Updated, June 2021.
What’s the first thing you should do when someone is experiencing a panic attack? What if you suspect someone is at risk of harming themselves? How should you approach them?
The Global Burden of Disease study (2017) revealed that 792 million people worldwide are living with a mental health disorder. That’s roughly one in ten people globally.
And yet, shockingly few of us know the signs of poor mental health, or how to respond to a mental health emergency.
We understand that early intervention is key to saving lives and getting people the help they deserve. But we are fearful of saying the wrong thing, causing offence, or making the situation worse.
Anyone who works in a community-serving role can benefit enormously from mental health first aid training. It’s not just health care providers who encounter people suffering from mental illness.
From teachers to social workers to law enforcement to business managers—everyone should know the basic response strategies.
So, let's get started. Here are the 5 steps of mental health first aid, explained in plain language.
Step #1: Assess for risk of suicide or harm
This first step focuses on immediate needs. You are looking for indications of self-harm or the intent to commit suicide. For example:
☑️ Threatening to commit suicide or inflict self-harm
☑️ Seeking means to commit suicide or inflict self-harm
☑️ Talking or writing about death, dying, or suicide
☑️ Expressions of hopelessness, futility of life
☑️ Acting recklessly or engaging in risky activities
☑️ Withdrawing from family, friends, or society
☑️ Dramatic changes in mood
Important: If you believe someone's life is in immediate danger, seek emergency help right away. Dial 911 or call the Canada Suicide Prevention Service (CSPS): 1-833-456-4566 (toll free).
See a list of crisis centres across Canada: Canada Crisis Centres
Step #2: Listen without judgment or criticism
Listening non-judgmentally is more challenging than it sounds. It means listening without interruption, without criticism, without looking to “solve” the problem.
Most of us don’t use this type of listening on a regular basis. It’s human to have (and express) opinions about what we hear, both verbally and non-verbally.
No one is truly neutral or impartial about anything!
However, when you are supporting someone in a mental health crisis, being critical is counterproductive. You need to create a safe space, where the individual can express themselves openly, without fear of judgment.
This is a crucial component of the mental health first aid action plan. Key features of non-judgmental listening include:
☑️ Keeping an open body posture (no crossed arms)
☑️ Maintaining comfortable eye contact (adjusting as necessary)
☑️ Regulating your facial expressions
☑️ Demonstrating empathy and acceptance (nodding, affirming, encouraging)
☑️ Resisting the urge to “fill” moments of silence
☑️ Using simple, short verbal cues to show you are listening
A good community mental health course will include role play and simulations, where you can develop your listening skills.
Every scenario and human being are different. However, the core tenets of non-judgmental listening remain the same, and can be honed and adapted to suit each situation.
Role play helps build confidence and a “toolkit” of listening strategies for different mental health crisis situations.
Step #3: Give reassurance and information
In many communities and families there remains a strong stigma around mental illness.
Despite awareness and education campaigns, mental health myths persist and there is confusion regarding causes, symptoms, and treatments.
Step 3 of mental health first aid involves giving reassurance and providing reliable information on resources for support and treatment.
It’s important to remind the individual that they are not at fault. They have a diagnosable, treatable illness, and deserve the same dignity and respect as any other patient.
Quality mental health training includes detailed information on common mental health issues, like depression, anxiety, addiction, impulse control and personality disorders.
Students get a solid understanding of symptoms and treatments, which is helpful when providing stage 3 support to someone in need.
You can counter feelings of shame and confusion with research-based facts, and start a conversation about seeking help.
Step #4: Encourage appropriate professional help
Back in 2001, the World Health Organization released a global report on mental disorders. The report revealed that although treatment options are available, many people are simply not using them.
In fact, two-thirds of people suffering from mental health disorders never seek out any form of treatment. Unfortunately, the situation hasn’t changed much over the past 20 years.
Because of stigma and lack of awareness, many people are still unwilling to discuss mental health issues or reach out for support. Some are simply unaware that they are suffering from a legitimate illness, while others feel too ashamed to discuss it openly.
Step 4 of mental health first aid seeks to break this negative cycle.
You should explain the types of mental health professionals available in your community and encourage the individual to seek out appropriate support.
Your goal is to connect the individual with an expert, who will arrange a complete mental health assessment and personalized treatment plan.
☑️ Family doctor
☑️ Social worker
Step #5: propose self-help and other support strategies
In addition to consulting with a health care provider, the individual can also utilize self-help techniques and other support strategies.
Self-care is a skill. It is essential for maintaining good mental health, advocating for oneself, and feeling empowered to lead a healthy life.
But, like most skills, it can take time and effort to learn good self-care practices. These habits don't always come naturally.
At stage 5, you can discuss possible techniques for coping with mental illness and maintaining overall wellness, such as:
☑️ Participating in support groups
☑️ Staying connected to friends, family, and social networks
☑️ Regular exercise
☑️ Healthy diet
☑️ Educating oneself on mental illness (exploring research, treatments, self-help strategies)
These techniques focus on supporting the whole person—their emotional, physical, psychological, and spiritual wellness.
It’s important to remember that mental health is one piece of the whole.
We must stand back, look at the big picture, and talk about ways to optimize health from every angle.
These mental health first aid steps can be applied to many different situations, including panic attacks, suicidal behaviors, self-injury, addiction relapse or withdrawal, and reaction to trauma.
Learn more about community mental health training
Are you interested in building your knowledge of mental health and addictions?
Explore the Community Mental Health & Addictions Certificate delivered online, through Kompass Professional Development.
This online course is taught by Rose Ceci, a certified psychiatric mental health nurse with the Canadian Mental Health Association (CMHA).
The course can be completed in 3-6 months, and covers the latest research, treatments, and issues surrounding:
☑️ Youth addiction and mental health
☑️ Mental health, culture and modern society
☑️ Concurrent, personality and impulse control disorders
☑️ Mood disorders and depression
☑️ Psychotic and dissociative disorders
Click below to explore the Community Mental Health & Addictions Certificate and chat live with an admissions advisor.