mental health first aid. the mental health first aid program was created by professor anthony jorm,...

Mental Health First Aid

The Mental Health First Aid Program was created by Professor Anthony Jorm, a respected mental health literacy professor and Betty Kitchener, a

nurse specializing in health education.

It has been slightly modified to meet the needs of the Mental Health Ministry at St. James Cathedral.

Similar to CPR and First Aid for emergencies of the body, the Mental Health First Aid Program was designed to help a person experiencing a

crisis of the mind and/or the spirit.

“Research has found that people trained in Mental Health First Aid have a greater

confidence in providing help to others, have a greater likelihood of advising people to seek

professional help, improved concordance with health professional about treatments, and

decreased stigmatizing attitudes. The study also found that Mental Health First Aid improved the

mental health of responder.”

-National Council for Community Behavioral Healthcare

The Mental Health First Aid Program incorporates the following general strategies into a plan of action for specific mental health related

situations or crisis.

Crisis of the Mind or Spirit• Experiencing a Panic Attack• Experiencing Severe Depression and/or

Thoughts of Suicide• Experiencing Hallucinations and Delusions• Experiencing Anger, Aggression, and/or the

Threat of Violence

If you feel that any situation is unsafe, do not get involved physically. Call 911

How to Respond when a Person is Experiencing a Panic Attack

Panic Attack: Sudden onset of intense

apprehension, fear, or terror.

The intense fear is inappropriate for the circumstances.

Physical symptoms include dizziness, shaking, nausea, increased heart rate, and hyperventilation.

The person feels there is impending doom and often fears another attack.

1. Assess for safety and risk of suicide or harm (person, others, and self)

• If you are unsure whether a person is having a panic attack, a heart attack, or an asthma attack, and the person is in distress, call 911.

• If you know that the person is having a panic attack, move person to a quiet, safe place

2. Express concern and willingness to help through this time

• Let person know they are not alone and you will stay with them until attack stops

• Help calm the person by encouraging slow, relaxed breathing in unison with your own. Encourage person to breathe in for 3- 4 seconds, hold for 3-4 seconds, and then breathe out for 3-4 seconds

• Encourage to breathe into paper bag

3. Listen non-judgmentally

4. Give honest reassurance, instill hope, and information

• This is a treatable medical illness• Many therapies and medications are successful in

reducing panic attacks• Panic attacks are temporary and will go away• Communicate positive expectations, offer options,

and allow person to make choices

5. Encourage appropriate professional

6. Encourage self-help and other support strategies to prevent future attacks

• Keep a list of contact names and numbers available.

• Talk to others, journal, meditate, or join a support group.

• Practice deep breathing, quieting response, or relaxation.

• Exercise, Walk, Laugh.• Avoid caffeine.• Avoid self-medicating with alcohol or drugs.• Take medication as prescribed by care provider.

Darkness into Light

How to Respond when a Person is Experiencing Suicide Thoughts

Suicide: Thoughts or attempts to take own life are believed by person as only way to stop overwhelming pain. Suicide is preventable.

Most suicidal persons desperately

want to live, and have tried to

communicate their pain to others.

Know the warning signs and take

all signs of suicidal behavior

seriously.

How to Respond when a Person is Experiencing Suicidal Thoughts

Warning Signs• Threatening to hurt or kill self or talking about wanting to kill self• Looking for ways to kill self• Seeking access to pills, weapons, or other means of killing self• Talking or writing about death, dying, or suicide• Expressing feelings of hopelessness, uncontrollable anxiety, rage,

or revenge• Engaging in reckless or risky behaviors• Withdrawing from family and friends• Expressing a lack of purpose and meaning in life, no reason for

living• Giving away personal items, changing a will• Loss of loved one, job, pet, home, independence

Myths About Suicide

Myth: Once people decide to die by suicide there is nothing you can do to stop them.

Truth: Suicide is preventable. People do not want to die, but see death as the only way to

end pain.

Myths About Suicide

Myth: People who are suicidal do not seek help. Truth: 75% of elderly had sought professional

help before committing suicide.

