Mental health first aid

We all see friends and loved ones go through rough times. Sometimes what we are witnessing is a developing mental health problem or a mental health crisis. To prepare for these moments, we can learn to provide what is known as mental health first aid.

What is mental health first aid?#

Mental health first aid is the help you give to someone who is developing a mental health problem, experiencing a worsening of an existing problem, or in a mental health crisis. You can give this first aid until the person has received appropriate professional treatment or the crisis is resolved.

It can help people experiencing conditions such as depression, anxiety problems, psychosis, substance use problems, eating disorders and gambling problems. It can also help during a crisis, such as suicidal thoughts and behaviors, non-suicidal self-injury (sometimes called deliberate self-harm), panic attacks, the aftermath of traumatic events, severe psychotic states, severe effects from alcohol or other drug use, and aggressive behaviors.

Around one in five adults experiences a mental health problem in any given year. That means almost everyone is likely to know someone affected, whether a family member, friend or colleague. Recognising problems early and responding well can lead to better outcomes.

Mental health first aid training#

Mental health first aid was developed more than two decades ago and is now used in many countries. Trained and accredited instructors deliver courses in workplaces, schools and community settings. Training covers how to apply mental health first aid across a range of situations, including suicidal thoughts and behaviors, information about the types of support available, and how to encourage someone to seek professional help.

Training equips you with the knowledge and practical skills to support a person who is developing a mental health problem or experiencing a crisis. Even without training, you can support those around you by following the steps below.

Recognise the signs#

The first step is understanding the signs and symptoms of an emerging or worsening mental health problem. Only a trained professional can diagnose a mental illness, but you can stay aware of changes in a person’s mood, behavior, energy, habits or personality. Signs that may indicate a serious problem include:

• bizarre or unusual thinking, or hallucinations such as hearing or seeing things that are not there
• extreme mood changes
• restless, agitated and disorganised behavior, or a marked decrease in activity
• difficulty concentrating and a significant drop in performance at work or school
• significant withdrawal from friends and family
• neglecting self-care, such as personal appearance, hygiene and eating well
• suicidal thoughts or behaviors, or non-suicidal self-injury
• destructive or high-risk behavior
• confusion and disorientation, emotional outbursts
• sleep problems, weight or appetite changes
• being quiet or withdrawn, feelings of guilt or worthlessness

Having one or two of these symptoms does not usually indicate a mental illness. But if a person shows several symptoms, especially if they have lasted for some weeks or are affecting work, school or relationships, they may need professional help. Do not ignore signs you notice in others, and do not assume they will simply go away. Remember that not everyone will show the same signs.

Approach the person#

Give the person a chance to talk to you. If they do not open up and you are still concerned, gently start the conversation. Be open and honest about your concerns for their mental health, and choose a comfortable space at a time when you will not be interrupted.

• Speak from your own perspective. Use “I” statements, such as “I have noticed…” and “I feel concerned about…”, rather than “you” statements.
• Say that you are concerned and that you are there to help.
• Respect the person’s own interpretation of their symptoms.
• If they do not want to talk to you, encourage them to talk to someone else they trust.

Be supportive#

Use words that help the person feel listened to, understood and hopeful, such as “I’m here for you”, “I can see this is a really hard time for you”, and “What can I do to help? Just tell me how.”

• Show the person dignity and respect, and don’t blame them.
• Be consistent in your emotional support and understanding.
• Listen well, and encourage the person to talk to you or someone else.
• Give the person hope for their recovery.
• Find accurate, appropriate resources for more information if they want it.

Sometimes, even with the best intentions, we can make matters worse. When reaching out to someone you suspect has a mental health problem, avoid:

• trying to cure them or solve their problems for them
• telling them to “snap out of it” or “get over it”
• being hostile or sarcastic
• getting over-involved or over-protective, or nagging
• trivializing or dismissing their experience and feelings
• being patronizing

Encourage them to seek help#

Ask the person if they need help to manage how they are feeling. If they want help, a good place to start is a visit to their doctor. You can also talk through their options, including local and online services, and encourage them to act on those options.

If the person does not want help, try to find out why. They may have some mistaken beliefs about getting help or about their options, so try to help them feel better about seeking it. If they still resist, let them know they can contact you if they change their mind. Respect their right not to seek help, unless you believe they are at risk of harming themselves or others.

Helping someone who may be suicidal#

Suicide can be prevented. Always take suicidal thoughts and behaviors seriously.

• If you think someone may be suicidal, ask them directly.
• If they say yes, do not leave them alone.
• Link the person with professional help.
• In an emergency, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) .

A range of crisis support and counseling services are available, including telephone and online services that operate around the clock. The resources listed below can help you find appropriate local support.

Build your knowledge#

You can improve your knowledge of mental health first aid by reading mental health first aid guidelines for specific problems, enrolling in a mental health first aid course, and learning more about early support for mental health problems.

Key points#

• You can give mental health first aid until the person has received appropriate professional treatment or the crisis is resolved.
• Do not ignore signs or symptoms you notice in others, and do not assume they will go away.
• Not everyone will show the same signs and symptoms.
• Respect the person’s own interpretation of their symptoms.
• Respect their right not to seek help, unless you believe they are at risk of harming themselves or others.

Where to get help#