Information below has been gathered from the Mental Health First Aid for adults manual: Mental Health First Aid USA. 2020. Mental Health First Aid for Adults Assisting Adults. Washington, DC: National Council for Behavioral Health
Also known as mental illnesses, mental health disorders are a diagnosable health conditions involving changes in emotion, thinking, or behavior (or a combination of these). Mental illnesses are associated with distress and/or problems functioning in social, work, or family activities.
Some of the main categories of mental health disorders are mood disorders, anxiety disorders, personality disorders, psychotic disorders, eating disorders, trauma-related disorders, and substance use disorders.
Anxiety is the most common mental health disorder amongst US adults, and often times mental disorders can occur simultaneously - this is referred to as co-occurrence, or comorbidity, to describe the presence of more than one mental health disorder. Of adults in the US with any mental disorder in any 1 year period, 14.4% have one disorder, 5.8% have two, and 6% have three or more.
Mental health challenges and disorders are the leading cause of disability in the United States and Canada (National Institute of Mental Health [NIMH], 2017). They account for 25 percent of years of life lost due to disability or early death (U.S. Burden of Disease Collaborators, 2013). Disability refers to the amount of disruption a health problem causes to a person's ability to study, work, look after themselves, and carry on relationships with family and friends.
Mental health disorders can culminate in signs, which are visual, observable characteristics, as well as symptoms, which the individual feels internally. Mental health disorders can affect the way a person thinks, the way a person feels, the way a person behaves, as well as the physical lived experience in the body.
The cards below are not exhaustive lists, and are intended to be a general offering of signs and symptoms of mental health challenges; they do not dive into specific mental health disorders. Individuals experience mental health disorders differently, and may present with different symptoms.
If a person is struggling with mental health challenges, they may not necessarily be having a crisis. They can be experiencing symptoms short or long term that, when managed with professional care, do not escalate to a state of emergency or crisis. It is important to intervene as soon as possible and help direct folks to professional medical care when the signs and symptoms above come into play.
● The person may harm themselves by attempting suicide, using alcohol or substances to become intoxicated, attempting to achieve extreme weight loss, engaging in nonsuicidal self-injury such as cutting or scratching the skin (intentional, but not a suicide attempt)
● The person experiences extreme distress, such as a panic attack or a reaction to a traumatic event - every person has their own unique way of reacting to traumatic events
● The person’s behavior is very disturbing to others (they become guarded, or frightened, or lose touch with reality)
● Threatening to hurt or kill themselves
● Seeking access to lethal means, such as pills, weapons, etc
● Talking or writing about death, dying, or suicide
● Expressing hopelessness, no reason for living, having no sense of purpose in life, or not wanting to be alive
● Sudden changes in behavior, like:
○ Ending friendships
○ Drastic drops in grades in coursework or drastic drop in work output
○ Starting or engaging in more arguments with friends and family
○ Withdrawing from friends, family, or activities they normally participate in
○ Having a sudden, dramatic change in mood or irritability
○ Dramatic changes in sleep (sleeping all the time or inability to sleep)
○ Giving away prized possessions
There are a variety of steps and actions that can be taken to assist a person who may be having a mental health emergency. Mental Health First Aid recommends an approach they call ALGEE.
● Approach the person about their concerns
● Find a suitable time and space where both people feel comfortable
● If the person does not initiate a conversation with you about how they are feeling, you can say something to start a conversation
● Respect the person’s privacy and confidentiality
● When someone is telling you about their challenges and struggles, it is important to set aside judgments about them or their situation
● Most people experiencing distressing emotions and thoughts want to be heard before being offered helpful options or resources
● A person may not want to open up to you until they feel you care enough or are trustworthy and willing to listen
● People may also downplay their problems, particularly if they feel guilty about upsetting you or disappointing you
● Some have trouble opening up for fear of the vulnerability and being perceived as weak
● Your goals in listening non-judgmentally are:
○ Allow yourself to really hear and understand what is being said
○ Make it easier for the person to feel they can talk freely about their problems without being judged
○ Respect the person’s culture, which may be much different than your own
● To accomplish this, you will
○ Use “I” statements and non-judgmentally state what you have noticed; for example, “I noticed that you look like you may be feeling a bit sad about something.”
○ Ask questions, but don’t push; “did something happen?” or “Is there something going on to make you feel this way?”
○ Be in the present with them, without comparing to your own experience; “A conflict with a coworker can be tough.” Saying something like, “I know exactly what you are going through,” may not be helpful as we can never know exactly what this other person is experiencing and we all experience things differently - this sort of statement may shut down a conversation.
○ Be accepting, even though you may not agree with the person; if the person says that going to work is too much to handle, empathize with their frustration - it is not the time to convince them otherwise or to take specific actions to fix the issue
○ Repeat back what you hear to make sure you have a mutual understanding
○ Be positive with any feedback given
● Being aware of your own verbal communication skills, as well as your nonverbal cues, can help you be a better listener. It is important to note that some neurodivergent folks may not present or comprehend the same non-verbal cues neurotypical people may while listening non-judgmentally - such as prolonged eye contact, sitting still, etc.
● While listening and in conversation with someone about their mental health:
○ Ask questions that show you genuinely care and want to understand
○ Check your understanding by restating what the person has said
○ Listen not only to the words said, but how they are said; tone of voice and other cues can give extra clues about how they are feeling
○ Be patient if the person is struggling to communicate
○ Do no be critical or express frustration at the person or their symptoms
○ Avoid giving unhelpful advice; “get a grip,” “cheer up,” “calm down.” If this were possible, the person would have done it already.
