Exploring the MHFA Action Plan

Factors that may impact how you apply an ALGEE Action Plan:

• The person experiencing the problem –age, sex, gender, culture, beliefs, personality, education, etc
• Your relationship – you can offer support to family members, friends, co-workers, clients, school peers, teammates, patients, acquaintances or other members of community
• The mental health problem may be experiencing – common concerns may include (but not be limited to): anxiety, panic attacks, depression, bipolar disorder, schizophrenia, psychosis, suicidal thoughts or behaviours, non-suicidal self-injury, gambling problems, eating disorders, drug addiction or substance misuse, or other personal crisis
•  The stage of their mental health problem – whether the problem is developing (possibly undiagnosed or early stage), worsening (they are exhibiting increasing struggle), or crisis point (in urgent crisis/risk
• The state the person is in – a person’s sense of awareness, their behaviours, and whether they are intoxicated, can all have a bearing
• The environment – the setting or location, the people around you, the noise level, the atmosphere, can all subtly impact your delivery of ALGEE
• Whether they have supports – some people may be receiving various treatments and supports including medications and therapies. Others may not have any formal or clinical support. Some may have a support network from family and friends, while others may not.

Action 1: Approach the person, assess and assist with any crisis

Why this action is important: This is often the first step in offering support. It involves finding the right time, place and manner to make an approach; initiating conversations if the person doesn’t say how they are feeling themself; assessing the situation; and applying crisis intervention if needed.

Some people may find the initial approach the hardest part. They might worry about timing, or how they will be received. It’s important to remember that your offers to help will usually be well received by someone needing support. The person may not be ready to accept support straight away and may require multiple attempts, but it’s important that if you are concerned, continue to reach out. Approaching someone needs to be done in a careful, considered and genuine way, but the most important part is being available and wanting to offer your support. 

Quick Tips:

• Ready yourself and be present in the moment
• Make sure you have time to see the Action Plan through
• Create a safe space free from interruptions, where you can have a conversation (this will depend on your location/environment)
• Approach in a genuine and inviting way – make it clear you are available to offer support
• Consider privacy, confidentiality and boundaries
• Think of all the options for connection (over a coffee, on a walk, in a private meeting room, over the phone, via text or an agreed video call)
• Be ready to assess mood, demeanour, body language and words to help you understand their situation
• Act in a crisis (if the person is hurting themselves, a risk to others, or in suicidal crisis) – see below about our specialised Conversations about Suicide and Talking about Suicide courses.
• Keep yourself safe and respect your own boundaries as a care giver. 

Action 2: Listen and communicate non-judgementally

Why this action is important: By expressing genuine concern and engaging in supportive behaviours such as active listening, you build a connection with the person needing support. Sometimes we can feel the need to jump to solutions, fill awkward silences, or chat about our own problems to make the person feel better. This can come from a good place, but it is not helpful to the process. Reminding yourself that supportive active listening and setting aside any negative beliefs or reactions are your goals in this step, can be helpful.

Quick Tips:

• Use words that encourage the person to talk and to share their feelings
• Be calm and approachable with tone, body language and words
• Don’t talk too much or take attention off the person and their problems
• Set aside any negative beliefs and reactions in order to focus on the needs of the person you are helping
• Don’t use dismissive, stigmatising or belittling language
• Use encouraging cues like nods, concerned expressions, and even smiles where appropriate – to show that you are listening and engaged
• Repeat things back for clarity and understanding if needed
• Ask questions and keep them talking and sharing
• Let them get their feelings out and feel safe in your space – they may cry, scream, get nervous, talk quietly, be jittery, act erratic etc.

Action 3: Give support and information

Why this action is important: This step is important because it may be the only support the person is receiving. It can be very empowering for a person to feel heard and finally let their feelings and situation be known to you.

Once the person you are supporting feels that they are being listened to, it can be easier to offer up support and information. It’s not your job to diagnose, provide formal care, or have all the answers. You are a first contact until appropriate help is received or the crisis is resolved. The support and information you give will vary depending on whether you are supporting the person at work, school, in the community or elsewhere.

Quick Tips:

• Explore experiences, symptoms, feelings and challenges with dignity and respect
• Do not blame the person for their mental health problems
• Help the person to see they are not alone and that their mental health problem is not shameful
• Provide reassurance and emotional support
• Don’t push the person into discussions, options or actions that they are not comfortable with
• Have realistic expectations of the person
• Offer positive and encouraging words that provide hope for treatment, management and recovery
• Offer practical help with immediate tasks to relieve symptoms or feel safe e.g. a quiet place to sit down, a drink of water, help to call a family member/friend
• Explore options – find out what they’ve tried, what has worked and what hasn’t
• Offer other information you have learned about through Mental Health First Aid Training – this can be specific to their problem or situation.

Action 4: Encourage the person to get appropriate professional help

Why this action is important: Many people with mental health problems do not get the help they need. Undiagnosed, untreated and unsupported mental health problems can be a significant burden to the person experiencing them and can worsen over time. Mental illnesses such as depression, anxiety, bi-polar disorder, schizophrenia, PTSD, non-suicidal self-injury and eating disorders (among many others), can only be formally diagnosed by a clinical professional. This is not your role.

Even people who have previously accessed medical or mental health supports can be experiencing worsening or crisis point problems. This can be especially true if a person feels they have not been properly supported in the past.

A person experiencing suicidal thoughts and behaviours may need immediate intervention. It is important to note that not everyone who is suicidal has a mental illness, just as not everyone who has a mental illness is in crisis.

Most people can live happily and productively with the right mix of care.

Quick Tips:

• Ask the person if they need help to manage what they are feeling and experiencing and whether they are receptive to seeking formal supports
• Talk about options that a professional can provide that you cannot: medications, referrals, professional counselling, therapies
• Explain that seeking professional help is brave, important, normal, common and nothing to be ashamed of
• Discuss options for the next step depending on their situation and your setting – local GP, Counsellor/Psychologist, Employee Assistance Program, School Counsellor
• Consider other services – mental health service providers, helplines, support groups
• Offer to help seek out options – look for local services online, make phone calls, etc
• If the person doesn’t want professional help explore possible barriers such as previous bad experience, financial barriers or access issues – help look for ways to overcome these
• Check to see that they are clear on their next steps
• Respect the person’s right not to seek further help (unless you believe they are at risk of immediate self-harm or harming others).

Action 5 – Encourage other supports

Why this action is important: Mental health problems can be complex and can change over time. A person will often need a mix of supports to improve their situation. While therapies, medications and formal support groups can be important to treatment, long-term management and recovery, people also need to feel connected and supported where they live, work, study and socialise.

Mental health problems often have stigma surrounding them which can make people feel alone, misunderstood and discriminated against. This step is about helping a person to realise that they have a place where they belong and people who care about them. It can also help them to connect with others experiencing similar difficulties.

There are also some self-help strategies that can help people to feel better. They won’t always be applicable but are worth exploring. Avoiding harmful substances e.g. alcohol and other drugs, practicing positive health and wellbeing actions, engaging in therapeutic activities, learning more about support options, and connecting with support groups are some examples.

Quick tips:

• Talk about family and friends who can support them
• Discuss how they might approach a discussion with these people
• Ask if they need help to facilitate contact with someone who can provide support
• Ask if there are self-care actions, activities or places that can help make them feel better in both the short and long-term
• Discuss finding local support groups for people with similar problems if the person is interested
• Talk about limiting alcohol/other substances that may exacerbate symptoms and impair thinking
• Talk about the next positive steps the person can take to keep the person feeling a bit better, safe and connected.