By CRISTINA JANNEY
If someone fell and gashed their leg, a stranger would likely jump to their aid. They would apply pressure to stop the bleeding and call 911.
Training in first aid and CPR is common for many Americans — even required by some professions and volunteer organizations.
How many of us would know what to do if someone was suicidal? How many of us even know the signs and symptoms of depression? How many of us would simply walk away too afraid to get involved?
High Plains Mental Health offers a day-long course in Mental Health First Aid. The program originated in Australia and now is offered across the U.S., including 10 years through High Plains for the adult program and six years for the youth program. Since the program started, HPMH has certified 2,387 northwest Kansas residents (from 20 counties) in Mental Health First Aid.
The course covers the most common mental illness, including depression, anxiety disorders, psychotic disorders and substance use disorders as well as ways every-day people can help people suffering from mental illness.
High Plains last year received a $20,550 grant from the Kansas Health Foundation to expand its Mental Health First Aid program and has had record participation this year. It has placed an emphasis this year on training first responders, said Kaley Conner, HPMH marketing coordinator and MHFA trainer. High Plains also received a $25,000 grant from the Schmidt Foundation this year to further public education and outreach efforts geared toward the agribusiness community. A small portion of that funding will also go toward MHFA.
Between 2014 and 2017, the suicide rate in the 20 northwest counties served by High Plains increased by 64 percent. In addition, a Centers for Disease Control study released in July 2016 reported farmers as a group had the highest suicide rate of any occupation in the U.S.
Mental illness affects about one and five Americans. It is more prevalent than cardiovascular disease, diabetes and chronic respiratory disease. Many people delay seeking help because of lack of education about mental illness or the stigma surrounding it. Support services may be hard to access, especially in rural communities, and the person suffering the illness might not have good insight into to their illness, according to the MHFA curriculum.
Conner talked about why the MHFA classes are important.
“First and foremost, this class helps raise awareness in our communities, as well as acceptance and empathy,” Conner said. “It is important for our communities to talk about mental health and to understand mental illness is a real illness that has the potential to be very impactful.
“It is also important to give community members practical, easy to remember tools for how they can approach and offer assistance to someone who might be struggling. When someone has a possible mental health problem, it is often going to be family members, friends, colleagues and others in the community who might first notice. For this reason, it is important for community members to be educated about possible warning signs and symptoms, and to know how to respond effectively.”
The first section in the MHFA curriculum discusses depression and goes on to discuss suicide prevention.
Although women present more often for treatment for depression, statistically men are more likely to complete suicide because they tend to use more lethal means, including guns and hanging. Men are four times more likely to complete suicide than women. Although this is a trend, it is not true in all cases.
Depression, which is believed to be caused by the changes in the natural brain chemicals called neurotransmitters, can have many causes, according to the HMFA curriculum.
Some of the risk factors include:
- Stressful or traumatic events
- A difficult childhood
- Ongoing stress and anxiety
- Long-term poverty
- Victim of a crime
- Long-term physical illness
- Death of a partner
- Substance abuse
Depression can also be the result of another medical condition, childbirth (AKA postpartum depression), side effect of medication, the stress of having another mental illness, withdrawal from drugs or alcohol premenstrual changes, lack of exposure to light in the winter (AKA seasonal affective disorder), caring for a person with a long-term disability.
You may be more prone to have depression if you have a family member who has had depression or you have had a previous episode of depression.
Additional risk factors for suicide, include a previous suicide attempt, a friend or loved one who has completed suicide, and an organized plan.
If you believe a person is suffering from mental illness, the trainers urged first aiders to talk to person using “I” statements, as opposed to “you” statements that may seem judgmental. For example, “I am concerned about you.”
There is a difference between empathy and sympathy. Avoid saying, “I understand exactly how you feel.” You don’t. Instead you might say, “I can imagine how you might be feeling.” Empathy, trying to put yourself in another’s shoes, is different than sympathy, feeling sorry for someone.
Other helpful examples included:
- How long have you been feeling this way?
