Mental health first aid

About mental health

We all see friends and loved ones going through rough times, but sometimes what we’re witnessing is a developing mental health problem, or a mental health crisis. In preparation for these times, we can learn to provide what’s known as ‘mental health first aid’.

What is mental health first aid?

Mental health first aid is the help you give to someone developing a mental health problem, experiencing a worsening of a mental health 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.

Mental health first aid can help people experiencing:

• depression
• anxiety problems
• psychosis
• substance use problems
• eating disorders
• gambling problems.

It can also help if a person is experiencing a mental health crisis, such as:

• suicidal thoughts and behaviours
• non-suicidal self-injury (sometimes called deliberate self-harm)
• panic attacks
• traumatic events
• severe psychotic states
• severe effects from alcohol or other drug use
• aggressive behaviours.

One in 5 Australian adults experiences a mental health problem in any given year. That means every person is likely to know someone who is experiencing a mental health problem, whether it is a family member, a friend or colleague. In fact, mental illness is now said to affect every Australian either directly or indirectly.

The early intervention of mental health problems can lead to better outcomes.

Mental health first aid training in Australia

Mental health first aid was developed in Australia more than 21 years ago and is now licenced in over 25 countries. Locally, Mental Health First Aid (MHFA™) courses are delivered by instructors trained and accredited by Mental Health First Aid® Australia. Instructors deliver training in workplaces, schools and community settings across the country.

MHFA training courses cover:

• how to recognise and respond to someone experiencing a mental health problem
• how to apply mental health first aid across a range of crisis situations, including suicidal thoughts and behaviours
• information about the types of supports available and how to encourage someone to seek professional help.

How to use mental health first aid

Mental Health First Aid training will equip you with the knowledge and practical skills to support a person developing a mental health problem or experiencing a mental health crisis. But even without training, you can support those around you by following these steps, which are provided from mental health first aid guidelines.

Know the signs

The first step in providing mental health first aid is understanding the signs and symptoms of an emerging or worsening mental health problem.

Only a trained professional can diagnose someone with a mental illness, but you can be aware of changes in a person’s mood, behaviour, energy, habits, or personality. These changes may be the sign of a mental health problem.

Some symptoms that may indicate a serious problem include:

• bizarre or unusual thinking
• hallucinations, such as hearing or seeing things that aren’t there
• extreme mood changes
• restless, agitated and disorganised behaviour
• marked decrease in activity
• difficulty concentrating
• significant drop in performance at work or school
• significant withdrawal from friends and family
• neglecting self-care (such as neglecting personal appearance and hygiene, and eating poorly)
• suicidal thoughts or behaviours
• non-suicidal self-injury (deliberate self-harm)
• destructive or high-risk behaviour
• confusion and disorientation
• emotional outbursts
• sleep problems
• weight or appetite changes
• being quiet or withdrawn
• substance use problems
• feelings of guilt or worthlessness
• changes in behaviour or feelings that have lasted for longer than 2 weeks.

Having one or 2 of these symptoms usually doesn’t indicate a mental illness, but if a person is exhibiting several symptoms, they may need professional help (particularly if the symptoms have lasted for some weeks or they’re impacting their usual activities, such as work, school or relationships).

Don’t ignore signs or symptoms that you notice in others, and don’t assume they will go away. And remember not everyone will show the same signs and symptoms.

Approach the person

• Give the person a chance to talk to you. If they don’t open up to you themselves, and you are concerned about them, initiate the conversation. Be open and honest about your concerns about their mental health.
• Make sure you approach the person in a comfortable space and at a time when you won’t be interrupted.
• Speak from your own perspective. Use ‘I’ statements, such as ‘I have noticed…’ and ‘I feel concerned about…’ rather than ‘you’ statements, such as ‘You seem to be withdrawn…’ or ‘You’re not eating and sleeping…’.
• Say you’re concerned and you’re here to help.
• Respect the person’s own interpretation of their symptoms.
• If the person doesn’t want to talk to you, encourage them to talk to someone else they trust.

Be supportive

• Use phrases that will help the person feel listened to, understood and hopeful. Some examples are ‘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.
• Don’t blame.
• Be consistent in your emotional support and understanding.
• Encourage the person to talk to you or someone else.
• Listen well.
• Give the person hope for their recovery.
• Find accurate and appropriate resources for more information if the person wants it.

Know what’s not helpful

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

• telling them to ‘snap out of it’ or ‘get over it’
• being hostile or sarcastic
• getting over-involved or over-protective
• nagging
• trivialising their experience (for example, don’t tell them to smile or get their act together)
• belittling or dismissing their feelings
• being patronising
• trying to cure them or solve their problems.

Encourage someone to seek help for a mental health problem

Ask the person if they need help to manage how they’re feeling. If they want help, a good place to start is a visit to their GP. You can also chat to them about their options, particularly local and online services. Encourage them to act on their options.

If the person doesn’t want help, try to find out why. They may have some mistaken beliefs about getting help or their options. Try to help them feel better about seeking help.

If the person still resists help, tell them 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.

Mental health first aid for someone who is suicidal

Suicide can be prevented.

Always take suicidal thoughts and behaviours seriously.

Take these actions when helping a person who is suicidal:

1. If you think someone may be suicidal, ask them directly.
2. If they say yes, do not leave them alone.
3. Link the person with professional help. Services such as Suicide Call Back Service, Lifeline and MensLine Australia offer 24-hour services. The Victorian Government also provides a list of mental health services in Victoria.
4. In an emergency, call triple zero (000).

Better Health Channel has more information on responding to suicide warning signs.

Read Mental Health First Aid Australia’s mental health first aid guidelines on suicidal thoughts and behaviours.

How to improve your knowledge about mental health first aid

You can improve your knowledge about mental health first aid by:

• downloading the mental health first aid guidelines for specific mental health problems
• enrolling in a mental health first aid course at Mental Health First Aid Australia
• learning more about early care for mental health problems.

Where to get help

Immediate assistance

• In urgent mental health and crisis situations, dial triple zero (000)
• Suicide Call Back Service – free nationwide professional telephone and online counselling for anyone affected by suicide Tel: 1300 659 467
• Lifeline – confidential telephone crisis support service (24 hours, 7 days) Tel. 13 11 14
• Kids Helpline Tel. 1800 551 800
• MensLine – professional telephone and online support and information service for men (24 hours 7 days) Tel. 1300 789 978

Non-urgent assistance

• Your local GP (doctor)
• Your community health centre
• Head to Health
• Beyond Blue Tel. 1300 224 636