Confronting crises that emerge from the brain

What would you do if you saw a man clutching his chest, gasping, sweating and turning pale? You'd probably think he was having a heart attack, so you'd probably help him sit, call 911, and stay with him.

If your friend slipped on a rock while hiking, slicing open an artery in her leg, what would you do? You'd grab the closest available clean cloth, apply direct pressure to her wound and get her to an emergency room as quickly as possible.

It's not as easy to see mental or emotional wounds, but the Mental Health First Aid program-run through UAA's Center for Human Development-aims to help people learn to spot warning signs of depression, substance abuse, panic attacks and other anxiety disorders, schizophrenia and other mental disorders. Trust Training Cooperative (TTC) coordinates the program.

TTC is a University of Alaska and Alaska Mental Health Trust Authority collaboration that promotes career development opportunities for professionals and care providers who work with Authority beneficiaries-people who have mental illness, developmental difficulties, chronic alcoholism and other substance disorders, brain injuries and Alzheimer's disease and related dementia.

"It's really important to have people who can recognize what they're seeing and guide people to treatment early on; it's a really big deal," said Jill Ramsey, TTC training coordinator.

Battling stigma and misconceptions

Mental Health First Aid trainers teach how to practice and respond appropriately to mental health problems in a variety of situations, such as helping someone through a panic attack, engaging with someone who may be suicidal or assisting an individual who has overdosed. Just as CPR training helps a layperson with no clinical training assist an individual following a heart attack, Mental Health First Aid training helps a layperson assist someone experiencing a mental health crisis until appropriate professional help arrives.

The TTC has trained 1,778 people over the last three years.

The media and Hollywood constantly feed people myths about mental illness, Ramsey said.

"There's a lot of judgment on TV, there's still a lot of stigma that's propagated by the media that's inaccurate," Ramsey said. "We have this perception that all people with mental health issues are associated with violence, that they're going to shoot up the campus. That's not true. There are some landmark studies that show clearly that mental health issues are not a precursor to violence. Now if you add in substances, you've got a different story-alcohol in particular is a precursor to violence. Our perception over time becomes, with someone who has schizophrenia, that that guy's going to kill me, that we're not safe around someone who's diagnosed."

Words and definitions hobble efforts to erase the stigma and adequately address mental health issues, Ramsey said.

"We still haven't used the proper language," she said. "We're talking about brain disorders when you're talking about something like schizophrenia. But why we can't call it a brain disorder is part of that stigma. Personally I blame René Descartes, the first philosopher to separate the head from the body. Then our health care system followed suit, then our insurance system followed suit, and our head's been separated all this time. Five visits to a therapist and then your problem should be done. Medicaid still doesn't like brain-based disorders in terms of coverage. There are still a lot of disparities."

There are also misconceptions about what to do, Ramsey said.

"For example, one of those is, don't ask a person if they're suicidal because it might make that person suicidal. I've had people say if someone's having a panic attack, should I shake them, should I slap them, the things they've seen on television. There are a thousand myths about what people are seeing and the causes of mental health issues and whose fault it is. So we explore all of that first. We really have people think about their own perceptions and where they came from, and then we educate them."

Educating, Ramsey says, involves improving literacy on the topic and then engaging in informed discussions about mental health issues.

"People have been socialized, raised in a way-and I certainly was-where you don't talk about that, that's family business," Ramsey said, "or, that's just none of your business when you see someone exhibiting symptoms. Now we can look at that and know what it is-those are symptoms of a panic attack; those are symptoms of schizophrenia; those are symptoms of depression, and I know what to do."

What to do, Ramsey says, is learn five steps, or ALGEE, an acronym representing:

• Assess for risk of suicide or harm.

• Listen nonjudgmentally.

• Give reassurance and information, "which is sometimes as simple as being there through a crisis, telling them, 'You can get through this, you won't be stuck here,'" Ramsey said.

• Encourage professional help.

• Encourage self-help.

Opening a window into a different world

Holli Yancey, faculty and student technology coordinator for the CHD, says the training contains an exercise that simulates what a person experiencing sound-based hallucinations goes through.

"Someone's talking in your ear through a tube while you're trying to carry on this other scripted conversation," she said. "It's annoying. You suddenly have this very different perspective on schizophrenia. If you walked up to a person shooing away things you didn't see, yelling at someone you didn't see, answering questions you didn't hear the question to, those things from the outside-because we don't know what's going on-the first thing we do is put up a guard. It just is that way. Being able to have that perspective makes a huge difference for people."

Yancey says she has been a first responder to suicide attempts several times in her life.

"During those times, I relied on what I knew in first aid training," she said. "The big thing is to be able to say, 'Are you OK? What's going on here?' and then to be able to look for those little clues and not be afraid to ask the next thing, which is, 'Do you want to hurt yourself? Can you tell me what's going on?'"

Yancey says you never know when you're going to encounter situations involving a person who's suffering depression, feeling suicidal or experiencing an anxiety attack or an episode of schizophrenia.

"It's a much more comfortable interaction even in a very uncomfortable situation to feel like you did everything you could, even if you're not professionally trained as a psychiatrist-to feel that confidence of knowing you did the things you could have done," she said. "It makes a difference in the way I've felt about myself after the situation."

Mya Dale was a UAA student who took her own life in June 2012. Her mother, Connie Dale, talked about her experience coping with Mya's mental illness.

The next Mental Health First Aid training is set for 8:30 a.m.-5 p.m., Friday, Sept. 12, at the BP Energy Center, 900 E. Benson Blvd., Anchorage. To register, visit www.ttclms.org.

The UAA CHD helped organize the event. 

Written by Tracy Kalytiak, UAA Office of University Advancement