Mental Health for the First Aider

By Kane Guthrie

About Me

• Former VFAS• Nurse• Researcher• Blogger

Mental Illness

• A mental disorder is a diagnosable illness which causes major changes in a person’s thinking, emotional state and behavior, and disrupts the person’s ability to work and carry on their usual personal relationships.

Mental Health First aid

• Preserve life where a person may be a danger to themselves or others

• Provide help to prevent the mental health problem developing into a more serious state

• Promote recovery of good mental health• Provide comfort to a person suffering a mental

illness.

What are the issues?

• Stigma (seeking help)• Alcohol• Knowing what to do• Limited resources• Limited bed’s• More presentations

The Stat’sType of mental disorder Males Females

Anxiety disorder 7.1% 12.0%

Substance use disorder 11.1% 4.5%

Depressive disorder 4.2% 7.4%

1: 5 Australian adults will suffer from some form of common mental disorder in any year

Over 2000 Australians commit suicide each year

The Disorders

• Depressive• Anxiety• Psychosis• Substance use• Personality disorders

The Basic Principles

1. Assess risk of suicide or harm2. Listen non-judgmentally3. Give reassurance and information4. Encourage person to get appropriate

professional help5. Encourage self-help strategies

Medical Causes

• Epilepsy• Blood sugar• Medication toxicity/overdose• Thyroid disorders• Strokes• Multiple neurological disorders• Infection• Hypo/hyperthermia

Depression

• Others imply they know what it is like to be depressed because they have gone through a divorce, lost a job or broken up with someone. But these experiences carry with them feelings. Depression, instead, is flat, hollow and unendurable.

• Kay Jamison, An Unquiet mind.

Depression

• Is a state of low mood and aversion to activity that can affect a person’s thought, behaviour, feelings and physical well-being.

• May include feelings of:

Sadness Anxiety

Emptiness Hopelessness

Worthlessness Guilt

Irritability Restlessness

Suicide

• Taboo subject• Men Vs Women• Committed out of despair• All patients with suicidal ideation need referral

to a healthcare professional for assessment• “Suicide is a permanent solution to a

temporary problem”.

The depressed/suicidal patient!

• Listen (everyone has a story let them tell it)• Ask about suicide/plan/overdose• Request help• Stay with patient until help arrives

Bi-Polar• Characterised by extreme mood swings.• Patient fluctuates between periods of

depression, mania, and normal mood.

Anxiety

• A normal reaction to a stressor.• Ongoing episodes is disabling • Characterised by:1. Physical2. Psychological 3. Behavioral

The anxious patient!

• Move to low stimulus environment• Give reassurance• Encourage them to breath in unison with you• Arrange for medical review

Psychosis

• Loss of some contact with reality• Severe disturbances in thinking, emotion and

behaviour• Causes severe disruption person’s life,

relationships, work and self care.

Psychosis

Delusions:• False beliefs of persecution, guilt, special mission, or

being under outside control.

Hallucinations:• These are false perceptions.• Most commonly involve seeing, feeling, tasting or

smelling things.• Perceived as very real by the person, but are not

actually there.

The Types of Psychosis

• Psychotic depression• Schizophrenia• Schizoaffective disorder (Bi-polar & SCZP)• Drug induced psychosis

The Thought-Disordered Patient!

• Call for help• Approach quietly and cautiously• Be polite and respectful, and reassure• Listen, don’t contradict, debate or interrupt

patient’s ideas

The Violent/Aggressive Patient!

• Call for help Police/Security• Don’t put yourself in danger• If safe to approach, do it slowly, identify

yourself.• Try to ascertain source of aggression• Monitor till help arrives

Substance Use Disorder

• Dependence on alcohol or a drug• Use of alcohol/drug which leads to problems

at work, school or home, and even legal problems

• Use of alcohol/drug at a level which causing damage to health.

The Intoxicated/Overdose Patient

• DRABC• Remain calm, reassuring, professional• Maintaining the airway is paramount• Assess for other injuries/medical conditions• Monitor conscious state• History, what, when,& how much?

Emergency Help

• Police• Ambulance• M.E.R.L. (1300 555 788)• Emergency department

Helpful ResourcesPhonelines

Lifeline Counseling: 13 11 14Kids Help Line: 1800 551 800Mensline Australia: 1300 789 978

Helpful ResourcesWebsites

www.blackdoginstitute.org.au• www.sane.org/• www.beyondblue.org.au

Take Home Points

• Your safety comes first• Listening is the best treatment• Remain open minded, non-judgmental• Don’t get into the circle of despair• Remember medical causes first• Mental illness doesn’t discriminate• Debrief yourself

Thank-you