Spot the changes, offer mental health first aid

Moses Mpanga

What you need to know:

Let them talk, listen; oftentimes people experiencing a mental health crisis/problem want to be heard, but very often we listen to respond, rather than to understand.

As May, the Mental Health awareness month, comes to an end, what are your takeaways? There has been a lot to learn from all the information that has been circulating in the media. Certainly, many of us have become accepting of the plight of mental health, and happily became mental health advocates, which is amazing! Problem is, if this enthusiasm stops, all the good initiatives we have initiated this May, will have to wait for May next year! But hopefully, this will be a great insight; individually, you have the power to contribute to one’s mental wellbeing in small manageable gestures. Take this for example; that friend/colleague that seemingly changed, did you ever find out why, or did you subsequently write them off!? There is an explanation in that change, all it takes to know is ‘presence’

You may say, “Your mate changed! She keeps to herself, and when you try to reach out, she’ll either make her number busy or not pick up!” You then reach out to a family member who reports that she’s always sad, keeps to herself and in an irritable mood. You can tell they have now left it to her, hoping she will miraculously snap out of whatever bubble she’s in.  You too stop trying; leaving her to whatever providence has for her, because you took it personally!

You’re taking your friend’s changes personally and subjectively, but this right here, is an indication that your friend is developing a mental illness, or well into their way through a mental health challenge. According to the (DSM-5), features in Depressive Disorders are the presence of sad, empty, irritable mood, accompanied by cognitive changes that considerably affect an individual’s ability to function. Your friend displayed all these, therefore needs you more now before she as well turns suicidal! If uninterrupted, she will progress into clinical stages of mental illnesses. A person you have known for a decade or so may in given instances gradually change.

People who have completed suicide, have hinted on it through suicidal ideations before those around or close to them, but didn’t know how to respond. Knowing what to say, or how to say it in the moment is the desired mental health first aid! Usually, suicidal warning signs present as subtle remarks like; ‘I would jump off this building if he doesn’t propose to me this year! I hate myself! I’m of no good, there’s no relevance in my existence!’ We hear these said by our friends, siblings, but write them off as jokes or threats. Sometimes they are repeated one time too many times. We learn to get used to hearing them; they stop to carry any weight whenever our silently woeful friends utter them!

How do we intercept progression of mental health symptoms into mental health problems/crises?

Spot the changes and provide Mental Health First Aid; Assess for any self-harm or suicidal risks; ensure confidentiality, then initiate a conversation. It is possible that they may not want to open up to you, encourage them to talk to someone they trust and follow it up to ensure they indeed talk to someone.  Join in; on separate instances, you have heard your colleague hold a seemingly uncoordinated conversation. Do not call them out; join them in their world to understand them from within. This will help you hold a conversation from within their space, understanding concerns or the crisis from their perspective. Let them talk, listen; oftentimes people experiencing a mental health crisis/problem want to be heard, but very often we listen to respond, rather than to understand. If you can get to start a conversation with them, let them talk more while you listen more. Be accepting, even when you don’t agree with what they are saying. This isn’t a time for you to display your intellectual prowess.

Hope is paramount, offer reassurance and information after they have shared their experiences and emotions with you. Be sure to provide useful facts, if you have none, you may skip this. Encourage appropriate professional help. Mental health illnesses are like cancer, easy to manage in the early stages, hard to contain in advanced stages. The earlier someone gets help, the better the chances of recovery. Encourage self-help and other support strategies. One of the main objectives through first aid interventions is to help individuals gain insight of their situation. This helps them become part of their own recovery process. Helping them identify their support network and creating personalised emotional and physical self-care plans is very instrumental.

Mr Moses Mpanga is Clinical Psychologist, Founder & Director MIND Nest Uganda [email protected]