Mental Health First Aid to 

Save and Enrich Lives

Iris C F Gomes

Mental Health First Aid (MHFA) is an unusual and unheard of concept in Goa, but a sorely needed one. With the plethora of undetected mental health issues that are plaguing the state, MHFA could be a ray of hope in the gloom of the prison of mental illness.

The story of MHFA began with Betty Kitchner, an educator, nurse and counsellor, who developed MHFA in 2000 after dealing with major bouts of depression. MHFA started out in Australia and is now present in twenty three countries all over the world. There are courses designed for adults, children and youth and the armed forces. There is a one day course specific to schools and colleges. The two day course offered for the youth allows participants to become youth mental health first aiders. The one day course is meant for all involved in the school system, not just teachers. The same applies to the two day course where all engaged with supporting the youth are also able to gain hands on training.

Andy Bacon works in the National Health Service to rehabilitate soldiers in the UK and has been a frequent visitor to Goa. He discovered MHFA while researching mental health programmes for soldiers. He speaks of the programme being adapted to the culture in Uganda, a country that stigmatises mental illness to the extent that its soldiers attach great shame to being diagnosed with mental health problems. He has seen how MHFA has yielded a wonderful response from Ugandan soldiers, where mental health problems were isolated in the early stages, allowing for better recovery from the traumatic effects of war and carnage. Having seen the positive results produced by Mental Health First Aid, he decided it was time to give something back to Goa after his many trips here, by introducing the concept of MHFA.

Poppy Jaman is the CEO of MHFA England. Having dealt first hand with depression herself, she knows all too well its implications. Poppy has worked with soldiers in Uganda and in Bangladesh, and is eager to bring MHFA facilities to Goa to combat hidden mental health issues that are creating debilitating conditions for people with little done to help them.

During the interactive presentation held at the Don Bosco Konkan Development Society headquarters at Odxel, Goa, the mental health problems that plague this state, and their causes, came to light. Depression and anxiety related to economic problems, academic performance, love affairs, terminal illness, neglectful parenting and the resulting tendency towards alcohol and drug addiction, besides being prone to commit suicide, were discussed by those present in the audience. MHFA, with its agenda to detect mental illness at its earliest stages, can do much to curtail the problem in Goa.

‘For me, mental health is on a continuum. Every single one of us has mental health,’ says Poppy. When one descends into mental illness, it is a feeling of helplessness where one cannot get out of the situation. In England particularly this would mean depression, anxiety and stress for prolonged periods of time. The condition could then degenerate into a psychosis, with a combination of different symptoms such as delusions, hallucinations and/ or paranoia; ultimately resulting in the two common categories of psychoses: schizophrenia and bipolar disorder. ‘Let’s not get caught up in labelling people,’ says Poppy, cautioning against stigmatising mental illness, ‘You can go from being well to mental illness if the trauma is severe enough.’

Recovery from mental illness is very possible with the right help at the right time. However, recovery has a different connotation for different people depending on their circumstances and ability to respond to treatment. For some it would be no dependence on medication again and for others it would require medication throughout their lives owing to recurring episodes of mental illness. The ability to live life to its full potential, engage in relationships at home and at work in a positive manner and cope with life issues and transitions, are behaviours that signify good mental health.

People who are mentally ill are globally treated as lesser human beings. In places like Bangladesh they are beaten with sticks and sexually abused, while in Bangladesh and Uganda, they are shackled to the beds. Even in the UK, a developed country, mentally ill people have fewer employment opportunities and are likely to die ten to fifteen years younger than the general population. All over the world, suicide is the leading cause of death of those who are 15 to 29 years of age, and yet more attention is given to research related to physical health rather than mental health.

Most people do not have the tools to address metal health problems and that is where MHFA comes in. Mental health issues are certainly common among children and young people but they are not well informed about mental health or mental health issues and lack insight, which prevents them from seeking aid.

The best approach is to educate young people and get them to open up about their struggles. Early intervention can stop or slow down mental health problems, lead to faster recovery and will encourage resilience. Ask the suicide question. There is a myth that asking the suicide question will put ideas into a suicidal person’s mind but in truth, it defuses the situation rather than aggravating it.

MHFA uses the ALGEE system which is: ask, assess and act; listen non-judgementally; give reassurance and information; enable the young person to get appropriate professional help: and encourage self-help strategies. Its objectives include saving young lives and improving the quality of their existence. This is an approach that will resonate with most social workers and professionals involved in mental health in Goa, and will make a world of a difference to the youth in a state that is facing burgeoning issues in terms of mental health. The introduction of the system in Goa is now being considered and if it is introduced it will be of great benefit across the state.