Myths About Suicide

Myth: Suicide always occurs without warning.

Truth: 8 out of 10 people who commit suicide have given definite clues and warnings.

Myths About Suicide

Myth: You should never ask people who may be suicidal if they are thinking about suicide.

Truth: Asking questions regarding suicidal thought or intentions won’t push

someone into doing something self-destructive. Your questions let the person know that you are hearing the seriousness of his/her pain, that he/she is not alone, and that you want to help. This may reduce the risk of suicidal feelings.

Myths About Suicide

Myth: The only effective intervention for suicide comes from professional doctors and therapists with extensive experience in the area.

Truth: Anyone can help.

1. Assess for the risk of suicide or harm (person, others, and self)

• Be alert for warning signs.• Ask direct questions. “Are you thinking about

hurting yourself?” “Do you have a plan?• If suicidal, stay with client and call for

professional help.

1-800-273-8255/TALK

• Immediately convey to the person that you care, you want to help, and that you will stay with them until help arrives.

• If this occurs over the phone, stay on the phone.

3. Listen non-judgmentally• Listen without judgment, criticism, or cliché’s. • Don’t lecture on the value of life.• Don’t appear shocked or appalled.• Never promise to keep someone’s suicidal

feelings a secret.

• Help is available.• You are not alone.• You are taking concerns seriously.• Unbearable pain can be survived.• Alternatives are available.• Depression is a treatable mental illness

5. Encourage appropriate professional help

6. Encourage self-help and other support strategies

• Talk to others, journal, pray, join a support group• Practice deep breathing, quieting response, or

relaxation,• Exercise, Walk, Laugh.• Avoid caffeine.• Avoid self-medicating with alcohol or drugs.• Take medication as prescribed by care provider.

How Would You Respond?

While working the phone line for the Mental Health Ministry you receive the following call. A young male voice says, “It’s over. Or at least it will be over soon. No one will know that I have gone. No one will care.” How would you respond?

How to Respond when a Person is Experiencing Suicide Thoughts

How Would You Respond?As you enter the church, you notice a young woman sitting in the very last pew. She is sobbing as she holds half of a bottle of wine in one hand and a bottle of medication in the other hand. As you approach, she pours all the pills from the bottle into her hand. What would you do? What would you say?

How to Respond When a Person is Experiencing Hallucinations and Delusions

Delusions are incorrect thoughts. A person experiencing paranoid delusions believes that someone is trying to harm, hurt, or control them.

Hallucinations are incorrect perceptions. Audio, visual, and tactile hallucinations are most common. Command hallucinations may order the person to do something harmful to self or another. Understand that delusions and hallucinations are very real to the person.

1. Assess for the safety of the situation before responding

• Stay visible to others, leave door open, no barriers between you and the exit.

• Do not stand directly in front of person who is experiencing agitation, hallucinations or delusions.

• To determine safety for self and client ask, “What are the voices telling you?”

• If the voices are cruel and harmful, call for professional help.

3. Listen non-judgmentally• Approach in a calm, relaxed and non-judgmental

manner.• Speak softly, gently, and with humility.• Allow personal space.• Try to get person to sit down, sit side by side.• Encourage the client to verbalize feelings.• Validate the feelings, but not the hallucinations

or delusions. “It must be frightening to hear voices.”

“I do not hear the voices, but I believe that you hear them.”

• Avoid raising your voice, confronting, arguing, or defending others.

• Avoid use of commands, sarcasm, or threats.• Avoid sudden movement, touching, constant eye-

contact .• To determine safety for self and client ask, “What are

the voices telling you?”• If the voices are cruel and harmful, call for

professional help.

• Mental Illness is a treatable medical illness.• Therapies and medications have been successful

in reducing and eliminating delusions and

hallucinations.• Communicate positive expectations, offer options,

and allow person to make choices.

6. Encourage self-help and other support strategies• Communicate positive expectations, offer

options, and allow person to make choice.• Talking to others, journaling, praying, joining a

support group.• Deep Breathing, Quieting Response,

Relaxation, Exercise, Walk, Laugh• Avoid self-medicating with alcohol or drugs.• Take medication as prescribed by care

provider.

