MENTAL HEALTH FIRST AID USA
BLENDED
PARTICIPANT
PROCESSING
GUIDE
FOR ADULTS ASSISTING
CHILDREN AND YOUTH
MHFA.ORG | THENATIONALCOUNCIL.ORG
COPYRIGHT
Mental Health First Aid® USA ©2020. National Council for Behavioral Health.
ISBN: 978-0-9600905-4-9
ALL RIGHTS RESERVED.
No part of this publication may be reproduced, stored in a retrieval system, transmitted in any
form or by any means — electronic, mechanical, photocopying, recording or otherwise —
without prior permission. To obtain permission, contact the National Council for Behavioral
Health at the address below.
Published by the National Council for Behavioral Health
1400 K Street NW, Suite 400
Washington, DC 20005
(202) 684-7457
communications@thenationalcouncil.org
Cite this material as follows:
Mental Health First Aid USA. 2020. Youth Mental Health First Aid Participant Processing Guide.
Washington, DC: National Council for Behavioral Health.
Mental Health First Aid Editorial Team
WELCOME
Dear Participant:
We are delighted that you have chosen to become a Youth Mental Health First Aider. Your
dedication to the program will greatly impact the lives of young people living with mental
health challenges.
More than 20 million Americans experience a mental health challenge in any given year.
In a world that sometimes makes it feel impossible to ask for help, it’s up to all of us to know
when and how to offer it.
During this course, you will learn how to recognize the signs and symptoms that suggest a
potential mental health challenge, how to listen nonjudgmentally and give reassurance to a
young person who may be experiencing a mental health challenge, and how to refer a youth
to appropriate professional support and services.
By taking this course, you are joining a network of more than 2 million people who have
made the commitment to #BeTheDifference in the lives of children and youth living with
mental health challenges.
Thank you again for your dedication. Best of luck to you as you begin your journey to
becoming a Youth Mental Health First Aider.
3
CALL TO ACTION
YOUTH MHFA
When you use the skills you learn in Youth Mental Health First Aid (YMHFA), you are the
first line of support for a child or youth in need. You are there to help them feel less distressed
and you can be a vital source in helping them seek further assistance.
Your body language, what you say, and how well you listen can have a powerful impact. The
quality and type of support you offer through listening can enhance coping and self- esteem.
With an accurate view of mental health challenges and using a strengths-based holistic
perspective, you can help children and youth help themselves. You can also be an advocate,
empower your community, and improve self-care.
As a First Aider, you can be the one to make a difference in the life of someone with a mental
health challenge. Your First Aid actions can be a first step in a youth’s recovery journey.
#BeTheDifference
4
PARTICIPANT RIGHTS
AND RESPONSIBILITIES
Youth Mental Health First Aid’s mission is to provide high quality, evidenced-based education so
everyone has the First Aid skills to support youth with mental health challenges. This is only possible
in training environments that foster nonjudgmental communication and understanding and reduce
the stigma around mental health challenges. Participants play critical roles in establishing these
environments by adhering to the following Participant Rights and Responsibilities.
Participants have the right to:
A safe learning environment. The learning environment will be conducive to open dialogue and
communication and will be free from harassment or discrimination on the basis of race, religion,
color, age, sex, gender, sexual orientation, national origin, or culture.
Clear and consistent instruction and evaluation. Course objectives, requirements, and evaluation
criteria will be clearly communicated to participants by the Instructor before instruction begins.
Equal access of resources and learning materials. If a participant requires an ADA
accommodation for instruction or instructional materials, they must complete an Accommodation
Request Form and submit to the Instructor no later than five business days before the course start
date.
Have grievances addressed appropriately. If a participant has a grievance that can be addressed
by the Instructor, the participant should make the Instructor aware of the grievance as soon as
possible. If participants has a grievance that cannot or has not been addressed by the Instructor,
they should contact the central office at:
The National Council for Behavioral Health
1400 K Street, NW Suite 400
Washington, DC 20005
(202) 684-7457
algee@thenationalcouncil.org
Participants have the responsibility to:
Participate. Actively participate and remain engaged in the learning process for the duration of the
course. Learners are encouraged to participate in every exercise but may opt out of exercises that
make them uncomfortable.
Be respectful. Openly respect the viewpoints of others, regardless of whether the participant
accepts or agrees with these viewpoints.
