What you should be doing on mental health day

Justin Thomas asks if any of us are prepared to render psychological first aid in the event a mental health crisis.

Psychological first aid is as crucial as physical first aid.  Bryan Denton
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Imagine you’re at the office and one of your colleagues starts to choke on his lunch. Within seconds he has turned a tortured shade of purple and his panicked eyes are screaming: “Save me.” What do you do? Even if you don’t know, the chances are you probably have one or two in your organisation who could intervene appropriately. But what if the problem is psychological, rather than physical? Can we give the psychological equivalent of first aid, and is it helpful?

The answer is an emphatic yes. In fact, for World Mental Health Day, the World Health Organisation and the World Federation for Mental Health have chosen “psychological first aid” as this year’s theme.

The concept of psychological first aid is more than 60 years old, but its benefits have recently come under the spotlight. According to Unicef, recent conflicts have resulted in a higher proportion of child and civilian deaths. It is hardly surprising then that the WHO’s Psychological First Aid: A Field Guide is one of the organisation’s most frequently downloaded publications and has been translated into 20 languages.

The general idea behind psychological first aid is that when people experience crises involving emotional trauma or sudden loss, they can benefit from having social support. Appropriate early intervention is thought to reduce the risk of people going on to develop more enduring psychological problems such as post-traumatic stress disorder, depression and substance dependence.

The person administering psychological first aid knows how to listen. They know what to say and, perhaps, most importantly of all, they know what not to say in such situations. Additionally, that person can also assess the needs and concerns of a person in crisis and provide essential information about how and where these needs can best be met.

While psychological first aid has obvious applications in conflict zones, it is also helpful in societies relatively unaffected by the trauma of war. In many countries road traffic accidents and suicide are among the leading causes of premature death. Witnessing or being connected to the victims of such tragic events can be highly distressing if not traumatic. The person administering psychological first aid can help in these situations too, perhaps preventing acute distress from morphing into chronic depression, substance dependence, both or worse.

Several nations have also incorporated psychological first aid into their major incident and disaster preparedness plans. The WHO recommends having psychological first aid teams who could, if needed, travel to areas affected by a disaster, be it famine, flood, fire or pestilence, and offer appropriate support to the survivors.

People who are likely to regularly meet trauma victims in their working lives – ambulance crews, law enforcement officers and healthcare professionals – should all also be likely candidates for training in psychological first aid. The training, like conventional first aid, is relatively simple and can be completed within a day. Furthermore, no existing healthcare or psychology background is assumed.

I would like to see every school and every organisation ensure that they have at least one psychological first aid person for every 100 students or employees. Those who are trained could be voluntarily entered in a register and mobilised in the case of a large scale humanitarian disaster within the UAE or even farther afield.

The WHO is keen to point out that while psychological first aid is necessary, it is not sufficient. Psychological first aid needs to be just one component of a broader stepped care model of mental health, with preventive, community-based, residential and specialist services all integral to a comprehensive mental health strategy. If you do one thing in support of World Mental Health Day, make a pledge to take a psychological first aid course. If you are prepared to help, you need to prepare to help.

Dr Justin Thomas is an associate professor at Zayed University

On Twitter: @DrJustinThomas