- Have you spoken to anyone about this before?
- Is something bothering you?
- You haven’t been joining us lately at coffee.
- If the feelings that you are describing have been present for a long time, I think it’s important that you see your family physician.
Your goal as a mental health first aider is not to treat the person who is suffering from the mental health crisis, just as a physical first aider you are not going to set a person’s broken leg. You can offer to get the person to the professional help they need.
“You may not know how to handle the situation,” Conner said, “but you can move them on to someone who does.”
The course offers the acronym ALGEE to help first aiders remember the steps in aiding in a mental health crisis.
- Access risk of suicide or harm.
- Listen non-judgmentally
- Give reassurance and information
- Encourage appropriate professional help
- Encourage self-help and other support strategies
When accessing risk of suicide, there are signs to look for:
- Saying goodbye
- Giving away items
- Saying they are thinking of killing themselves
- Talking about suicide, death or dying on social media
- Seeking means to kills themselves (buying a gun, seeking pills)
- Expressing hopelessness
- Engaging in reckless behavior
- Increased alcohol or drug use
- Dramatic mood change
- Anxiety or agitation, unable to sleep or sleeping all of the time
- Saying they feel trapped
According to the MHFA trainers, asking a person if her or she is considering suicide will not cause the person to kill him or herself or “put the idea in their head.” Talking about their thoughts and feelings may give them a release.
Amy Bird, MHFA trainer, said talking about death or suicide should not be thought of as an attention-seeking behavior. It should be thought of as attention-needing. The person may feel hopeless and worthless, and they need your help.
If you believe a loved one or you may be at risk of suicide, it is wise to put as much distance between thought and action as possible, the trainers said. For instance, move guns out of the house, separate guns from ammo, remove pills from the house.
If you have an immediate concern about a person’s safety, speak to them calmly and sincerely. Appearing confident can be reassuring. Ask:
- Are you having thoughts of suicide?
- Are you thinking of harming yourself?
- Have you decided how you are going to kill yourself?
- Have you decided when you are going to kill yourself?
- Have you collected the things you need to carry out your plan?
If you have a serious concern about a person’s safety, do not put yourself in danger. If the person has a weapon or is acting aggressively, call 911.
High Plains has a 24-hour crisis line that can be reached at 1-800-432-0333. The National Suicide Prevention Lifeline is 1-800-273-TALK (8255). The national suicide crisis text line can be reached at 741741.
The annual Hays Area Out of the Darkness Walk, which seeks to bring light to the issue of suicide is Saturday at Municipal Park. Registration will start at 1 p.m. in Municipal Park and the walk will start at 2 p.m. If you are interested in walking, volunteering or donating, go to www.asfp.org/Hays.
When dealing with a mental health crisis, include the person in making a safety plan. Do not leave a person who is actively suicidal alone. However, you must recognize you can’t be with a person at every moment. You can help them with the second E in ALGEE by asking them what has been helpful in the past.
Do not use guilt to try to dissuade the person from hurting his or herself. Don’t make comments such as “You will go to hell” or “You are going to ruin other people’s lives.” Also don’t agree to keep the person’s suicide plan a secret.
Help can be found through doctors, psychiatrists, social workers, counselors, peer specialists and other mental health workers. Some people suffering depression may be prescribed medication. They may also engage in talk therapy, support groups or other professional support. Sadly, only about half of the people with depression in a given year receive treatment.
Other self-help strategies can include:
- Relaxation and meditation
- Peer support groups, such as National Alliance on Mental Illness (NAMI). The local NAMI group meets on the first Monday of the month at 6 p.m. at the Hadley Center. For more information contact Ann Leiker, coordinator at 785-259-6859 or email her at firstname.lastname@example.org.
- Light therapy
- Family, friends, faith and social networks
- American Association of Suicidology
- American Foundation for Suicide Prevention
- National Alliance on Mental Illness (NAMI)
- National Council of Mental Health
- 7 Cups of Tea
- Postpartum Support International
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