Rob Ford Shows That 'Mental Health First Aid' is Expensive and Ineffective

Toronto mayor Rob Ford’s recent bizarre behaviour, drinking and illegal drug use has led many of this friends and colleagues to suggest that he get help. But, he insists that he does not have an addiction problem and that he does not need help. What his friends and colleagues are doing is known as mental health first aid. They see a problem and suggest a solution. And that is something that many of us do when we see a close friend or relative exhibit behaviour that might suggest depression, anxiety, alcoholism or other mental health problems.

It is a difficult topic to broach with people but we do it out of concern and love and it is intuitive. But, quite often it is met with the same denials as those by Rob Ford with little achieved.

So, imagine my surprise to discover that this act of common sense is actually an international movement that governments spend scarce mental health money on. In 1997, a couple of Aussies walking a dog in Canberra came up with the trademarked Mental Health First Aid (MHFA) Program. Tony Jorm, a mental health literacy researcher, developed the idea of a first aid course for depression and other mental illnesses with his wife Betty Kitchener. Betty had taught first aid and had also suffered with severe depression.

Today, Mental Health First Aid has spread beyond Australia to Canada, the U.S., and a total of 22 countries . And the standard course involves a 12 hour program that helps participants learn about the signs and symptoms of a number of common illnesses, how to provide initial help, where to get professional help and how to provide first aid in a crisis. In Canada, MHFA is supported by the Mental Health Commission of Canada. In the US, MHFA is supported by the National Council for Behavioral Health and in January, President Obama announced that $50 million would be allocated to “train teachers to identify signs of mental illness or provide “Mental Health First Aid” and ensure that students have access to mental health care.”

I would assume that the purpose of first aid is to provide the initial treatment until emergency personnel arrive. With traditional first aid, those who are trained would give CPR to someone in cardiac arrest until the paramedics arrived or staunch bleeding or do mouth to mouth. The ill individual would be helped and then handed over to the professionals. So, my question is does MHFA accomplish the same. Do those they counsel end with professional help? The answer from the evaluations that have been done is no.

Great article! Very educational and timely.

It’s true that most initial interventions for the mentally ill do nothing to facilitate treatment. And when these interventions DO result in treatment, it’s usually through involuntary hospitalization, which most people find horrific and detrimental to their already stressed minds.

What’s missing from the First Aid programs is patient education. Most people in a state of psychosis are terrified about what’s going on in their heads. They feel that they’re “going crazy” or losing it. And that fear, shame, and stigma prevent them from seeking treatment BEFORE the need for involuntary hospitalization.

First responders need to be equipped with the knowledge to educate the person in need about what’s going on in their mind. Normalization, rationalization, and reassurance (all techniques used in the highly successful approach of Cognitive Behavioral Therapy) should be used by first responders as a way to educate and calm the person in need.

Stabilizing the person in need enables him or her to make their own informed decisions about their own treatment. Instead of just placing them into the harsh reality of involuntary treatment.

Clearly, there are problems with the First Aid programs. But I see potential for helping, if the approach is modified to meet scientifically validated interventions.

Again, great article!



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