The Mental Health First Aid action plan

Posted on June 23rd 2018 Read in 7 minutes

The tech industry suffers from a lack of support for good mental health. A lot of companies are focused on delivering a thing above all else, an demand an unhealthy work-life balance to sprint to the finish line before the budget runs out.

I’ve worked for enough companies that clearly prioritise profit over people, and they manipulate employees to putting their own personal life and health below the profit of the company. Overworking is built-up to be some badge of honour.

People who are workaholics are likely to attempt to fix problems by throwing sheer hours at the problem. If you’re dealing with people working with anything creatively that’s a deadbeat way to get great work done. People who always work late makes the people who don’t feel inadequate for merely working reasonable hours. That’ll lead to guilt, misery, and poor morale. Worse, it’ll lead to ass-in-seat mentality where people will “stay late” out of obligation, but not really be productive.

Fire the workaholics — Signal v. Noise

At Convivio we aim to work a healthy way. By healthy, I mean putting people first, looking after each other, and working in a sustainable long-term way.

Part of that is encouraging and supporting each other to exercise and eat healthily, to care of our bodies physically. Our ambition is for mental health to be treated equally to physical health, and to take serious responsibility for the effects on mental health in the workplace.

To learn more about this, I took part in a two-day Mental Health First Aid course developed by MHFA England. It gave me a lot more confidence to help people with their mental health. They’ve done a really good job of making Mental Health First Aid accessible in a similar way to physical first aid.

ALGEE: The action plan

Physical first aid has the ABC plan: Airways, Breathing, CPR. This is a simple and memorable list of steps. In a crisis situation, you need something simple to refer to instead of complex instructions.

MHFA developed a similar plan: ALGEE

Approach and assess for risk of harm or even suicide.
Listen non-judgementally.
Give support and information.
Encourage appropriate professional help.
Encourage other forms of support.

The role of a mental health first aider is very similar to physical first aid. You’re not expected to diagnose or treat any issues, just keep someone safe and help them receive professional support. You can save lives!

1.1 Approach

If you spot signs of mental health issues, the best thing to do is approach that person directly. Doing this well is not always easy.

Is it the right time or place? Consider the most comfortable environment to raise your concerns. A public place might be less intimidating than an office.
Be mindful of personal space. Different people have different levels of comfort opening up.
Respect their privacy unless you think there is a risk of harm to self or others.
Start an open conversation, without judgement. This gives the other person a chance to express their own concerns without having to fit your perception. For example: “I’ve noticed that you’ve been working late recently and wondered how you are?”

1.2 Assess for signs of a crisis

With physical first aid, you first need to check for the most serious and life-threatening issues. If someone isn’t breathing, there is little reason checking for broken bones or bleeding.

The same is true for mental first aid. It’s important to check for the warning signs of the most serious mental health issues.

Learn to watch for warning signs of suicide, it is a potential outcome of several mental health illnesses. Noticeable signs include: excessive sadness, hopelessness, a sudden calmness, withdrawal, or making preparations.

Look for signs of self-harm, not just cutting but potentially dangerous behaviour, such as reckless driving, engaging in unsafe sex, and increased use of drugs and/or alcohol. It’s worth noting that self-harm is rarely a suicide attempt, the risk of death is mostly accidental.

Look for signs of a panic attack. They can feel similar to a heart attack.

Panic attacks can also have physical symptoms, including shaking, feeling disorientated, nausea, rapid, irregular heartbeats, dry mouth, breathlessness, sweating and dizziness.

Look for signs of an eating disorder. Anorexia has the highest morality rate of any psychiatric disorder. (Source)

These issues are statistically more common than you think, in many cases these aren’t officially diagnosed, especially with men. However, don’t discount more common issue like anxiety or depression, these can definitely feel like a crisis to the person suffering, even you can’t see the symptoms as clearly.

2. Listen

The key to non-judgemental listening is that you:

Hear and understand exactly what’s being said.
Allow the person to speak freely and comfortably without feeling judged.

Tips for non-judgemental listening

Set aside any judgement or preconceptions you hold.
Listen without interrupting.
Ask appropriate clarifying questions.
Reflect back what the person has said.
Use minimal prompts (“Mmm”, “Ah”, etc.).
Silence can be supportive, avoid the temptation to fill the silences.
Open body language.
Comfortable eye contact.
Don’t be critical, argue, or get frustrated.
Don’t offer glib advice (e.g. “Cheer up”).
It’s helpful to draw on previous experiences so that person does not feel alone and their issues are common. However, don’t take over the conversation and make it about you.
Avoid confrontation unless necessary in a crisis.
Remember, you can acknowledge emotional experience without agreeing with actions you find concerning.

3. Give support and information

Treat the person with respect and dignity.
Don’t blame them for their difficulties. Mental health issues are real and they are coping the best they can.
Have realistic expectations. Any change takes time and it doesn’t mean they are not weak or lazy.
Offer consistent emotional support and understanding.
Give hope for recovery. There are many effective treatments available.
Give practical help, but don’t try to take over and solve all their problems. Instead support new coping strategies.
Find high quality information relevant to their condition.

4. Encourage appropriate professional help

Getting professional help is very difficult but a vital step in mental health recovery. Help that person make the decision.

Discuss a wide range of options:

GPs.
Counsellors.
Psychologists.
Psychiatrists.
NHS IAPT.
Crisis Resolution Teams.
Community Mental Health Teams.
Helplines like Mind, Samaritans, Careline, and Rethink.

Their GP is usually the first port of call. In a crisis situation you can call 999.

What if a person doesn’t want help?

Explore the reasons why. It can be due to costs, fears, or a negative experience.
Tell the person you’ll support them if they change their mind.
Respect the person’s right not to seek help, unless they are a risk to themselves or others.
If a person is very unwell, seek help on their behalf. Try and involve them as much as possible.
Never threaten with forced treatment, it’s a legally complex area and rarely the best solution.

5. Encourage other forms of support

Family and friends can play key roles and can help by listening, encouraging and providing practical emotion support.
Support groups and information services can help validate experiences, reduce isolation and provide peer learning for self-help.
Self-helper strategy can help and also give people a sense of regaining control of their lives and doing something positive. There are many books, leaflets, groups, websites or apps.
Complementary therapies such as mindfulness, massage therapy, yoga, relaxation strategies, nutrition, exercise, creativity, avoiding alcohol/drugs.

What next?

Hopefully I’ve given you a good idea of the ALGEE plan and how to put it into action. You may have many more questions, feel free to ask me on Twitter or leave a comment on this post.

Also consider taking the first aid course, there’s a lot covered in two days. For more information see the MHFA England website.

After taking the course I felt a lot more comfortable talking about and raising these issues, especially self-harm which i’ve always found scary. Depression and anxiety are massively common, even if people aren’t diagnosed, and a thorough understanding of what they are helped me a lot.

You will learn:

How to spot the early signs of many mental health issues.
Feel confident helping someone experiencing a mental health issue.
Provide help on a first aid basis.
Help prevent someone from hurting themselves or others.
Help stop a mental health issue from getting worse.
Help someone recover faster.
Guide someone towards the right support.
Reduce the stigma of mental health issues.