Just as we learn CPR to help someone in a physical crisis, Mental Health First Aid (MHFA) teaches us how to assist someone experiencing a mental health challenge or crisis. It is a vital skill that empowers individuals to provide initial support until appropriate professional help is received or until the crisis resolves.
What is Mental Health First Aid?
Mental Health First Aid is an evidence-based training program that helps you identify, understand, and respond to signs of mental illnesses and substance use disorders. The training gives you the skills you need to reach out and provide initial support to someone who may be developing a mental health or substance use problem and help connect them to the appropriate care.
Core Goals of MHFA
- Preserve life where a person may be a danger to themselves or others.
- Provide help to prevent the mental health problem from becoming more serious.
- Promote recovery of good mental health.
- Provide comfort to a person experiencing a mental health problem.
Why is Mental Health First Aid Important?
Prevalence of Mental Health Issues
Nearly one in five adults in the U.S. lives with a mental illness. Despite this high prevalence, many people delay seeking help due to stigma or lack of knowledge. MHFA bridges this gap.
Reducing Stigma
By talking openly about mental health and treating it with the same seriousness as physical health, MHFA helps destigmatize mental illness and encourages people to seek the support they need.
Early Intervention
The earlier a person receives help, the better their recovery outcomes. Mental Health First Aiders are often the first to notice changes in behavior and can intervene before a crisis escalates.
Recognizing a Mental Health Crisis
A mental health crisis exists when someone's behavior puts them at risk of hurting themselves or others and/or prevents them from being able to care for themselves effectively. Warning signs vary but often include:
Immediate Danger Signs (Call 911 or 988)
- Talk of suicide or wanting to die
- Looking for ways to kill oneself (researching methods, obtaining means)
- Talking about feeling hopeless or having no reason to live
- Extreme mood swings
- Threatening to hurt others or destroy property
- Acting violently or out of control
- Seeing or hearing things that aren't there
- Inability to perform daily tasks or care for self
Behavioral Changes
- Withdrawal from friends, family, and activities
- Dramatic changes in eating or sleeping patterns
- Rapid or dramatic shifts in emotions
- Increased use of alcohol or drugs
- Giving away prized possessions
- Taking unnecessary risks
- Neglecting personal hygiene
- Increased agitation or inability to stay still
Emotional/Mental Changes
- Expressing feelings of being trapped or in unbearable pain
- Talking about being a burden to others
- Saying goodbye to people as if they won't be seen again
- Extreme feelings of worthlessness or guilt
- Sudden calmness after period of depression or anxiety
- Paranoid thoughts or excessive worry
- Inability to concentrate or think clearly
- Unexplained physical problems
How to Help Someone in Crisis
Use the ALGEE action plan, an evidence-based approach for Mental Health First Aid:
Assess for Risk of Suicide or Harm
If you're concerned someone may be suicidal, ask directly: "Are you thinking about killing yourself?" This doesn't increase risk—it shows you care and gives them permission to talk.
If risk is present:
- Call 988 (Suicide & Crisis Lifeline) immediately
- Don't leave them alone
- Remove access to lethal means
- Take all threats seriously
Listen Nonjudgmentally
Sometimes the most powerful help you can offer is simply listening without judgment. This means:
- Give your full attention—put away phone, make eye contact
- Don't interrupt or offer solutions immediately
- Avoid phrases like "just think positive" or "others have it worse"
- Use reflective listening: "It sounds like you're feeling..."
