A co-worker of mine and I just participated in a Mental Health First Responder course, offered through Mental Health First Aid Colorado network, part of the larger national Mental Health First Aid group. The groups’ aims are to have many more people complete Mental Health First Aid Responder training, similar to CPR and other first aid trainings. The training covered signs and symptoms for common mental health issues: depression, anxiety, panic attacks, suicidal thoughts, psychotic disorders, and substance abuse issues. The course emphasizes that mental health first aid is first and foremost a bridge to professional mental health resources. Yet the course gave practical, down to earth recommendations for compassionately talking with friends, family, (or patrons!) dealing with these issues.

I thought it was particularly helpful that our instructor discussed mental health in terms of a spectrum–that many mental health disorders are manageable with treatment–and gave clear definitions of when a mental health issue needs to be addressed with professional help, usually when the symptoms starts to interfere with work, home, relationships, or a person’s normal activities.

The course also addressed the very real mental health stigmas in our culture. I thought it was particularly interesting to hear that on average, it takes someone suffering from a mental health issue eight or more years of struggling on their own before they seek treatment (Wang, Berglund, Olfson, Pincus, Wells, & Kessler, 2005). And that when people do seek treatment, they are much more likely to focus on describing any physical symptoms rather than emotional ones. Some of the other statistics presented painted a very different picture of mental illness compared with what we see on tv and other media. The training handbook cites Kessler, Berglund, Demler, Jin, and Walters (2005), saying that more than half of American adults will experience some type of mental health issue at some point.

The program teaches an acronym for mental health first aid steps that is similar to CPR’s ABC. The ALGEE acronym stands for Assess for risk of suicide, Listen non-judgmentally, Give reassurance, Encourage appropriate professional help, and Encourage self-help and other support strategies (Mental Health Association of Maryland, Missouri Department of Mental Health, and National Council for Behavioral Health, 2013).

My cohort was primarily other librarians from public, academic, and specialized libraries. It was really interesting to me that the public librarians had no qualms about whether conversations with patrons on mental health issues were part of their jobs. A colleague mentioned that Denver Public Library is hiring a social worker and quite a few other public libraries have done or plan to do so soon. Yet among the academic and special library folks, I think many of us experienced a hesitancy– that mental health first aid was maybe “none of our business,” outside of our boundaries as professionals.

I was glad that our instructor underlined the importance of boundaries and your own comfort level when attempting to offer help to others; yet she made it very clear that caring for our neighbors, our patrons, and those in our community is something every person can, and  should do. Also that checking in with someone or having a conversation about what they need to feel better is a very human thing to do. These conversations needn’t be stressful or scary when prepared with the courses’ techniques. I would highly recommend this course to anyone–and I think it would be particularly valuable for librarians and educators.

And so the past few weeks I’ve been intentionally asking a few more open-ended questions when patrons disclose a mental health issue they are struggling with instead of shying away. I’ve offered additional resources to a couple of folks. And I am much more aware of my own reactions to patrons’ behavior and what messages I might be unconsciously sending.

References:

Kessler, R.C., Berglund, P.A., Demler, O., Jin, R., and Walters, E.E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV Disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry. 62, 593-602.

Mental Health Association of Maryland, Missouri Department of Mental Health, and National Council for Behavioral Health. (2013). Mental Health First Aid USA, Revised First Edition. Lutherville, MD: Mental Health Association of Maryland.

Wang, P.S., Berglund, P. Olfson, M., Pincus, H.A., Wells, K.B., and Kessler, R.C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry. 62, 629-640.