What’s Involved in Learning Mental Health First Aid?

Courses can teach you how to assess someone’s problem and offer concrete steps for treatment.

Let’s say you’re at the gym, playing in your weekly pickup basketball game. Another player complains of chest pain, feels dizzy and heads to the bench. Chances are someone in the game or at the gym knows basic first aid and can help the player until a professional health care provider arrives.

Now let’s say you’re at work, and a co-worker complains of lack of focus, lethargy and feeling down in the dumps. Chances are, no one in the office knows how to help this person in any practical way. But they could learn what to do by taking a mental health first aid course.

Mental Health First Aid USA, operated by the National Council for Behavioral Health, or NCBH, is a program that offers an eight-hour course that teaches participants the risk factors and warning signs of mental health issues, fosters a deeper understanding of their impact and presents common treatments. Through role-playing and simulations of realistic scenarios, the course teaches participants how to assess a mental health crisis, provide initial help and direct someone with a mental health issue to professional, peer and social supports and to self-help resources.

“As the name implies, the training is about first aid. It is not to be a clinician or diagnostician,” says Betsy Schwartz, vice president for public education and strategic initiative for the NCBH. “It’s like with CPR, you are not teaching cardiology.” She says that research shows that people who take the training have increased literacy on behavioral problems and are more comfortable having a conversation with someone having a mental health problem. “The training is effective because it is experiential,” she says. “It is not eight hours of presentations. It is very much interactive and based on problem solving.”

Teaching Concrete Skills

The concept of mental health first aid was created in Australia, in 2001, by a nurse and her husband. She had experienced major depression, and the couple wondered why there wasn’t a mental health equivalent for first aid and CPR, Schwartz says. So they created a course curriculum, rooted in scientific evidence. “They made sure every word was solidly based on research,” Schwartz says.


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In 2007, executives at NCBH learned about it. “Based on the name alone, they thought it needed to be brought to the U.S.,” Schwartz says. So they did, in 2008, acquiring the copyright to offer the course here. (It is now offered in a total of 25 countries around the world.) To date, more than 1 million people in the U.S. have been trained through a network of more than 12,000 certified instructors. Participants include health, human services and social workers; employers and business leaders; faith community leaders; college and university staff and faculty; law enforcement and public safety officials; veterans and family members; and persons with mental illness and addictions and their families.

But the “vast majority” of participants are members of the general public, Schwartz says. “Part of the reason the trainings have taken off is because everybody knows someone with a mental health or addiction problem. People want to do the right thing, but it is not common sense to know what to say and do. Mental health first aid has resonated in a powerful way. It teaches very concrete skills, and eases people’s confidence and comfort levels.”

[Read: Mental Health Experts Recommend Their Favorite Depression Books.]

Those skills include recognizing the signs and symptoms of specific illnesses like anxiety, depression, schizophrenia, bipolar disorder, eating disorders and addictions. The program offers practical answers for those who want to know, “What can I do?” and “Where can someone find help?” Instructors provide local and national mental health resources and support groups, and they also suggest validated online tools for mental health and addictions treatment and support.

A newer program focuses on mental health first aid for preteens, teenagers and young adults. It teaches parents, teachers, peers and caring community members how to help a youth or teen who is experiencing a mental health or substance use challenge or is in crisis with anxiety, depression, substance use, psychosis, disruptive behavior disorders (including ADHD) and eating disorders. The NCBH has partnered with Lady Gaga’s Born This Way Foundation and recently announced that 150,000 people were trained in mental health first aid as part of a joint effort to promote awareness of and help for those with mental and behavioral health issues.

Skills Known as ALGEE

James Radack, a certified mental health first aid instructor, says that participants learn to follow a set of skills known by the acronym ALGEE:

  • Assess: Assess if the person is in crisis and at risk for suicide or harm and needs emergency attention or not.
  • Listen nonjudgmentally: Listen to the individual talk about his or her feelings using verbal and nonverbal skills such as open body posture, comfortable eye contact and other strategies to engage in nonjudgmental conversation.
  • Give reassurance and information: “We delineate between assurance and advice,” Radack says. “Sometimes advice gets into our own experiences or trying to cure or fix the problem, but that is not our role. Our role is to listen and reassure.”
  • Encourage appropriate professional help: If the person is seriously impaired by a mental or behavioral health issue, encourage him or her to seek professional help and show where that help can be found.
  • Encourage self-help: Tell the person that actions like exercise, meditation, support groups and self-help books can make a difference in their mental health.

“We teach participants to stay in your lane,” Radack says. “We are not trained to diagnose or treat these issues,” in the same way knowing CPR does not qualify someone to diagnose or treat cardiac arrest.

[Read: How to Help Someone Else Who Has Depression.]

“It’s nice knowing I am contributing toward something that is helping millions of people,” Radack says. “I get that feeling all the time. I see lightbulbs going off as people see things differently in relation to mental health. I hear people talk about how that night or that week they came across a situation and had a better sense of how to address it.”



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You know you best.

Only you truly know the unique triumphs and travails of living in your own head. If you experience ongoing depression, anxiety or other symptoms, “Seeking professional help as early as possible, rather than waiting, can be critical,” says Dr. Robert Klitzman, a professor of psychiatry at Columbia University in New York City. However, you needn’t be diagnosed with a mental health condition to benefit from taking steps to improve your psychological well-being. Here are some ways you can get a mental edge. The payoff could include everything from a happier, healthier, longer life to better relationships.

