Learn How to Assess a Mental Health Crisis

by Tricia Dewey & Joan Allison | photo by Cindy McMillion

Many demands, both large and small, can create stress during the rush of the holidays–end of semester tests, work deadlines, and seasonal gatherings with too much food, drink, and family. But actually, according to the Center for Disease Control, December has the lowest monthly suicide rate of the year. So while it is important to discuss mental health needs and advocate for additional support around the holidays, suicide rates actually peak in the spring and fall indicating that year-round mental health care is essential.

Mental health problems are common in the United States. According to the National Alliance on Mental Illness (NAMI) 1 in 5 adults and 1 in 6 youth aged 6 to 17 experience mental illness each year. Suicide is the second leading cause of death among people aged 10 to 34, while lesbian, gay, and bisexual youth are four times more likely to attempt suicide than straight youth. The overall suicide rate in the United States has increased by 31 percent since 2001 and mood disorders are the most common cause of hospitalization for all people in the United States under age 45 (after pregnancy and birth).

These are grim statistics but there is reason for cautious optimism due to organizations that work to address mental health problems. Mental Health First Aid (MHFA) Training is a curriculum for teaching friends, family, and others how to respond to mental health emergencies such as suicide or longer-term problems such as alcoholism or mood disorder. MHFA was create in 2001 by Betty Kitchener, a nurse specializing in health education, and Anthony Jorm, a mental health literacy professor. Kitchener and Jorm run Mental Health First Aid Australia, a national non-profit health promotion charity focused on training and research.

According to the research, safety is essential, so calling 911 as in any emergency or the National Suicide Prevention Hotline at 1-800-273-TALK is critical in certain situations. Just as many learn the basics of medical first aid, the training teaches people how to offer initial support until appropriate professional help is received or until the crisis resolves. The MHFA format provides a first aid action plan known by the acronym ALGEE: Assess the risk of harm; Listen non- judgmentally; Give reassurance and information; Encourage appropriate professional help; and Encourage self-help and other support strategies. Locally, the Church Health Center hosts MHFA trainings free of charge at least once a month at their offices. You can find upcoming classes on their website at churchhealth.org.

Lauren Hales, Faith Community Outreach Coordinator, present Mental Health First Aid training. The training guide was developed in Australia and later adapted for U.S. audiences.

Youth Villages is another local resource that also operates in 20 states and helps more than 30,000 youth and families each year. It offers a variety of program services to youth experiencing emotional, mental, and behavioral problems, including residential treatment, intensive in-home treatment, life skills for youth over 18 (LifeSet), foster care and adoption, and specialized crisis services and crisis support. Dr. Lindsay Pate, licensed psychologist and clinical services program manager at Youth Villages, says there are some suicide prevention actions to take that are just good health practices that can benefit everyone. These include following healthy sleep patterns and getting adequate exercise even when it’s cold outside. And then obviously, something that may be harder to do around the holidays, maintaining a healthy diet. All of these behaviors can have positive impacts on the brain. There are other good behavioral and medial treatments that can provide relief and lead to wellness.

What about more serious depression? “One of the things we commonly misinterpret at least for young people,” Dr. Pate notes, “is it’s not always the persistent sadness we think of as adult depression.” Instead kids may be more irritable and inattentive, or unable to stay on task at home or at school. One action that can be really helpful for kids as well as adults around them is to start a dialogue about depression to make sure your young person has a safe place to express emotions. “Talking about depression, especially talking about suicide” she says, “…can actually be a proactive factor. A lot of caregivers might be hesitant to bring up that topic but actually putting it out on the table gives kids the opportunity to express concerns, to let you know what’s going on with them, and opens up the door for safety planning.”

There is hope in how young people are tackling the challenges of living with mental illness like depression and anxiety. They are generally more open to the idea of considering mental health just a part of their overall health, Dr. Pate said. Dr. Pate recommends that during the holiday season and year-round, we find a way to reach out and connect. “Figure out things that bring you joy,” Pate says. “Caring for others can have a very positive effect on one’s own mental health.”

________________________________________________________________________________________

If you find someone considering suicide, you may wonder if it’s a true 911-level crisis. Follow step one of the ‘ALGEE’ protocol to help guide you
(From mentalhealthfirstaid.org):

  1. ASSESS for risk of suicide or harm: The best way to find out if someone is considering suicide and determining the urgency of the situation is to ask them:

    Are you having thoughts of suicide?
    Do you have a plan to kill yourself?
    Have you decided when you’d do it?
    Do you have everything you need to carry out your plan?

    IMPORTANT NOTE: Some people believe that mentioning suicide might cause someone to consider suicide for the first time. This is not true, so do not be afraid of this outcome. You’re much more likely to help someone feel less alone if they were considering it.

    If they have a plan and are ready to carry out that plan, call 911 immediately. How you respond to other answers will depend on the situation, but always call 911 if you’re unsure. It’s better to be safe than for someone to lose their life.
    Additionally, not having a plan doesn’t mean they’re not in danger. All thoughts of suicide must be treated seriously.

    If you think the person is in danger, you need to keep the person safe. Stay with them for as long as you can, because an actively suicidal person SHOULD NOT be left alone. If you can’t stay, find someone who can until help arrives.

    If you determine the person is having suicidal thoughts but there’s no immediate danger, engage in conversation with them if possible.

    SUICIDE PREVENTION RESOURCES
    If You Know Someone in Crisis

    Call the National Suicide Prevention Lifeline (Lifeline) at 1-800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741). Both services are free and available 24 hours a day, seven days a week. The deaf and hard of hearing can contact the Lifeline via TTY at 1-800-799-4889.

