There are 5 key actions in the Mental Health First Aid Action Plan, commonly referred to as ALGEE:
Approach the person, assess and assist with any crisis
Listen and communicate non-judgementally
Give support and information
Encourage the person to get appropriate professional help
Encourage other supports
Taking a closer look at each of the 5 actions, this page has been created to help MHFAiders refresh their skills and help MHFA Workplace Program Coordinators by providing some tools that can be shared with MHFAiders in your organisation or used as discussion points in networking meetings.
Approach the person, assess and assist with any crisis
The first key action in ALGEE is to approach the person, and assess and assist with any crises. This ALGEE in Action takes a closer look at the ‘Approach’ part of this action.
When the COVID-19 pandemic first hit we were all very aware of the impact on our relationships and the need to connect with others in new and different ways. Now, more than one year on workplaces and community groups have settled into the ‘new normal’, but it’s important to reflect on what this looks like for you as an MHFAIder. If you and your team are still working from home remember to be intentional in connecting with others by arranging to have a virtual coffee chat, trivia or movie night, all great ways to stay connected and engage.
Here is a timely reminder on connecting with others during our ‘new normal’:
Create a space – This is always important when initiating an MHFA conversation but can be challenging when doing it virtually. Consider the best option for this conversation – phone call, video chat or perhaps text-based communication.
Consider privacy – If connecting virtually, consider who else is around in your or the other person’s environment, e.g. partner, housemate, children? If privacy is difficult to achieve consider taking a virtual walk ‘together’ and talk over the phone.
Build opportunities to talk about feelings – Now that we are settling into the ‘new normal’ it is more important than ever to acknowledge that these are challenging time and reassure those you are in contact with that any mental distress they are experiencing is reasonable. As things settle in to the ‘new normal’ people may be surprised that they are continuing or even beginning to feel isolated, disconnected, down or anxious.
It has been a huge year and a half and it is important to acknowledge that there is no recipe or schedule for emotional responses.
Are you concerned about a family member, a friend or work colleague? You may have been concerned for some time and have attempted a conversation with them about their mental health. They may have been reluctant to talk, perhaps even assuring you that they were fine. If this situation sounds familiar and you are still concerned you may need to approach them gently, over a period of time, before they are ready to talk to you or seek help.
In this type of situation, what you don’t do can be as helpful as what you do.
Don’t give up, just because they are not ready to talk to you or seek help yet, doesn’t mean they won’t want to talk or seek help in the future.
Don’t push, but do stay in touch. Someone who is unsure or resistant to seeking help is likely to need a gentle approach. Check in on them regularly, but talk about other topics, e.g. their weekend, politics, current news, their family. If you are ‘always’ talking about mental health they may shut down as soon as you start speaking.
Your number one goal should be to maintain the relationship so that when they are ready they will feel comfortable to come back and seek support from you.
Remember, it is not your responsibility to get them to professional help. All you can do, is point them in the right direction so that they can take the steps needed to look after themselves.
In this ALGEE in Action, we take a closer look at some of the signs that may be more commonly observed in a man who is experiencing suicidal thoughts.
Because men are often taught to hide or suppress their feelings, it can sometimes be difficult for a friend or family member to recognise when a man they know is experiencing a mental health crisis or feeling suicidal. If you notice that a man in your life is behaving differently (e.g. withdrawing, angrier than usual), maybe it’s time to connect and have a conversation.
Agitation is an unpleasant state of extreme arousal. The person will appear restless, stirred up, excited, tense, confused or irritable.
Anger and Violence can be a sign of suicidal thoughts, particularly in men. If a man you know seems to be more angry than usual or is getting into fights or behaving in a violent way, it may be time for a mental health first aid conversation. It’s important to choose an appropriate time and place, for example when neither of you have been drinking alcohol and when you are both calm. Keep your safety and the safety of others in mind as you navigate any conversations.