Get moving.

(Getty Images)

Get moving.

You might not want to sit down for this. “Physical exercise is very important in preventing or reducing mental health problems,” Klitzman says, which include depression. “When we exercise, our body releases endorphins – natural opiates that improve our mood and make us feel good. Exercise can also help cognitive functioning – how well we think.”

Watch your weight.

Being sedentary, by contrast, can prove a double whammy, since we don’t get the mental jolt from exercise – and we’re more likely to pack on pounds. Putting on extra weight, research shows, can weigh down our mental health, too. Obesity and diabetes increase the risk for depression, says psychiatrist Dr. Mahendra Bhati, an assistant professor of clinical psychiatry in the Perelman School of Medicine at the University of Pennsylvania in Philadelphia.

Be careful what you consume.

Your diet – whether predominantly plant-based with healthy greens, nuts and other lean proteins (good), or laden with saturated fat, processed foods and sugars (not so good) – can impact mood and anxiety levels. So, too, can other things we put in our body to get by in the moment, from tobacco and alcohol to recreational drugs. Better to avoid the feel-good momentary fixes, Klitzman says, and spare yourself the crash later.

Stay in the moment.

We all sometimes seek to avoid uncomfortable situations, either by physically removing ourselves or checking out mentally. “That’s normal … it’s just that when you do that very chronically and habitually, it could develop into significant problems with anxiety and depression,” says psychologist Brandon Gaudiano, an associate professor of psychiatry and human behavior at Brown University in Providence, Rhode Island. Experts recommend practicing mindfulness instead to help deal with difficult circumstances and emotions. “It’s paying attention to the present moment and what your experience is,” says Gaudiano, noting that approaches vary. “Bringing awareness, acceptance, self-compassion, curiosity and just noticing non-judgmentally those internal experiences as they’re arising.”

Meditate about the ones you love.

Want to get even more from that wonderful vacation or visit with family? Focus your mind on it. In researching different forms of meditation, Barbara Fredrickson, a professor of psychology and neuroscience at University of North Carolina–Chapel Hill, has found that so-called kindness meditation or loving-kindness meditation can improve a person’s emotional well-being and reduce symptoms of depression; she adds that other researchers have found it eases anxiety. “It’s a very simple meditation based on … sending well-wishes to yourself or others,” Fredrickson says, describing it as somewhat similar to mindfulness meditation.

Keep a journal.

Just as mindfulness can help a person recognize and cope with difficult thoughts and emotions in the moment, experts say it’s important to have outlets to process complex experiences. Journaling, or expressive writing, allows a person to put negative thoughts, feelings, aspirations and anything else that might be going through their mind to paper – and, Gaudiano says, to get some mental distance from those experiences. “It has been [shown to be] very helpful in some of the research I’ve done as well for [addressing] anxiety and depression,” he says.

Stay socially connected.

Social support plays a vital role in helping optimize our overall mental well-being, Klitzman says. He recommends “surrounding ourselves with supportive people – loving friends and family – and avoiding, if we can, ‘difficult’ people who may bring us down.” By contrast, a lack of social connectivity can put us at risk for health problems that affect body and mind and contribute to premature death. “Lack of socialization is … the leading cause of geriatric depression,” Bhati says.

Prioritize – and schedule – positivity.

Pay bills, do work, spin wheels. Check, check, check. Lunch with a friend? Not on the list. “Basically when people make their ‘to-do’ list, they are often thinking of achievement, as opposed to scheduling something in their day that they know is a boost to their positive emotions and their mood,” Fredrickson says. But her own research finds those who prioritize positivity, such as allotting time to visit loved ones or engage in a beloved hobby, tend to be mentally healthier.

Assess your stress.

Avoiding high levels of stress and finding ways to cope can make a big difference. “Many times, we can actively avoid difficult, stressful situations,” Klitzman says, When we can’t, “framing our experiences positively, and trying not to worry (especially about things you can’t change) can also be beneficial – focusing on the positive, not stewing about the bad things that may occur.” Under such circumstances, he adds: “Mindfulness – relaxation or meditation – can also help.”

Sleep on it.

Whether you’re wrestling with serious mental anguish or just smelling the roses, it’s important to get ample rest and practice proper sleep hygiene – room-darkening blinds in the bedroom, TV out. “Poor sleep wreaks havoc on the brain and circadian rhythms, [and it can] alter brain function and gene expression,” Bhati says. In short, whether you’re predisposed to mental health issues or not, skimping on shut-eye can awaken psychological problems that make it even harder to function during the day.

Find purpose.

Just as making time to visit with friends can change the complexion of a day, mental health experts say doing something meaningful and finding purpose can ground a person in psychologically beneficial ways. “Engaging in activities that give us meaning in our lives can further aid us,” says Klitzman, in terms of improving mental health. That might include volunteering to help others, engaging in hobbies as well as doing other things we enjoy, he adds. Bhati echoes that doing things with a sense of purpose or meaning is a proven way to improve mental health.

David Levine is a freelance health reporter at U.S. News. He is a contributing writer for and Wainscot Health Media, a former health care c… full bio »