The theme for today, World Mental Health Day is, psychological and mental health first aid so I thought I’d do a short blog on this topic.
Everyone is aware of, and many people even attend compulsory training in, physical first aid. We all know what to do if someone has a nose bleed or faints, but what if someone presents as confused, seeing or hearing things that aren’t there, having a panic attack or in emotional crisis? Why do we never talk about this?
Psychological first aid is needed in the aftermath of a traumatic or critical event and can be vital for alleviating longer term conditions such as post traumatic stress disorder. Mental health first aid may be needed for someone who has a mental health condition (either pre-existing or undiagnosed) if they experience a crisis.
Yes, there is extensive training for both types but no training is needed to provide the basic human contact that would provide some relief in each situation. Here are some of the things anyone can provide in a variety of situations:
Meeting practical needs – this could mean ensuring someone is drinking enough water but could involve ensuring someone’s bills are paid or their pet is fed.
A listening ear – this does not mean pressurising someone to talk but if they need to or want to, just listen, without judging, jumping to conclusions or providing solutions too quickly. Ask them what you can do to help.
Ensuring a calm environment – a trauma or crisis situation is likely to involve heightened emotions, these are valid and it’s important not to shut them away or put a lid on them but providing a calm environment will enable the individual to feel calmer in order to express their emotions rationally
Connecting with others – the person may need to contact next of kin or someone they trust or who knows/understands the situation. It is also likely professionals will need to be involved at some point.
Protection from physical harm – when mentally unwell someone may behave in uncharacteristic ways. They may need someone to stay with them. Do not be afraid to call the police or for an ambulance if you are unsure.
What next? – ensure you and the person in need knows that plan even just in the short term.
Always remember to look after yourself in these situations. Just like if you’ve performed basic life support on someone, it can be quite shocking, managing a mental health crisis can be difficult – make sure you talk about it and get the support you need too.
Imagine you feel so overwhelmed by your feelings that you cope by cutting down on food… Imagine that as you lose weight you start to feel a bit more in control and a bit better… Imagine that you start hearing a voice that tells you to eat less and less… Now imagine the voice shouts at your when you eat, tells you you’re stupid, fat, lazy… Imagine that the only thing that makes sense in your life is not eating and losing weight… Imagine that one day you start to feel scared of this thing that once made sense… Imagine that you think you might need some help because you’re scared of your thoughts, scared of this voice, scared that you might actually be unwell. You’re scared of getting help but you’re more scared of not getting help… Now imagine, you’re told, you’re not sick enough, your weight is too high, you’re not skinny enough to get help… Now, that voice will scream at you even louder because not only did you consider fighting back against the voice but a professional has actually agreed with the voice that you should be skinnier…
This is what is happening up and down the country because the NHS doesn’t have enough money to help everyone and they have to find some way of deciding who they can help.
This is a crisis within the NHS.
I was tossed from service to service with a number of different mental health difficulties…on numerous occasions I would admit that I wasn’t eating or that I was making myself sick or doing a number of other disordered behaviours but my BMI was never quite low enough for that side of things to be taken seriously. When it finally was, I was offered “psychoeducation” (would you believe my computer wanted to change that to “psyched inaction”?!) because my BMI was 17. My BMI had to drop below 15 before I was offered more intense support. I did not deliberately drop my BMI to get the support, it was something that naturally happened because I was ill, I didn’t understand what was going on and no amount of “education” about what my body needed was going to stop the tourment inside my head that told me I was stupid, fat and lazy and had to lose weight at all costs. If, however, I’d been offered more intense support earlier, I know I would have recovered more quickly and cost the NHS less as I would have needed fewer therapy sessions to undo the extra damage that had been done.
These barriers to treatment are a false economy. Assessing anorexia and other eating disorders on physical signs alone does not take into account the fact that there are complex mental elements to the disorders. Mental health services need more funding so they can:
Stop only treating the critically physically ill
Treat everyone with a mental illness who needs it, when they need it
Support people for as long as they need it instead of cutting treatment short