Many people know what to do if they encounter someone having a heart attack. They check for pulse and breathing, and administer CPR if necessary. CPR training is widely available.
Fewer people know what to do if they encounter a mental health crisis – someone who is suicidal, or in the midst of bipolar mania or a schizophrenic hallucination.
Carolyn Griess, assistant teaching professor in Penn State Harrisburg’s School of Behavioral Sciences and education, wants more people to know what to do. She is teaching a one credit course on youth mental health First Aid. While most of her students are working toward education degrees, the course is also open to the public.
The Mental Health First Aid Organization, which started in Australia in 2001 and now has programs in 25 countries, offers similar eight-hour classes in various locations.
According to the organization, the course, titled "Youth Mental Health First Aid," is designed to teach parents, family members, caregivers, teachers, school staff, peers, neighbors, health and human services workers, and other caring citizens how to help an adolescent (age 12-18) who is experiencing a mental health or addictions challenge or is in crisis. It introduces common mental health challenges for youth, reviews typical adolescent development, and teaches a five-step action plan for how to help young people in both crisis and noncrisis situations. Topics covered include anxiety, depression, substance use, disorders in which psychosis may occur, disruptive behavior disorders (including AD/HD), and eating disorders.
“Everybody should be trained,” Griess said. “Parents, friends, teachers, clergy, scout leaders, anyone who interacts with youth. Some schools train their janitors, their cafeteria workers.”
Kara Mancini, a senior elementary education major at Penn State Harrisburg, thinks the course will help her in the classroom.
“I did my residency at Middletown Middle School, and I know there were kids there going through a lot of the things we have been talking about,” she said.
Some students might be dealing with depression but don't know the words to describe it, Mancini said. She now knows to first make sure they are safe and not suicidal. Then ask them if they would like to talk about it, or let them know she is available to talk if they are not yet ready. She also would let them know there are options, such as speaking with a counselor.
“The class opened my eyes to behaviors that might indicate trauma,” she said. “Maybe there is an underlying problem at home we don't know about. [We shouldn’t] just jump to conclusions.”
While Griess' class is concerned with adolescents, there are similar courses for adults and for younger children.
Griess said the course emphasizes that first aiders do not diagnose a mental illness or treat it, but to render aid until more experienced help is obtained.
It is based on a five step action plan that goes by the acronym ALGEE.
A: for Assess. It's a way to help the first aider determine if the crisis is an immediate emergency that requires calling 9-1-1 or if a longer approach is sufficient.
For instance, if someone appears suicidal, the first aider should ask specific questions about the person's plans to harm themselves. Don't just ask “Are you OK?” because that hardly ever solicits a useful answer, Griess said. Instead, say something like “Tell me more.”
L: for Listening. Listen nonjudgmentally while staying calm. Even if someone is in the midst of hallucinations, don't contradict.
G: Give information and reassurance, but not advice. For instance, if a young boy says he's depressed because his girlfriend broke up with him, don't brush it off with “you'll have another one,” but acknowledge the pain that can cause.
E: Encourage appropriate professional help. Griess has done this with one of her students who was threatening to harm herself. She walked the student over to the University's counseling center and made sure she got an appointment. The first aider could help someone by searching online to find an appropriate therapist.
E: Encourage self-help and other support. Question them on what makes them feel better – Music? Running? Meditation? Ask them, “What soothes you?”
Griess said a focus of the course is to destigmatize mental illness. For that reason, she is willing to share about her experiences with anxiety and panic attacks.
“I'm open about my struggles,” she said. “That way we can hold each other accountable, we can ask, ’What can I do to help?' or ‘What do you need?’ It's such a difficult topic.”
To find local courses on mental health first aid, go to mentalhealthfirstaid.org and enter your location.