Social Workers Learn From and Raise Awareness Through Mental Health First Aid

by Barbara Trainin Blank

     With greater knowledge comes greater potential to confront a problem. The growing Mental Health First Aid (MHFA) movement helps individuals identify, understand, and respond to signs of mental illness.

    MHFA originated in Australia, with some 24 other countries, including the United States, following suit. In the United States, it is the National Council for Behavioral Health—the unifying voice of America’s health care organizations that deliver mental health and addictions treatment and services—that drives the movement.

     Since the National Council introduced Mental Health First Aid USA, more than 1 million Americans have received training in it. Those who complete training are certified for three years.

    MHFA is “often likened to CPR,” says Betsy Schwartz, vice president of public education at the Council, located in DC. “It’s different from treatment, just as doing CPR is not the same as being a cardiologist. Trained individuals continue to give MHFA until professional treatment is obtained or the crisis is resolved.”

    The training covers many different types of mental illness and offers an action plan represented by the acronym ALGEE: Assess for the risk of suicide or harm. Listen nonjudgmentally. Give reassurance and information. Encourage appropriate professional help. Encourage self-help and other support strategies. There are specialized MHFA modules for adults, youth, older adults, college students, police, veterans, and EMTs.

     Several populations have particularly been targeted to receive training, including social work and public safety. At the International Association of Chiefs of Police conference in Philadelphia on October 23, 2017, the organization announced that more than 80,000 public safety officers have been trained in the first year of the One Mind Campaign, which aims to train 100 percent of law enforcement in MHFA for Public Safety.    

    This reflects the realization that approximately one in 10 police calls involves a person with mental illness, making police the nation’s de facto first responders to mental health crises. The ability of public safety officers to respond effectively to such crises is enhanced, as well, by the growing trend of police departments hiring social workers.

    The Pennsylvania Department of Corrections (PADOC) recently completed a training program for all members of the Harrisburg Bureau of Police to help identify mental illness and appropriately respond to individuals in crisis.

     Social workers are also among those who become MHFA instructors. Certified instructors are required to order manuals and prepare course materials and resources for all their participants. Upon completion of a class, instructors must provide participant evaluations to Mental Health First Aid USA.

    Certified instructors may teach the 8-hour Mental Health First Aid course to any interested audiences in the community. Those trained have included social workers, as well as educators and school administrators, members of faith communities, health and human services workers, homeless shelter workers, nurses, physicians, substance-use treatment professionals, persons with mental illness or addictions and their families, and concerned citizens.

    Renee Rawcliffe, LCSW, works for the Salvation Army of Greater New York, with a focus on disaster response and recovery. She was certified to teach MHFA in September 2012 and went on to be certified in Youth MHFA the following year.

    “I became aware of MHFA through the New York City Department of Health and Mental Hygiene, which, at the time, had a grant providing the instructor training at no cost, to service providers,” says Rawcliffe. “I knew little about the program and wasn’t sure how helpful it would be to my own practice. But the certification was excellent, and it was clear our entire agency would benefit from the training.”

    Rawcliffe continues to work with her colleague, Diane Lopez, to train the agency’s social service staff. “But the goal is to also train everyone who works with us, no matter if they are a housekeeper, maintenance worker, or case manager,” she says.

    Training everyone regardless of position is the policy of Cornerstone Montgomery, the largest provider of behavioral health services in Montgomery County, Maryland, says Whitney Reigel, LCPC, CRC, manager of Healthcare Innovations/Integrated Health.

     “It’s wonderful training, even for those who don’t provide direct service to clients,” she says. “At the very least, training makes people think about how they would respond and what they would do. For me—I hold a clinical license in counseling—it was a wonderful refresher.”

    Mavis Smith is a second-year student at New York University’s Silver School of Social Work and a paralegal with the Legal Aid Society.

    “My clients often are getting sued in housing court and experience depression and anxiety; they feel their back is against the wall,” she says. “I took the MHFA training in the fall and expect it to be effective as I have more and more clients with substance abuse problems.”

    Home Care Partners in DC offers three trainings a year to maintain its instructor designation, says Marla Lahat, LCSW, executive director, who often co-trains with Mary Ellen Zook, RN.

    “We do a standardized evaluation at the end of training and submit the results to MHFA through the National Council on Behavioral Health,” says Lahat. “Plus, anecdotally, I’ve had employees mention that they used the knowledge/skills that they learned in class in dealing with clients or family members and were grateful for the training.”