- Allow silence—don't rush to fill it
- Take their feelings seriously, even if you don't understand
Give Reassurance and Information
Provide hope without minimizing their experience:
Helpful Statements:
- • "I'm here for you"
- • "You're not alone in this"
- • "This is treatable and you can feel better"
- • "Your life matters to me"
- • "Let's figure this out together"
Avoid Saying:
- • "Just snap out of it"
- • "Everyone feels like this sometimes"
- • "You have so much to live for"
- • "This is all in your head"
- • "Things could be worse"
Encourage Appropriate Professional Help
Help them access professional support:
- Suggest they talk to a therapist, counselor, or doctor
- Offer to help them find resources or make appointments
- If they're resistant, respect their autonomy while staying supportive
- Provide crisis line numbers: 988 or Crisis Text Line (text HOME to 741741)
- If in immediate danger, accompany them to emergency room
Encourage Self-Help and Other Support Strategies
Suggest coping strategies while they wait for professional help:
Specific Crisis Situations
Panic Attack
Panic attacks are terrifying but not dangerous. Help by:
- Staying calm yourself—your calm helps them feel safe
- Moving to a quiet, less stimulating environment
- Encouraging slow, deep breathing
- Reminding them this will pass (usually within 10-20 minutes)
- Helping them focus on the present moment
- Not leaving them alone until symptoms subside
Suicidal Thoughts or Behavior
This is a medical emergency. Take immediate action:
- Ask directly: "Are you thinking about suicide?"
- If yes: Call 988 or 911 immediately
- Remove access to firearms, medications, sharp objects
- Don't leave them alone
- Listen without judgment
- Don't promise to keep suicide plans secret
- Take all statements seriously
Psychosis (Hallucinations/Delusions)
Someone experiencing psychosis may see or hear things others don't, or have fixed false beliefs:
- Stay calm and speak in a clear, concise manner
- Don't argue about the reality of their experiences
- Validate their feelings without agreeing with delusions
- Reduce stimulation (noise, lights, crowds)
- Call for professional help—this requires medical attention
- Ensure safety for everyone present
Severe Depression
When depression becomes debilitating:
- Check in regularly—isolation worsens depression
- Help with basic tasks if they're overwhelmed
- Encourage professional treatment
- Be patient—depression isn't weakness or laziness
- Watch for suicidal thoughts
- Learn about treatment options like TMS therapy
Substance Abuse Emergency
Overdose or severe intoxication:
- Call 911 immediately if person is unconscious, having seizures, or trouble breathing
- Administer Narcan if available and you're trained
- Place person on their side if unconscious to prevent choking
- Stay with them until help arrives
- Don't leave them to "sleep it off"
- After crisis passes, encourage addiction treatment
Self-Care for Helpers
Providing mental health first aid can be emotionally draining. Taking care of yourself enables you to help others effectively.
Recognize Compassion Fatigue
Signs you need to step back and recharge:
- Feeling emotionally exhausted
- Difficulty sleeping or concentrating
- Decreased empathy or numbness
- Irritability or mood changes
- Physical symptoms (headaches, fatigue)
- Withdrawal from others
Set Boundaries & Practice Self-Care
Set Boundaries
- Recognize your limitations
- It's okay to say you need help
- Don't try to be someone's sole support
- Set limits on availability
Practice Self-Care
- Maintain your own mental health routines
- Talk to someone about the experience
- Engage in stress-relieving activities
- Get adequate sleep and nutrition
When to Seek Professional Help
While Mental Health First Aid is a powerful tool, it is not a substitute for professional medical or psychiatric care. If you or someone you know is experiencing the following, it is crucial to seek professional help:
- Inability to cope with daily problems or activities
- Extreme mood swings or persistent sadness
- Marked changes in eating or sleeping habits
- Substance abuse or excessive alcohol consumption
- Thoughts of suicide or harming others
About the Author
Dr. Keerthy Sunder
Board-Certified Psychiatrist | Medical Director at KarmaTMS
Dr. Keerthy Sunder is a board-certified psychiatrist specializing in TMS therapy for veterans and treatment-resistant mental health conditions. With extensive experience in neuroscience and innovative treatment modalities, Dr. Sunder is dedicated to helping veterans overcome PTSD, depression, and anxiety through evidence-based, compassionate care.
Frequently Asked Questions
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If you or a loved one needs professional mental health support, including advanced treatments like TMS therapy, contact Karma TMS today.
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