Mental Health First Aid

Thanks to Kalamazoo County Community Mental Health & Substance Abuse Services (KCMHSAS) for providing me with a full scholarship to attend this training, I went to an 8-hour Adult Mental Health First Aid course yesterday afternoon. According to their website, this course “teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders. The training gives you the skills you need to reach out and provide initial help and support to someone who may be developing a mental health or substance use problem or experiencing a crisis.”

The program was initially developed in Australia and has since been adapted for use in over 20 countries, including the United States. The main goal is to equip people with the tools they need to start a dialogue about mental health so that individuals who are in crisis can get the help that they need.

“Most of us would know how to help if we saw someone having a heart attack—we’d start CPR, or at the very least, call 9-1-1. But too few of us would know how to respond if we saw someone having a panic attack or if we were concerned that a friend or co-worker might be showing signs of alcoholism.

Mental Health First Aid takes the fear and hesitation out of starting conversations about mental health and substance use problems by improving understanding and providing an action plan that teaches people to safely and responsibly identify and address a potential mental illness or substance use disorder.” The Mental Health Action Plan utilizes the following acronym: ALGEE (pronounced like the word, “algae”)

  • Action A: Assess for risk of suicide or harm
  • Action L: Listen nonjudgmentally
  • Action G: Give reassurance and information
  • Action E: Encourage appropriate professional help
  • Action E: Encourage self-help and other support strategies

In the course, we learned the signs and symptoms of depression, anxiety disorders, suicidal behavior, non-suicidal self-harm, psychosis, and substance use disorders. We did a lot of group work, where we were given hypothetical situations and asked to use the Mental Health Action Plan to determine how to help the individuals in our case studies. We learned that the action plan is non-linear, meaning that you don’t necessarily complete all of the steps in order and you don’t have to complete all of the steps in each situation.

There were a dozen individuals in the class with me and the majority of them are social workers, but there were a few people who work outside of the mental health/substance abuse field, including business professionals, a college student and so on. I think that everyone found the course to be helpful. Much of the material seemed like common sense to me, but that may be because I have lived a lot of it. I found it interesting listening to people talk about the signs and symptoms. For example, we did an activity related to hearing voices (psychosis) in which we broke into groups of three and two people had a conversation with each other while the third person whispered into one of the other people’s ears. Everyone was shocked at how distracting this is but I have experienced auditory hallucinations, so I was not very surprised. I’m glad that it helped them to better understand what an individual that is hearing voices might be experiencing.

I think that the most important activity of the day was breaking into groups of two for role playing, having a conversation with a friend that we think might be suicidal, and asking them directly, “Are you having thoughts of suicide?” or “Are you thinking about killing yourself?” This activity is required in the course because how can we help someone who is suicidal if we can’t even ask them if we are? I had never said those words out loud and it was hard but we all did it and now I know that I can. I guess I just assumed that I would be able to do it before. We learned not to ask vague questions such as, “Are you thinking about harming yourself?” or “You’re not planning on doing anything crazy, are you?” because the individual may not see suicide as harmful or crazy. We need to be very direct. If the person says “yes,” there are four follow-up questions to ask:

  1. Do you have a plan?
  2. Have you decided when you would do it?
  3. Have you collected the things you need to carry out your plan?
  4. Do you have another plan?

I’m going to share two crisis resources here.

  • The National Suicide Prevention Lifeline is 1-800-273-TALK (8255). It is “a national network of local crisis centers that provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week.”
  • The Crisis Text Line is a 24/7 anonymous service for anyone experiencing any kind of crisis. Text 741741 or message them on Facebook and you will be connected to a trained counselor. If your cell phone plan is with AT&T, T-Mobile, Sprint, or Verizon, texts to 741741 are free of charge. If you have a plan with a different carrier, standard text message rates apply.

We covered a lot of material throughout the day, but we didn’t have to try to memorize everything because we were given a copy of the book, “Mental Health First Aid USA” to keep. It’s full of information about mental health conditions, plus statistics and vetted resources. KCMHSAS also provided us with a detailed resource list specific to our county.

If you’re able to attend a Mental Health First Aid training, I highly recommend it. Did you know that 19.6% of American adults (1 in 5) have a mental disorder in a given year? This is equivalent to 45.6 million people. These types of disorders can have a huge impact on their education, work, relationships, and health. Early intervention can greatly reduce the impact and first aiders can make a big difference by helping individuals that are in crisis to have their needs met. Can you imagine what the world would be like if we had as many people trained in Mental Health First Aid as we do in First Aid and CPR?

