| Feature
Mental health training key for many jobs
by Pam Christensen
Betty Kitchener wants people to be as proactive about giving first aid to persons experiencing mental illness as they would be giving CPR or bandaging a cut. Kitchener and Anthony Jorm of the University of Melbourne (Australia) have teamed up to develop a program that trains people to do just that.
“Mental Health First Aid” is a groundbreaking twelve-hour training program that equips interested individuals to assist persons in the early stages of mental illness or to take action in cases of a mental heath crisis.
In June, a dozen local residents participated in a Mental Health First Aid (MHFA) training offered by NorthCare Network. Trainers Sally Olson of NorthCare and Phillip Hefner of Northpointe Behavioral Health of Kingsford led an intrepid group through two solid days of training. Participants realized this was going to be like no other training when Hefner went over the ground rules at the beginning of the session: be honest, treat each other with respect, ask questions—and the big rule—what you hear or observe in training, stays in training. Just like Las Vegas—what happened during those two days was to stay confidential.
Each student was issued a workbook, and Hefner encouraged participants to share their thoughts and experiences. Trainees represented a variety of groups—Superior Alliance for Independent Living (SAIL), Room at the Inn, Michigan Rehabilitation Services, Great Lakes Recovery Centers, National Alliance on Mental Illness (NAMI) and Peter White Public Library.
In addition to caring individuals, Kitchener encourages educators, school administrators, members of the faith community, human resource professionals, homeless shelter workers, nurses, physicians, physician assistants, primary care workers, law enforcement, first responders, public safety workers, substance abuse professionals, social workers and consumers to take advantage of Mental Health First Aid training.
NorthCare Network received a grant through the Supported Employment Program of the Michigan Department of Community Health to offer this training throughout the U.P. Mental Health First Aid trainings will be held in Escanaba, Iron Mountain, Houghton, Gogebic County and Marquette over the next year. Trainers Becky Mills and Bonnie Kaunisto of Hiawatha Behavioral Health also have received training and will offer workshops in the east end of the Upper Peninsula.
Employers, not only from the human services field, are encouraged to attend these sessions, so they can understand how mental illness negatively impacts their employees and businesses. The hope is to assist employers in recognizing mental illness problems and steer employees who are impacted by mental illness into the appropriate avenues for assistance. Mental disorders are not uncommon in the United States, and many employers do not realize these disorders can have a detrimental affect on their businesses, especially if employees are unwilling to seek assistance due to the stigma attached to mental illness.
According to research conducted in the United States between 2001 to 2003, one in four adults has a mental disorder in any one year. This is equivalent to 57.7 million people. In any one year, anxiety disorder affects 18.1 percent of adults, a major depressive disorder affects 6.7 percent, substance abuse affects 3.8 percent, bipolar disorder affects 2.6 percent, eating disorder affects 2.1 percent and schizophrenia affects 1.1 percent. Mental disorders often occur in combination, so an individual can have one or more of these disorders at a time.
Just as with CPR or first aid, Mental Health First Aid is help given to preserve life, prevent further harm, promote recovery and provide comfort for the person who is ill or injured. Individuals trained in MHFA are not expected to cure the person affected by mental illness; he or she is to act until professional medical treatment can be obtained.
Mental Health First Aid uses the acronym ALGEE as the core of the training program. ALGEE also is the name of the Mental Health first aid mascot—a koala bear. The koala bear was chosen as a tribute to the Australian origins of the program. As the group discussed the steps in ALGEE, stories from participants’ personal and professional lives started to surface. The shared stories added another dimension to the training. Some of the stories were poignant, some tragic, some funny and others hard to forget. The reason for the “What happens in Vegas, stays in Vegas” ground rule became apparent.
One participant confessed to suffering from Obsessive Compulsive Disorder (OCD) and shared how the disorder detrimentally affects normal life functions. The coping mechanisms that were developed, and a wonderful sense of humor, have helped mask the disorder. Most were amazed to learn this person had OCD, but it also made everyone aware of how well some people can deal successfully with the symptoms of their mental illness.
