Most people are familiar with CPR. In fact, more than 12 million Americans are trained in CPR every year to appropriately respond in case of a cardiac emergency. But what do we do if someone is having a mental health emergency? According to Mental Health America’s 2017 report, one in five adults has a mental health condition. That’s over 40 million Americans, making it arguably more likely to come in contact with someone in an emotional crisis or with a mental illness.
Mental Health First Aid (MHFA), is a lesser known but equally important form of emergency assistance. It is a public education program that prepares people to respond to individuals experiencing a mental health crisis. Participants learn how to identify the symptoms associated with mental health disorders, assess for suicide risk, and encourage appropriate intervention or care.
MHFA has been around for over a decade and it is estimated to be as common as CPR by 2020. In honor of Mental Health month, this article puts a spotlight on MHFA as a catalyst for reducing stigma and improving mental health literacy throughout communities nationwide.
The Evolution of MHFA
MHFA was created in Australia in 2001 at the University of Melbourne where preliminary studies found that the training helped individuals expand their understanding of mental disorders and interventions and enabled them to gain confidence in crisis response and their helping abilities. It was later adopted in the United States and is currently overseen by the National Council for Behavioral Health (the National Council) and the Missouri Department of Mental Health. Over the years, MHFA has gathered a strong following from mental health advocates and coalitions across the country and public recognition for creating an ongoing dialogue about mental health and substance use.
Research demonstrating the benefits of MHFA continues to grow. As part of the training, instructors conduct pre- and post-tests, results of which not only highlight what individuals gain by taking the course, but also support the effectiveness that the program can have on the greater community. In 2013, MHFA was added into the Substance Abuse and Mental Health Services Administration’s (SAMHSA) National Registry of Evidence-based Programs and Practices (NREPP). While the literature strongly favors MHFA, past and current research focuses only on the training participants and not the individuals benefiting from the training participant’s gained knowledge, this creates an opportunity to explore this other perspective in future research.
MHFA has also been a vehicle for bringing awareness of mental health and substance use into the political arena. Mental health has become the focus of national policy discussions in the wake of tragedies such as Sandy Hook and San Bernardino. Recognizing the increasing need for training and support, former President Barack Obama in his national gun reduction proposal – Now in the Time – called for teachers and school personnel to have access to MHFA to better recognize the signs and symptoms of mental health disorders in young people and connect them with appropriate services. The initiative created the Now Is Time Project AWARE grant program aimed at improving behavioral health awareness among school-aged children and youth. In September 2016, Congress passed The Mental Health First Aid Act of 2015 (S. 711/H.R. 1877) authorizing $20 million in grant allocations for MHFA around the country. Political figures are also showing their support for MHFA by becoming certified. Former First Lady Michelle Obama is a Mental Health First Aider, as well as Former Congressman Patrick Kennedy, both of whom are advocates for increasing mental health literacy among youth and adults nationwide.
Meeting the Need
The primary curriculum for MHFA training is designed for adults. The pervasiveness of mental health conditions in adulthood has been identified. While access to treatment has increased in recent years, over half of all adults with a mental illness do not receive treatment.
Unfortunately, the statistics on youth and mental health are just as grim. One in five children ages 13-18 exhibits, or will develop, a mental health disorder; and suicide rates, particularly among adolescent girls, are on the rise. In late 2012, Youth Mental Health First Aid (YMHFA) was introduced. YMHFA teaches adults that work with adolescents (ages 12-18) how to recognize youth experiencing a mental health challenge or in a crisis. Recognizing the power of YMHFA, states are starting to require that foster parents become trained in MHFA as part of their licensing process. New Mexico is the first state to pass legislation on this front, and other states are looking to do the same.
In addition to MHFA and YMHFA, there are also training supplements geared towards specific populations, including: veterans, military members and their families; law enforcement, corrections, first responders, and other public safety professionals; college students; older adults; and individuals residing in rural areas. The tailored curricula build off the primary adult or youth certification courses to address unique service needs.