Ask for help. Seek help or clarification for any instructional material that is unclear. Request
accommodations in advance of the course start date.
Be present. Attend at least 90% of the course and participate in at least 70% of the activities in
order to receive a certificate.
5
COURSE OBJECTIVES
The Youth Mental Health First Aid course focuses on recognizing the patterns of thoughts, feelings,
behaviors, and appearance that show there might be a challenge rather than on a specific disorder. You
will learn an action plan for non-crisis and crisis scenarios. By the end of the course, you will be able to:
Describe the purpose of Youth Mental Health First Aid and the role of the First Aider.
Recognize the signs and symptoms of mental health challenges that may impact youth.
Explain the impact of traumatic experiences and the role of resilience on adolescent development.
Apply the appropriate steps of the YMHFA Action Plan (ALGEE) to crisis situations.
Apply the appropriate steps of the YMHFA Action Plan (ALGEE) to non-crisis situations.
Choose appropriate methods for self-care following the application of YMHFA in a crisis or non-
crisis situation.
6
OUR VALUES AND HOW WE
DEVELOPED THE CURRICULUM
Mental Health First Aid developed the curriculum carefully to reflect our commitment
to equity and justice.
» MHFA affirms that unfair and unjust institutions have prevailed in our communities. These
include a lack of proper funding for education and health care services; covert and overt
violence, and resulting immediate, historical, and intergenerational trauma; egregious
barriers to critical resources; and more. When noting that health inequities are present,
Mental Health First Aiders should not draw conclusions about the group or community where
health outcomes are not optimal. Health inequities do not result from individual choices but
rather, systemic forces, and assumptions about a group’s values, efforts, abilities, strengths,
health behaviors, health choices, resilience, and well-being are not useful.
Health inequities should not be used to draw conclusions
about a group or community’s
Values. Health behaviors.
Efforts. Health choices.
Abilities. Resilience.
Strengths. Well-being.
» Further, MHFA believes that scientific and health research and data collection should include
all genders to amplify the experience, rights, and needs of all members of our communities.
We note that to date, health and science research often does not use a framework that includes
people of all genders but rather the binary of woman/man in data collection.
» Mental Health First Aid USA wrote and chose scenarios and videos to elevate the visibility
of varying identities, perspectives, challenges, and stories of participants and Instructors
in communities across the United States. The stories and characters in the scenarios and
videos are not meant to be used for generalizations about communities or for confirmation
of stereotypes.
7
YOUTH MENTAL HEALTH FIRST AID:
SELF-PACED INTRODUCTION RECAP
Youth Mental Health First Aid is the help offered
WHAT IS YOUTH to a young person experiencing a mental health
MENTAL HEALTH challenge, mental disorder, or a mental health
FIRST AID? crisis. The first aid is given until appropriate help is
received or the crisis resolves.
2
Mental Health First Aiders…
» Do not diagnose or treat themselves or others.
WHAT DO YOUTH » Observe changes in behaviors.
» Offer a nonjudgmental listening ear.
MENTAL HEALTH » Respect the privacy of the youth and family.
FIRST AIDERS DO? » Serve as a vital link to early intervention.
» Respect and honor the culture of the youth
» and family.
WHAT IS
THE MENTAL
HEALTH FIRST AID
ACTION PLAN?
WHAT DO YOUTH » Staying safe is the most important thing for all
Mental Health First Aiders to remember.
MENTAL HEALTH » YMHFA does not replace any professional
FIRST AIDERS NEED or legal responsibilities a First Aider has or
TO CONSIDER organizational procedures a First Aider must
BEFORE REACHING follow as a mandatory reporter, first responder,
OUT? clinician, or government employee.
8
YOUTH MENTAL HEALTH FIRST AID:
SELF-PACED INTRODUCTION RECAP
Mental Health is a state of well-being in which an
individual:
WHAT IS » Realizes their own capabilities.
MENTAL HEALTH? » Can cope with the normal stresses of life.
» Can work productively.
» Can contribute to their community.
The Impact of Culture on Health
» Cultural beliefs influence our health decisions
2
WHAT IS THE » every day.
IMPACT OF » Different cultures have different norms about
CULTURE ON health that impact what people think about
mental health and how they treat it.
HEALTH? » As First Aiders, the more we keep this in mind,
» the better we can support others.
