Mental health first aid

If you had taken first aid and came across someone with a broken arm or chest pain, you would likely know how to stabilize them and get help. But what if a coworker or a client was having a panic attack or showing signs of depression, talking about killing herself or himself…would you know what to do to help? Just as first aid is the help given to an injured person before professional medical treatment can be obtained, mental health first aid (MHFA) is the help provided to a person developing a mental health problem or in a mental health crisis until appropriate professional treatment is received or the crisis is resolved.

The aims of mental health first aid (1) are to

1. Preserve life where a person may be a danger to herself/himself or others.

2. Provide help to prevent the mental health problem from becoming more serious.

3. Promote the recovery of good mental health.

4. Provide comfort to a person experiencing a mental health problem.

Mental health first aid (1) teaches people to

1. Recognize the symptoms of mental health problems. It does not teach diagnosis.

2. Provide initial help.

3. Guide a person towards appropriate professional help. It does not teach people to be therapists.

Mental health first aid is evidence-based and several research studies (2–5) demonstrate that it

• improves the ability to recognize a mental health disorder;

• increases the confidence and ability to provide the appropriate first aid response;

• improves people’s capacity to seek help for their own mental health problems; and

• reduces stigmatizing attitudes and beliefs.

My opinion is that every clinic needs at least one physical and one mental health first aider

You need this to keep you and your coworkers safe and ensure that everyone gets the help they need. As you read this article, think about what you can do to help your local veterinary association deliver MHFA to you and your peers.

Veterinary professionals need training in mental health first aid

Veterinary work involves stressors such as poor work-life balance, long hours, student debt, interaction with animal owners, performing euthanasia, dealing with poor animal welfare, staff management responsibilities, and meeting the clinic’s financial demands. These stressors, along with personality and perfectionism, can contribute to increased risk for mental health problems, burnout, maladaptive coping strategies, and suicide (6,7). One USA study showed 87% of veterinarians found their job stressful and 67% had symptoms of the beginnings of burnout syndrome (8). Female veterinarians, younger veterinarians, and those working alone have been identified with higher risk of suicidal thoughts and mental health difficulties (6,9).

Mental health problems are common

Approximately 1 in 5 adults in the United States and Canada experience mental illness in a given year (10,11). The prevalence of mental disorders is so high that virtually every person will develop a mental health problem themselves or have close contact with someone who does. One USA study demonstrated that 2/3 of veterinarians, including 79% of associate veterinarians in practice, reported experiencing feelings of depression, emotional exhaustion, and anxiety or panic attacks within the past year (8). Veterinary professionals may encounter clients who are at risk for mental health problems because of high levels of animal attachment whilst facing crises such as euthanasia, herd morbidity/mortality, and emergencies. Research shows high rates of depression and suicide in farmers (12), almost equivalent to those for veterinarians. The relationship many veterinarians have with client farmers often extends beyond supporting animal health and as such veterinarians are uniquely positioned to recognize when farmers are under pressure and need mental health support.

Not everyone with a mental health problem seeks treatment

Not all mental health problems need professional help and people who need treatment may not reach out for help. One USA study showed that half of veterinarians with serious psychological distress were not receiving treatment because they did not realize that they needed help, did not know where and how to get help, were embarrassed to ask, and feared peer judgment and employer discrimination (8).

We often do not know how to respond

In a mental health situation, a person wishing to give assistance may miss, dismiss, or avoid offering support. People may feel unprepared, scared, nosey (“it’s not my business”), and dismiss signs thinking that the person is having a bad day or “it’s just their personality,” among other reasons. Negative attitudes, called stigmas, often get in the way. These include thoughts such as, “people with mental health problems could snap out of it if they wanted” or the belief that mental health problems are a sign of weakness. People with mental health problems self-stigmatize and feel embarrassed, shameful, or guilty, which prevents them from seeking help.

Mental health first aid follows the principles of conventional first aid

Mental health first aid teaches people how to provide help to those in mental health crisis situations or with developing mental disorders. It is an intervention that will help people feel confident and more willing to support others in seeking help for mental health problems and will improve the quality of first aid support.

Taking a mental health first aid course as an entire clinic team will help create a culture of caring

Mental health first aid courses help to air out the stigmas, normalize the thoughts, and reassure people that they will not be judged if they ask for help. We all have mental health issues and learning about them changes the way that we perceive them at work and it makes the clinic environment more mental health friendly, something that becomes part of everyday life. Imagine working in a mental health friendly and literate veterinary clinic? Wouldn’t it be wonderful to know you can talk to a co-worker who will listen non-judgmentally, or on the flip side, if you are the listener who can hear colleagues without getting emotionally bogged down or checking out. Imagine knowing how to approach clients when they are showing signs of suicide and grief over the loss of their animal(s). You would recognize the key warning signs of mental health concerns, know how to initiate the right kind of conversation, and connect the affected individuals to helpful community resources. You can do this. Reach out to your local MHFA chapter (1,13) to register for an open enrollment course or gather a minimum of 15 veterinary professionals and invite an MHFA trainer to teach the 2-day workshop. There is no time to waste, we can’t afford to lose another colleague, let’s start now.