    All calls are confidential. Contact social media outlets directly if you are concerned about a friend’s social media updates or dial 911 in an emergency. Learn more on the Lifeline’s website or the Crisis Text Line’s website.

    The Veterans Crisis Line connects Service members and Veterans in crisis, as well as their family members and friends, with qualified, caring Department of Veteran’s Affairs (VA) responders through a confidential toll-free hotline, online chat, or text messaging service. Dial 1-800-273-8255 and Press 1 to talk to someone or send a text message to 838255 to connect with a VA responder. You can also start a confidential online chat session at veteranscrisisline.net/get-help/chat.

    For LGBTQ youth in crisis, call the National Trevor Project Crisis Line for LGBTQ youth 1-866-488- 7386, and visit theTrevorProject.org.

NEWLY OUT YOUTH? LEARN THESE SELF CARE HABITS

Coming out and learning more about yourself can sometimes feel like a roller coaster — full of emotional ups and downs. Coming up with some go-to self-care ideas can be a helpful way to make your mental and physical health a priority. Sometimes we all need a little extra self-care when times are tough.

HERE ARE SOME IDEAS FOR A SELF CARE PLAN:

  1. Call, text, or chat with a friend for support
  2. Talk to a supportive person in your life if you’re feeling
    sad or unsafe
  3. Identify safe places you can go to get away from a
    stressful situation
  4. Connect with a trained counselor via TrevorLifeline,
    TrevorText, or TrevorChat
  5. Log on to TrevorSpace.org to connect with other LGBTQ
    young people
  6. Focus on your interests: Do something you enjoy. Write
    your thoughts out in a journal or create an art project to
    express your feelings
  7. Connect with your body: Take deep breaths. Take a
    shower or bath. Some people find movement like yoga, walking, or running helpful. You know your body best and what feels good for you
  8. Put on headphones and listen to your favorite music
  9. Watch your favorite TV show and relax
  10. Remind yourself that you are a valuable person exactly as
    you are
    When I’m having a hard time, what do I do to cope?
    What helps me stay healthy, relaxed and positive?
    Who could I call, text, or chat with if I need support?
    What are my favorite things to do?
    What are my goals for the future?
    What are some self-care activities I want to try out?

CHECKING IN ON YOUR MENTAL HEALTH– WARNING SIGNS
Feeling sad or alone can be overwhelming, especially if people in your life are unsupportive. While these feelings are completely normal, it’s important to keep an eye out for warning signs of larger mental health struggles. You are not alone and asking for help is a sign of strength.
Have You Felt…?
Unimportant, Alone
Trapped and/or Hopeless Overwhelmed and/or Unmotivated Angry and/or Irritable, Impulsive Suicidal
Have You Been…?
Using drugs or alcohol more than usual
Acting differently than usual
Giving away your most valuable possessions
Losing interest in your favorite things to do
Planning for death by writing a will or letter
Eating or sleeping more or less than usual
Feeling more sick, tired, or achy than usual
Do You…?
Not care about the future
Put yourself down (and think you deserve it)
Plan to say goodbye to important people
Have a specific plan for suicide

If you answered yes to any/several of these questions, you can reach out to a trained crisis counselor for support by calling TrevorLifeline (866.488.7386), texting “START” to 678678 for TrevorText, or by visiting TrevorChat.org — we’re here for you 24/7. You are not alone.

________________________________________________________________________________________

SUPPORT FOR LGBTQ+ YOUTH AND FAMILIES
Family Acceptance Project (research, intervention, education and policy initiative that works to prevent health and mental health risks for LGBTQ children and youth: familyproject.sfsu.edu

Gay, Lesbian, and Straight Education Network
Organization working to create safe and affirming schools for all, regardless of sexual orientation, gender identity, or gender expression: GLSEN.org

Gender Spectrum Organization working to help create gender sensitive and inclusive environments for all children and teens: genderspectrum.org

GLBT Near Me Database of LGBTQ resources, offers a national hotline and a youth talkline: glbtnearme.org

GSA Network Trans and queer youth uniting for racial and gender justice: gsanetwork.org

HelpPRO National search for social workers, mental health counselors, and psychologists, with the ability to search for providers who serve specifically LGBTQ populations: helppro.com

Human Rights Campaign Largest civil rights organization working to achieve equality for LGBTQ Americans: hrc.org

It Gets Better Project Creating media sharing stories around the resilience of LGBTQ people across the globe: itgetsbetter.org

Lambda Legal American civil rights organization focusing on equality for LGBTQ people: lambdalegal. org

National Suicide Prevention Lifeline National network of local crisis centers that provide free and confidential emotional support to people in suicidal crisis or emotional distress 24/7: suicidepreventionlifeline.org, 800.273.8255

Scarleteen Inclusive, comprehensive, supportive sexuality and relationships info for teens and emerging adults: scarleteen.com

TransLifeLine Peer support hotline run by and for trans people, providing micro-grants around legal name changes or updating IDs: TransLifeLine.org, 877.565.8860

Parents, Families and Friends of Lesbians and Gays
(nation’s largest family + ally organization): PFLAG.org

The Institute for Welcoming Resources International organization working to make churches become welcoming and affirming spaces for all congregants regardless of sexual orientation and gender identity: welcomingresources.org

Trans Youth Family Allies Partnering with educators, service providers and communities, to develop supportive environments in which gender may be expressed and respected: imatyfa.org

This information was excerpted from “Coming Out: A Handbook for LGBTQ Young People” on TheTrevorProject.org