In Defence of Mental Health First Aid

Marvin Ross claims that the unfolding Rob Ford spectacle is proof that Mental Health First Aid is expensive and ineffective ( His argument contains some core truths but ultimately fails because it is based on a flawed understanding of the nature of first aid and it does not consider the importance of context.
As Mr. Ross notes, Mental Health First Aid is an international movement that focuses on providing individuals with basic “helping” skills that enable them to assist people experiencing a mental health crisis. As he observes, there are data suggesting that mental health first aid training is effective in changing the attitudes and perceptions of those that are trained – what we (and others) have referred to as mental health literacy. There is less evidence that speaks to whether or not providing mental health first aid actually helps the “victim”.
Here is the problem. As many others have noted, mental health services in Canada are underfunded, and chronically unable to meet the demand. The simple fact is that if you or a loved one are having a mental health crisis it is going to be difficult to obtain professional health in a timely fashion. Mr Ross assumes that “the purpose of first aid is to provide the initial treatment until emergency personnel arrive” – since, in the case of mental health, the “professionals” are unlikely to arrive, the provision of mental health first aid is a waste of effort. Moreover, the money spent developing and training mental health first aiders would be better spent on treating mental illness.
There is absolutely no doubt that increased funding for mental health treatment is required. This truth does not mean that mental health first aid is ineffective – it means that we need to understand the role, limits and context of mental health first aid.
Mr. Ross assumes that first aid is designed to provide initial treatment until the professionals arrive. This is a partial truth – there are many cases in which first aid is, in fact, the only treatment required. There are many minor injuries (e.g., cuts, bee stings) in which the treatment begins and ends with first aid. In an analogous manner, many individuals experience a mental health crisis that can be substantially mitigated just by talking to someone. Having helping resources available early in the process may reduce the possibility of the situation escalating into one that does require professional intervention – thereby reducing demands on the underfunded system.
For those cases in which professional intervention is required, the mental health first aider may be able to direct individuals to immediately available resources. We offer a program called Mental Health Awareness Training for organizational leaders. Although the program draws on some of the principles of mental health first aid, it also includes making sure leaders are aware of the resources available to employees through the organization. Many organizations provide resources such as Employee Assistance Programs that can provide speedy access to mental health professionals. These resources are often underused but they are already being paid for as an employee benefit and do not rely on the chronically underfunded public mental health system. Leaders have a valuable role to play in recognizing when someone is in distress and directing individuals to the appropriate resources.
Do these considerations make a difference? Does mental health training in the workplace actually help individuals? Ultimately this is an empirical question. As researchers we need to make the distinction between “the absence of evidence” (i.e., nobody has collected the data) and the “absence of supporting data” (i.e., the data are available but do not support the intervention). Although we have some promising initial data that suggests a real benefit for mental health awareness training, we are currently seeking research partners interesting in exploring this topic. If your organization is interested in evaluating the effectiveness of mental health first aid training, we invite you to get in touch with us – and…… PLEASE be an advocate for increased resources for our strained mental health system. We all need help at some point and need to work to ensure the availability of the right type of assistance at the right time for everyone.