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Cause and Effect

On Wednesday morning, I was one of three first responders on the scene of a fatal car accident. If you need to stop reading right now, please do. I won’t describe much, but I know that these subjects can trigger unpleasant feelings in some people.

I was on my way to a business meeting with a potential gig venue and as I approached the street that my destination was on, I saw a truck parked in the ditch parallel to the road. This is common in the country, especially in the spring and fall, when farmers are out working the fields. As I slowed to make the turn and drove past the truck, I noticed that the front of it was smashed up and that there was another vehicle maybe 100 feet into the field, smashed and perpendicular to the road that I was about to turn onto.

I pulled over immediately. Another person did too. We jumped out of our vehicles. I checked the truck and saw that there was nobody inside. Another man stopped. We ran towards the other car. One man called 911. We met the driver of the truck at the other car. She was trying to help the woman who was inside. I knew when I saw the young woman in the car that there was nothing that we could do. She wasn’t breathing and didn’t have a jugular pulse. There was blood. Her airbag was deployed, the car horn blaring. The 911 operator asked us to try to get her out of the car. We tried in vain.

A young man drove up and ran out of his car. He knew the young woman and was distraught. He ran out into the field and wailed. I followed him, hugged him, held him tight. A fire truck arrived. More followed, then sheriffs and ambulance. At least 10 minutes of jaws of life, an eternity of CPR, the whole time hoping for a miracle.

Road blocked off. Young woman pronounced dead and covered with a white sheet. My worries shift the survivor. I don’t see her. She must have been taken to the hospital to get checked out. The damage to her vehicle and the other suggests hard impact. The survivor had told us that the young woman drove through a stop sign.

I answered the sheriff’s questions, then a firefighter helped me clean the blood off of my face and hands. An EMT cleaned up a cut on my finger. A trip to the ER was suggested, counseling mentioned, appreciation vocalized between everyone there for their help. As one firefighter us, he tells us that in many instances, nobody stops. This horrifies and infuriates me. In my mind, I  didn’t have an ounce of a choice. Yes, it was definitely going to make me late for my meeting. Yes, I might see something that will haunt me. No way in hell that I was going to drive right by without stopping to see if everyone was okay and if there was something that I could do to help.

I wish that there was more that I could have done. Having witnessed a lot of death in my lifetime, both animal (my pets and veterinary patients) and human (family), I am saddened by it but I also have a bit more experience with and understanding of it than most people. I’m also good at keeping a level head in emergency situations. No, I couldn’t save the young woman, but I did make sure that the other driver was okay. I made sure that 911 had been called and helped the others try to get the young woman out of the car. I comforted the young woman’s friend. I checked on the other responders and kept an eye on them, making sure that they were okay. I helped the other responders and the sheriff establish a timeframe for when the accident occurred. When I couldn’t do anymore, I noticed that I needed a bit of medical attention and I asked for help. I thanked everyone and when I thought that my presence was no longer needed, I asked if there was anything else that I could do. There was not, so I left.

I called and left a message with the woman who I had stood up for over an hour and then I drove to the meeting place. She wasn’t there, so I washed up in the restroom and ordered lunch at the bar. I noticed that I was shaking. I don’t know if this was a good idea, but I ordered a coffee and a coke with my brisket sandwich and collard greens. I made small talk with the waitress and a patron. I called work and let them know that I had helped out at an accident and would be a bit late because I needed to do some self-care in the form of comfort food. I took my time and then I drove to work. My coworkers were clearly concerned about me. I reassured them that I can handle being present in times of death.

BUT, I have had an inner dialogue slowly building girth in my head for some time. I drive almost 25 miles one-way to get to work and the commute was getting to me before this experience. That’s a lot of time spent in the car. And, truth be told, I don’t practice ideal driving skills. In an attempt to multitask, I make phone calls, answer texts, update my calendar, and check my emails and social media when I am driving because I feel like I don’t have enough time in my everyday life to take care of these things elsewhere. I could very easily end up like the young woman because of my distracted driving habits.

Everyone handles trauma differently. As an individual living with mental illness, I know that I have to be gentle with myself. I look within. This experience brought my talents, habits, and values to light. I realized that helping others (both human and animal) in times of great need is my superpower. I decided to change my bad driving habits and to look for a job that is closer to home and that allows me to utilize my superpower. On Friday, I gave my boss notice that I am looking for a different job. My phone goes in the glove box now.

When life throws you something that makes you think differently about your current situation, embrace the challenge! It can feel scary, but you will feel better in the end if you do what is best for you.