Reducing Stigma & Empowering Our Community: An Introduction to Mental Health First Aid

1. Reducing Stigma & Empowering Our Community: An Introduction to Mental Health First Aid Jessica Heavin, MS, LPC, NCC

2. Agenda • Discuss the prevalence of mental health disorders in the US • Discuss how mental illness impacts the workplace • Discuss the purposes and effectiveness of Mental Health First Aid (MHFA) • Discuss how MHFA can be utilized in the HR/business environment • Identify the primary audiences for MHFA training

3. You tell me... • How many of you have ever been asked to address a mental health issue or crisis at work? • Make a mandated referral to an EAP? • Did you feel prepared? Why or why not?

4. Quick Poll... • How many people are certified in CPR/First Aid? • How many people are certified in Mental Health First Aid or some sort of MH crisis intervention? • Fact: Statistically, you are more likely to encounter someone in an emotional or mental health crisis than someone having a heart attack, yet there are huge disparities in the numbers of people trained • Mental Illnesses are more common than heart disease and cancer combined

5. Defining the Issue • Let’s write our own definition of Mental Illness- • If you struggle with how to word it, how would you describe it to a child?

6. What Is a Mental Disorder? A mental disorder or mental illness is a diagnosable illness that: • Affects a person’s thinking, emotional state, and behavior • Disrupts the person’s ability to • Work • Carry out daily activities • Engage in satisfying relationships

7. Another poll.... • What is the #1 mental health disorder in the United States? • What is the #1 reason for disability in the United States? • What percent of individuals in the United States can be diagnosed with a mental health disorder in any given year?

8. U.S. Adults with a Mental Disorder in Any One Year

9. In any one year, 1 in 4people report symptoms sufficient for diagnosing a mental disorder during the past year. • 2004 = 57.7 million people • Mental Illness can be mild, moderate or severe • The median (50% of cases above and below) delay was 10 years before seeking professional help • Why do the columns add up to over 26%?

10. The Impact of Mental Illness • Mental illnesses can be more disabling than many chronic physical illnesses. For example:  • The disability from moderate depression is similar to the impact from relapsing multiple sclerosis, severe asthma, or chronic hepatitis B. • The disability from severe post-traumatic stress disorder is comparable to the disability from paraplegia. • “Disability” refers to the amount of disruption a health problem causes to a person’s ability to:  • Work • Carry out daily activities • Engage in satisfying relationships

12. Workplace Impact: The Case for Depression • Workplace costs of over $43 billion per year in direct and indirect costs • Major depression is associated with more annual sick days and higher rates of short-term disability than other chronic diseases. • People suffering from depression have high rates of absenteeism (in some cases, three times more sick days than non-depressed workers) and are less productive at work. • In a study comparing depression treatment costs to lost productivity, 45-98% percent of treatment costs were offset by increased productivity

13. Depression in the Workplace • Decreased productivity • Morale problems • Lack of cooperation • Safety problems, accidents • Absenteeism or presenteeism • Being tired all the time • Complaints of unexplained aches and pains • Alcohol or other drug misuse

14. Statistics • Nationally, there are approx. 100 deaths by suicide each day. That’s the equivalent of a plane full of people every other day. • Suicide is the 10th leading cause of death in the US; Homicide ranks 15th (2009). • Oklahoma: • 567 suicide deaths in OK in 2009 • OK ranks 12th (2009) for numbers of suicides per year (population differences controlled) • In 2005, the age group most at risk for suicide was 30-49 y.o. individuals; 80% of deaths were males.

15. MENTAL HEALTH FIRST AID A Collaborative Partnership of National Council for Community Behavioral Healthcare, Maryland State Department of Mental Hygiene and Missouri Department of Mental Health

16. WHAT IS MENTAL HEALTH FIRST AID? • Similar to Traditional First Aid & CPR • Mental Health First Aid (MHFA) is the help offered to a person developing a mental health problem or experiencing a mental health crisis. The first aid is given until appropriate treatment and support are received or until the crisis resolves. MHFA is a public education program. • 12-hour training program teaches a 5-step action plan • Trainees learn risk factors and warning signs of mental illnesses (depression, anxiety, substance abuse, eating disorders, psychosis) and available health treatments to better support family members, friends, coworkers/employees and the community • Upon completion, trainees receive a 3-year certification

17. Why is Mental Health First Aid so important? • Mental health problems are common. • Stigma is associated with mental health problems. • Many people are not well informed about mental health problems. • Professional help is not always on hand. • People often do not know how to respond.Sometimes this results is saying/doing nothing so the person interprets this as no one caring. • People with mental health problems often do not seek help.