Someone providing Mental Health First Aid needs basic knowledge about mental health problems. The MHFA training program uses the training handbook, exercises, role playing and audio visual materials to present information on various types of disorders, so the responder can recognize if a disorder may be developing. The importance of acting on symptoms and not wishing them away or making excuses also is stressed. The Mental Health First Aid USA manual is divided into three parts, as is the training program. The first segment discusses the mental health action plan also known as ALGEE.
• “A” stands for assess for risk of suicide or harm. Training participants had the most difficulty with this first step of the program. Most were concerned that even mentioning suicide to someone suffering from mental illness might encourage such action. Hefner said in the majority of cases, the person affected by mental illness already has considered suicide. Any outsider’s action would not trigger a suicide, but we should try to determine whether a suicide plan had been developed and whether the tools to carry out the plan were available.
• “L” reminds the caregiver to listen non-judgmentally. This is important for assessing the situation as well as demonstrating to the person experiencing problems that you care. The training also included an exercise, similar to the telephone game, on listening. A graphic demonstration showed how important listening is in this process and how difficult it is to be a good listener.
• “G” relates to giving reassurance and information. Once a person with a mental health issue feels heard, he or she is much more willing to accept assistance from the caregiver. Reassurance, empathy and practical help can be offered at this stage. Not being alone in this battle can change the attitude from despair to hope.
• The first “E” stands for encourage appropriate professional help. Medication, counseling, psychological therapy, support from family, assistance with income and accommodation may be needed to set the stage for recovery. Persons suffering from mental illness may not be able to identify what services are needed or where they can be obtained. The first aid responder is not expected to provide this help, but should be proactive in identifying what services can be of most assistance.
• The second “E” is encourage self-help and other support strategies. Once a mental-health problem has been identified, the support of family, friends, colleagues, employers and others is especially important. A self-help plan should be followed, including the development of self-help strategies.
The second section of the MHFA manual is dedicated to applying the Mental Health First Aid Action Plan to a variety of mental disorders. Depression, anxiety disorders, psychosis, substance abuse and eating disorders are all discussed. During this section of the training, participants are introduced to the various types of problems, the causes, benefits of early intervention, the appropriate action plan and helpful resources.
The wealth of knowledge of the trainers as well as real-life examples of participants made this section of the training especially interesting. This was the time when personal and professional examples most often were shared.
The group discussed some of the situations and determined whether they had been handled in the most effective way or how the response could have been improved. Through the discussion, participants developed an understanding of the role of the various agencies represented at the training and a stronger appreciation of staff members who work with persons who often are affected by mental illness.
The activities vividly demonstrated the challenges of mental illness. Participants were split into groups of three. Two participants were asked to carry on a conversation while the third whispered negative and confusing comments into the ear of one of the conversationalists. This experience was conducted to mimic the voices heard by someone suffering from schizophrenia. It was virtually impossible to carry on a conversation or normal activities while hearing voices. This was a graphic demonstration of the difficulties someone with schizophrenia encounters on a daily basis, and I will never forget the feeling of helplessness I experienced during the exercise.
The third section of the training prepares participants for dealing with an actual mental health crisis. There have been several crises with persons suffering from mental illness in a library setting. Each was traumatic for all concerned, but situations were handled effectively and correctly. Nevertheless, this section of the training prepared everyone to better handle such situations in the future.
A video clip is used during this section of the training. It shows a young woman observing a very anxious and paranoid male neighbor. She intervenes without success, until she enlists the aid of an older and wiser woman who also lives in the complex.
The second neighbor aptly demonstrates how to use ALGEE, despite the well-meaning interference of the first neighbor. In the end, the two women are able to get their neighbor the help he so desperately needs.
Hopefully, those who are being trained will never have to use their new skills, but the knowledge they receive will make them more compassionate and understanding of the enormous toll untreated mental illness places on our society.
Nelson and Hefner will offer Mental Health First Aid training, without charge, at Peter White Public Library on September 28 and 29 and again on December 7 and 8. Participants must commit to attending both days of the training.
Additional dates are being planned for other sites across the U.P. Information about the program and registration can be obtained by calling 225-4411 or (888)333-8030 or visiting www.northcare-up.org
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