INTRODUCTION

1. Mental Health Awareness is having a basic understanding of mental health issues.
2. Mental Health First Aid is the help offered to a person developing a mental health issue, in a mental health crisis or helping with an existing metal health issue. 

The four aims of mental health first aid are to:

• Preserve life where a person may be at risk to themselves, or others.
• Provide help to prevent the mental health issue becoming more serious.
• Promote recovery of good mental health.
• Provide comfort to a person with mental health issues.

Mental Health First Aid teaches people how to spot the early signs of a mental health issue, including warning signs of common mental health crisis, how to offer and provide initial help, listening to the issues concerned and how to guide a person towards appropriate help. Mental health first aid and support is given until appropriate professional help is received, or until the crisis appears to be resolved. There are many reasons why people need mental health awareness training as mental health issues are very common including stress, depression, anxiety, loneliness, the misuse of drugs, alcohol and the pressure people face via social networks and media. Research indicates that 1 in 4 people experience a mental health issue within a course of a year. Understanding how to recognise the symptoms of mental health and effective treatments are not widespread, and there are many common myths and misunderstanding surrounding mental health including: 

1. People with mental health issues are dangerous.
2. That they are weak.
3. That they avoid professional help.
4. That you can pull yourself out of mental health issues by sheer will power.

Lack of knowledge may result in people avoiding or not responding to someone with a mental health issue or not dealing with issues themselves. As a result, people may not know where to seek help, or what help is useful. Professional help is not always available, even when they seek help it may not be available to them straight away. The longer they have to wait without any help the longer the recovery. People with mental health issues will be more likely to seek help if someone close who recognises the signs suggests it. GPs, counsellors, psychiatrists and psychologists are not always available straight-away, so first aiders in mental health can offer immediate support and help.

Some mental health issues can cloud a person’s judgement and make it difficult for them to make informed decisions, therefore an appropriate mental health First Aider can facilitate appropriate help. In a mental health crisis situation, the First Aider's actions may determine how quickly the person with the problem gets help and/ or recovers.

In any first aid course, whether mental health or medical, participants learn how to help someone who is injured or ill. They learn an action plan to help them to remain calm, confident and respond in an appropriate way. This course provides a basic but effective action plan for non-mental health professionals to provide mental health first aid.

ACTION PLAN

This information provides an action plan on how to help a person in a mental health crisis or developing mental health issues. However, before they can provide any form of mental health support, mental health first aiders need some basic knowledge about mental health issues so that they can recognise that an issue may be developing. It is important that the first aider does not ignore the symptoms that they have noticed, or assume that they will go away, instead they should approach the person and ask if there is anything they can do to assist them

This is done by the following acronym: A.L.G.E.E.

IMPORTANT: Although the action of assisting with a crisis is the highest priority, the other actions in the mental health first aid action plan may need to happen first. Therefore these actions are not necessarily steps to be followed in a fixed order; they are lettered purely to help remember them. The first aider has to have good judgement about the order, and needs and be flexible and responsive to the person they are helping. Listening and communicating non-judgementally is an action that occurs throughout the giving of mental health support.

A.L.G.E.E

A. APPROACH - Approach the person, assess and assist with any crisis.

Approach the person about your concerns about their mental health, and try and find a suitable space where you both feel comfortable if the situation permits. Initiate a conversation about how they are feeling if they do not do so themselves. Respect the person's privacy and confidentiality.

L. LISTEN – listen and communicate non-judgementally.

Listening to the person is a very important step. It is important for a First Aider to set aside any preconceived ideas or judgements about the person or their situation. Any person experiencing distressing signs needs to feel he or she is being really listened to, and understood.

G. GIVE – Give support and information

Once the person with mental health issues has felt listened to, it can be easier for the first aider to offer support, help and information. This could include emotional support such as recognising and accepting the way the person feels and giving them hope for recovery, as well as offering additional information about mental health issues. But be mindful if the person wants this information at the time of the conversation, especially if they seem overwhelmed by distressing information.

