Witnessing a loved one, friend, or stranger under mental distress leaves many people at a loss.
“Certainly in my own experience I’ve seen people avoid talking to people they think might be mentally ill or having some kind of emotional crisis. Not because they’re mean, but because they don’t know how to talk to the person or they understand little about mental illness,” Linda Rosenberg, president and chief executive officer of the National Council for Behavioral Health (NCBH) told Healthline.
In an effort to change this, the NCBH announced this month the “Be 1 in a Million Campaign” with a goal to train 1 million Americans in Mental Health First Aid.
Offered in various community settings, Mental Health First Aid is an 8-hour course that teaches participants how to identify, understand, and respond to signs of addictions and mental illness.
The process is simple. People are taught how to approach family members, friends, or even people on the street who they think might be under mental duress. After that, they simply talk to them.
“Think of it like a CPR course for dealing with an emotional crisis,” Rosenberg said. “It teaches you what the different mental illnesses are, the signs and symptoms, and the skills to be an active and attentive listener, how to offer reassurance, and how to connect the person with local resources.
It’s not teaching you to do treatment and it’s not treatment, but it teaches you how to be a better informed friend, colleague, and relative.”
Developed in Australia in 2000, the program is currently available in 24 countries from Canada to Great Britain to Sri Lanka.
The course is taught by local instructors trained by the NCBH. It includes interactive tools, such as videos, role playing, and games.
The NCBH brought Mental Health First Aid to the United States in 2008.
This year it has dedicated $1 million to cut the cost of materials for the program in order to jump start more trainings as well as fund instructor scholarships with an emphasis on those who have experienced mental illness or substance use problems. The program will also offer grants to instructors who train people working in homeless shelters, call centers, and more.
For the past three years, Congress has supported Mental Health First Aid with funding that helps communities offer the course for free. This year, it included a $15 million appropriation for the program in the omnibus spending agreement released in December.
A Potential for Misuse or Abuse?
Spreading the word about mental health seems like a good thing, but can Mental Health First Aid be misused?
Rosenberg said it’d be hard to abuse the program.
“If I take a CPR course, I don’t go around accusing people of having a heart attack because they have indigestion,” she said. “It is not a screening tool for treatment. It does not teach psychotherapy skills, or the skill to prescribe medication.”
It’s an approach to help you talk to someone in a way that’s not judgmental, that isn’t offensive, that shows you understand they’re hurting, and informs you how to send them in the right direction for resources.”
Carol Landau, Ph.D., clinical professor of psychiatry at Brown University, Alpert Medical School, said the only negative she sees with the campaign is in realms that are out of the campaign’s control.
“It’s great to direct people to resources and crisis teams in their area, but who the crisis teams are vary by state and region,” she told Healthline.
She referred to the 1963 Community Mental Health Act, spearheaded by President John Kennedy. The act stated that the country couldn’t have a two-tiered system of mental health. That every American should have access to in-patient, out-patient, partial, emergency, and outreach services.
However, the act was de-funded in 1980, which means states no longer have to allocate money to these five services.
“As a result, these wonderful centers that we had were dismantled,” Landau said. “Today, if you call the emergency or crisis team that may mean the police not mental health professionals.
So we want to make sure that whoever the crisis team consists of is trained in the same way, [and] in some places they are.”
Lack of Services
The National Alliance on Mental Illness states that one in four Americans experiences mental illness in a given year.
Landau said that reinforces the idea that the biggest issue in mental health is lack of services.
“We all know that local community mental health centers are understaffed. In some communities, they’re so understaffed that they basically will treat people who have a severe and persistent mental disorder, such as bipolar disorder or psychosis, and the rest of the 25 percent of the country is left out,” she said. “With the Affordable Care Act, you have many more people covered for services, but we don’t have enough providers.”
Due to barriers to psychiatric services, Landau says primary care doctors are performing a lot of psychiatric services.
“They do a lot of diagnosis and referrals for depression, anxiety, and substance use, but more than half of them report that they have trouble finding psychiatrics and psychiatric services for their patients,” she said.
Still, Landau added that this doesn’t discredit initiatives like Mental Health First Aid.
“This program is great in showing people how to be supportive and understanding of mental health conditions like depression, suicide, and psychosis so that they can help those in need rather than ignore them,” she said.
Landau notes that one program that has had success with this type of intervention is the Samaritans.
“It’s a suicide hotline that is international and has trained people in a process they call befriending, which is a very similar model,” she said. “Only if a person is imminently in danger of suicidal behavior, as if they have a weapon or pills with them during the call and plan to use them, would the volunteer call the police to prevent a suicide.
But the rest is just supportive and helping the person decide what they can do. As long as initiatives are within that model, I don’t see any harm.”
To find a Mental Health First Aid program in your area visit http://www.mentalhealthfirstaid.org/cs/take-a-course/find-a-course/.