A Mental Health Challenge is When:
» There is a major change in a person’s thinking,
feeling, or behavior.
WHAT IS A MENTAL
» The change interferes with the person’s ability to
HEALTH live their life.
CHALLENGE? » The interference does not go away quickly and
lasts longer than typical emotions or reactions
would be expected to.
HOW MANY YOUTH
WILL EXPERIENCE A 1 in 5.
MENTAL DISORDER Many mental disorders begin to show up in
childhood or adolescence.
IN THEIR LIFETIME?
» Early intervention refers to recognizing the
warning signs of a mental health challenge and
WHY IS EARLY acting before it becomes worse.
INTERVENTION » Early intervention helps to prevent symptoms
IMPORTANT? from becoming more serious and lessens the
overall impact on the young person’s life.
9
YOUTH MENTAL HEALTH FIRST AID:
SELF-PACED INTRODUCTION RECAP
Stigma includes negative attitudes toward people
with mental health challenges and can lead to
WHAT IS STIGMA? discrimination.
Stigma makes it hard for young people to talk
about their challenges and reach out for help.
2 WHAT IS PERSON-
Person-first language is language that honors
a person’s individuality and humanity first and
recognizes that a diagnosis is not who a person is
FIRST LANGUAGE? but rather a part of them.
“A young person living with a diagnosis of...”
Half of all mental disorders begin by age 14 and
HOW DO GAPS IN three-quarters by age 24, yet only 7.4 percent of ALL
youth receive any type of mental health visits or
TREATMENT
screening each year.
IMPACT YOUNG First Aiders can help to remove barriers to
PEOPLE? care, such as cost, stigma, logistics, and lack
of awareness.
» Adolescence refers to the period when a young
WHAT IS TYPICAL person develops from a youth into an adult.
» This period varies across cultures.
ADOLESCENT
» Adolescent development involves changes in
DEVELOPMENT? these broad areas: physical, cognitive, social, and
emotional.
WHAT ARE RISK
AND PROTECTIVE » Risk factors increase the likelihood of developing
FACTORS? a mental illness or addiction.
» Protective factors counteract risk factors.
» Protective factors are environments, supports,
and behaviors that act opposite to risk factors.
The more protective facts that are present,
the less likely, the more likely a youth will be
resilient in the face of adversity.
10
YOUTH MENTAL HEALTH FIRST AID:
SELF-PACED INTRODUCTION RECAP
11
YOUTH MENTAL HEALTH FIRST AID:
SELF-PACED INTRODUCTION RECAP
12
YOUTH MENTAL HEALTH FIRST AID:
SELF-PACED INTRODUCTION RECAP
13
YOUTH MENTAL HEALTH FIRST AID:
SELF-PACED INTRODUCTION RECAP
14
The concepts introduced in the YMHFA Self-paced
Introductionconnects to my community because...
The concepts introduced in the YMHFA Self-paced
Introductionmakes me think about my role as a
because...
15
YMHFA in Non-Crisis
Situations
Learning
Objectives
In this segment, you will learn to:
• Apply the appropriate steps of the
YMHFA Action Plan (ALGEE) in non-
3 crisis situations.
Important
Concepts
• ALGEE Action Plan.
Title: “Skin Deep”
By Althea Pos
16
Important Concepts
What do you think that the artist is trying to convey
about mental health or mental illness?
Mental Health First Aid Action Plan
3
What are helpful and unhelpful approaches?
1. I understand and know exactly what 8. Pull yourself together.
you are going through. That happened to 9. Is something bothering you?
me when I was your age. 10. You haven’t been joining your friends
2. I am concerned about you. at lunch — are you doing okay?
3. You’ ll get over it, you’ve just got to 11. It is hard for me to understand
ignore it and get on with life. exactly what you are going through, but I
4. You’ ll feel differently tomorrow. can see that it’s distressing for you.
5. It’s such a beautiful day outside. How 12. Something seems to be bothering
can you feel so sad? you. Do you want to talk about it?
6. How long have you been feeling like this? 13. You’ve got schoolwork to get done. It
7. Have you spoken to anyone about is time to get on with it.
this before?
17
Important Concepts
What are examples of verbal and nonverbal cues to
demonstrate listening?
3
How does culture intersect with how we communicate
and listen?
