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Be the Light at the End of the Tunnel

Mental health first aid allows you to stand in the gap of a crisis until professional help arrives.

When a medical emergency occurs, having someone there who knows what to do can mean the difference between life and death. Nobody questions the importance of first aid training, especially on the farm.  

If someone gets a bad cut, you apply pressure. If someone is choking, you give them the Heimlich maneuver. If someone’s heart has stopped, you do chest compressions to the beat of Staying Alive by the Bee Gees until the ambulance arrives.

But what if the emergency is someone having an anxiety attack, dealing with an opioid addiction, or contemplating suicide? Again, having someone available who knows what to do can mean the difference between life and death.

When you’re the person giving chest compressions, nobody expects you to perform the open-heart surgery. Likewise, when you’re the person providing support and resources during a mental health crisis, nobody expects you to have all the answers or be a therapist. Your job is just to provide help until the services of a professional can be obtained. That’s where mental health first aid training comes in.

Mental Health First Aid USA, a program managed by the National Council for Behavioral Health and the Missouri Department of Mental Health, offers an eight-hour course that gives people the skills to help someone experiencing a mental health crisis. Trainees learn to identify, understand, and respond to signs of mental illness. 

Two different courses are available through this program. The adult course includes training to deal with depression, anxiety, trauma, psychosis and psychotic disorders, substance abuse, and self-injury. Another course aimed at helping young people includes insight into adolescent development and how it affects mental health.

Jami Dellifield is an Ohio State University Extension educator and a certified instructor. She says the combination of mental health concerns and the opioid epidemic makes it crucial to have mental health first aid resources available in rural America.

Missing Piece

Dellifield says Extension is a natural outlet for mental health first aid since it has offices in nearly every county. “Extension is the missing puzzle piece to help get the word out that this resource exists,” she says. 

Since Extension offices are a hub for so many different activities and conversations, Dellifield says educators really get to know the people in their counties. “They share personal things with us because we work so closely with them and their families,” she says. “We need to be comfortable enough to help and have the knowledge of what to do if someone is struggling with a mental health problem. We should have the kind of rapport with people in our community that we can reach out to them if we notice they don’t seem to be themselves.”

Dellifield says that since Extension agents are already seen as local experts, mental health crisis training is a tool they should add to their toolbox. “If someone doesn’t know what a particular weed is or if they need help with a sewing project, they know they can go to Extension for research-based knowledge,” she says. “We take classes on child abuse and neglect as well as classes to teach us to be better educators. Becoming trained in mental health first aid should just become part of what we do.”

Take the Training

Anyone can become trained in mental health first aid, and a background in mental health is not required. The program aims to improve mental health literacy in the general population and to prepare people to help others in one-on-one situations.

This is done through a five-step, triage-style response plan learned in class. Trainees are taught to assess for a risk of suicide or self-harm, listen and support the individual without judgment, provide reassurance and information, encourage the appropriate professional help, and offer self-help and other support strategies. (See how to find a class below.)

The training may come into play if someone is having a panic attack, contemplating suicide, or dealing with a substance abuse crisis like an opioid addiction or overdose. Practicing these different experiences in class helps trainees learn how to apply their knowledge in real-life situations. “This helps make it less scary when you’re actually faced with a crisis,” Dellifield says.

That fear – the fear of saying the wrong thing or not knowing what to do – is one of the hardest things for trainees to overcome. “Don’t be afraid to be a good friend and a good neighbor and to help somebody who needs it,” she says. “Without training, you may not know what steps to take, or you may not want to step in, but the class teaches you how to stand in the gap until the appropriate help can arrive.”

When you’re a caregiver for or are close to the person in crisis, the fear of stepping in may not be an issue, but Dellifield says exhaustion can get in the way of offering the best help. “For example, when there’s a mental health issue and you’re in a rural area, and the person you’re caring for doesn’t want to take their meds, that’s exhausting,” she says.

Just like with physical first aid training, many of the ideas and steps taught in mental health first aid training may seem like common sense, but taking the training cements the steps in your mind. “You think, ‘Of course I’m going to listen in a nonjudgmental way,’ ” Dellifield says. “But when that fear or exhaustion creeps in, you’re not always as understanding as you could be. Being trained in mental health first aid helps by stocking your tool kit with strategies.”

Another benefit to taking the course is that it offers community members a first-step resource for dealing with mental health issues. “If someone walks into our office or I’m on a farm visit or in a 4-H meeting and I notice someone doesn’t seem themselves, nobody is going to think anything of it if I strike up a conversation with that person,” Dellifield says. “It would be a lot harder for that person to just walk into the behavioral health center, if there’s even one available. That person can use us as a resource and we can get the ongoing help that’s needed from a professional.”

Become a Trainer

For those who wish to go one step further and become a mental health first aid instructor, certification can be obtained after completing a five-day training session and agreeing to teach at least three courses per year. 

The fee for this weeklong class is $2,000, but Dellifield says there are grants available for Extension educators and others interested in becoming trainers. Commodity groups and local banks may also be willing to help foot the bill, she says.

If Extension educators choose not to become trainers themselves, Dellifield says she hopes they would at least take the first aid class, become familiar with nearby certified instructors, and offer their office as a site for training. Class sizes can range from five to 35 participants.

“We don’t necessarily have to be experts in every field,” she says. “If there are people in my county expressing an interest in learning something I’m not familiar with, I will find an expert to teach a class. If someone isn’t already teaching mental health first aid in your community, though, consider adding that to your wheelhouse. At Extension, we provide awesome information on everything from home canning to quality assurance for livestock, so why not provide this?”

Dellifield says several states are working to provide mental health first aid training to all Extension agents, including New Hampshire, Minnesota, Ohio, and Michigan. There are trainers available in every state, from a range of backgrounds.

“The conversation is ongoing, and we’re still learning,” Dellifield says. “With opioid addiction, the dairy crisis, and falling farm prices, we’re talking about this more than ever. Mental health first aid training is one way we’re learning to better take care of ourselves and our communities.”

Find a Class

Mental Health First Aid was created in Australia in 2001. Today, through Mental Health First Aid International, programs are offered in more than 25 countries around the world, including through this program in the U.S. More than 1 million people across the U.S. have taken the council’s mental health first aid training.

Find a course near you (or see how to offer one if none is available in your area), learn how to become an instructor, donate to the program, and see more examples of how mental health first aid training saves lives at or 888/244-8980, Ext. 4. Follow Mental Health First Aid USA on Twitter at @MHFirstAidUSA, and join in a monthly Twitter chat using the hashtag #BeTheDifference. A recap of past chats is available on the group’s website.

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