem simple, but the ability to listen and have a meaningful conversation requires skill and patience. Listening is critical in helping an individual feel respected, accepted, and understood.
G: give support and information
It is important to recognize that mental illnesses and addictions are real, treatable illnesses from which people can and do recover. When talking to someone you believe may be experiencing symptoms of a mental illness, approach the conversation with respect and dignity and don’t blame the individual for his or her symptoms.
E: encourage the person to get appropriate professional help
There are many professionals who can offer help when someone is in crisis or may be experiencing the signs and symptoms of a mental illness or addiction.
- Types of Professionals
- Doctors (primary care physicians or psychiatrists)
- Social workers, counselors, and other mental health professionals
- Certified peer specialists
- Types of Professional Help
- “Talk” therapies
- Medication
- Other professional supports
E: encourage other supports such as self-help strategies.
Individuals with mental illness can contribute to their own recovery and wellness through:
- Exercise
- Relaxation and meditation
- Participating in peer support groups
- Self-help books based on cognitive behavioral therapy
- Engaging with family, friends, faith, and other social networks
But these are principles to remember, not steps to be followed in a fixed order. The helper needs to be flexible about the order and relevance of these actions (although assisting with a crisis should be the highest priority). Listening non-judgmentally is an action that occurs throughout the giving of first aid.
Always seek emergency medical help if the person’s life is in immediate danger. If you have reason to believe someone may be actively suicidal, call Lifeline.
- Life Line National – 0861 322 322 – 24 H Crisis online help, counselling & referrals
- Suicide Prevention & Awareness
- +27 (0)51 444 5000 – Friends for suicide and crisis support
- +27 (0)11 783 1474 – SADAG – Support for Teenagers
- preventsuicidenow.com – Support group awareness and prevention
Mental Health First Aid South Africa is delivering courses which have been adapted to suit the South African context.
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