18
Important Concepts
Scenario 1
A Assess: Is the person in crisis? How would you approach the person?
L What would you do to show nonjudgmental listening?
3
G What reassurance and information would you give in this scenario?
E How would you encourage appropriate professional help?
E How would you encourage self-help and other support strategies?
19
Important Concepts
Think about a time you felt reassured by someone. Circle
the actions they used to provide you reassurance.
• Had realistic expectations about what • Gave you hope.
you were going through. • Gave advice.
• Made promises they couldn’t keep. • Tried to fix the problem themselves.
• Dismissed the problem or emotions. • Provided practical help.
• Focused on what was the “right” or • Made light of or made fun of the
“wrong” thing to do. problem.
• Offered consistent emotional support. • Provided information.
• Acknowledged the limits of what they • Talked in a sarcastic, hostile, or
could do. patronizing way.
Who are the professionals we could encourage a youth or their
family to connect to for a mental health challenge?
3
20
Important Concepts
Talking About It, Part 2
Keep your focus on the same youth you focused on for Part 1 and
answer the following questions.
I’m focusing on:
How did the youth know they needed to seek treatment?
Who did they reach out to for help?
What were some barriers to asking for help that the youth
described?
How could you, as a First Aider, assist in this process?
21
Important Concepts
What should a Youth Mental Health First Aider do if someone
does not want to connect with professional help?
3
What people, programs, and activities may be helpful for
a young person with a mental health challenge?
People Programs Activities
22
Important Concepts
Scenario 2
A Assess: Is the person in crisis? How would you approach the person?
L What would you do to show nonjudgmental listening?
3
G What reassurance and information would you give in this scenario?
E How would you encourage appropriate professional help?
E How would you encourage self-help and other support strategies?
23
Emergency Contact Information
NOTES NATIONAL SUICIDE
PREVENTION LIFELINE
1-800-273-TALK (8255) [24/7 Hotline]
1-888-628-9454 (Spanish)
1-800-799-4889 (TTY)
This hotline is available 24 hours a day.
CRISIS TEXT LINE
Text “MHFA” to 741741 to speak
with a compassionate, trained crisis
counselor, a volunteer who has been
trained to help with proble-solving and
will address the caller’s situation.
Key Takeaways
3
The ALGEE action plan is a non-linear plan.
If the person is not in crisis, you may move to other parts of the action plan.
Use verbal and non-verbal cues to convey nonjudgmental listening.
Giving reassurance and information is not the same as giving advice.
Reassurance is a statement or action taken to help remove a person’s fear.
Information is a set of facts given about a specific topic.
There are many types of professionals who can help and a wide variety of
treatments available to help a youth recover from a mental health challenge.
There is a wide range of self-help and coping strategies that are effective
in youth. Coping strategies for youth should be safe, interesting, and
satisfying; should build a new skill, and should help build social and
familial ties.
24
YMHFA in Crisis Situations
Learning
Objectives
In this segment, you will learn to:
• Apply the appropriate steps of the
YMHFA Action Plan (ALGEE) in
crisis situations.
Important
Concepts
• YMHFA Action Plan (ALGEE). 4
• Crisis.
Title: “Narcissistic
Personality Disorder” • Suicide.
By Sasha Mosquera • Overdose.
• Recovery Position.
• De-escalation Strategies.
25
Important Concepts
What do you think that the artist is trying to convey
about mental health or mental illness?
What is a crisis?
What do First Aiders need to consider before reaching out in
crisis situations?
What are some de-escalation strategies?
26
Important Concepts
Key Actions to remember when trying to help someone
exhibiting aggressive behaviors:
• Ensure your own safety.
Key Actions • Attempt to de-escalate.
• Connect to appropriate professional help as needed.
What are some examples of medical emergencies?
27
Important Concepts
What are warning signs of suicide?
Key Actions to remember when you notice warning signs of
suicide
4 Key Actions
• Ask directly: “Are you thinking about killing
yourself?” or “Are you thinking about suicide?”
• Work together to keep them safe for now. Consider
calling the National Suicide Prevention Lifeline.
• Connect them with a professional.
• If you don’t feel as though you can keep the individual
or yourself safe, get help immediately.
28
Important Concepts
What is an overdose?
Key Actions to remember when you notice signs and symptoms
of an overdose:
Key Actions
• Call 911.
