BRAMPTON — A few weeks ago, in a small classroom at a vocational college in Brampton, I sat back to back with a woman I’d just met. Her task was to describe an illustration, which our instructor had handed her, by breaking it down into a series of lines (vertical, diagonal-left, 360-degree, etc.). Mine was to recreate that illustration, with nothing to go on but my counterpart’s description. In the end, my doodle of a spiky orb held aloft by a semicircle didn’t quite match up with the assigned drawing of the sun shining on a flower.
When the exercise was over, our instructor, Rajeev Persaud, a registered nurse, asked us what had been more difficult: drawing the images or describing them. We all agreed that describing them was trickier. Persaud pointed out that many of us had tried to hurry our partners along — butting in to their descriptions with questions rather than giving them a chance to find the right words on their own.
The activity was one of several that I and five other participants worked through as part of a two-day course, offered by the Mental Health Commission of Canada (MHCC), that provides training in basic mental-health first aid (the basic course covers disorders related to substance abuse, anxiety, trauma, and mood, as well as psychotic disorders). The program, which is intended to teach non-professionals how to respond to people experiencing symptoms of mental-health problems, was developed in Australia in 2001. It was first taught in Canada in 2006; since then, more than 400,000 Canadians have taken the training — 42 per cent of them in Ontario.
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Denise Waligora, the commission’s first-aid training and delivery specialist, says the course is available to anyone who wants to learn more about mental health, and she notes that several organizations now offer it to employees as well. Health Canada, for example, which funds the MHCC, has committed to training all of its employees, and 2,219 Hydro One staff have voluntarily taken the training since the company started offering it, in 2015. Several Ontario school boards and colleges also offer the course to their employees.
“We can’t teach you to be a therapist or counsellor, nor can we teach you in two days how to diagnose somebody,” Waligora says. “Our course is about learning how to truly be the best support to those in your life that are living with or struggling with mental-health problems.”
Participants are taught the ALGEE (pronounced “algae”) model, a set of steps that you can take if you believe someone is experiencing psychological distress or a problem related to mental health:
Assess the risk of suicide and/or harm
Give reassurance and information
Encourage the person to get appropriate professional help
Encourage other supports
Say a friend seems to be having a panic attack. Following the ALGEE model, you would move the person to a quiet location, sit them down, encourage them to slow their breathing, and determine whether to call for help (symptoms of a panic attack can mimic those of a heart attack). Throughout, you would try to remain calm, listen to their concerns, and, if necessary, explain that what the person is experiencing will pass; you would also be sure to stay with them until the panic attack stopped or medical help arrived.
“One of the biggest takeaways [from the course] is the ALGEE model,” says Persaud, who’s been teaching mental-health first aid for three years now. “It’s having that tool to be able to work through the problem.” Throughout the course, he stressed the model’s fluidity: the order in which the steps are taken can be altered depending on the severity of the episode, and the kind of support offered can be adapted to different cultural contexts (touch or prolonged eye contact, for example, may be considered inappropriate in some cultures, Persaud says).
Mark Sinyor, a psychiatrist at Sunnybrook Hospital and an assistant professor of psychiatry at the University of Toronto, notes that, in a typical first-aid course, you might learn how to use a defibrillator and to call 9-1-1 when trying to help someone experiencing cardiac arrest — but you don’t learn how to cure heart disease. Similarly, mental-health first aid is about providing basic, immediate support while you wait, if necessary, for experts to arrive.
“People are better equipped to deal with mental health than something like cardiorespiratory problems, because we’re all human beings, and we’ve all probably experienced some form of distress in the past and benefited from sharing that with someone,” he says. “Being that ear and being able to provide that kind of support really is all you need to do as a starting point.”
Giving people the confidence to provide that support is part of the first-aid training. One of our first assignments during the course in Brampton was to describe how we felt when trying to take care of someone with a mental-health problem. Each of us was there for different reasons, but we all said that we felt afraid — of doing or saying the wrong thing, of not being able to help, of making the situation worse.
Persaud reassured our class that, while it’s impossible to fix a mental-health problem with one conversation, listening non-judgmentally and asking someone who’s in distress what they find helpful can empower them to make decisions about their own care. Even if the person is not ready to talk, he noted, just making it known that you’re available can provide a sense of comfort.
Still, Persaud says, while the course gives participants the knowledge and tools to help those in need, building self-confidence takes practice: “A lot of it is having that first-hand exposure, and the more that you engage in conversations, the better you’re going to become at it.”