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First aid for psychiatric crises

January 1, 2008
by Lea Ann Browning-McNee
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The National Council is launching the Mental Health First Aid program

Betty Kitchener has been a nurse and health educator for much of her life, and she has taught more first-aid courses than she can remember. She has helped thousands of people recognize the warning signs of a heart attack, stroke, and other medical emergencies and prepared them to provide assistance.

Yet in the United States and much of the world, we are much more likely to encounter a person experiencing a panic attack or depression, or even contemplating suicide, than we are to encounter someone who needs us to perform CPR. Kitchener knows this firsthand: She has experienced depression—at times, severe.

A few years ago, she and her husband, respected mental health literacy researcher Professor Tony Jorm, teamed up to create Mental Health First Aid, a mental health “CPR” program under the auspices of the ORYGEN Research Centre at the University of Melbourne in Australia.

“The concept is really very simple,” explains Linda Rosenberg, president and CEO of the National Council for Community Behavioral Healthcare. “Mental Health First Aid applies a very familiar concept—CPR and first-aid training—to mental health situations, which often feel unfamiliar and uncomfortable to many in the public. The program positions mental health and addiction disorders alongside common health problems and then provides trainees with the tools they need to better support family, friends, co-workers, and others in need.”

The National Council is launching Mental Health First Aid in the United States early this year and expects to conduct trainings in a half-dozen communities during Mental Health Month (May). It is adapting the program and its materials for U.S. audiences, and this winter it will train its inaugural sites, which include behavioral healthcare provider organizations in California, Colorado, Florida, Illinois, and Rhode Island.

“National Council members are problem solvers in the communities they serve,” notes Rosenberg. “Mental Health First Aid gives them a new offering—an innovative tool—to reach out to policy makers, educators, primary care professionals, police and emergency responders, business leaders, and the faith community. The education and partnership opportunities within the community are limitless.”

Providing Key Skills

Mental Health First Aid is a 12-hour training course designed to give members of the public key skills to help someone developing a mental health problem or experiencing a mental health crisis. Participants learn a five-step process that teaches them to assess a situation, select and implement appropriate interventions, and help the individual in crisis connect with appropriate care.

The skills can be applied to a variety of mental health situations as well as medical crises. For example, the interventions for calming someone experiencing a panic attack align with the initial steps for helping an individual having a heart attack. The goal is to provide help and support rather than diagnose.

Participants also are introduced to the risk factors and warning signs of specific illnesses such as anxiety, depression, psychosis, and addiction; engage in experiential activities that build understanding of the impact of the illnesses; and learn top-line information about evidence-supported treatment options.

Supported by Research

“The research shows that Mental Health First Aid can potentially save lives,” says Rosenberg, “but it also changes the lives of both course participants and individuals they may interact with.”

Mental Health First Aid in Australia has been thoroughly evaluated using randomized controlled trials and a qualitative study, and has been found to be effective at improving participants’ knowledge of mental disorders, reducing stigma, and increasing the amount of help provided to others. One trial of 301 randomized participants found that those who trained in Mental Health First Aid have greater confidence in providing help to others, greater likelihood of advising people to seek professional help, improved concordance with health professionals about treatments, and decreased stigmatizing attitudes. Unexpectedly, the study also found that Mental Health First Aid improved the mental health of the participants themselves.

Rosenberg says that the substantive evidence behind Mental Health First Aid is one component of its appeal to the National Council and its members—and vows to maintain strict fidelity to the original, proven program. That promise means a lot to the behavioral healthcare provider organizations that will operate Mental Health First Aid in their communities.

“They are setting tight credentialing requirements and staying very true to the program's core content, which is so well-supported in research,” says Don Miskowiec, president of North Central Behavioral Health Systems, Inc., an Illinois-based center that is among the initial launch sites.

Increasing Mental Health Literacy

Health literacy has long been a public health focus in the United States, since an individual's health literacy directly impacts his/her ability to prevent and/or manage illness and disease. We know more than ever about the importance of diet and exercise, prevention activities, health screenings, and where to find credible health information. Yet much of that philosophy has not yet transferred to the behavioral health field.