What Is Mental Health First Aid?

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Most people are familiar with basic first aid actions – cleaning and bandaging wounds, performing CPR, and determining if an injury warrants a trip to the emergency department or urgent care. But did you know that people may also need first aid for mental health conditions?

Just like medical first aid, mental health first aid is intended to stabilize a person in crisis until a decision about further care can be made. People who may require this type of help may be struggling with one or more of the following:

  • Anxiety disorders.
  • Depression and mood disorders.
  • Psychosis.
  • Self-injury.
  • Substance use disorders.
  • Trauma (current or remembered).

Assessing the Situation

Sometimes the challenge is easy to discern: a person may be experiencing a psychotic episode, or they may have withdrawn from others while in a depressed state. The situation may be mild, moderate, or serious. One of the first steps of giving mental health first aid is to determine whether you will need professional assistance.

Think about how well you know the person and whether their behavior or speech is unusual. If a person is acting in a way that may endanger themselves or others, you should call for professional help. Calling 911 for a psychiatric emergency is appropriate.

In other cases, you may be able to help on your own.

Emergencies vs. Ongoing Signs

If the person is engaged in an act that could lead to death or harm — such as handling a gun or preparing to jump from a height — call 911. Then talk to and, if safe to do so, stay with the person. Listen to their concerns. Remind them that you are there for them, and stress that problems can be handled over time. Be respectful and calm. Explain that you are ready to help.

If the person could be experiencing an overdose, call 911, administer Narcan® if available, and stay with the person until medical help arrives. After the person recovers, offer to help them find treatment for substance use disorder. Remember (and remind the person) that this is an illness, not a personal failing, and that treatment can help.

You may suspect that a person is at non-immediate risk for suicide – for instance, they could be self-harming, drinking heavily, or engaging in other risky behavior. Ask the person if they are considering suicide or if they have a plan; asking does not plant the idea of suicide in a person's mind. Listen, respectfully express your concern, and encourage them to call the Suicide & Crisis Lifeline and to consider professional help. Check in periodically to see how they are doing.

If the person is exhibiting ongoing behavior that indicates a quieter or more introspective state of mind — such as staying in their room day after day or neglecting self-care — you may choose to talk to them or connect them with the Suicide & Crisis Lifeline. Listen to the person; let them do most of the talking. Be nonjudgmental, respectful, and reassuring, but make it clear that you want to help.

If someone is not exhibiting particularly alarming signs but just seems a bit off, simply ask what's wrong and whether you can help. Sometimes, mild mental health crises can be managed with friendly chats, exercise, a healthy diet, meditation, or other self-care approaches. Offer to take the person to lunch, go for a walk, or engage in some other low-key activity, and use the time to decide what to do next. Reaching out could save or improve a person's life.

Identifying Suicide Risks

According to the National Alliance on Mental Illness (NAMI), 46% of people who die from suicide have a known mental health condition. Those conditions may include:

  • Bipolar disorder.
  • Depression.
  • Eating disorders like anorexia or bulimia.
  • Post-traumatic stress disorder (PTSD).
  • Schizophrenia.

Other factors can put people at risk of suicide, including:

  • Acute stressors or crises.
  • Alcohol or drug use.
  • Family history of suicide.
  • History of trauma or abuse.
  • Recent tragedy or loss.
  • Serious or chronic health conditions.
  • Access to lethal means such as firearms.

You may wish to connect the person with one of these resources:

You Can Help

Therapy, medication, hospitalization or a combination can help a person to manage mental illness. You can help a person in need by offering to connect them with the appropriate mental health resources or just by being there.

#BeThe1To — an effort by the National Action Alliance for Suicide Prevention and the 988 Suicide & Crisis Lifeline — outlines five action steps you can take to help someone experiencing a mental health crisis, or having suicidal thoughts or actions.

1. Ask

Asking the question, “Are you thinking about suicide?" communicates that you're open to talking about the subject in a nonjudgmental way. Studies show that talking about suicide may reduce suicidal thoughts or actions.

2. Be There

This could mean being physically present, talking on the phone, or any other way you can support the at-risk person. Increasing the person's connections to others and limiting their isolation (both in the short and long term) can protect against suicide.

3. Help Them Keep Safe

If you have concerns about someone who may be at risk for suicide, immediately establish their safety. Remove any lethal items from the at-risk person, such as firearms, medications, and sharp objects that can cause harm.

4. Help Them Connect

Establish a safety net of ongoing support that the at-risk person can connect with when they find themselves in crisis. Help the person develop a safety plan of who to call and what to do if they start to have severe thoughts of suicide.

5. Follow Up.

Follow up with them to see how they're doing and make sure they've connected with immediate support systems. Leave a message, send a text, or give them a call. At-risk people are less likely to follow through with suicidal actions when they have a constant connection with someone. It's important to maintain communication with the person and show support.