Mental Health First Aid: Another Psychiatric Expansionist Tool

On December 25, 2016, the Baltimore Sun published an excellent article titled Drug companies prey on children, by Patrick D. Hahn, PhD.  Dr. Hahn is an affiliate professor of biology at Loyola University, Maryland.  Here are some quotes:

“I recently attended Youth Mental Health First Aid Training at a local public school. It was an eye-opening experience.”

“Youth Mental Health First Aid Training, sponsored by the National Council for Behavioral Health, is intended to enable teachers, parents and others in contact with young people to identify potential ‘mental illnesses’ in order to facilitate early detection and treatment by our mental health care system. My fellow attendees were surprisingly open about their own experiences with that system. One mentioned that her son became manic after being diagnosed for ADHD. Another said that both she and her roommate became bipolar after being diagnosed for depression. Neither our facilitators nor anyone else present pointed out that mania and bipolar disorder are toxic effects of medications commonly prescribed for ADHD and depression.”

“Our training manual didn’t say anything about this either, although it did claim that depression is caused by a deficiency of serotonin — a fable that by now has become as discredited as the phlogiston theory of chemistry. It also stated that mental health interventions are ‘evidence-based’ and ‘scientifically tested’ — neglecting to mention that much of that evidence is put forth by drug companies who have a fiduciary duty to do everything they can to maximize sales of their products.”

“So is all this a scheme to push more drugs to more kids? The 2013/2014 annual report for the National Council for Behavioral Health, titled ‘A Legacy of Excellence and Impact,’ gives us a hint. It lists the organization’s supporters as including the Pharmaceutical Research and Manufacturers of America (PhRMA) along with no fewer than 12 different drug companies. Would these folks be ponying up the cash if they weren’t confident this program would increase sales? And do the parents and teachers who attend the council’s training program — no doubt with the best intentions in the world — realize that they are essentially sitting through an eight-hour infomercial bought and paid for by the drugmakers?”

“One out of 13 American children between the ages of 6 and 17 has taken a psychotropic medication within the last six months, according to the Centers for Disease Control. Meanwhile, youth suicide rates are at their peak going back at least as far back as 1999, while the number of children receiving disability benefits for mental illness is at an all-time high.”

Please take a look at Dr. Hahn’s article, and pass it on.  Mental Health First Aid is not a good thing.  Rather, it is just another psychiatric expansionist tool.

MENTAL HEALTH FIRST AID

For readers who are not familiar with the term, Mental Health First Aid, according to its own website, is “…an 8-hour course that teaches you how to identify, understand and respond to signs of mental illnesses and substance use disorders.”

From its FAQ page:

“The evidence behind the program demonstrates that it does build mental health literacy, helping the public identify, understand, and respond to signs of mental illness.”

Incidentally, I Googled the term “mental health literacy” and got 28.8 million results!  There’s also a Wikipedia article on mental health literacy.  Here’s a quote from the opening paragraph:

Mental health literacy has been defined as ‘knowledge and beliefs about mental disorders which aid their recognition, management or prevention. Mental health literacy includes the ability to recognize specific disorders; knowing how to seek mental health information; knowledge of risk factors and causes, of self-treatments, and of professional help available; and attitudes that promote recognition and appropriate help-seeking.1‘”

So mental health literacy doesn’t just mean the acquisition of some information and skills; it also means accepting the psychiatric hoax:  “attitudes that promote recognition and appropriate help-seeking”.  The goal is not just the dissemination of psychiatry-friendly information, but also the active conversion of skeptics to the psychiatric cause.

Reference # 1 in the above quote refers to Jorm et al “Mental health literacy”: a survey of the public’s ability to recognise mental disorders and their beliefs about the effectiveness of treatment, Med J Aust. 1997 Feb 17;166(4):182-6.  The survey in question was conducted in Australia in 1995 and sheds particular light on the present discussion.  Here’s the abstract of the article:

“OBJECTIVES:
To assess the public’s recognition of mental disorders and their beliefs about the effectiveness of various treatments (‘mental health literacy’).

DESIGN:
A cross-sectional survey, in 1995, with structured interviews using vignettes of a person with either depression or schizophrenia.

