What’s The Mental Health First Aid Algorithm?

Mental illnesses affect the major section of the population in the USA and Canada, including both adults and youth. According to the National Institute of Mental Health (NIMH), more than 46 million people, almost one in five US adults, live with mental illness. Unfortunately, mental illnesses reflect a grouping of disorders that can be difficult to recognize. The diverse set of symptoms and ongoing stigma surrounding mental health force millions of people to sweep their illnesses under the rug. When a crisis arises, actions and thoughts become erratic and present a risk. However, the application of Mental Health First Aid can make all the difference in the world.

Mental Health First Aid is a relatively new approach to caring for those with illnesses that lack visible symptoms. When someone experiences a crisis, the public may not know how to respond. In a sense, each person, including strangers and acquaintances, may become a first responder of sorts to those in need, performing life-saving care. Health care professionals need to understand mental health statistics, the impact of First Aid for mental health, why it was developed and how to respond to mental health emergencies.

Mental Health Disorder Statistics and Prevalence

Mental health illnesses affect millions of people in the USA and around the globe. Unfortunately, mental health disorders affect all demographics, but the prevalence varies. According to the National Institute of Mental Health (NIMH), key statistics include:

• Members of the LGBTQ community are twice as likely to suffer from mental health disorders, including 11% of transgender individuals that have reported being denied for basic mental health services.
• LGBTQ youth have two to three times more likely to attempt suicide.
• Up to 11.3% of white males and 21.5% of white females rely on mental health services.
• Asian individuals have the lowest rates of using mental health services, (4.4% of males and 5.3 of females).
• One-half of chronic mental illnesses begin by age 14.
• Almost one in 25 Americans live with a serious mental illness.

Two additional statistics are even more frightening:

• Suicide rates increased 33% between 1999 through 2017, notes the Centers for Disease Control and Prevention (CDC).
• Suicide is the 10th leading cause of death for all ages in the U.S., the second leading cause of death for those aged 10-34 and the fourth leading cause of death for people ages 35-54.

Due to the high prevalence of mental illness and the sharp rise in suicide rates, people need a way to intervene before a crisis takes a turn for the worse. This is where Mental Health First Aid comes into play.

What Is Mental Health First Aid

Betty Kitchener and Anthony Jorm developed Mental Health First Aid in 2001 as a way to help educate people on mental health crisis management and improve public safety, notes Mentalhealthfirstaid.org. While a massive marketing campaign focused on educating people about how to respond to someone choking or experiencing cardiac arrest, little had been accomplished in the way of caring for those with a non-traditional emergency, such as mental health crises.

Unfortunately, horror stories and blame games litter news outlets when someone in the grip of a mental health crisis leads to tragedy. However, mental health first aid dispels the myths surrounding mental health crises and provides a framework that people can use to help those unable to help themselves.

This innovative form of first aid focuses on hidden, non-visible illnesses. Someone suffering a traumatic event, grieving, panic attacks, delusions, paranoia and other issues needs more than treatment of scrapes and bruises. They need someone to intervene. The Mental Health First Aid algorithm is the intervention tool that will help people in mental health crises survive.

Who Benefits From the Mental Health First Aid Algorithm

Becoming certified in this form of First Aid offers key benefits to many people, including:

• Those living with mental health disorders
• First responders, including police officers, emergency medical services, firefighters and others
• Health care professionals
• Educators
• Public safety officials

With mental health illness rates affecting 20% of the population, chances are good that you or someone you know will encounter another person living with a mental illness. Although the severity of mental illnesses may vary, a time of crisis is no time for uncertainty. In addition, those certified in Mental Health First Aid will save lives, either by preventing suicide or even homicidal behaviors and actions that may arise from a severe crisis. There is no excuse for failure to complete training to care for those suffering in mental health crisis.

 Indicators of Someone in Need of Help

The biggest factor in deciding whether to apply the principles of Mental Health First Aid or contact first responders is recognizing when an emergency exists. For the purposes of this discussion, all mental health crises are emergencies. However, contacting emergency services first is not always the proper solution.

For example, contacting EMS might seem ideal, but ill-informed responders could exacerbate the situation. Instead, those with the proper training to recognize the indicators of a mental health crisis could intervene and share information with EMS or respond themselves. Obviously, anyone threatening self-harm or harming another person warrants an immediate call to emergency services.

The indicators of someone experiencing a mental health crisis may include:

• Isolationist behaviors, including a fear of the outdoors, unwillingness to respond to phone calls or inquiries, the buildup of trash outdoors, failure to check the mail and more.
• New signs of hallucinations, such as talking to oneself, focusing intently on something that is not there, or continuously swatting at their skin.
• People that express a flight of ideas during the conversation, jumping from one point to another.
• Poor personal hygiene and an unkempt appearance.
• Alcohol and drug abuse, which constitute mental health disorders in and of themselves.
• Erratic behaviors or mood swings, such as those displayed by individuals suffering a manic episode.
• An accusatory stance or statement, such as accusing a person of “not minding their business” when the prior indicators exist.

