National Association of Counties
Washington, D.C.

 Mental health first aid gains traction with counties

By Charles Taylor

Aides to the Fairfax County, Va. Board of Supervisors will receive 12 hours of first aid training this month. That may sound fairly routine, but the training has nothing to do with splints, bandages or CPR.

The 10-member board’s support staff to will join the hundreds of county residents and employees who have taken Mental Health First Aid USA (MHFA-USA) classes, taught by trainers from the county’s Community Services Board. Nationwide, counties as geographically diverse as Sedgwick County, Kan.; Fresno County, Calif.; Clackamas County, Ore. and Fulton County, Ga. also offer or have offered the program.

During the training, certified instructors teach the common warning signs and risk factors for mental health problems — such as depression, anxiety disorders, psychoses (delusions, hallucinations), eating disorders and conditions caused by substance abuse — and how to respond to or help someone experiencing them.

Bryan Gibb, a trainer of trainers with the National Council for Community Behavioral Healthcare (NCCBH), explains the similarities to “regular” first aid.

“We do not teach people how to diagnose or treat mental illness any more than first aid teaches you how to put in a breathing tube or diagnose hypertension in someone,” he said.

Rather, Mental Health First Aid teaches a five-step action plan for individuals to provide help to someone who may be in crisis. The steps are known by the acronym ALGEE, shorthand for:

  • Assess for risk of suicide or harm
  • Listen nonjudgmentally
  • Give reassurance and information
  • Encourage appropriate professional help, and
  • Encourage self-help and other support strategies.

NCCBH coordinates the program nationally along with the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health.

Photo-MentalHealth.pngPhoto courtesy of Mental Health Association of Montgomery County, Md.
Jessica Fuchs (l) and Jack Kenney of the Mental Health Association of Montgomery County, Md. introduce an exercise to a mental health first aid class that simulates auditory hallucinations — hearing voices. Students later play the roles and discuss their reactions.

Fairfax County began offering the training in November 2011, according to Belinda Buescher, a spokeswoman for the Fairfax Community Services Board (CSB), which provides services for people with mental illness, substance use disorders, and intellectual and developmental disabilities. Since then, about 500 people have been trained, some 350 county employees among them.

Board of Supervisors Chairman Sharon Bulova decided it was time for County Board office staff to do likewise. “This program is immensely helpful in preparing our staff to connect people with the services they need,” she said. In Fairfax, county employees can take the classes for free; the instruction is offered to the general public for $25. Gibb said many jurisdictions subsidize the cost of the training, which he valued at about $250. Sedgwick County charges $85; in Clackamas County it’s $200 for the general public, $100 for county employees.

Leslie Roberts is a trainer with Fairfax CSB, she said oftentimes, when people encounter someone exhibiting signs of mental illness, they respond fearfully.

“This takes the fear out of it and gives people just hands-on education about how they could intervene and help someone to get them to either an intervention or treatment or a therapist,” she said.

The classes are highly interactive, Gibb said — including a simulation of someone having a psychotic episode who is hearing voices (the person interacts with a group while another trainee whispers messages into the “psychotic” person’s ear).

“We take the action plan and apply it to various different scenarios, both crisis and non-crisis situations,” he said.

To become a certified trainer, a person must undergo five days of instruction, offered several times a year throughout the U.S., at a cost of $2,000 per student, according to MHFA-USA.

Bullet Click here for more information on Mental Health USA.

BulletClick here to watch Fairfax County, Va.’s 2-minute presentation on Mental Health USA.

The concept originated in Australia and gained traction in the United States about five years ago, said Linda Rosenberg, CEO and executive director of NCCBH, also known as The National Council. A colleague in New Zealand mentioned the program to her around the time Missouri and Maryland were also becoming interested in the concept. She believes the program is helping to de-stigmatize mental illness.

“If you remember back, 30 years ago, people didn’t talk about having cancer. And now we have pink ribbons and runs for breast cancer,” she said. “We talk about things like pancreatic and lung cancer, and the need for funding for research. Well, we have to do the same thing around mental illness.”

Sedgwick County was an early adopter — offering the program since 2008 — and will conduct its next training in February, said Jason Scheck coordinates the program there. Among those who have taken the classes in the past are hospital and school personnel, members of faith communities and state policymakers.

He said trainees leave the classes with increased mental health literacy and a greater sense of confidence that they can help a person deal with a mental health problem. “It just helps overcome that stigma or fear of saying the wrong thing and encourages people to do those basic things like listen, provide support.

“We’ve had people in the days and weeks following the training make very appropriate referrals to our mental health center for people who were really at risk of hospitalization or suicide,” he said. “So, I think we have seen referrals from our graduates that have been really on-target and possibly life-saving.”