    There have also been offshoots of MHFA. Jewish Family Service (JFS) of Harrisburg, Pennsylvania, for example, offers training that lasts four rather than the requisite eight hours and draws on but isn’t the official curriculum, says Barry Stein, MSW, executive director.  

    “We felt that people could get overwhelmed by the eight hours,” he says. “Our goal is not to certify people but to sensitize them and create awareness, to be comfortable in dealing with the mentally ill and knowing how to handle a person who may be suicidal.”

    JFS has also sponsored other programs, such as speakers, to raise awareness of mental illness.

    Jack Register, LCSW, a social worker, has taken both the MHFA youth and adult courses. A former state director of NAMI (in North Carolina), he is now the CEO and clinical director of his private practice and consulting firm. He is using MHFA in working with families and in community trainings.

    “I definitely have seen the impact of MHFA on the help line with NAMI and with the individuals I teach in my diversity class for undergrad BSW students,” Register says. “It does have limitations in that it doesn’t cover co-occurring disorders.”

    Maha Younes, Ph.D., MSW, LCSW, professor and social work program director at University of Nebraska Kearney, has been researching how many social work programs—either graduate or undergraduate—are employing MHFA with their students. So far, the number of responses hasn’t “been thrilling.”

     In contrast, she says, nursing departments are using MHFA “a lot.” For her, it’s a “no-brainer” that all students in human service professions should be taking the course to help them identify symptoms of mental illness and learn how to intervene.

    While “hundreds of thousands” of individuals are using it, the social work profession is “just beginning to realize there is such a thing as MHFA,” Younes added. “We’re all broken in one way or another. How do you recognize it in others and in yourself?”

    Social worker Dianne Mack, LCSW, is the Executive Consultant for Creative Social Solutions, a training, consulting, and clinical group specializing in agency advocacy and personal/professional development for social and human service professionals, organizations, individuals, families, and communities.

    She took the MHFA training as part of the New York City Department of Mental Health and Hygiene ThriveNY Initiative launched by the City’s First Lady Chirlane Irene McCray, whose goal is to have some 200,000 New Yorkers certified in MHFA.

    So far, more than 50,000 New Yorkers have been certified, according to Meagan van Harte, Senior Director, Office of Community Resilience—NYC Department of Health and Mental Hygiene.

    “We know that mental illness doesn’t impact only the individual and his or her family, but also society at large,” she says.  “And there are societal factors that impact mental illness.”

    MHFA trainings are scheduled regularly in all five boroughs of New York City. They’re available in English, Spanish, and Mandarin, with other languages to come.

    “Response to the training courses has been widely positive,” says van Harte. “It’s about changing the culture. People are having conversations about mental illness, and there’s more non-clinician awareness. This also speaks to reducing the stigma and reducing suicide.”

    New York will be the first state to require mental health instruction for all grades. Recent legislation, slated to take effect in July 2018, was motivated by an increase in the percentage of young people who have reported a major depressive episode. This effort, like MHFA, serves to educate as many people as possible about mental health and to treat mental-health education like physical-health education.

    School-age children are considered particularly vulnerable, with eight percent of students nationwide having attempted suicide in the past six months, notes the Mental Health Association in New York State.

     Jodi Flick, MSSW, is a clinical associate professor, Behavioral Health Springboard, University of North Carolina School of Social Work. The entire university is offering Mental Health First Aid classes to all staff and faculty—at no charge—until September 2018. This was made possible by a grant from the Substance Abuse, Mental Health Services Administration.

    “MHFA is important because all of us are more likely to encounter someone experiencing a mental health problem than someone having a heart attack,” says Flick. “"But while we train everyone in CPR, very few people have any training in how to respond to someone in their life who is having a problem with depression, anxiety, substance abuse, psychosis, or trauma.”

    “We know that the earlier a person gets treatment, the less damage the problem causes to that person’s education, career, relationships, and health,” she adds. “We also know that people are more likely to recover when their community is more understanding and supportive.”

    The MHFA movement—spreading in an increasing number of countries and across the United States—is promoting knowledge about mental health among mental health/helping professionals, non-mental health professionals who may encounter mental-health issues, and others in the general community.

    For information on Mental Health First Aid, visit: http://www.mentalhealthfirstaid.org

Barbara Trainin Blank is a freelance writer in the DC area.