I have long felt stymied in response to mental illness. I felt terrifyingly unprepared: From my first encounter with a homeless man arguing with an imagined person to hearing that a boy died by suicide on the sidewalk in front of my apartment, to the many instances of mental illness in my own family.

I felt too insecure to step in, unsure of what I would do if I did and scared to talk about it with anyone, even those I loved most.

Then I discovered Mental Health First Aid and realized that, like learning to use CPR to help someone suffering a heart attack, I could learn how to help someone suffering from mental illness.

Mental Health First Aid was conceived in Australia in 2001 and came to the United States in 2008. This international evidence-based program has been studied in multiple randomized controlled tests and is currently the best evidenced-based practice for recognizing and responding to mental health disorders. This is accomplished with the Mental Health First Aid action plan, known as “ALGEE.”


Action A: Assess for risk of suicide or harm

Ask the person directly, “Are you having thoughts of suicide?” and “Are you planning to kill yourself?”

Action L: Listen Nonjudgmentally

Really listen as the person explains what they’re experiencing. Don’t judge or react.

Action G: Give reassurance and information

Assure them that their feelings are heard and there is hope. Provide them with resources such as the help line 1-800-273-8255. You can also connect with local resources and additional help by dialing 211. If the person is actively suicidal – meaning they have a plan, tools to carry out the plan and/or know when they plan to die by suicide – STAY WITH THEM and call 911 for mental health assistance.

Action E: Encourage appropriate professional help

If the person is not actively suicidal, encourage them to get help from a counselor, psychologist or other mental health professional.

Action E: Encourage self-help and other support strategies

Ask them if they have experienced this mental health challenge in the past and, if so, what helped them recover. Encourage positive self-help strategies, in addition to appropriate professional help, such as physical exercise, social interactions and pursuing enjoyable pastimes.

Mental Health First Aid Works

Mental Health First Aid Instructor Tony Cloud shares the story of a MHFA graduate who was checking out at a store. Her son gasped and said, “Mommy, look at her arms!” He had noticed cuts on the checker’s wrists, momentarily unconcealed by her long sleeves.

In this moment, when so many would turn away, the MHFA graduate knew she needed to respond. She chose to “lean into the discomfort,” as Cloud says, and asked the checker if she was having thoughts of killing herself. The checker replied in a whisper, “Please help me.”

The graduate, who normally considers herself a quiet, reserved person, says her inner mama bear took hold. She dropped the “lane closed” sign on the belt and told everyone behind her they had to move. Then she accompanied the checker to the break room where she employed the Mental Health First Aid action plan.

The MHFA graduate determined that the checker was actively suicidal. She stayed with her, called 911 to obtain the proper mental health assistance and remained with her until appropriate help arrived. “Then she stepped back and gently passed the checker to the appropriate professionals,” Cloud says. Today, when the two women pass, they smile and nod.

During one MHFA class, a Lewis County supervisor realized her employee exhibited all the signs of experiencing a mental health challenge. Her work performance had been declining and her absentee rate was increasing. The class empowered the supervisor to lean into the discomfort and approach the employee, whom she discovered was deeply depressed.

“Because she was willing to step out and ask personal and probing questions, the employee was comfortable communicating and the employer gained much better understanding,” Cloud says. “She connected her with resources by calling 211 and assisted her in getting herself into treatment.”

With this treatment, the employee improved over time. Today she is a model employee and has become a liaison for mental health. “She shares her story to encourage others to seek and engage help if they or someone they know is experiencing a mental health situation,” Cloud says.

A Lewis County pastor reported using the MHFA action plan four times in one week. Because he found the class so impactful, he partnered with another pastor across faith lines to host a MHFA training for upwards of 30 church leaders in Centralia.

Many people turn to their church in a crisis. As such, the impact of this effort could be substantial. “Most churches have heart and want to assist,” says Cloud. “They’re doing great work but this arena of mental health challenges can be an arena that many churches are unprepared for.” This will no longer be the case for these proactive clergy.

After completing my own MHFA training, I discussed what I learned with my family. When I shared the checker’s story and mentioned the cuts on her arms, my elementary school child said, “Oh, my friend does that.” I was shocked but, thanks to MHFA, I knew what to do; we deployed the MHFA action plan.

Although we may be unaware, we all have many friends, family members and associates living with mental illness. Many of us will experience it ourselves.

Mental disorders affect one in five individuals. “They’re very common,” says Cloud, who prefers the term “mental health challenge” over the term “mental disorder” or “mental illness.”

“I’m speaking of one and the same,” he says, “but when people say ‘disorder,’ that sounds like chaos. Or ‘illness’ – that sounds like ‘sick’ and we don’t want sick people around because we don’t want to get sick. I have this preference of saying mental health challenge because challenges can be big and they can be full of obstacles but obstacles can be overcome and barriers can be broken down.”

According to Cloud, it’s important to understand that mental disorders aren’t voluntary. They’re the result of predisposition combined with neuro-biochemistry and environmental stress. “Nobody signed up for this,” he says.

In addition, brain function drives behavior. “We need to give greater pause and thought to brain function and how it impacts a person’s behavior,” Cloud says. “When we do that, our educational and our criminal justice systems will radically change.”

When you keep in mind that mental health challenges aren’t a choice and that brain function drives behavior, it’s easier to withhold judgement and extend compassion. “My mantra is ‘be quick to care and slow to judge,’” Cloud says. “I believe we need to return to a place of elevating the value of all human life.”

In doing this, we can ensure that everyone receives the care and assistance they deserve. When community members have the tools to identify and assist those experiencing a mental health challenge or crisis, the results are better for all. That’s where Mental Health First Aid comes in.

Thanks to a Providence Saint Joseph Health  grant, Mental Health First Aid classes are being offered free of charge at Providence Centralia Hospital on April 28, May 5 and June 30. Additional free classes are being offered in Thurston County at Providence St. Peter Hospital. If you would like to attend one of these classes, email TonyCloudMHFA@gmail.com.

If you would like to attend on a different date, visit mentalhealthfirstaid.org. These classes may incur a cost.

If you would like information on bringing MHFA training to your business, organization or community group, email TonyCloudMHFA@gmail.com.


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