○ Do not interrupt when they are speaking
○ Remember that pauses and silence are okay! The person may need time to think on what has been said or may be struggling to find the words they need
● Start by offering general reassuring statements, such as “thank you for sharing your experience with me, I appreciate your trust, a lot of people have reported similar experiences and have found support from a professional who knows treatments that may help.”
○ Yale Mental Health and Counseling
○ Magellan
○ Optum EAP
○ 988 Suicide and crisis line call or text
○ Text 741741 Crisis text line
○ Call 211, Connecticut Crisis Response line
○ Call 911, federal life threatening emergency line
○ Krista Dobson, non-clinical counselor for DGSD students
○ SHARE Center
○ Good Life Center
○ Chaplain’s office
● Many do not consider professional help from a therapist, psychiatrist, social worker, counselor, or otherwise because they feel (or are) inaccessible. At Yale, all students and staff have mental health care coverage included in their insurance, so coverage should not be a concern within our community; professionals are equipped with resources that others are not to help a person develop healthy coping strategies and work through the challenges they are facing
● Ask the person if there are any self-help strategies in the past they found helpful when they were having a mental health challenge; such as deep breathing through a panic. If they need support for these self-help strategies, offer it
Recovery is a process of change through which people improve their health and well-being, live self-directed lives, and strive to reach their full potential. Recovery is also a term used to describe the period of time when people with mental illness come to accept the challenge of their illness and work to overcome it (SAMHSA, 2017). There are four major dimensions in a person’s life that support recovery:
Health - Overcoming or managing one's disorder(s) or symptoms and making informed, healthy choices that support physical and emotional well-being
Home - Having a stable and safe place to live
Purpose - Conducting meaningful daily activities and having the independence, income, and resources to participate in society
Community - Having relationships and social networks that provide support, friendship, love and hope
Hope - the belief that these challenges can be overcome - is the foundation of recovery. Setbacks are not failures but rather part of the recovery process. It is not linear.
The 988 Suicide & Crisis Lifeline provides free and confidential emotional support to people in suicidal crisis or emotional distress 24 hours a day, 7 days a week, across the United States. The Lifeline is comprised of a national network of over 200 local crisis centers, combining custom local care and resources with national standards and best practices.
The United Way of Connecticut (UWC), in partnership with the CT Department of Mental Health and Addiction Services (DMHAS), has established the Adult Telephone Intervention and Options Network (ACTION) line for adults 18 years of age or older who are in the community and in the midst of a psychiatric or emotional crisis for which an immediate response may be required.
The ACTION line is a centralized phone number answered by 2-1-1 staff trained to offer an array of supports and options to individuals in distress, including: telephonic support, referrals and information about community resources and services; warm-transfer to the Mobile Crisis Team (MCT) of their area; and when necessary, direct connection to 911.
The ACTION line operates 24 hours a day, seven days a week, 365 days a year (24/7/365) with the availability of multilingual staff or interpreters as needed. The centralized line is available to provide after-hours coverage for mobile crisis providers throughout the state
The services and supports offered through the ACTION line are available to all residents of Connecticut at no financial cost to the caller.
The ACTION line team is comprised of dedicated contact specialists, licensed clinicians and a peer support specialist with lived experience with mental health and substance use/addiction.
The DMHAS mobile crisis teams and ACTION Line staff work in collaboration with family members, peer-run organizations, faith-based communities, law enforcement, and other civic and community organizations to ensure that persons in distress and their families/friends/supporters have the support and resources they need within their local community.
United Way of CT meets and exceeds the highest national standards for a call center. It is a National Suicide Prevention Lifeline (NSPL) provider that maintains national accreditations from the Alliance for Information and Referral Services (AIRS) and the American Association of Suicidology (AAS).
Mobile Crisis Team (MCT) staff provide immediate assistance to people in distress by identifying options and resources that meet the unique needs expressed by the individual. The Mobile Crisis Teams are mostly located across the DMHAS Local Mental Health Authority (LMHA) Network and DMHAS funds and operates MCT services throughout the state. MCT services are mobile, readily accessible, short term services for individuals and families experiencing acute mental health and/or substance use/addiction crises offered in a rapid response framework. MCT aim to promote the prevention of crises among persons and families and postvention activities that support persons in developing a meaningful sense of belonging in their communities. Mobile Crisis Teams are comprised of a multidisciplinary team which may include licensed master’s level social workers, licensed clinical social workers, licensed professional counselors, peer support specialists, nurses, mental health workers and psychologists.
The Crisis Text Line provides free, 24 hours/7 days a week, high-quality text-based mental health support and crisis intervention by empowering a community of trained volunteers to support people in their moments of need.
This service provides support through active listening, collaborative problem solving, and safety planning for texters in their moment of crisis. The Crisis Text Line is a resource for folks experiencing difficulties with a wide variety of emotional experiences and mental health conditions - including (but not limited to), living with eating disorders, anxiety, depression, and more. Volunteer counselors can provide support - not medical advice.
The Crisis Text Line can be accessed through SMS text message, WhatsApp, Facebook Messenger, as well as their own online chat platform on their website!
A trained volunteer counselor will text with you until you both feel you are in a "cool," safe place.
The Crisis Text Line is also available in Spanish - text AYUDA to 741741