Increased risk taking. Risk taking on its own is not a sign of suicide, however risk-taking behaviour that is unusual for the person or breaches social acceptability (e.g. driving at excessive speeds) may be a cause for concern.
Increased self-destructive behaviours. Self-destructive behaviour can include alcohol or other drug use and an excessive amount of time spent working. These behaviours may indicate the person is trying to cover their pain or avoid facing their feelings of suicide.
While these are the more typical signs of suicidal thoughts in men, it is important to remember that an individual may show different signs and behaviours. The signs and behaviours listed above may also present in people of other genders, not just men. If you are concerned about the changes in a person’s usual behaviours, a mental first aid conversation may be needed.
Listen and communicate non-judgementally
Active listening is a way of listening and responding to another person that improves mutual understanding.
It is the process of listening attentively while someone else speaks, paraphrasing and communicating your understanding of what was said, and withholding judgment and advice.
Active listening involves more than just hearing someone speak. When you practice active listening, you are fully concentrating on what is being said. You listen with all your senses and give your full attention to the person speaking.
Below are some ways of active listening:
Be neutral and non-judgemental and while it may be difficult not to judge, it’s important to avoid communicating that judgement to others.
Be patient remember periods of silence are helpful, try not to ‘fill’ them.
Use verbal and nonverbal feedback for example, make appropriate eye contact, lean towards the person and nod your head or use verbal cues such as ‘I see’ to show you are listening.
Ask questions, that show you are listening or that seek to clarify what the person has said.
Reflect back what you understand the person to have said. This can be done by paraphrasing what you have heard.
Don’t interrupt or prepare your reply while the other person is speaking.
Shut down your internal dialogue while listening. It is difficult to actively listen to someone else and your own internal voice at the same time.
Active listening is not adding to the story (e.g. saying “that reminds me of the time…”), forgetting what was said in the past, asking about unimportant details or only pretending to pay attention.
When you practice active listening, you make the other person feel heard and valued. In this way, active listening is the foundation for any successful MHFA conversation.
We all make judgements; it is human nature, and a protective mechanism that is hardwired into us. While it is impossible not to make judgements, it is both possible and vital that you refrain from expressing those judgements when providing mental health first aid.
Reflect. Before offering mental health first aid, make sure you are in the right frame of mind to talk and listen without expressing judgements. Are you feeling calm, open, and ready to help?
Respect. Adopting an attitude of acceptance means respecting the person’s feelings, personal values, and experiences as valid, even if you disagree or they differ from your own. Taking time and making the effort to see things from the other person’s perspective can help you be more genuine and empathic.
Respond. Responding to the person using simple verbal skills, can help show that you are actively listening. Asking questions and using minimal prompts like “I see” and “ah” gives the person time to express their thoughts and feelings.
Refrain. While providing mental health first aid, you may find yourself feeling fearful, overwhelmed, sad or even irritated. Despite any emotional response you may have, it is important to continue listening respectfully and refrain from expressing any negative reactions.
This can sometimes be difficult and may be made more complex by your relationship with the person or your personal beliefs about their situation. Set these beliefs and reactions aside and focus on the person you are helping; their need to be heard, understood and helped.
Revive. If you have found a mental health first aid conversation to be challenging make sure you take time to practice good self-care afterwards. You may not always have time for this at work, but try to find 5-10 minutes to go for a quick walk, meditate, be mindful or be kind.
Give support and information
Give support and Information is the 3rd step in the ALGEE in action plan. Support includes empathising with how they are feeling, giving them hope for recovery and, if appropriate, helping them with tasks that seem overwhelming for them. You can also ask them if they would like information about mental health problems.
You can support a person experiencing a mental health problem by showing them respect and dignity. It is important to respect the person’s autonomy, resist the urge to try and ‘solve’ their problems and, wherever possible, allow them to make their own decisions for recovery, even if you disagree. Try to convey acceptance, but remember it is more important that you are genuinely caring, rather than saying all the ‘right things.’
