1. Mental Health First Aid USA is coordinated by the National Council for Behavioral Health, the Maryland Department of Health and Mental Hygiene, and the Missouri Department of Mental Health. Mental Health First Aid USA – A Public Education Program for Adults, Older Adults and Youth Missy Moore Community Liaison, Right at Home of DC National Trainer, Mental Health First Aid Bryan Gibb Director of Public Education National Council for Behavioral Health

5. Mental Health First Aid is the help offered to a person developing a mental health problem or experiencing a mental health crisis. The first aid is given until appropriate treatment and support are received or until the crisis resolves.

6. Mental Health First Aiders What we are Mental Health Ambassadors Caring Colleagues Informed Helpers Resource knowledgeable Aware of what’s appropriate for each audience What we are not Diagnosticians Treatment Providers Trained interventionists Long term care providers Emergency providers

7. Growth by the Numbers MORE THAN 8,000CERTIFIEDINSTRUCTORS 4,500+ YOUTH INSTRUCTORS As of August 1, 2015 we have trained 425,000 people total As of August 1, 2015 we have trained 105,000 people in the youth program

8. Reported through April 2015 AK 2,289 (42) WA 6,570 (132) OR 5,203 (110) CA 35,285 (700) NV 1,139 (66) ID 956 (20) MT 1,353 (46) WY 565 (43) UT 1,620 (37) AZ 9,271 (165) CO 14,873 (248) NM 5,343 (106) TX 19,096 (581) OK 2,476 (61) KS 9,236 (119) NE 1,233 (53) SD 1,636 (17) ND 762 (17) MN 3,956 (45) IA 9,716 (107) MO 19,445 (238) AR 1,670 (15) LA 419 (11) MS 3,089 (70) AL 1,732 (53) GA 5,001 (112) FL 6,474 (207) SC 513 (14) TN WV 164 (11) OH 5,240 (190) IN 2,782 (104) IL 13,501 (229) KY 1,224 (54) MI 18,028 (250) NY 7,269 (272) PA 28,403 (514) NC 8,818 (216) VA 8,827 (274) ME 1,211 (15) WI 1,318 (49) 1,990 (40) 0.15% or more 0.075%-0.149% 0.04%-0.074% 0.025%-0.039% Less than 0.025% PERCENTAGE OF POPULATION TRAINED MD 12,073 (510) DE 298 (18) NJ 4,630 (147) CT 5,760 (109) RI 631 (11) MA 2,231 (95 ) NH 470 (50) DC 2,682 (80) VT 997 (46) GUAM 37 (2) PR 340 (2) HI 107 (7) ALGEE-OMETER More than 450,000 First Aiders in the US Trained by more than 8,000 Instructors

9. Audiences 31.4%General Community/Not Specified 25,000 Courses (through April 2015) 24.7%Behavioral Health 15.9%Higher Education 7.0%Social Services 6.9%Primary Care 6.7%Law Enforcement/Public Safety 5.6%Faith Communities 4.5%Youth-focused entities 0.6%Business/Corporations 2.2%Other

10. MHFA Action Plan Assess for risk of suicide or harm Listen nonjudgmentally Give reassurance and information Encourage appropriate professional help Encourage self-help and other support strategies

11. Adult Curriculum Overview What is Mental Health First Aid? Mental Health Problems in the United States Mental Health First Aid Action Plan Understanding Depression and Anxiety Mental Health First Aid Action Plan for Depression and Anxiety  Suicidal Behavior - Depressive Symptoms  Nonsuicidal Self-Injury  Panic Attacks  Traumatic Events  Anxiety Symptoms Understanding Psychosis Mental Health First Aid Action Plan  Acute Psychosis - Disruptive or Aggressive Behavior Understanding Substance Use Disorders Mental Health First Aid Action Plan  Overdose - Withdrawal  Substance Use Disorders Using your Mental Health First Aid Training

12. Youth Curriculum Overview: What is Youth Mental Health First Aid? Adolescent Development & Mental Health Problems in Youth What you may see:  Signs and Symptoms  Risk Factors and Protective Factors Mental Health First Aid Action Plan Using the Mental Health First Aid Action Plan  In Non-Crisis Situations  In Crisis Situations

13. U.S. Adults with Higher Incidence Mental Disorders/Addictions in Any One Year Type of Mental Disorder% Adults Anxiety disorder19.1. Major depressive disorder6.8. Substance use disorder8.0. Bipolar disorder2.8. Eating disorders2.1. Schizophrenia0.45. Any mental disorder19.6. Only 41% of people with a mental illness use mental health services in any given year

14. U.S. Youth with a Mental Disorder During Adolescence (Age 13-18) Prevalence (%) With severe impact (%) Anxiety disorders31.98.3 Behavior disorders19.19.6 Mood disorders14.311.2 Substance use disorders11.4 n/a Overall prevalence (with severe impact) 22.2

15. Why MHFA Focused on Older Adults?

16. Why Mental Health First Aid for Those who Work With Youth? Mental health problems are common Mental health problems often develop during adolescence Youth and young adults may experience mental health problems differently than adults Youth may not be well informed The sooner an individual gets help, the more likely they are to have a positive outcome Misunderstanding and discrimination are often associated with mental health problems Professional help is not always on hand Youth Empowerment is key!