The numbers highlight how vital these training supplements are, the prevalence of mental health conditions among individuals who are incarcerated is undeniable. When we look at the criminal justice system, a reported 1.2 million individuals are living with mental health conditions every year. Given the current social climate, there has been a national focus on law enforcement’s response to responding to mental health and substance use issues, highlighting the need for increased education, training, and understanding. Many police departments are turning to MHFA. More than 80,000 criminal justice personnel have been trained in MHFA throughout the United States.
Another vulnerable service population to take into consideration is veterans. In 2014, a Department of Veterans Affairs study found that roughly 20 veterans a day die by suicide. Returning service members are at greater risk of developing a mental health condition or post-traumatic stress disorder. Female veterans experience higher rates of mental illness, as it is reported that one in five female veterans suffer from post-traumatic stress related conditions associated with military sexual assault. MHFA can help connect former service members and their families with the support that they need.
A Closer Look: MHFA Curriculum
The eight-hour session focuses on a five-step action plan designed to empower and equip participants to respond to individuals exhibiting a mental health crisis – ALGEE.
A: Assess for risk of suicide or harm
L: Listen non-judgmentally
G: Give reassurance and information
E: Encourage appropriate professional help
E: Encourage self-help and other support strategies
The course material covers a range of topics: prevalence of behavioral health issues, intervention strategies, and information and referral sources. The structure of the training creates a safe space for participants, allowing for interactive discussion and open dialogue. Role-playing emphasizes the importance of perception and language and enables participants to gain empathy and understanding, which is key in helping eliminate the stigma associated with mental health and substance use conditions.
It’s important to acknowledge that MHFA does not teach participants how to diagnose conditions or provide training on counseling or therapy techniques – these areas are left to qualified professionals with the appropriate training, education, and licensure.
Who should take this course? In short…everyone. MHFA is intended for the general public and can be applied in one’s personal or professional life.
The Power of Personal Stories
The stories of Mental Health First Aiders and instructors strengthen the case for MHFA. Even more powerful is the message of hope conveyed by Kevin Hines, a survivor of a suicide attempt. In sharing his personal struggles with mental illness, Kevin communicates the need for ongoing education and prevention efforts around mental health conditions, all the while underlining the importance of empathy and compassion.
COA recognizes that it is best practice for organizations to train their staff on identifying individuals and families experiencing a mental health crisis and highlights the research supporting MHFA in its standards. We asked staff that received MHFA certification to share their thoughts on the training – click the image below to view the
Join the MHFA Movement
At their annual conference this April, the National Council announced that one million people have been trained in MHFA nationwide. The National Council began spearheading the Be 1 in a Million movement in 2016, which is geared toward promoting MHFA training. At its core, the campaign aims to eradicate the stigma associated with mental health and substance use disorders and give individuals the confidence to recognize that they have the capacity to help. The reach of MHFA is visually displayed on Mental Health First Aid USA’s ALGEE-OMETER, which tracks the number of Mental Health First Aiders and instructors across the country, breaking them down by state.
Here are just a few ways that you can be part of the MHFA movement:
Take the MHFA Training Course
Want to be a Mental Health First Aider? Find a training course near you.
Educate Your Community about MHFA
If you have already taken a course and want to bring MHFA to your local community, check here for specific action items.
Become an Instructor
As an MHFA instructor, you are an advocate for opening minds and changing attitudes about mental illness and substance use disorders. MHFA utilizes a train-the-trainer approach and teaches instructors how to engage, motivate, and encourage empathy among trainees all while providing them with the knowledge that they need to step into action. Learn more about becoming an instructor.
Advocate for Policy Changes that Support MHFA
Ask your state or local representative to support legislative activity for the promotion of MHFA. Advocacy efforts can also be centralized locally; you can encourage school boards, first responder groups, or faith-based groups to educate themselves on MHFA to evoke positive changes in your community.
Okay, your turn! Have you been trained in MHFA?
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Would you recommend the course? If so, who would you recommend it to?
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Share your thoughts in the comments below!