• Mention methods that have been used by others to reduce hallucination

Listening to music Inserting earplugsSaying “STOP” to the voicesEngaging in relaxation techniquesEngaging in a pleasurable activityHelping othersAvoiding use of non-prescribeddrugs or alcoholTaking medication as prescribedby care provider

Mental Health First Aid Role Play

How Would You Respond?A young man is approaching the door of the cathedral. He is approximately 30-years-old and carrying a sign that reads, “Homeless & Hungry.” He is waving his arms in the air and appears to be talking to another person, but no one else is around. As he sees you he says, “Can you help us?” What would you say?

Coffee hour is interrupted when a young woman runs into the hall yelling, “Help me!” Hide me! This time is different. This time they will kill me!” What would you do? What would you say?

While visiting an elderly woman in her home, she joyously confides in you that she has been visited by angels. She states that the angels read, sing, and pray with her. Some days they even stay for dinner. How would you respond?

QuietSerenity

How to Respond to a Person Experiencing Anger, Aggression, or Violence

Anger is an emotional response to one’s perception of the situation and one’s inability to cope.

Aggression is a behavioral response which threatens injury to others. Feelings of anger and aggressive behaviors are caused by fear.

De-escalation is another way of saying “talking down” or “calming down” a person who is feeling out of control. The primary goal of de-escalation is to prevent violence. Remind self that angry feelings and aggressive behavior are based in fear.

1. Assess for safety and risk of suicide or harm (person, others, and self)

• Assess safety of the situation before responding• If you perceive that the person is violent, do not

get physically involved.• Call 911, ask for mental health crisis team and

plain-clothes policeperson.• Stay visible to others, leave door open, no

barriers between you and exit.• Do not turn your back, or stand directly in front,

of an angry person.

• Approach in a calm, relaxed and non-judgmental manner.

• Create a calm non-threatening environment.• Speak softly, gently, and with humility.• Express your willingness to determine and meet needs

of person.• Allow personal space, avoid sudden movement, and

constant eye contact.• Try to get person to sit down, sit side by side, avoid

touching.

3. Listen non-judgmentally• Avoid raising your voice, confronting, arguing, or

defending others.• Avoid use of commands, sarcasm, or threats.

• Communicate positive expectations, offer options, and allow person to make choices.

6. Encourage self-help and other support strategies to manage anger

• Talk to others, journal, or join a support group.• Practice deep breathing, quieting response, or

relaxation.• Exercise, work out feelings in acceptable ways• Avoid caffeine.• Avoid self-medicating with alcohol or drugs.• Take medication as prescribed by care provider.

During dinner hour, you observe a change in the young woman seated at the end of your table. Her voice is getting louder. Her language is becoming rude and obscene. When another guest requests that she lower her voice, she responds, “Mind your own damn business, you jerk.” Then she intentionally tips over the empty chair beside her. How would you respond?

How Would You Respond?During a friendly conversation that spontaneously occurred on the street in front of the church, the person you have been talking with becomes increasingly agitated. He clenches his jaw and both fists. He yells, “How in the hell can you possibly know what it is like to be homeless. You probably have a home, a family, and a job.” He moves closer to you, and is standing directly in front of you when he yells, “Get the hell off of my street.” What would you do? What would you say?

“In the next decade, we expect Mental Health First Aid will become as common as CPR and First

Aid. It has the potential to reduce stigma, improve mental health literacy, and empower

individuals- the benefits are limitless.”

-National Council for Community Behavioral Healthcare

MH First Aid Resources• MentalHealthFirstAid.org

• www.mhfa.com.au

• SAMHSA (Substance Abuse & MH Services Administration)

• CDMHP (County Designated Mental Health Professional)

• Treatmentadvocacycenter.org

• Crisis Line (24/7 – 206-461-3222)

• Suicide Hotline (1-800-273-TALK(8255))

• Suicidepreventionlifeline.org

• 911 (request assistance for mental health crisis)

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