18. Spectrum of Mental Health Interventions

19. Recovery from Mental Illness “Recovery is the process in which people are able to live, work, learn, and participate fully in their communities.” “For some, this is the ability to live a fulfilling and productive life despite a disability.”  “For others, recovery implies the reduction or complete remission of symptoms.”  — President’s New Freedom Commission on Mental Health, 2003

20. Program Origins • Created in Australia in 2001 • Research sponsored by the University of Melbourne • Expanded to 14 countries including: Scotland, Hong Kong, Canada, Finland, Singapore, England, Japan, New Zealand, Northern Ireland, South Africa, Thailand, and Wales • Piloted in the U.S. in 2008

21. MHFA in OK • Nationally, 30,000 people have been certified in 45 states • There are approximately 35 MHFA instructors in Oklahoma • 1000 people have been certified in OK and 63 courses have been offered since July 2009. • OK is 13th in the Nation for #’s of people certified in MHFA

22. Evidenced Effectiveness • Four published randomized control trials and a qualitative study (in Australia) • Increases mental health literacy • Expands individuals’ knowledge of how to help someone in crisis • Connects individuals to needed services -Reduces stigma -http://www.mhfa.com.au/evaluation.shtml

23. Potential Audiences • State policymakers • Employers • Faith communities • Law Enforcement • Hospitals and Medical Centers • Schools • Mental Health Clinics • Nursing Home Staff • Families and caring citizens • Anyone who works with or lives around people!

24. Learning Objectives & Activities of MHFA

25. Mental Health First Aid Agenda 12 Hour Course Two day course (6 hours per day) Four day course (3 hours per day) 1 ½ day course (8 hours; 4 hours) *All twelve hours must be attended in order to receive certification SESSION 1 Part 1 What is Mental Health First Aid? Mental Health Problems in the USA The Mental Health First Aid Action Plan Part 2 Understanding Depression Crisis First Aid for Suicidal Behavior & Depressive symptoms SESSION 3 Part 1 Understanding Psychotic Disorders Crisis First Aid for Acute Psychosis, Aggressive Behavior, and Psychotic Symptoms Part 2 Understanding Substance Use Disorder Crisis First Aid for Overdose Crisis First Aid for Withdrawal SESSION 4 Part 1 Understanding Eating Disorders Crisis First Aid for Eating Disorders Part 2 Using Mental Health First Aid/Wrap Up SESSION 2 Part 1 What is Non-Suicidal Self-Injury? Understanding Anxiety Disorders Crisis First Aid for Panic Attacks Part 2 Crisis First Aid for Traumatic events Crisis First Aid for Acute Stress Reaction

26. What You Learn • Overview of mental health problems • Depressive disorders • Anxiety disorders • Psychotic disorders • Substance use disorders • Eating disorders • Mental Health First Aid for crisis situations • Mental Health First Aid for non-crisis situations

27. Curriculum Slide Examples

28. Mental Health First AidFive Step Action Plan • A ssess Risk of Suicide or Harm • L isten Non Judgmentally • G ive Reassurance and Information • E ncourage Appropriate Professional Help • E ncourage Self-Help Strategies • Similarities to First Aid and CPR?

29. Remember that a MHFA certification makes you a gatekeeper to help the person seek professional assistance • Just like CPR/First Aid doesn’t make you a Doctor, MHFA doesn’t make you a counselor. • The 12 hour course does not qualify you to train other people.

