Mental Health First Aid

The most basic and powerful way to connect to another person is to listen. Just listen. Perhaps the most important thing we give each other is our attention. . . A loving silence often has far more power to heal and to connect than the most well-intentioned words.

Rachel Naomi Remen

When we think of “first aid,” we think of helping a person who has a physical injury – and having the knowledge to do so. First aid is a well-known process that has a wide range – from how to stop a small cut from bleeding to how to use a tourniquet. Most people have some knowledge about aiding people who have a physical injury. In fact, the term “first aid” has in some ways become a household name, and many people have first-aid kits in their homes and/or cars.

Recently, two Australians, Betty Kitchener and Anthony Jorm, took the concept of helping people with physical injury and applied it to helping people with mental health issues. They developed the concept of Mental Health First Aid. This is the natural next step for first aid, since mental health conditions are more common than heart disease, lung disease, and cancer combined. In the United States, more than half of adults will experience a mental health disorder in their lifetime.

Many people with mental health conditions either never seek help or delay seeking help. Individuals with mental health challenges frequently do not seek assistance for a variety of reasons, including the stigma still associated with mental conditions, lack of awareness that effective help is available, or lack of access to professional mental health services. Just as we might learn how to offer basic first aid for someone who is physically injured, we can learn the basic tools of Mental Health First Aid to help someone who is experiencing a mental health condition.

The Mental Health First Aid Action Plan for assisting someone who is experiencing mental health challenges consists of five steps:

1. Assess for the risk of suicide or harm (Click here for general warning signs and recommendations for how to respond).
2. Listen nonjudgmentally.
3. Give reassurance and information.
4. Encourage appropriate professional help.
5. Encourage self-help and other support strategies.

Listen nonjudgmentally. People have a fundamental need to be understood – not agreed with, but understood.

• Listen respectfully and be supportive. Refrain from expressing any negative reactions you are having to the person’s impairment or what they have done.
• Be patient, even if the person is not communicating well, is repetitive, or is speaking slowly or unclearly.
• Express genuine empathy whenever possible.
• Focus on listening and not directing, unless it is to prevent self-harm.

Show that you are listening attentively:

• Paraphrase or repeat back what was said to you.
• Ask questions to clarify.
• Summarize facts and feelings.

Give reassurance and information. Once a person with a mental health problem feels that he or she has been heard, it becomes easier to offer encouragement and information. Reassurance includes emotional support, such as empathizing with how the person feels, and voicing hope. If you know of resources or have experiences that can help, discuss them with the person.

Encourage appropriate professional help and other support strategies. If the person who is experiencing a mental health crisis is not receiving professional help, encourage him or her to do so. Call the NCLAP or BarCARES for resources and assistance. Also, encourage the person to seek the support of family, friends, and others. Peer supporters – others who have experienced mental health problems – can provide valuable help.

NCLAP is a service of the North Carolina State Bar which provides free, confidential assistance to lawyers, judges and law students in addressing substance abuse, mental health issues and other stressors which impair or may impair an attorney’s ability to effectively practice law. Please visit www.nclap.org for additional information and to locate the office nearest you.

BarCARES is a confidential, short-term intervention program provided cost-free to members of participating judicial district bars, voluntary bar associations and law schools. More information is available at www.ncbar.org/members/barcares/. For immediate assistance, please call 800-640-0735 or 919-929-1227.

Adapted from Mental Health First Aid USA, Revised First Edition, Mental Health Association of Maryland, Missouri Department of Mental Health, and National Council for Behavioral Health (2013).

Reprinted with permission from the Oregon Attorney Assistance Program, In Sight, March 2015, all rights reserved. For more information, contact Barbara S. Fishleder, barbaraf@oaap.org.