• Place the person in the recovery 4
position while you wait for help
to arrive. Do not use the recovery
position if the person has a head,
back, or neck injury.
29
Important Concepts
“BOXING”
What ALGEE steps were demonstrated?
By whom?
Helpful Unhelpful
A
4 E
After the crisis: How did the coach continue to help after the
crisis situation resolved?
30
Important Concepts
Auditory Hallucination Exercise: The Setup
• To simulate the experience of auditory hallucinations.
The Purpose
• To practice noticing skills.
The Roles
Youth Mental Adult Script Reader Observer
Health First (Optional)
Aider
• Challenge by choice.
The Rules • Only read from the script.
• Maintain your typical speaking voice.
• Respect the activity and lived experience.
• Roll a paper into a paper cone.
The Directions • Use the paper cone to speak into the adult’s ear.
• Do not deviate from or alter this script.
• Read through script two times and switch roles.
31
The Script
• Why are you talking to them?
• Don’t trust them.
• Why are you talking to them?
• Don’t trust them.
• Are they looking at you?
• Why would they want to talk with you?
• Do you think you can trust them?
• You can’t trust them. You can’t trust anyone.
32
Important Concepts
Auditory Hallucination Exercise: The Debrief
How did the adult appear?
How did the adult behave?
What feelings did you notice or did the adult express?
What did you notice about the adult’s thoughts?
33
Important Concepts
Talking About It, Part 3 – “Our Journey Forward”
Keep your focus on the same youth you chose to focus on for Parts 1
and 2 and answer the following questions.
I’m focusing on:
Do you think this youth would have gotten professional help without the
assistance of their family and friends?
Do you think this youth would have gotten better without professional help?
Do you think Dorothy, Colby, or Novak feel trapped or limited by their
experiences? Why or why not?
Do the stories of these youth help you feel confident that you can help a youth in
need of support or in crisis?
34
Important Concepts
Scenario 3
A Assess: Is the person in crisis? How would you approach the person?
L What would you do to show nonjudgmental listening?
G What reassurance and information would you give in this scenario?
How would you encourage appropriate professional help?
E
4
E How would you encourage self-help and other support strategies?
35
Emergency Contact Information
NOTES NATIONAL SUICIDE
PREVENTION LIFELINE
1-800-273-TALK (8255) [24/7 Hotline]
1-888-628-9454 (Spanish)
1-800-799-4889 (TTY)
This hotline is available 24 hours a day.
CRISIS TEXT LINE
Text “MHFA” to 741741 to speak
with a compassionate, trained crisis
counselor, a volunteer who has been
trained to help with proble-solving and
will address the caller’s situation.
Key Takeaways
4
A crisis is a situation when a person’s life or health is in danger, or a person poses a
threat to the lives of others.
The following situations may become a crisis: panic attacks, aggressive
behaviors, substance misuse, and following a traumatic event.
The following situations are an immediate crisis: medical emergency, suicidal
thoughts and behaviors, severe effects of drug or alcohol use, nonsuicidal self-
injury ideation, and severe psychotic states.
More detailed information on how to respond to crises can be found in your
manual .
36
Self-care for the Youth Mental
Health First Aider
Learning
Objectives
In this segment, you will learn:
• How to choose appropriate methods
for self-care following the application
of Youth Mental Health First Aid in a
crisis or non-crisis situation.
Important
Concepts
• Self-care.
Title: “Don’t Stress Out,
Work Out”
By Joseph Dimataris
37
Important Concepts
What do you think that the artist is trying to convey about
mental health or mental illness?
How do you know when you need to refuel with self-care?
38
Emergency Contact Information
NOTES NATIONAL SUICIDE
PREVENTION LIFELINE
1-800-273-TALK (8255) [24/7 Hotline]
1-888-628-9454 (Spanish)
1-800-799-4889 (TTY)
This hotline is available 24 hours a day.
CRISIS TEXT LINE
Text “MHFA” to 741741 to speak
with a compassionate, trained crisis
counselor, a volunteer who has been
trained to help with proble-solving and
will address the caller’s situation.
Key Takeaways
5
Self-care is an important part of being a Youth Mental Health First Aider.
39
REFLECTION
3 2 1
Resources to Things Action
Remember I Learned I will Take
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Resource Alert
41