17. Recovery from Mental Illness “Recovery is the process in which people are able to live, work, learn, and participate fully in their communities.” “For some, this is the ability to live a fulfilling and productive life despite a disability.” “For others, recovery implies the reduction or complete remission of symptoms.” — President’s New Freedom Commission on Mental Health vii

18. Exercise Disability Weights

19. Depression and Anxiety Are among the most common mental illnesses Can impact individuals through their lives Can have some similar signs and symptoms Can frequently co-occur

20. Signs and Symptoms of Depression Symptoms What they may feel Sadness/anxiety Low energy Sleep disturbance Appetite change Headaches Pessimism Loss of sexual desire Unexplained aches and pains Hopelessness Helplessness Thoughts of death and suicide Signs What we may see Weight change Withdrawal from others Irritability Changes in self care/appearance Personality change Tearfulness Errors Indecisiveness/confusion Disorganized Forgetful Self-criticism

21. Signs & Symptoms of Anxiety Symptoms What they may feel Fearfulness Excessive worry Mind racing Avoiding situations Feeling “on edge” Sleep disturbance Shortness of breath Dizziness Dry mouth Signs What you may see Physical tension/fidgeting Impatience Irritability Anger Difficulty completing projects Avoidance of situations Panic Excessive worry

22. (From Living with IT: A survivor’s Guide to Panic Attacks – Bev Aisbett)

23. Film Clip Alice’s Story

24. Suicide Risk Assessment Sex Age Chronic physical illness Mental illness Use of alcohol or other substances Less social support Previous attempt Organized plan

25. Warning Signs of Suicide Threatening to hurt or kill oneself Seeking access to means Talking or writing about death, dying, or suicide Feeling hopeless Feeling worthless or a lack of purpose Acting recklessly or engaging in risky activities Feeling trapped Increasing alcohol or drug use Withdrawing from family, friends, or society Demonstrating rage and anger or seeking revenge Appearing agitated Having a dramatic change in mood

26. Questions to Ask Ask the person directly whether he or she is suicidal: “Are you having thoughts of suicide?” “Are you thinking about killing yourself?” Ask the person whether he or she has a plan: “Have you decided how you are going to kill yourself?” “Have you decided when you would do it?” “Have you collected the things you need to carry out your plan?”

27. How to Talk with a Person Who Is Suicidal Let the person know you are concerned and are willing to help Discuss your observations with the person Ask the question without dread Do not express a negative judgment Appear confident, as this can be reassuring Check For Two Other Risks Has the person been using alcohol or other drugs? Has he or she made a suicide attempt in the past?

28. Keeping the Person Safe Provide a safety contact number Help the person identify past supports Involve them in decision making Call law enforcement if the person has a weapon or is behaving aggressively Do Not Leave an actively suicidal person alone Use guilt and threats to try to prevent suicide  You will go to hell  You will ruin other people’s lives if you die by suicide Agree to keep their plan a secret

29. Listening Nonjudgmentally Key attitudes to make the person feel respected, accepted, and understood: Acceptance Genuineness Empathy Key nonverbal skills to show you are listening: Attentiveness Comfortable eye contact Open body posture Being seated Sitting next to the person rather than directly opposite Not fidgeting

30. Give Reassurance and Information Treat the person with respect and dignity Do not blame the person for his or her symptoms Have realistic expectations Offer consistent emotional support and understanding Give the person hope for recovery Provide practical help Offer information

31. What Isn’t Supportive Do not just tell the person to “snap out of it” Do not be hostile or sarcastic Do not adopt an overinvolved or overprotective attitude Do not nag the person to do what he or she normally would do Do not trivialize the person’s experiences Do not belittle or dismiss the person’s feelings Avoid speaking with a patronizing tone Resist the urge to try to “cure” the person

32. Encourage Appropriate Professional Help Types of Professionals  Doctors (primary care physicians)  Psychiatrists  Social workers, counselors, and other mental health professionals  Certified peer specialists Types of Professional Help  “Talk” therapies  Medication  Other professional supports

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34. Mental Health First Aid USA

35. @NationalCouncil @MHFirstAidUSA /TheNationalCouncil /Mental-Health-First-Aid-USA info@mentalhealthfirstaid.org 202. 684.7457