When school administrators in Appleton, WI, saw the results of a behavioral health risk assessment for 9th and 11th grade students in their district, they knew they had a problem that required attention.

The number of students who reported that they had contemplated taking their own lives during the past 30 days was above the state average.

“Mental health has been identified universally as a priority,” says Valerie Dreier, assistant superintendent for the Appleton Area School District. “One of the things we’ve been working to do is make sure everyone is given the resources they need — regardless of their situation.”

To accomplish that goal, the district has worked with a number of federal and state agencies and nonprofits to provide more advanced behavioral health services and to educate the community about the importance of mental health.

It has also become one of the community grantees for SAMHSA-funded Mental Health First Aid training.

Five Steps in Mental Health First Aid

  1. Assess risk of self-harm or suicide
  2. Listen without judgment
  3. Reassure and provide helpful information
  4. Encourage professional support
  5. Suggest self-care techniques

Mental Health First Aid is an 8-hour mental health literacy program in which laypeople learn the signs and symptoms of behavioral health problems and crises, ways to support those who are facing a crisis, and where to refer for appropriate professional care.

Ingrid Donato, Chief of the Mental Health Promotion Branch in SAMHSA’s Center for Mental Health Services (CMHS), likens the program to physical health first aid. Instead of helping people understand how to identify the signs of a heart attack or to stabilize a broken bone, they are taught how to identify and triage behavioral health issues.

“If you’ve taken a first-aid course, you have a general idea of what you do when someone has a broken bone,” Ms. Donato says. “You are given the training to provide preliminary first aid, and then you call a professional to come in. This is the mental health parallel to that.”

With help from a SAMHSA grant, 23 adults in Appleton took part in the 40-hour educational program in February 2015 that certifies them to teach others in the community about Youth Mental Health First Aid. Those 23 trainers have since provided training to more than 300 people. Ultimately, they aim to train 900 people or more through the program. The early trainers are already achieving results — referring at least 20 youths in Appleton to behavioral health professionals.

The growth of Mental Health First Aid programs like the one in Appleton have been fueled by the Obama Administration’s Now is the Time initiative, which aimed to address mental health in the wake of the December 2012 school shootings in Newtown, CT.

Through Now is the Time, CMHS was provided the resources to develop grant programs — Project AWARE (Advancing Wellness and Resilience in Education) State Education Grants and Project AWARE Local Education Grants — to expand Mental Health First Aid and Youth Mental Health First Aid training in local communities.

“The goal is to train as many people as we can in Mental Health First Aid and Youth Mental Health First Aid,” Ms. Donato says. “For youth, we want to not only reach the teachers, we want to get the school bus drivers, we want to get the juvenile justice folks, the police, the firefighters, the nurses — anyone who comes into contact with children. We want everyone to be able to understand when a child is in distress and to be able to understand how to appropriately intervene and provide support.”

Both programs emphasize helping detect and respond to mental illness among school-age youth. Participants are taught how to assess for risk, how to listen, how to provide reassurance and support, and how to connect those who are at risk with the appropriate professional services.

Within the first 6 months, grantees have already reported thousands of adults being trained in either Youth Mental Health First Aid or Mental Health First Aid, with thousands of kids being referred to services as a result, Ms. Donato says. Ultimately, the program aims to support trained first aiders who will reach as many as 500,000 children and youth.

In 2015, CMHS was able to add a third program called the Project AWARE. These grants provide $125,000 a year for three years to an additional 70 community-based organizations and schools.

“It provides more money to really be able to bridge outside of the school districts and get everyone involved,” Ms. Donato says.

In many communities, Mental Health First Aid training programs are being supplemented with other behavioral health programs such as Emotional CPR. Like Mental Health First Aid, Emotional CPR aims to guide laypeople to help those who are experiencing a mental health crisis.

Often, the first step for those witnessing someone facing a mental health crisis is to call 911 — a move that is designed to help but often leads to law enforcement addressing a situation that is better served by someone trained in behavioral health.

With Emotional CPR or eCPR, the public health education program is designed by people with behavioral health conditions to teach others how to help those who are experiencing an emotional crisis. Those who are trained in eCPR are better able to understand and assist those who are exhibiting unusual behavior that is brought on by an emotional crisis, and to provide the support needed to work through a crisis. “With Emotional CPR, peers and laypeople are trained in how to talk to someone who is facing a crisis and identify how to get that person the right help,” says Keris Jän Myrick, M.B.A., M.S., Director of the Office of Consumer Affairs within CMHS at SAMHSA.

“When you need help, you really don’t want the police to come,” Ms. Myrick says. “Emotional CPR helps you, as a person in the community, learn how you can actually help and get that person the assistance that is most helpful.”

That more holistic approach to mental health is gaining momentum in communities like Appleton, which are dedicating more resources to training programs that help laypeople provide support to those who need assistance.

“We want to be a mentally healthy community, Ms. Dreier says. “We recognize that we cannot do this alone. We need the support and involvement of the entire community.”



From SAMHSAs Blog