PARTICIPANTS:
A representative national sample of 2031 individuals aged 18-74 years; 1010 participants were questioned about the depression vignette and 1021 about the schizophrenia vignette.

RESULTS:
Most of the participants recognised the presence of some sort of mental disorder: 72% for the depression vignette (correctly labelled as depression by 39%) and 84% for the schizophrenia vignette (correctly labelled by 27%). When various people were rated as likely to be helpful or harmful for the person described in the vignette for depression, general practitioners (83%) and counsellors (74%) were most often rated as helpful, with psychiatrists (51%) and psychologists (49%) less so. Corresponding data for the schizophrenia vignette were: counsellors (81%), GPs (74%), psychiatrists (71%) and psychologists (62%). Many standard psychiatric treatments (antidepressants, antipsychotics, electroconvulsive therapy, admission to a psychiatric ward) were more often rated as harmful than helpful, and some nonstandard treatments were rated highly (increased physical or social activity, relaxation and stress management, reading about people with similar problems). Vitamins and special diets were more often rated as helpful than were antidepressants and antipsychotics.

CONCLUSION:
If mental disorders are to be recognised early in the community and appropriate intervention sought, the level of mental health literacy needs to be raised. Further, public understanding of psychiatric treatments can be considerably improved.”

So, in 1995, the general public in Australia, as represented by the sample of 2031 individuals in this study, had some interesting views concerning psychiatry.

  1. They rated GP’s and counselors as more helpful than psychiatrists and psychologists for problems of “depression” and “schizophrenia”.
  1. They rated many “standard psychiatric treatments” (antidepressants, neuroleptics, electric shocks, and psychiatric wards) harmful, more often than helpful.
  1. They rated some “nonstandard treatments” (increased physical or social activity, relaxation, stress management, reading about people with similar problems) highly.
  1. They rated vitamins and special diets helpful more often than antidepressant and neuroleptic drugs.

At the risk of stating the obvious, those of us on this side of the issue would consider the general public’s beliefs, as reflected in this survey, to be accurate, and grounded in common sense.  But from the aspect of psychiatry – and particularly psychiatry’s expansionist agenda – these findings are cause for particular concern.  And so, as the authors state:  “…the level of mental health literacy needs to be raised…”

Here’s an interesting quote from the study’s Introduction:

“The lifetime risk of developing a mental disorder is so high (nearly 50%)2 that almost the whole population will at some time have direct experience of such a disorder, either in themselves or in someone close. A high public level of mental health literacy would make early recognition of and appropriate intervention in these disorders more likely.”

Incidentally, the survey was conducted by the Australian Bureau of Statistics, presumably at public expense.

Three years later, Dr. Jorm, the lead author, and his wife Betty Kitchener, founded Mental Health First Aid.  According to his biography on the University of Melbourne site, Dr. Jorm is a highly cited mental health researcher whose work “…focuses on building the community’s capacity for prevention and early intervention with mental disorders.”

The MHFA program spread rapidly in Australia, and by 2015, 350,000 people had received the training.

And Dr. Jorm has been busy promoting mental health literacy in other venues.  In 2000, he published a paper in the British Journal of Psychiatry, the stated aims of which were:

“To introduce the concept of mental health literacy to a wider audience, to bring together diverse research relevant to the topic and to identify gaps in the area.”

And in 2012, he and Nicola Reavley published a paper Public recognition of mental disorders and beliefs about treatment: changes in Australia over 16 years, also in the British Journal of Psychiatry.  The conclusions of this paper were:

“Although beliefs about effective medications and interventions have moved closer to those of health professionals since the previous surveys, there is still potential for mental health literacy gains in the areas of recognition and treatment beliefs for mental disorders. This is particularly the case for schizophrenia.”

THE SCOPE OF THE MENTAL HEALTH FIRST AID PROGRAM

Here’s another quote from MHFA’s FAQ page:

“Mental Health First Aid is intended for all people and organizations that make up the fabric of a community. The course is presented to chambers of commerce, professional associations, hospitals, nursing homes, rotary clubs, parent organizations, social clubs, and other groups. Professionals who regularly interact with a lot of people (such as police officers, human resource directors, and primary care workers), school and college leadership, faith communities, friends and family of individuals with mental illness or addiction, or anyone interested in learning more about mental illness and addiction should get trained.”

