Can the principles of First Aid be applied to helping people suffering from mental health crises? That's exactly what the Richmond Foundation is offering with their Mental Health First Aid Course.
Having already benefitted from a standard First Aid course, I was keen to try the new Mental Health First Aid (MHFA) Course currently being offered by the Richmond Foundation. The Richmond Foundation is Malta’s leading mental health NGO, and it has recently managed to obtain certifications to deliver MHFA to interested members of the Maltese public.
This course is the only one of its kind in the country, and consists of a 12-hour programme that is modelled on standard first aid. Richmond Foundation staff deliver the course in a very welcoming manner, and includes several non-formal learning techniques which make the experience quite enjoyable.
At only €40, participants are provided with a copy of the standard MHFA Manual, a Certificate of Completion valid for three years, and a unique sense of accomplishment at having ventured into the interesting yet under-discussed field of mental health in Malta.
Why should I do MHFA?
The value of a First Aid course is now recognised globally, so much so that the majority of public and private entities are investing in training their staff to be able to respond in the case of an emergency. Whether you’re a teacher, a scout group leader, a floor manager, or even a supervisor at a factory, there is no telling when a person can get injured or suffer some form of physical ailment.
Now, let’s just take a moment to transpose all the above and add the words ‘Mental Health’. Current statistics paint a pretty stark picture, with about 1 in 4 adults suffering from some form of mental health illness. This figure is projected to eventually rise to 1 in 3 adults, as western civilisations continue to grapple with increasing economic, social, and environmental pressures.
This begs the following question: If there are so many individuals currently suffering a mental health illness, can I do something to alleviate a crisis situation if it arises?
The answer is a well-rounded ‘Yes’, and this is where the Richmond Foundation’s Mental Health First Aid (MHFA) course comes into play.
MHFA in a nutshell
Put simply, MHFA is First Aid that can be applied in a crisis situation that involves some form of mental health issue. Do not be fooled by the word ‘crisis’, as this is general technical jargon. In physical First Aid, people will learn how to conduct CPR or the Heimlich manoeuvre (abdominal thrusts), but it is unlikely that they will ever be placed in a situation where they actually have to use it. However, they will be prepared in the eventual case that an emergency does arise.
Mental illnesses are recognised as diagnosable illnesses, which means that people suffering from depression and anxiety are not making a fuss out of nothing, but are actually contending with a recognised ailment. In fact, when we talk about health we don’t distinguish between mental and physical - when one doesn’t work, the other cannot function as well.
And just like physical diseases, mental illness does not distinguish between race, class, gender, age, or any other social construct. This is precisely why MHFA is such an important tool, as anyone can become afflicted at any stage of their lives.
"Current statistics paint a pretty stark picture, with about 1 in 4 adults suffering from some form of mental health illness. This figure is projected to eventually rise to 1 in 3 adults, as western civilisations continue to grapple with increasing economic, social, and environmental pressures."
A stigma that needs to be disintegrated
One of the main points that was tackled in the MHFA course was the reality of how stigmatised mental health sufferers are in Maltese society. Some people may disagree with this statement, but if stop to think about it, this stigma has long permeated into our everyday vocabulary.
Maltese people have a longstanding habit of using derogatory terms on mental health issues in their quotidian conversations. Whether it is adjectives such as ‘mignun’ or ‘spissjat’, or even trivial phrases such as ‘I’m quite OCD about…”, or “I’m so depressed today”, these terms only manage to foment the stigma and diminish the severity of these illnesses.
But why is stigma such a relevant issue in the context of MHFA? Such a question can be answered by positing another question: Have you ever made a joke about sending someone to Mount Carmel Hospital (or Ta’ Frankuni)?
Therein lies the problem – how can people suffering from mental health issues seek the appropriate help and treatment when there is such disrepute about Malta’s only mental health hospital? According to Richmond Foundation staff delivering the MHFA course, this is a very harsh reality that they experience first-hand on the job.