Offering consistent emotional support and understanding is an important part of providing mental health first aid. While you may not fully understand how a person feels, let them know you care, that you’re there to help and reassure them that they are not alone. Listening or being with the person is a simple way to let them know you care.
Have realistic expectations of the person you are trying to support and remember that their mental health problems may be preventing them from behaving in the ways they normally would. Everyday activities like cleaning the house, paying bills, or feeding the dog may seem overwhelming. Let the person know that they are not being ‘lazy’, ‘weak’ or ‘selfish’ and do not push them to do activities that they feel are too much. It is important to accept the person as they are.
It is important to keep the boundaries of your relationship in mind when offering support. For example, if you work with the person, it may not be appropriate for you to walk their dog, but you could offer to edit a document or take over their kitchen duty for a time.
Watch this webcast for more information on the role and boundaries of a mental health first aider.
Encourage the person to get professional help
This ALGEE in Action will take a closer look at Encouraging professional help.
Seeking professional help for mental illness is key to recovery, but there can be barriers that stop someone from getting the professional help they need and it is important to explore their reasons for not wanting to seek help.
Here we look at some of the common barriers to professional help-seeking and what you, as an MHFAider, can do to help the person overcome them.
Common barrier #1: The person does not know that help is available.
Possible response: People may not realise that what they are experiencing is a mental health problem that can be treated. This is especially true of anxiety disorders. You can let the person know that mental illnesses, like physical illness can be treated and reassure them that lots of people with experiences like theirs have received effective treatment.
Common barrier #2: The person may not believe professional help will work.
Possible response: If this is the case let them know that professional help has worked for others and it can work for them too. If it seems appropriate you can share any positive experiences you may have had with seeking professional help.
If they have tried professional help in the past but felt it didn’t work, let them know that it can often take time and a few attempts to find the right fit. Encourage them to keep trying and remind them that it will be worth the effort. If you have explored and addressed their barriers, but they still do not wish to seek professional help, think outside the box and look for alternative ways to provide support. For example, if they have shared feelings of loneliness, ask if they would engage in a social group or activity like a men’s shed or walking group.
Common barrier #3: They may be worried about what will happen if they seek professional help or what they may have to do.
Possible response: If they are worried about having to do something they don’t want to (e.g. go into hospital, take medication, stop drinking alcohol) assure them that they can make the final choice for any treatment options. Let them know that most mental illnesses can be treated in the community and that only in extreme circumstances does treatment become involuntary.
Common barrier #4: They feel that asking for help is a weakness or may burden others.
Possible response: Reframe this as a strength. Asking for help is sensible, if you needed help lifting something heavy you wouldn’t hesitate to ask a friend. Asking for help with mental health problems is not that different. Regardless of the outcome of the conversation, congratulate them for opening up to you, it is a good first step.
Don’t forget that listening and communicating non-judgementally underpins all you do as an MHFAider and will certainly help you support the person to overcome any barriers to seeking appropriate professional support.
Encourage other supports
Need to refresh your mental health first aid skills? Here is one key action of the ALGEE Action Plan, Encourage other supports, for you to review:
Encouraging other supports includes helping the person to consider who in their life may be able to provide them support, like family, friends or colleagues. It can also include peer support groups and self-help strategies.
There are a number of self-help strategies that have evidence for helping with depression and anxiety. The following are activities that have evidence that they help with the symptoms of depression or anxiety*:
- Acupuncture (General anxiety disorder (GAD), Post-traumatic stress disorder (PTSD), Depression)
- Bibliotherapy (Panic Disorder and Agoraphobia, Depression)
- Self-guided computer-assisted therapy (Depression)
- Exercise (Depression)
- Light therapy (Seasonal affective disorder)
- Meditation (PTSD)
- Relaxation therapy (GAD, PTSD, Social anxiety disorder, Depression)
- Yoga (Depression)
Resources from Beyond Blue :
A guide to what works for depression
A guide to what works for anxiety
The headtohealth.gov.au website also provides a list of available online treatments for depression.