And so the tentacles of psychiatric destruction, disempowerment, and, ultimately, despair, are spread to all parts and segments of our society, and people of all ages and all walks of life are shoveled indiscriminately into the insatiable maw of psychiatric dependency and premature death.

Mental Health First Aid (USA) lists on its website 109 organizations across the US (including 45 NAMI chapters) that offer MHFA training.

MHFA AND THE APA

Not surprisingly, the APA has enthusiastically endorsed the program.  Here are some quotes from Mental Health First Aid:  Training for Communities and Families, which you can find on the APA website:

“Mental Health Fist Aid (MHFA) is an eight-hour, in-person training that teaches how to help a person struggling with a mental illness or in a crisis. It provides a basic understanding of mental illness and addiction, signs of addiction and mental illness, the impact of mental and substance use disorders, what helps individuals experiencing these challenges get well and local resources for help.”

Note the emphasis on “mental illness” and “mental disorders”, and the notion that individuals “experiencing these challenges” need to “get well” by accessing “local resources for help”.

“Trainees are taught a five-step action plan and how to apply it in a variety of situations such as helping someone experiencing psychosis, engaging with someone who may be suicidal, or assisting an individual who has overdosed. The training uses role play and demonstrations to convey the information.”

“Five-Step Action Plan – ALGEE

  1. Assess for risk of suicide or harm
  2. Listen nonjudgmentally
  3. Give reassurance and Information
  4. Encourage appropriate professional help
  5. Encourage self-help and other support strategies”

Note:  “encourage appropriate professional help”, conveniently ignoring the reality that the most common form of “professional help” (psychiatric drugging) is causally implicated in the creation of the problems.

“More than 250,000 people have been trained in Mental Health First Aid in the U.S. by 5,200 certified instructors. Twenty-one states have legislation to support Mental Health First Aid, and federal grants support training in some communities.”

So American psychiatry has effectively recruited 250,000 volunteer sales reps, and has managed to get state and federal money to support this enterprise.

“A recent national study of the training concluded that MHFA improves confidence about being able to recognize someone who may be dealing with a mental health problem or crisis and to actively and compassionately listen to someone in distress. Researchers surveyed more than 35,000 people who had completed the training for the study published in the APA journal Psychiatric Services.”

The study mentioned is Crisanti AS, Luo L, McFaul M, et al. Impact of Mental Health First Aid on confidence relation to mental health literacy: a national study with a focus on race-ethnicity. Psychiatric Services in Advance. Published online Nov. 2, 2015.

Here’s the abstract:

“OBJECTIVE:
Low mental health literacy (MHL) is widespread in the general population and even more so among racial and ethnic minority groups. Mental Health First Aid (MHFA) aims to improve MHL. The objective of this study was to determine the impact of MHFA on perceptions of confidence about MHL in a large national sample and by racial and ethnic subgroup.

METHODS:
The self-perceived impact of MHFA on 36,263 people who completed the 12-hour training and a feedback form was examined.

RESULTS:
A multiple regression analysis showed that MHFA resulted in high ratings of confidence in being able to apply various skills and knowledge related to MHL. Perceived impact of MHFA training differed among some racial and ethnic groups, but the differences were small to trivial.

CONCLUSIONS:
Future research on MHFA should examine changes in MHL pre-post training and the extent to which perceived increases in MHL confidence among trainees translate into action.”

In other words, people who take the Mental Health First Aid course expressed confidence that they could apply the skills and knowledge acquired to actual situations.  The implication is that this is important because “Low mental health literacy (MHL) is widespread in the general population and even more so among racial and ethnic minority groups.”

Note that the term “mental health literacy” has now been reified into a desirable commodity, the lack of which can be identified, measured, decried, researched, funded, etc., in the interests of bringing more and more people into psychiatry’s insatiable clutches.  Mental health literacy means the extent to which one has bought the psychiatric hoax.  Those of us who are active in the anti-psychiatry movement are, of course, by implication, mental health illiterates.

There are absolutely no limits to psychiatry’s expansionist agenda.  Despite the well-established destructiveness of their “treatments”, they will never voluntarily curtail their relentless drive for more victims.