This is why MHFA is such an important tool to have, as it allows ordinary people to support and direct others to appropriate services without exposing them to any shame whatsoever.
How can the Mental Health First Course be applied?
There are various real life situations that may be resolved by using the knowledge and skills acquired through MHFA. As already mentioned, the odds of having a close friend, colleague, or family member that is battling with a mental health issue are pretty high.
MHFA allows users to become more aware of certain cues and behavioural patterns that may indicate a mental health issue. We are not saying that MHFA automatically transforms you into a qualified psychologist, much in the same way that normal First Aid won’t suddenly turn you into a physician.
In fact, MHFA can be very effective in the ‘early intervention’ phase, by helping individuals before they become too unwell and cannot function. Early intervention also prevents certain problems from becoming more serious, as well as reducing secondary impacts such as job loss and poverty.
One of the highlights of the MHFA course was the role playing exercises. Before you start rolling your eyes, you might just be surprised at how close to home these scenarios actually are. The MHFA offered by the Richmond Foundation has now equipped me with the skills needed to handle a situation where a colleague may suddenly not performing on the job and is alienating themselves from other staff.
I now also know what I need to do when someone is suffering from a panic attack, has experienced some traumatic episode, and also in the rare case that an individual has a psychotic episode. In addition, I am now fully aware of the necessary steps that need to be taken if I know someone that is contemplating suicide.
"I now also know what I need to do when someone is suffering from a panic attack, has experienced some traumatic episode, and also in the rare case that an individual has a psychotic episode."
Straight from the horse’s mouth
Since reviews and window shopping are pretty much still a thing in Malta, you should definitely have a quick read through some of the feedback passed by a couple of MHFA course participants:
The Physiotherapist: "This course is just a taster, and it helps you become more sensitive to what is going on around you. It is a good tool to provide mental health first aid in certain situations."
The Medical Student: "It provides us with more compassion. From an educational perspective, it fills in a lot of gaps that are not covered by the Medical Degree psychiatry module. In fact, I think it should be part of the actual course, as it does give doctors important basics that are essential when dealing with mental health patients."
The Nutritionist: "I realised how many people that I had met have had mental illnesses and how much they were suffering. The pain seems obvious to me now after this course, but it makes me feel sad to realise that these people have never sought any help."
The Psychology Student: "Some of the notions on mental health should also be included as part of PSD in secondary schools. Including issues of sexual health has already provided added benefits to teenagers, so why not also discuss mental health issues?"
Interview with Malta’s Commissioner for Mental Health
The Mental Health Commission was established in 2012 and began operating in 2013. Dr. John Cachia, the Commissioner for Mental Health, also participated in the MHFA course held in August at the Richmond Foundation, so it seemed opportune to get a couple of comments from him:
Did you learn anything new from this course?
It was an excellent refresher. As with any profession, you need to keep yourself current and abreast with topical issues. In addition, you need to ground yourself by going back to the basics. I enjoyed the interaction between the course presenters and the participants, and the content of the course is very good as it embodies what it should be doing. I see it as one of the building blocks for general mental health awareness among the public.
Who do you think should attend this course?
Everyone and anyone should do this course. If I have to be more specific, especially in the immediate term, I would hope that people that work on the frontline of society should take this course. These include priests and village chaplains, staff working for national employment agencies (Jobsplus), social security staff, welfare officers, social workers, teachers, and medical staff to name a few.
What should the next steps for mental health in Malta be?
We need to make mental health more mainstream. This will allow us to understand the mental health perspectives of situations such as those connected with disease, early school leavers, unemployed individuals, people with housing issues, the elderly that live alone, and drug and alcohol abusers. These people have to be supported by putting mental health on the national and economic agenda.
Malta is a country that lacks resources, which makes the Maltese population one of the most important forces that drives the national economy. If our society is built on the brain power of people, then why are we discarding the only raw material that Malta has by not taking serious action?