In addition, recognizing the warning signs of suicide, as explained by NAMI, warrants intervention with Mental Health First Aid as well. These signs include:

• Giving away personal property.
• Dramatic changes in behavior or personality.
• Making negative remarks about oneself.
• Recent failed romantic relationships.
• History of suicide or self-injurious behaviors.
• Sudden cheerfulness or contentment following a period of despondency.
• Preoccupation with death.
• Making or changing a will suddenly.
• Stocking pills or obtaining a weapon.

How to Respond to a Mental Health Crisis

Mental Health First Aid follows a five-step mnemonic, ALGEE, to help people intervene when someone experiences a crisis. These steps include:

1. Assess the Situation

Assessing the situation mirrors recognizing when someone is in crisis. Recall substance abuse is a mental health disorder; entering withdrawal increases the risk of experiencing a crisis by 25%.
While a person may recognize the signs of someone in crisis, it is equally important to assess the situation for safety. This follows the same pattern of safety assessment in providing any other form of life-saving care. After all, a person cannot help if the scene is unsafe. Unfortunately, engaging the ALGEE mnemonic requires a level of trust and willingness to respond.

In other words, assess the person’s actions based on visible observations and interactions. If the person does not appear to demonstrate immediate danger to themselves or others, continue to step two.

2. Listen Non-Judgmentally

The second step involves an unparalleled level of restriction of judgment. Those experiencing a mental health crisis may speak of countless issues and appear suspicious of your actions. As a result, those responding should maintain an open body posture, including:

Maintaining appropriate eye contact. Remember not to stare or make sudden eye movements. Your actions will be criticized and scrutinized by someone who may lack the capacity to understand your intent.

Be mindful of body language, such as keeping your hands and posture relaxed. Avoid crossing your arms; show compassion in your dialogue.

Let the person in crisis lead the conversation at first. This builds rapport and trust.

3. Give Reassurance

After hearing a person’s concerns, take the next step; reassure the person. For example, “I understand you are worried about…”

This simple way of reiterating a topic will show the person you have been listening. In addition, make a personal connection, such as “I understand why you feel as though…”

Offer practical assistance to things you can control, such as providing a ride to get medications from the pharmacy, going grocery shopping or visiting family members. Be willing to check in on the person to see how he or she feels. Sometimes, that extra level of compassion can mean the difference between a pleasant conversation and a tragedy. Ultimately, you want to make sure the person in crisis recognizes you take ownership and are willing to care about their life.

4. Encourage Professional Help

This step can be difficult, especially for those new to mental health interventions. Instead of making accusatory or demanding statements, steer the conversation toward possible solutions. For instance:

• “I hear they have a great team of professionals trained in psychological care at…”
• “Have you ever considered visiting a counselor to discuss the more intense personal matters?”
• “I believe in you, and I can help you find treatment to help make it through the withdrawals.”

The exact language depends on each situation and what the person needs. The goal revolves around giving a person options for seeking care and locating available resources. Samhsa.Gov is an excellent place to start the search.

5. Encourage Self-Help

The final part of the mnemonic is encouraging self-help behaviors. These include actions that help a person cope with their illness, such as exercising, engaging in hobbies, practicing yoga, joining group therapies and more. The list of potential self-help opportunities is endless. Even something as simple as having a cup of tea can be helpful. This step rests on encouraging a person to do something positive that counteracts the adverse effects of stress and mental health deterioration.

If the person becomes violent at any point, attempt to resolve the situation through communication. However, be mindful of your surroundings, and contact emergency services when necessary. If so, make sure to explain the situation and the person’s current crisis in detail. This will reduce the risk of violence when additional help arrives.

Know How to Intervene During Mental Health Crises to Reduce Risk and Save Lives.

Anyone may experience a mental health crisis. As explained by the World Health Organization (WHO), those who experience emergencies—including war, conflict, stress and the challenges of underdeveloped economies—have a higher incidence of mental health illnesses. In addition, millions of people in the U.S. and Canada suffer from mental health disorders, and when crises occur, those certified in First Aid for mental health care have the skills necessary to help prevent tragedies. Health care professionals and those working in areas susceptible to a higher risk of mental illness need to know how to apply ALGEE. Mental Health First Aid saves lives. Period.

Have you encountered someone experiencing the throes of extreme mental anxiety or irrational behaviors? If so, that person may have suffered a mental health crisis, and knowing how to apply ALGEE in Mental Health First Aid could help others in similar situations in the future. Share your experiences and this article on social media now. Also, remember to enroll in your life-saving skill courses today.