And they will not commission, or even call for, a formal, comprehensive study to examine the now blatantly obvious link between psychiatric drugs and the murder-suicides that have become commonplace in our communities.  Psychiatry is intellectually and morally bankrupt.  They have no valid response to their critics, but instead resort to spin and tawdry marketing tactics to shore up their crumbling sand castle.  But just as the tide cleans the foreshore, so the light of logic and truth, and the outspoken protests of its survivors, will one day wash the world of the blight known as psychiatry.

  • Growing

    Working in the sector and with a brief to impart community education in relation to mental health issues, I share your views on MHFA. It is the most oft-cited solution to raising community awareness and battling stigma, but I think it does impart the clinical model and actually reinforces the stigma.. What I think we badly need is a similarly short course to let the community know that MH challenges are a human experience and that one doesn’t need to be a counsellor, professional or specially trained to know how to “approach” or “talk” to a person with these issues. I think there are a lot of very good concepts in the Intentional Peer Support program that would be of value to the general community, but that is also an extensive, “specialised” sort of program . I held hopes for emotional CPR, but found that to be a little too touchy-feely-mystical. Do you or your readers know of any short, practical program that might offer an approach to mental health that humanises it, takes the emphasis off diagnoses and analysis and puts it onto things like acceptance, compassion, honesty and non-judgemental inclusion?

  • Echo

    Hi Phil, reading this makes me sigh because I am not surprised. What all this ‘training’ and literacy reminds me of is a phenomenon of which I have currently forgotten the name. It’s the phenomenon that happens that when a health issue/disease/disorder is constantly in the media more and more people become convinced that they have said disorder/disease but it is actually a psychosomatic manifestation. I feel like the more people you ‘train’ in ‘MHL’ the more they will see mental health issues everywhere, even where there are none and convince vulnerable people that they have something they do not.
    We as a society are being increasingly encouraged to see the world through a mental health lens. I wonder also if this isn’t causing a kind of mental health ‘hypochondria’, where people, frightened into thinking every problem and negative experience is a potentially big issue, rush off for help to psychiatrists, therapists and sundry professionals instead of waiting it out, using their own resources or using their friends and family as help and thus never really gain resilience and the belief that they can deal with their challenges without some sort of professional expert.
    Thanks again Phil for writing. Please don’t ever stop.

  • Rob

    Kristin Neff and Dr. Chris Germer (associated with University of California at San Diego and the Center for Mindful Self Compassion) are excellent highly recommended resources. I’ve attended talks by Kristin and read her fantastic book. She has free videos online and her book is easy to read. There’s significant research behind Stanford’s CCT program, teaching self-care, and reduction of stress, anxiety, and depression, while creating emotional resiliency.

  • Phil_Hickey

    Echo,

    I very much agree. In the “old days”, it was accepted that adversity was a normal part of life – something to be dealt with, as you say, with help from friends, neighbors, etc. as needed. Now it is something to be drugged away – or else it will get worse, lead to suicide, ruin one’s children, etc.

    And thanks for your support.

  • Phil_Hickey

    Growing,

    Thanks for writing. I agree that there needs to be far more naturalistic or peer support rather than expert support. Also, I think it needs to be aimed at specific problems rather than “mental health” in general. Compassionate Friends, for instance, is a group that helps people grieve for a deceased child; Alcoholics Anonymous and Rational Recovery help people deal with drinking problems; etc. CASPER (Community Action on Suicide Prevention Education and Research) sounds promising, though I have no direct knowledge of how it’s doing. In the “old days” neighbors and friends provided a great deal of mutual support, and I think it might be fruitful to try to recreate some of the dynamics that drove this kind of help.

    Best wishes.

  • Growing

    Thank you Rob. I’ll check these out.

  • Growing

    Thanks Phil, I agree and am often pushing the barrow in my role for govt programs to giver greater recognition and support to self-help groups, as well as natural supports in the community and for greater understanding of mental health/ mental disorder by the “helping” sectors of the community (eg church/ spiritual; groups). Community advocacy is another great program that offers growthful, compassionate friendship to people who are struggling with life. It is for come of these community groups that I am looking for the alternative to MHFA, which my colleagues seem to press as the ideal tool for informing the layman about mental health issues. To this end, some of your articles and links are very helpful for me to disseminate. Thanks again.

