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First aid for mental health

If you see a man on the street bleeding, you might apply pressure to his wound if you know what you're doing, or call an ambulance if you know that you don't.

How about if you see a woman panicking, or mumbling incoherently? Do you talk to her? Ignore her? Call 911?

"Most people don't have a clue what to do," said Arthur C. Evans, Philadelphia's director of behavioral health, who on Thursday rolled out a "Mental Health First Aid" campaign that officials described as the biggest implementation of a relatively new concept, at least in the United States.
A pilot training program begins Friday for an effort that city officials say will eventually put thousands of volunteers on the street, invisible but prepared. In much the same way, traditional first aid has provided an emergency safety net for decades.

An estimated 26 percent of adults experience a mental disorder at some point, although the numbers for conditions that most people fear or do not understand are far lower. Schizophrenia afflicts about 1 percent, compared with 18 percent for an anxiety disorder and 7 percent for a major depressive disorder.

Most mental health first aid encounters are "low intensity," Bryan V. Gibb, director of public education for the National Council for Community Behavioral Healthcare, told about 300 people from city, faith, and community organizations who turned out for a long briefing Thursday at the Convention Center.

Volunteers learn how to listen without judgment, assess the seriousness of a person who, for example, is talking about suicide, and refer him or her for treatment, if necessary. As with regular first aid, volunteers would not provide actual treatment.
Still, just knowing how to approach someone who is having a crisis can begin to resolve the situation. Rather than reacting with alarm, for instance, volunteers are taught to ask questions such as "What would make you feel safer or calmer?"

The program is also intended to reduce the stigma of psychiatric disorders by demystifying them.

"Mental illness is like physical illness. It just attacks the brain rather than the heart or the lungs," said Gibb, who will lead the training. And much like physical illness, "the sooner a person gets help," he said, "the more likely they are to have a positive outcome."

Training for instructors are scheduled through spring. Twelve-hour courses for faith groups, community organizations, and the general public are expected to begin in early summer.

Evans said the city hoped to train 1,500 people in each of the next few years. That number would be more than in the only other American city with the program, Washington, or the two states, Missouri and Rhode Island. Philadelphia will also be the first place in which independent researchers - at Drexel University School of Public Health - will study its effectiveness. Mental Health First Aid originated in Australia in 2001 (and has a koala mascot).

Instructors are the main expense and are funded in the first year by $40,000 from the Pennsylvania Commission on Crime and Delinquency. Future training, and the Drexel research, will be paid for by the city Department of Behavioral Health and Intellectual Disability Services, which Evans directs.

Evans, who is a psychologist, described the program as a "public health approach" to mental health as well as substance abuse, which are often linked.

"The way I was trained - the way most are trained - was to wait until people get sick and then to treat them," he said. The new approach is intended to take what Evans called the "treatment black box" out "into the community."

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Source: Health News , By By Don Sapatkin "Inquirer Staff Writer"

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