Whispers and shadows and Mental Health First Aid

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Chirlane McCray, first lady of New York City, said her parents’ depression was “talked about in whispers and shadows.” Now she’s talking out loud about mental health, trying to bring it out of the shadows. Hiding or ignoring mental health issues hurts all of us. Everyone has a family member, friend, or co-worker who is affected. One in four people in this country suffers from some mental illness or addiction each year. Suicide is the tenth leading cause of death in the United States, taking at least 41,149 lives in 2013. Minnesota’s suicide rate has risen sharply since 2014.

Mental health first aid training equips people to respond to mental health crises, just as CPR training equips people to respond to physical emergencies. Every year, 38,000 people suffering heart attacks in public get help from some regular person using CPR or a defibrillator. CPR training is widespread, so why not mental health first aid training?

“‘The truth of the matter is that you are more likely to encounter someone who is experiencing a behavioral health condition or crisis’ than someone facing a physical emergency, said Laira Roth, the council’s project manager for the first aid course.” (Washington Post)

While anyone can benefit from the training, clergy and police need it most. Clergy often become first responders, with people going to them because they are more comfortable and familiar or because mental health professionals are simply not available.

Law enforcement, from police officers to prison guards, deal with mental illness daily. According to the National Alliance on Mental Illness:

“In a mental health crisis, people are more likely to encounter police than get medical help. As a result, 2 million people with mental illness are booked into jails each year. Nearly 15% of men and 30% of women booked into jails have a serious mental health condition.”

The Treatment Advocacy Center reports that about 1 in 25 Americans adults has a severe mental illness, but that they account for 1 in 10 police calls and “occupy at least 1 in 5 of America’s prison and jail beds.”

Too often, police interaction with mentally ill persons ends very, very badly. This year, tragically, police in Roseville shot and killed a man suffering from mental illness after being called because “because neighbors heard pounding, profanity and breaking glass coming from the man’s unit.” According to the Treatment Advocacy Center report, “a minimum of 1 in 4 fatal police encounters ends the life of an individual with severe mental illness.”

Whether arresting people or taking them to emergency rooms, police often fill the void left by lack of mental health treatment services. The Star Tribune reported in April that Minnesota emergency rooms are “holding pens” for mental health patients because there’s no psychiatric bed or treatment available. Some hospitals turn away ambulances when emergency rooms fill up with people in mental health crises. Others send patients with mental illness out of state when they cannot locate in-state psychiatric beds. Even when psychiatric beds are available, people may be trapped there with no way out because there are no community residential resources.

MPR’s recent investigation of Mesabi Academy highlighted the bigger, systemic problem: “Minnesota doesn’t have enough places to treat difficult children with mental health problems.” KARE 11 recently told the story of an eight-year-old with severe mental illness: “Adrian was trapped; too dangerous to go home, with no child psychiatric beds immediately available anywhere in the state.”

We need to bring talk about mental illness and mental health out of the realm of whispers and shadows. Three essential steps are

  • Increase mental health resources.
  • Train first responders, especially police, in crisis intervention and de-escalation techniques.
  • Expand mental health first aid training for everyone.

Increasing mental health resources

The need, as the Star Tribune reports, is huge:

“Hennepin County’s 60 mental health professionals now field more than 24,000 crisis calls and visits a year to adults and children in crisis, up from 3,154 when the service started in 2006.”

Funding approved by the legislature in 2015 will expand county crisis teams across the state, making such referrals more practical. That’s a first step, but it’s far from enough.

We need increased access to help for people who cannot afford to pay for it. That means increasing resources for talk therapy, for support groups, for medication, for in-patient treatment, and for supportive living and halfway homes.

Train first responders:

During this session, Senator John Marty introduced a bill to require four hours of mental health crisis response training for police officers. Marty’s proposal became part of the Senate omnibus funding bill, but even this very minimal proposal was not passed by the Republican-controlled House of Representatives.

All police officers need crisis intervention training. As Bob Collins noted in his blog about the Roseville death:

“If you have a family member in crisis, you have to think twice before calling the police for help because you don’t know whether you’re setting in motion a chain of events that could lead to their death.”

Police need training, and they also need back-up from mental health professionals, such as mental health crisis teams. In Minnesota, the law allows 911 operators to send mental health professionals instead of police. Ramsey County just started a pilot program to train operators to make such referrals. We need more than a pilot program, and we need it now.

Expand Mental Health First Aid training for everyone.

Mental health first aid training is one small but important step that each of us can take. Mental health first aid started in Australia and has spread across the world. New York City is gearing up to provide mental health first aid training to 250,000 people, including police. In the United States, the National Council for Behavioral Health operates Mental Health First Aid USA in partnership with the Missouri Department of Mental Health.

Here’s the website for Mental Health First Aid in the United States. You can look up courses offered near you. I looked for courses within 25 miles of my zip code. Of the nine courses listed during the next six months, seven are already filled and the other two are offered for specialized groups of professionals. I’m going to keep on looking, and hope that sooner or later I’ll find a course I can attend. Maybe I’ll see you there.

Resources:

 

 

 

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