Content warning: this article discusses suicide and self-harm
Mental health awareness has shifted in the last decade – steadily, mental health has become to be viewed as something that we all share, rather than something that resides solely in those with diagnosed psychological conditions. Along with that shift in wellbeing awareness, the general public and non-traditional institutions are increasingly being utilised to improve the quality of preventative community care and to provide a form of psychosocial support.
Aiming to improve general mental health awareness and support, Mental Health First Aid is a standardised course designed to be accessible and comprehensive to give the public the basic skills to combat mental health problems by enhanced mental health literacy. By way of practical knowledge, the course programme challenges unhelpful stereotypes, thereby reducing stigmas and facilitating supportive and help-seeking behaviours.
According to 2014 Public Health England stats, almost 1 in 6 adults have a diagnosed mental health condition, over 15m days are lost each year due to stress, depression, and anxiety, and 19% of long-term sickness absence is attributed to mental ill-health. In addition, more recent figures have found that this situation has been made worse by the mental health crisis of the Covid-19 pandemic.
This is not surprising; stress and anxiety are common occurrences, especially during work hours. However, long periods of stress can trigger mental health problems, disorders, and even lead to a severe mental health crisis. By identifying the early signs of stress and crisis behaviours, we can collectively support each other with Mental Health First Aid techniques, preventing the situation from worsening and developing a more mindful, resilient, and stress-free work environment.
Below are some expert tips from St John Ambulance to recognising someone at the point of crisis and how you can practically support them to get professional help.
- See also: 'St John Ambulance calls on employers to step up mental health support'
- See also: ''Does the idea of mental health first aid match the reality on the ground?''
Recognising the symptoms of a mental health crisis
The St John Ambulance First Aid Manual, written in partnership with St Andrew’s First Aid and the British Red Cross, indicates that a person at the point of a mental health crisis may express their internal disquiet in a variety of symptoms, behaviours, and feelings, these include:
- Described feelings of worthlessness, entrapment, hopelessness, and social isolation.
- Insomnia and/or loss of appetite.
- Feelings of depression or anxiety. Potentially expressed in physical symptoms such as sweating, trembling, shaking, chest pain, feeling faint, hyperventilation, numbness, and tingling in fingers or legs.
- Described feelings of disassociation, fears of losing control, being hated, and/or expressing the wish to not live anymore.
- Behaviours such as self-harm and substance misuse.
What do to when someone is experiencing a mental health crisis
In the St John manual, it is suggested that by identifying the signs of stress or a potential mental health crisis early, and then supporting the person to seek help, the severity of the crisis can be alleviated. The manual recommends to practically support someone, you should:
- Listen with empathy: encourage the person to speak freely by demonstrating that you are emotionally supportive through non-judgemental, confidential, calm, and understanding listening.
- Let them know that effective support is available: encourage the person to seek professional help. Advise them to speak to their GP, seek counselling, or self-refer to mental health services.
- Promote self-care and coping techniques: explain that many have got through similar struggles by talking to supportive friends or family, contacting support groups, or by seeking financial, employment, educational or accommodation assistance. Additionally, co-occurring or symptomatic substance issues such as excessive caffeine or alcohol intake may need to be addressed through professional support. Conversely, positive lifestyle changes such as physical exercise, yoga, meditation, or even more simply walking in nature may be constituent parts in alleviating their negative emotions.
- If the person has self-harmed, is attempting to, or is at risk of, maintain empathy and understanding. Offer to treat any wound if they want you to do so. Call the emergency services and ask for an ambulance or go straight to your nearest A&E if they have self-harmed or are attempting to.
- If the person is expressing suicidal thoughts, help them to call a close friend, family member, healthcare professional, or the Samaritans on 116 123. If they are attempting or are acting on that feeling, call 999 for emergency help.
More information on Mental Health First Aid and training
St John Ambulance offers more in-depth advice and training than set out in their manual. The organisation provides Mental Health First Aid courses to help employers and employees spot the signs that a colleague may be struggling; their one and two-day courses, taught online and face-to-face, are designed to be practical, to help staff members begin a conversation on mental health and provide any necessary support.
Additionally, Mental Health First Aid England offers courses tailored to the university environment and those who work with young people or in the Armed Forces.