NYC to adopt ‘first aid’ program for mental health

A daylong training program that teaches volunteers to recognize and respond to mental health crises will soon be offered to a quarter of a million New Yorkers, in a bid to make such training as common as that for CPR or first aid, officials said this week.

Mayor Bill de Blasio on Monday announced the creation of an $850 million initiative called ThriveNYC, which he said would help combat New York’s problems with mental illness — which costs the city’s economy an estimated $14 million annually in lost productivity.

“We have a fundamental health problem in our city, in our nation, in New York City, as one in five New Yorkers [is] affected by some form of mental illness,” de Blasio told NPR on Wednesday. “And this requires a very comprehensive response, and it begins with making sure people can get access to mental health services.”

ThriveNYC will involve a public-awareness campaign intended to destigmatize mental illness and educate residents about where they can find help. De Blasio said there will be a new “mental health corps” of 400 doctors who will work in high-need areas. Serious mental illness is more than twice as common in adults living below 200 percent of the federal poverty line than those who live 200 percent above it, according to the New York City Department of Health and Mental Hygiene.

The city also wants to train average citizens to help out. Starting in 2016, the program will train 250,000 volunteers in Mental Health First Aid (MHFA), an eight-hour course that teaches people how to recognize the signs of mental health or substance-abuse problems and offer help in a variety of scenarios, from the throes of psychosis to post-traumatic stress disorder.

The MHFA program was created in Australia in 2001 by Betty Kitchener, a nurse who had suffered from recurring major depression, and her husband, Anthony Jorm, a professor and public health researcher at the University of Melbourne. The training involves a  five-pronged action plan that includes learning how to approach someone in crisis and assess the risk of mental health problems. Much of the training involves role-playing through different scenarios and going over the most helpful ways to respond to them, including how to refer people to professional help if they want or need it.

Kitchener went on to become the founder and CEO of Mental Health First Aid, a national nonprofit organization that promotes MHFA training and research. The curriculum has since been adopted in 23 countries.

MFHA is still relatively new in the United States. In 2008 the mental health departments of Maryland and Missouri and the nonprofit National Council for Behavioral Health worked with Kitchener’s group to adapt the program for the U.S. Since then, the National Council has certified hundreds of MHFA instructors across the country, and half a million people have completed the curriculum nationwide, including first lady Michelle Obama.

At least 15 U.S. states have appropriated annual funding to train law enforcement, teachers or health care workers in MHFA this year. President Barack Obama called for MHFA training for teachers and school staff as a way to prevent gun violence in the wake of the Sandy Hook school shootings in Connecticut and has appropriated $15 million in federal funding for such training since 2014, but no national legislation calling for MHFA training has been passed.

Betsy Schwartz, the vice president of public education and strategic initiatives at the National Council, which also oversees community mental health and addiction treatment programs across the country, says MHFA training is crucial to easing the stigma surrounding mental illness and educating the public.

“The reality is that we’re all much more likely to run into someone experiencing a mental health problem or a serious mental illness or an addiction than we are to run into somebody having a heart attack or needing the Heimlich [maneuver],” she told Al Jazeera. “It’s designed to increase people’s knowledge and to enable people to feel more comfortable to have a conversation with someone.”

In other words, the MHFA protocol isn't solely to refer someone for psychiatric help, nor does the training call for lay people to replace professionals when it comes to serious mental illness; it could just mean helping someone open up about anxiety or depression.

While much of the research on the effectiveness of MHFA has been done by Kitchener and Jorm, the training was accepted in 2013 into the Substance Abuse and Mental Health Services Administration’s national registry of evidence-based programs, on the grounds that it helps people recognize symptoms of mental illnesses and makes them feel more confident in helping people with them — and in some ways, it might even improve participants’ own mental health.

“What the research says is that just by having the conversation, you’re helping someone,” Schwartz said.