MENTAL HEALTH FIRST AID:

1. MENTAL HEALTH FIRST AID: Pathways to Promise 2009 Conference Companions on the Road to Recovery from Mental Illness: Pathways for the 21st Century – Models of Ministry and Collaboration Dottie Mullikin, Director of Prevention Missouri Department of Mental Health 1706 E. Elm Street Jefferson City, MO 65102 Phone (573) 526-3702 E-mail: dottie.mullikin@dmh.mo.gov Dr. Michael Jones, Associate Professor of Psychology, College of the Ozarks NAMI MO Board member NAMI National Veterans Council (417) 690-3462 E-mail: mjones@cofo.edu

2. MENTAL HEALTH FIRST AIDShow Me How! Office of Transformation Department of Mental Health 1706 E. Elm Street Jefferson City, MO 65102 Phone: 573-526-3702 Email: transformation@dmh.mo.gov

3. Mental Health Basics • 1 in 4 adults has a diagnosable mental disorder in any given year • Stigma is considered the biggest barrier to recovery for people with mental health disorders

4. Mental Health Facts • Missouri’s suicide rate is 13.3 per 100,000; for men over age 70 the rate soars to 37.0 per 100,000 • Physicians are more likely to ignore depression in older patients & focus on physical complaints

5. Mental Health and Children • Half of all lifetime cases of mental illness begin by age 14. • At least 1 in 5 children and adolescents has a mental disorder and 1 in 10 has a serious emotional disturbance.

6. Older Adults and Depression According to the National Institutes of Health, of the 35 million Americans age 65 or older, about 2 million suffer from full-blown depression. Another 5 million suffer from less severe forms of the illness.

7. Depression Looms As Global Crisis InSeptember 2009, WHO predicted that by 2030, depression will be the biggest health burden on society both economically and sociologically.

8. Take Action! It’s time to make a difference; enter Mental Health First Aid…

9. History of MHFA In 2001, Betty Kitchener and Tony Jorm developed the Mental Health First Aid (MHFA) Program at the Centre for Mental Health Research at the Australian National University.

10. MENTAL HEALTH FIRST AID The concept of first aid by the public for physical health crises is familiar to most of us. This makes it relatively easy to extend this approach to early intervention by members of the public for mental disorders and crises.

11. What Is MHFA? 12-hour course Participants learn how to: • Give first aid in a mental health crisis and/or early stages of mental health problem; • Identify early stages of mental health problems; • Recognize signs and symptoms of the most common mental health problems; • Know where and when to get help; and • Understand what types of help have been effective

12. Mental Health First Aid Content MHFA covers the symptoms and risk factors in R common mental health issues and R associated mental health crises situations ■ suicidal thoughts and behaviors ■ panic attack ■ experiencing a traumatic event ■ behavior which is perceived as threatening and ■ drug overdose

13. Mental Health Topics • Depression • Anxiety Disorders • Schizophrenia • Bipolar Disorder • Substance Use Disorders • Eating Disorders • Self-Injury

14. MHFA Action Plan A. Assess Risk of Suicide or Harm L. Listen Non-judgmentally G. Give Reassurance and Information E. Encourage Person to Get Appropriate Professional Help E. Encourage Self-help Strategies

15. MHFA is Researched-based • Formal evaluation • Publication in peer-reviewed journals

16. MHFA Evaluation Results ◘ improved recognition of mental disorders ◘ changed beliefs about treatment - more like those of health professionals ◘ decreased social distance from people with mental disorders ◘ increased confidence in providing help ◘ an increase in the amount of help provided to others

17. MHFA/USA • National Council for Behavioral Healthcare • Maryland MHFA Team • Missouri MHFA Team Working in conjunction with SAMHSA for national unity

18. MHFA/USA • Emphasis on program fidelity • Consistency of materials and trainings • Communication • Business Plan • National Evaluation

19. How Does It Work? • Contact a certified MHFA Instructor • Arrange a 12 Hour MHFA course • Order manuals • Move forward • Practice what has been learned

20. In Missouri, Here’s Our Plan: • Initially, Office of Transformation is subsidizing tuition to certify Instructors • Approaching systems: higher education, state employees, businesses, faith based organizations, partnerships with others (such as NAMI)

21. Our Goals: Thousands of Missourians will be trained how to: • Identify a mental health emergency and emerging mental illness; and (2) be effective responders to these situations

22. Mental Health and Religion The manner in which a man utilizes his religion—whether it be to enrich and ennoble his life or to excuse his selfishness and cruelty, or to rationalize his delusions and hallucinations or to clothe himself in a comforting illusion of omnipotence—is a commentary on the state of his mental health. -Karl A. Menninger

23. MHFA & Faith Based Organizations • Houses of worship are a source of shelter and comfort for so many • The stigma of mental illness can prevent individuals and families from getting the shelter and comfort they so desperately need • It is vital that mental illness be recognized as a medical issue and be treated as such

24. When the Rubber Meets the Road Often, in rural communities, when mental health disorders begin to manifest, help is sought from the local pastor…

25. MHFA Can Be a Resource • Relatively affordable • Empowering • Makes a difference • Readily embraced

26. Here Is An Example From MHFA: Topic • Film clip from DVD • Discussion • Manual • Exercises

27. Depression • What is depression? • Symptoms • Other mood disorders • Causes of depression • Mental Health First Aid Action Plan for Depression: ALGEE • Interactive; film; suicide

29. Identifying Depression • Measure depression by time and by severity — impact on function. When you have severe symptoms that last at least two weeks and are interfering with fundamental basic functions, it falls into the realm of clinical depression.

32. Depression: Symptom Summary • 5 Signs of Clinical Depression: Changes in • Appetite • Sleep • Concentration • Energy level • Interest in activities one would normally enjoy

36. ALGEE for Depression • Action A: Assess the risk for suicide or harm

46. ALGEE for Depression • Action L: Listen non-judgmentally

50. ALGEE for Depression • Action G: Give Reassurance and Information