  • Echo

    Hi Growing, I would also recommend the book “Guilt, Shame and Anxiety” by Peter Bragging.
    Be careful with self-compassion resources that aren’t by Kristin Neff (I’m not even a fan of Germer). It can tend to be very fatalistic. Neff is great, her idea is that there are negative things in our lives that we can control and those we can’t. For those we can’t we should show ourselves kindness, for those we can change we should use kindness and compassion to motivate us to do so. Unfortunately, as you may be aware, many people believe that ‘mental illness’ is something they can’t change and so they end up showing themselves the sort of kindness that reinforces their sense of fragility etc.
    I have been to the self-compassion course developed by Neff (it wasn’t run by her, but someone that trained under her) and I was gobsmacked. The message given repeatedly was that there’s nothing we can do about anything in life except show kindness to ourselves and that trying to make any changes is ‘resistance to what is’.
    I asked ‘What if say someone has a phobia that limits their lives. It’s good to show kindness to yourself but shouldn’t the person learn some techniques to help them overcome that phobia? Like do some exposure therapy or learn some relaxation techniques?’ and I was told that it’s resisting and there’s nothing to be done.
    Imagine a kid comes home from school upset because he’s failing maths. He goes to his parents all upset and says ‘I’m really upset I’m failing maths since I want to be an architect or an engineer. Can we look for a tutor please?’ and the parents go ‘Oh honey, it must be so hard for you to feel so upset. We really understand.’ and the kid goes ‘Thanks, that’s really kind. But could I get some extra help?’ ‘Oh no honey, that’s just how you are. Getting a tutor would be resisting what is. Come here so we can hug you.’ That’s how some view self-compassion. The crux is to have a good understanding of what you can change.

  • Growing

    Thanks Echo, I’ll bear that in mind when I check out the resources. Certainly I think it is easy to misconstrue the “acceptance” thing into “not taking responsibility” for the things that need changing for the benefit of self and others. I do believe that life requires courage and extension of ourselves in order for us to fully experience what it has to offer, to make the best of our relationships as well to realise our own true self and potential.
    “Serenity to accept what I can’t change, courage to change what I can and the wisdom to know the difference” really sums it up so well and simply for me. Sadly, the prevailing social wisdom seems to promote helplessness and victimhood, the direct opposite of what this common -sense, whole-making philosophy prescribes.

  • Rob

    Understanding how cognitive distortions create emotional disturbances is critical to understanding our role in the equation of cause and effect… You say in your first paragraph Neff teaches there are things in life we can change, and then you say she supports the notion “…there’s nothing we can do about anything in life except show kindness to ourselves and that trying to make any changes is ‘resistance to what is’…..That’s not her core message at all. Our resistance to what we can not change causes us misery. Many people ridicule compassion and acceptance, and bash it for being passive, weak, submissive, and not engaged, but that’s misconstruing what it is. Just like many people ridicule contentment. Many people mock the idea of our potential for being happy. To be miserable is to be the center of the universe (and it’s so much more exciting and dramatic than contentment!) Misery is the strongest temptation.

  • Rob

    Cognitive behavioral therapy exposes our irrational thinking habits that create disturbing emotions.It’s the most widely used researched-based practice for treating anxiety, depression, rage, and addiction. At the root of every disturbing emotion is a simple thought. Understanding the relationship between our thinking and our moods is a skill that is being widely taught.

  • Echo

    Hi Rob, please reread my message. I thoroughly recommended Neff and said OTHERS (unfortunately even those who studied under her as witnessed in the course I attended) misrepresent her ideas and encourage a helpless attitude towards life.

  • Growing

    Yes, Rob, and its a skill / realisation that has proven life changing for many people. I would like to see it used more in therapy, and taught in schools and through the wider community.

  • Cledwyn B’Stard

    There’s no such thing as common sense; that’s a contradiction in terms.

    To borrow from Balzac on the subject of revolutions, it is in human society as in the sea; the lightest trash floats to the surface, while anything (or anyone) of substance sinks in the obscurity of its depths.

    In human society, the worse a thing is, the greater its reproductive capacity.