Mental Health First Aid: psychology’s CPR

Middletown — Mary Botti gave her class a scenario: Someone in front of you is stressed, maybe having a panic attack for the first time. What do you say?

The students — adults from a variety of backgrounds — consulted a handout with sample responses.

Several hours into their two-day training, the class had little trouble identifying the problematic approaches to the problem (“I know exactly what you’re going through,” “You’ll get over it. You’ve just got to ignore it and get on with life”) and the better ones. (“I am concerned about you,” “Have you spoken to anyone about this?”)

The exercise was part of a training course in Mental Health First Aid, a program started in Australia that aims to give people a basic knowledge of mental illness and the ability to respond if they see a person who needs help.

Mary Botti

Instructor Mary Botti teaches her students how to properly respond to someone who is anxious or distressed.

Interest in the program has grown dramatically since the mass shooting at Newtown’s Sandy Hook Elementary School. As part of his response to the massacre, President Obama called for $15 million to provide Mental Health First Aid training for teachers and other adults who interact with youth. U.S. Sen. Richard Blumenthal, D-Connecticut, co-sponsored legislation that would fund the classes. And a bipartisan legislative panel crafting mental health policy changes recommended that Connecticut promote the training for teachers, school nurses, school counselors and other community members.

Some people liken it to CPR training: It won’t help you treat the condition, but you could assist someone while help is on the way. For teachers, it could help in determining when a student needs assistance, although it won’t tell those teachers how to manage mental health issues in their classrooms.

“It’s not going to make someone a clinician,” said Sheryl Sprague, an instructor at Rushford, a mental health and substance abuse services provider, where Botti’s class took place. “It’s providing information on how to provide early intervention, temporary assistance for someone who may be suffering from a mental health or substance-abuse disorder.”

Most people who have taken the classes through Rushford thought they’d use the training on recognizing and addressing mental illness in their professional lives.

“But they’ve found that they have actually utilized it more in their personal lives,” Sprague said, adding that she doesn’t know anyone who doesn’t have a friend or relative affected by mental illness.

The training is also aimed at reducing stigma.

“One of the most harmful things with mental health is that people fear it,” said Dr. J. Craig Allen, Rushford’s chief medical officer.

When someone starts to act unusual, it’s not uncommon for his family to pull back. A teenager might get teased. “It’s that isolation, it’s that lack of support,” Allen said. “You already feel horrible and now you feel bad about feeling horrible.”

Allen said it can make a big difference for people to know that mental illness is a disease, and that the symptoms aren’t character flaws or a choice. And he said it’s important for people to know that it can be treated, and that people can get better.

In any given year, about a quarter of American adults have at least one mental health disorder, according to the National Institute of Mental Health.

The 12-hour training includes information on the prevalence of mental illness and ways to recognize signs of disorders. In one exercise, class members drew pictures of a person experiencing anxiety. They showed people sweating, with bitten fingernails, rapid heartbeat, snacking or drinking alcohol.

Class members also got cards with a five-step “action plan,” abbreviated as ALGEE: Assess for risk of suicide. Listen non-judgmentally. Give reassurance and information. Encourage appropriate professional help. Encourage self-help and other supports.

Stephen Knight took the training as part of his role with the Wallingford medical reserve corps, a group of volunteers trained to help in disasters and other emergencies.

“The first thing I learned was how little I, frankly, knew about mental health,” Knight said.

Among the things he learned: How common mental illness is, how different the various conditions are, how far treatment has advanced, and how it’s possible for people to achieve stability and lead normal lives. “That was an eye-opener right there,” he said.

Before taking the class, Knight said, he’d probably avoid a person showing signs of a mental-health crisis. Now, he said, he would approach the person, communicating in a calm, deliberate way, sit with the person and talk or otherwise help before professional assistance arrives.

Dawn Roy

Instructor Dawn Roy

“Most people would say, ‘Oh man, get me away from this guy,'” he said. “I came away with … the confidence to say, ‘Ok, I know just enough that I’ve had this training, maybe I can help.'”

Elise Delacruz came into the class with more knowledge of mental health issues. She’s a sexual assault counselor at the Women and Families Center in New Haven, and expects to see signs of post-traumatic stress disorder in her clients.

But during a session on anxiety disorders, Delacruz was struck by how common they are — 18.1 percent of American adults have one. And she wondered if there are ways to determine if a client’s anxiety is more than a response to trauma.

“What’s a good tipping point where you could recognize that this anxiety is … more persistent?” she asked.

“If it’s lasting more than four weeks, if it’s really continually disrupting their social life or their work life,” Botti, the instructor, said.

Dawn Roy, another instructor, suggested showing people a list of symptoms of anxiety, showing how it affects the cardiovascular, neurological and respiratory systems.

“People come in and basically, they just know they feel bad,” she said. “But when you put it up there by category, it’s so helpful to people to say, ‘Wow, yes, I have that,’ and ‘Wow, I don’t have that, but wow, that’s what’s going on for me in my head.'”

Mackenzie Tyson, who manages a Middletown homeless shelter, said she came away with two main messages: People with mental illness should get the same accommodations made for people with physical illnesses or disabilities, like pre-boarding airplanes.

She also gained an appreciation for the importance of terminology. “You don’t say that person is schizophrenic. You say that person has schizophrenia,” she said, noting that the disease is not all a person is. When talking to someone with cancer, she added, “You don’t say ‘You’re cancer.’ You say, ‘You have cancer.’ It just makes sense.”

Follow Mirror health reporter Arielle Levin Becker on Twitter @ariellelb.