Mental illness is common. In the United States, the United Kingdom and Canada an estimated 17% – 20% of persons experience mental illness (NHS Confederation, 2011; Bekeimpis, 2014, www.chma.ca). While these statistics may not reflect the Caribbean context, due to thelack of published studies andavailable information regarding mental health, there is limited data regarding the overall prevalence of mental illness in the region(Hickling, 2005, WHO, 2011, Abdel et. al, 2012).
Rather than ignoring this issue, however, it is important to address stigmas associated with mental illness and to share knowledge of useful tools and techniques that can support persons with mental illness. This brief article will provide a concise overview of mental health and mental health problems and then highlight the major steps in providing Mental Health First Aid. While this feature does not have the scope to thoroughly cover Mental Health First Aid or teach individuals how to become Mental Health First Aiders, it is hoped that persons will have a better understanding of what actions are beneficial.
Mental Health, Mental Illness and Mental Problems
The World Health Organization defines mental health as “a state of wellbeing in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to his or her community.”Amental illness (disorder) is a diagnosable illness that affects a person’s thinking, emotions and behaviours, hampering his or her ability to lead a productive life. A Mental Health Problem is a broader term that includes mental illness, symptoms of mental illness and mental health related crises (Kelly et.al, 2013).
It is common for mental illness to first manifest in adolescence. Half of all persons who will develop a mental illness have their first episode under the age of 18 (Kelly et. al, 2013). Common mental illnesses include:
- Psychotic disorders – which alter a person’s perception of reality and manifest in the form of delusions, hallucinations, poor organization and expression of thoughts and unusual behaviour in the context of cultural norms (eg. schizophrenia)
- Mood disorders – which affect emotional experiences (eg. depression and bipolar disorder)
- Anxiety disorders– where experiences of fear and tension are sufficiently excessive to hamper the ability of an individual to function.
Suicidal thoughts are a mental health problem while suicide is regularly associated with mental illness (Abel et. al, 2012; Kelly et.al, 2013). Figures 1 and 2, taken from “WHO-AIMS Report on Mental Health Systems in the Caribbean Region” (WHO, 2011) show a summary of patients’ diagnosis in outpatient facilities in the sub-region and typical diagnoses encountered in general and mental hospitals respectively.
Due to societal stigmas surrounding mental illness, many persons experiencing mental health problems do not seek care. While there is little mental illness stigma research for the Caribbean, Arthur et.al (2010) found that in Jamaica the most common emotion expressed towards mentally ill persons was fear. Additionally, avoidance, abuse and exploitation were the most common behavioural responses to persons with mental illness. Although stereotyped as violent and dangerous, persons with mental health problems are more at risk of harming themselves or being harmed by others. Persons with mental health problems should also be encouraged to seek treatment, as many persons with such problems recover or are able to manage their illness (mentalheath.org.uk).
Mental Health First Aid
First aid is the assistance given to an ill or injured person before professional medical treatment can be accessed. The aims of first aid are to:
- Preserve life
- Prevent further harm
- Promote recovery
- Provide comfort to the person who is ill or injured.
Mental health first aid, is the assistance offered to an individual developing a mental health problem or experiencing a mental health crisis. It will often be performed by someone in the individual’s social group rather than a mental health professional (Kelly et al, 2013).
Like with traditional First Aid, Mental Health First Aid can be taught as a course. The Mental Health First Aid Action Plan outlined in “Youth Mental Health First Aid” (Kelly et at, 2013) provides the basic steps for assisting a person developing a mental problem or experiencing a mental health crisis. These steps are often referenced as ALGEE and are summarized below.
Mental Health First Aid Action Plan
Approach the person, assess and assist with any crisis – find a suitable time and space to approach the person about your concerns. Respect the individuals privacy and confidentially. Possible crises include a person harming themselves (eg. self-injury, drug/alcohol abuse), experiencing extreme distress (eg. a panic attack), engaging in disturbing behaviour(eg. becoming aggressive).
Listen non-judgmentally – it is important to refrain from expressing any judgments about the person’s thoughts, feelings or situation. It is important to create an environment where the person feels like they can speak freely.
Give support and information – once the individual has felt listened to, it is easier for the first aider to offer emotional support, such as empathizing with their feelings and practical support, such as offering relevant helpful information.
Encourage the young person to get appropriate professional help
Encourage other supports – such as self-help strategies and seeking the support of family and friends. The individual should be encouraged to try self-help strategies that interest them, encourage a sense of achievement or satisfaction, are social and are likely to be safe.
As aforementioned, Mental Health First Aid is meant to assist an individual until professional treatment can be accessed. Itis, therefore, not suitable for all situations. It is important for the first aider to maintain his or her safety and to recognize situations that require immediate professional intervention.
Responding with empathy and support rather than fear and mistrust is a significant move towards assisting persons with mental health problems and addressing stigma in our society.
Executive Officer, Department of Gender Affairs
Abdel, Wendell, NelleenBaboolal, and Roger Gibson. “The Epidemiology Of Mental Health Issues In The Caribbean”. Mental Health And Psychosocial Support In Disaster Situations In The Caribbean. 1st ed. Washington, D.C: Pan-American Health Organization, 2012. Print.
Arthur, C. M. et al. “”Mad, Sick, Head Nuh Good”: Mental Illness Stigma In Jamaican Communities”. Transcultural Psychiatry 47.2 (2010): 252-275. Web.
BEKIEMPIS, Victoria. “Nearly 1 In 5 Americans Suffers From Mental Illness Each Year”.Newsweek. N.p., 2014. Web. 9 July 2016.
“Fast Facts About Mental Illness – Canadian Mental Health Association”. Canadian Mental Health Association. N.p., 2016. Web. 10 July 2016.
Kelly, Clair, Betty Kitchener, and Anthony Jorm. Youth Mental Health First Aid. 3rd ed. Parkville, Victoria: Mental Health First Aid Australia, 2014. Print.
NHS Confederation,. Key Facts And Trends In Mental Health. London: NHS Confederation Events &Publishin, 2011. Print.
Stigma And Discrimination”. Mentalhealth.org.uk. N.p., 2015. Web. 10 July 2016.
“WHO | Mental Health: A State Of Well-Being”. Who.int. N.p., 2016. Web. 10 July 2016.