E. ENCOURAGEMENT - Encourage the person to get appropriate professional help.

The Mental Health First Aider can also let the person know what options may be available to them by way of professional help and support. The Mental Health First Aider knows of various other options of help available such as medication, therapies, counselling or psychological therapy, complementary therapies, support from family members, assistance with employment and educational goals etc. Exploring options may also identify any barriers and reluctance the person may experience about accessing treatment.

E. ENCOURAGEMENT – Encourage other support and support networks.

The second encouragement in A.L.G.E.E. is to encourage and support the person to use self-help strategies. These strategies will allow people to make positive choices that put them back in control of their lives. Seek support from family, friends and others. Other people who have experienced mental ill health can also provide valuable help in the person's recovery. Other sources of support, in particular community and voluntary sector e.g. by providing alternative therapies, social inclusion or employment related support. 

IMPORTANT: After applying first aid to a person in distress you may feel worn out, frustrated or angry. It can be helpful if the first aider also has someone they can talk to about what has happened and how they felt. However, it is important to remember to respect the person's privacy, and never disclose names or personal details of the person they have helped.

Giving mental health first aid to someone from a different cultural background.

Being aware that a person’s culture might shape how they understand health and ill health, especially mental health. It is important to learn how mental health is described and accepted in the person's community, and being aware of concepts, behaviour and language which are taboo. Respecting the culture of the community by using appropriate language, and not doing anything that causes them to feel ashamed or embarrassed. Support the person’s right to make decisions about culturally based care.

EARLY WARNING SIGNS OF MENTAL ILL HEALTH IN THE WORKPLACE

It is important to understand how a mental ill health presents itself within the workplace. Once the signs are spotted, approaching the person at an early stage will help before the problems spiral out of control. Signs and symptoms may include:

• Decreased productivity
• Morale problems
• Lack of cooperation
• Absenteeism
• Frequent complaints of being tired
• Complaints of aches and pains
• Alcohol and substance misuse

Ideally mental health first aid training should be available to all employees and all line managers, giving them the skills, knowledge and confidence to support their colleagues and subordinates. Line managers play a crucial role in promoting positive employee wellbeing. As the workplace continues to evolve at a rapid pace, there is increasing pressure on line managers to deliver business objectives while at the same time supporting the wellbeing of employees. It is therefore vital that line managers receive the best possible training and support to help them manage these responsibilities effectively. There are also a number of additional strategies employers can pursue to support employee’s mental health:

• Placing confidential self-rating sheets in kitchens or cafeterias, break rooms to assess levels of staff wellbeing.
• Promoting greater awareness through employee assistance programmes.
• Consider mental health routinely through employer’s policies and procedures e.g Those relating to managing sickness and supporting them back to work or making reasonable adjustments.
• Ensuring workers' access to mental health services through health insurance benefits and structures.

MENTAL HEALTH ISSUES

Let’s now look at some common mental health issues, and we can help and support people suffering from these issues. Click on the appropriate links for further information:

FIRST AID FOR DEPRESSION

FIRST AID FOR ANXIETY

FIRST AID FOR SUBSTANCE MISUSE & VIOLENT BEHAVIOUR ALIGNED WITH SUBSTANCE MISUSE

FIRST AID FOR PEOPLE CONSIDERING SUICIDE OR SELF-HARMING

SKILLS FOR NON-JUDGEMENTAL COMMUNICATION

BUILDING A MENTALLY HEALTHY COMMUNITY

Recovery is about growing new skills to support wellbeing. It is about growing new and existing relationships to support at times of difficulty. As mental health first aiders we can all contribute in a million different ways to build a mentally healthy community and use these principles in our daily interactions by spotting the signs of ill health early. We can then cultivate and grow hope for recovery. In our workplaces we can familiarise ourselves with our legal responsibilities (Health & Safety at Work Act 1984 and The Equality Act 2010) to manage work related risks to mental health and to prevent people with mental health issues from being treated unfairly. And in our personal lives we can use A.L.G.E.E. to help someone we are close to, a family member or friend or someone more distant that we know through shared hobbies or activities. Not only can we support others towards more hope and greater resilience, but we can also do this for ourselves. Now that we have learned the importance of mental health and the warning signs of becoming unwell, we can become more mindful of our own wellbeing and steps we can take to promote it.