If a woman at a restaurant chokes on a chicken bone, millions of people know to wrap their arms around her abdomen and dislodge it, thanks to countless classes that teach first aid.
But if she starts hyperventilating during a panic attack, many people wouldn’t know how to help. If she stops showering or coming to work, her friends might not know what to do.
To teach people how to respond, St. Louis organizations have started training the public in mental health first aid, which aims to offer immediate help for people experiencing emotional and mental health emergencies. It’s the same idea as traditional first aid, except that the wounds treated are emotional.
“You could be a general lay person, or you could be the best heart surgeon in the world; there are certain similar things that we’re going to do in terms of first aid,” said Stacie Zellin, a community educator at the National Council on Alcoholism and Drug Abuse. “There are certain steps we can take to help the person right in front of us.”
Classes use the acronym ALGEE. First, they assess if a person is a danger to themselves or others. After that, the course tells people to listen, give support and encourage appropriate help. That could be professional help or self-help, such as social interaction or exercise.
The training covers the signs and symptoms of different mental health disorders, such as schizophrenia or clinical depression. It also teaches participants how to listen empathetically and give support and guidance.
‘Knowledge is power’
NCADA has been conducting mental health first aid classes since 2012. At a recent daylong training, more than a dozen adults — parents and professionals — came to the organization’s headquarters in west St. Louis County to learn the basics of how to recognize and care for people in crisis.
The Rev. Shirelle Anthony came to the class to learn to help her 13-year-old foster daughter, who recently moved in with her. Anthony leaned forward in her seat as the instructor walked through a PowerPoint about the warning signs of substance abuse and alcoholism.
“She’s just really broken; she’s having a difficult time trying to find her place in society,” said Anthony, 47. “I wanted to pick up whatever tools I could utilize to be of better assistance to her as well as other things that God is using me for.”
Anthony, of Florissant, has a history of mental illness. She began experiencing emotional mood swings when she was a teenager. Although her parents took her to therapy, she struggled to talk to them about her problems.
“They had no clue what was going on,” she said. In the black community, “this is the kind of thing that’s hushed and swept under the rug and not dealt with.”
Anthony was in her late 20s before doctors diagnosed her with bipolar disorder. She hopes the mental health first aid training will teach her to be there for her daughter in a way her parents weren’t able to be, she said.
“Knowledge is power, and I want the knowledge I have to be effective, wherever I may be,” she said.
A bigger safety net
A nurse and a professor in Australia introduced mental health first aid in 2001. Since then, millions of people around the world have received the training, including more than 50,000 in Missouri.
The idea of training people to administer care to those in crisis is critically important in the U.S., said Zellin, of NCADA. Although an estimated 1 in 4 adults in the U.S. have a mental illness, many don’t receive treatment because they are ashamed, there are too few providers or the medical care cost is too high.
It isn’t a substitute for professional treatment, Zellin said. But people trained in mental health first aid can help comfort someone in crisis and keep them safe.
“Unfortunately, we can’t have therapists everywhere that we want,” she said. But “if something were to happen, there are people around who are either a little bit more informed about what might be happening, and they might be a little bit more informed about what to do.”
For example, the course emphasizes listening to people in crisis without judgment. If a person is paranoid or hearing voices, trying to convince them the voices don’t exist could further isolate or agitate them, putting them in more danger.
Instead, the course teaches people to empathize, support and try to direct the person to medical help.
Reducing stigma in a new generation
The steps can be especially helpful for teens, who often first seek support from their peers.
“Teens are pressed and stressed in all directions,” said Chris Allen, a counselor at Northwest High School in Jefferson County. “Everyone has someone in their life who is experiencing a mental health challenge or crisis. It’s real to them, so they’re very locked in.”
Last year, the school’s entire junior class took a mental health first aid course tailored for teens. The steps are similar to those in the adult course offered by NCADA, but with more of an emphasis on enlisting help from trusted adults.
In the weeks that followed, more students reached out to school counselors about their and their friends’ mental health problems, Allen said.
“We do see with our students, they’re opening up; they’re talking; they’re recognizing mental health is a real thing,” he said.
That’s another benefit of the training, counselors say. Treating a mental health crisis as if it were an asthma attack or broken leg shows mental health problems are nothing to be ashamed of.
But mental health first aid has its limits. Directing people to help can only be effective if there are professionals available to see patients, Allen said. Sometimes, students have to wait months for an appointment with a counselor or psychiatrist.
“We have more kids that need mental health services than ever; we’re just inundated,” he said.
Shirelle Anthony knows that all too well. The licensed minister and chaplain is often the first or only person available to help someone in crisis — and she’s glad she can help.
“I’ve been a first responder at a shooting; I’ve been the first responder at an automobile accident,” she said. “It’ll help if there’s more people like myself, who’ve taken a class to be present and to advocate for them and offer comfort.”
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