30. Vision for MHFA in U.S. Mental Health First Aid will be as commonplace in 5-10 years as CPR and First-Aid are today.

31. Best Practices List? • MHFA is currently being reviewed by SAMHSA for inclusion in their National Registry of Evidence Based Programs and Practices [NREPP]

32. Recertification Credits for Human Resource Professionals MHFA has been approved by the Society for Human Resource Management’s HR Certification Institute as a pre-approved provider of 12 general Recertification Credit Hours.  The Recertification Credit Hours apply to the Professional in Human Resources (PHR), Senior Professional in Human Resources (SPHR) and Global Professional in Human Resources (GPHR) certifications. End date: 12-31-12

33. Ready to Implement — What Next? • Step 1: Experience Mental Health First Aid — attend a course. • Build a training: Consider organizing a training with your workplace or through a professional organization for CEU’s • Training between 15-25 people is usually more cost/time effective • www.mentalhealthfirstaid.org; Click on Find a Course or Find an Instructor • Contact me at jessicaheavin@yahoo.com for assistance/more info • Step 2: Determine whether you would like to train a broader population at your site— define key target audiences and how to reach them: managers, supervisors, HR reps, general employees, etc. • Step 3: Get key influencers — community partners, policymakers, media, funders — to support and endorse • Step 4: Offer/organize 12-hour programs

34. Community Champions Program • ODMHSAS is sponsoring a program that encourages businesses to do mental health/addiction awareness campaigns with employees. • For more information, go to http://www.ok.gov/odmhsas/Additional_Information/Communications,_Public_Information_and_Other_News/Community_Champions_Initiative/index.html and click on Implementation Guide.

35. Bringing it all Together • Mental illness is common and costly to both the person and employers/companies. • MHFA is a research based public education program for ANYONE and can be used in HR/business environments. • MHFA is fairly low cost, more in depth than singular suicide prevention programs and provides a common and accurate vocabulary about mental health problems. • Offers participants an opportunity to engage in empathy exercises to better understand mental illness and to practice new skills. • Teaches participants not only how to support, but also how to effectively refer individuals without engaging in stigmatizing statements • Skills can be used in personal or professional capacities.

36. Benefits of MHFA in the Workplace • Positive implications for the organization (decrease in healthcare costs, improvement in productively and morale) and the person (better quality of life).

37. Final Thought... • MHFA gives us an opportunity to change the culture by de-stigmatizing mental health issues. • Less stigma = more people seeking assistance = everybody wins!

38. Q & A

39. HR Specific Articles/Info • Andors, Alice. Dispel the Stigma of Mental Illness. HR Magazine, Vol. 55, Number 10. 10-1-10. • Employers Web article: Mental Illness in the Workplace: http://www.employersweb.com/SITEFORUM?t=/contentManager/onStory&e=UTF-8&i=1188837331537&l=0&ParentID=1189212975918&StoryID=1283311146264&active=no2

40. References/More Information • Oklahoma Suicide Fact Sheet: http://www.sprc.org/stateinformation/PDF/statedatasheets/ok_datasheet.pdf • Summary of CDC Report on Mental Illness, 2011: http://yourlife.usatoday.com/health/medical/mentalhealth/story/2011-09-05/CDC-Half-of-Americans-will-suffer-from-mental-health-woes/50250702/1 • The Global Cost of Mental Illness-National Institute of Mental Health: http://www.nimh.nih.gov/about/director/2011/the-global-cost-of-mental-illness.shtml

41. References/More Information • Prevalence Statistics (NIMH): http://www.nimh.nih.gov/statistics/index.shtml • Disease Burden/Disability Impact (WHO): http://www.nimh.nih.gov/statistics/index.shtml • Impact on the Workplace Information (NAMI Public Policy): http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Public_Policy/Policy_Research_Institute/Policymakers_Toolkit/Facts_on_Access_to_Medications_Policymakers_Resource_Long.pdf

42. References/More Information • Depression in the Workplace (Mental Health America): http://www.mentalhealthamerica.net/index.cfm?objectid=C7DF951E-1372-4D20-C88B7DC5A2AE586D

43. MHFA media links • SAMSHA’s What a Difference Campaign: http://www.youtube.com/watch?v=XUtrDkE6Zd0&feature=related • What is Mental Health First Aid You Tube Clip: http://www.youtube.com/watch?v=VsIDFDFmfX8&feature=related • What would you do You Tube Clip: http://www.youtube.com/watch?v=G07eAN06qPw&feature=related

44. MHFA media links • http://thekojonnamdishow.org/shows/2011-04-04/mental-health-first-aid • http://www.mentalhealthfirstaid.org/cs/news_updates

45. For More Information www.MentalHealthFirstAid.org or contact Jessica Heavin, MS, LPC, NCC Licensed Professional Counselor jessicaheavin@yahoo.com