Mental Health First Aid: what it is and how to use it

TW: mention of suicide and  harm to others/self

 Just as there is physical first aid, which helps to provide basic medical care to another person who is experiencing an emergent health concern, injury or illness, mental health first aid helps to support an individual going through a mental health problem or crisis.

Learning more or getting trained in Mental Health First Aid is known to have several benefits for both the individual and community:

•         Improves knowledge of mental health conditions, by promoting a more accurate understanding and portrayal of mental illness and removing misconceptions and myths
•        Reduces stigma related to mental health by promoting more positive attitudes and behaviours towards mental health
•         Helps build confidence in speaking about mental health, and in turn building safer spaces for all to share their concerns
•        As anyone could be trained to provide first aid, it would help reduce the pressure on the existing health infrastructure (specifically, the severe shortage of mental health professionals in India) by building a better capacity for dealing with mental health concerns
•        It is probable that such training of individuals would not just impact that one person but create a ripple effect in raising awareness and literacy related to mental health
•        Help individuals know the support they can provide, and guide others towards appropriate recovery paths if the need arises, thus bettering access to healthcare services, and reducing the delay in treatment

How to provide Mental Health First Aid:

Even without specific training, you can learn more about the steps involved in mental health first aid to help friends, family, or others around you

1.             Know and recognise the signs of a mental health problem: While we may not know precisely what is going through someone’s mind, it is possible to become more cognizant of specific observable changes in behavior that are likely to be seen when a person is going through a difficult time:

• Withdrawal from social situations
• Withdrawal from activities that would generally interest them
• Irritability or aggression
• Sudden changes in mood, or mood swings
• Changes in sleep or appetite
• Facing difficulty in communication with others
• Drop in their performance at work or school
• Emotional outbursts
• Hearing or seeing things that aren’t present in that current time and space
• Reduced concentration, focus or facing concerns with memory
• Talking about causing harm to self or others
• Sudden changes in weight
• Signs of substance use or abuse

.. so on and so forth

Please take note that gaining knowledge of such signs is not enough to make a diagnosis of any mental illness (unless you’re trained as a mental health professional), but their observation can be used to initiate a conversation about another’s current state of mental health, and to urge them to seek proper help and support.

2.  Starting a Conversation: While it is best to allow space for the other to come speak with you, you may need to initiate the conversation at times. The following pointers can be kept in mind while doing so:

3. Providing Support: Several communication skills could be used and built on to create a safe space with the other person:

• Try to maintain a non-judgemental manner to what they share with you
• You may use the skill of ‘active listening’ to better attend to the other’s needs
• Do not attempt to solve all of their problems, or to overpromise. Being aware of your own boundaries, resources and mental health is as important as reaching out to the other person
• Do not provide advice unless asked for by the other person
• Express a sense of empathy for what they are going through
• Help validate their experience, and be cautious of trivializing or minimizing the same
• Treat their concerns with dignity and holistically – remember that any problem or illness is just one part of the individual’s life experience
• ·      Encourage them to seek further help, if needed
• It may be that the individual needs help beyond what you are able to offer presently. In these moments:
• Ask and confirm if they need help in managing their concerns
• If they respond with a ‘yes’, discuss all options that could be explored to see what will help them – talking about their concerns to their family, friends, guides, teachers or any other person they trust
• If not spoken about already, talk about the possibility of reaching out to a mental health professional 
• If the person communicates that they don’t want help, try to ask and understand their reasons for saying so, and clear out misconceptions or myths that may support said reasons
• If they still maintain their choice, do not try to persuade them. It would be better to respect their stance and let them know that they can contact you if change their mind
• You may need to take additional steps if you believe the person is at risk of harming themselves or others

Such steps could include:

1.     Any and all expression of thoughts relating to suicide, harm of self or others should be taken seriously.

2.     Ask the person directly if they are currently dealing with such thoughts and/or behaviours. Do not hesitate in using the word ‘suicide’

3.     Work with the person to make a space that enables them to speak about such thoughts, and the reasons behind them

4.     Do not leave them alone, particularly if they are is an imminent possibility that they might act on their thoughts

5.     Contact others who would be likely to provide further support to the individual – their family, friends, a emergency/crisis helpline (REDIRECT), or a mental health professional

6.     Know that if, despite your best efforts the person dies by suicide, the blame does not lie with anyone – you, the other person or others who attempted to help them.

——————————————————————————————————————————————————————————–

This article  includes opinions expressed by a mental health professional. But we were humans long before we trained as professionals, and so are always looking to learn better! If you found that any of the above is inaccurate, irrelevant or unhelpful, or would like to suggest ways to make this article more helpful in any way, please let us know in the comments below.