Mental Health for All

MELBOURNE – One spring evening in 1997, when I was a mental-health researcher at the Australian National University in Canberra, I was discussing with my wife, Betty Kitchener, a registered nurse who taught first-aid courses for the Red Cross in her spare time, the inadequacy of conventional first-aid training. Such courses typically neglect mental-health emergencies, leaving participants poorly equipped to help people who are struggling with suicidal thoughts, panic attacks, post-traumatic stress, the effects of alcohol or drug abuse, or a diminishing grip on reality.

Betty knew firsthand the potential consequences of this lack of knowledge. When she was 15, she experienced an episode of severe depression, which culminated in a suicide attempt. But her family and teachers failed to recognize the problem, so she received no support or professional help. This lack of early treatment undermined her recovery, and she has continued to experience episodes of depression throughout her life.

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In order to help ensure that more people did not have to suffer alone as Betty had, we resolved to create a mental-health first-aid training course in our local community. Three years later, when Betty reduced her paid employment in order to develop Mental Health First Aid training, we were finally able to launch the course.

The benefits of this initiative quickly became apparent, with evaluation studies showing that participants became more accepting of the health significance of mental illnesses, more confident in their ability to help others, and motivated to apply their knowledge after completing the course. Such positive results helped to drive the course’s expansion. By 2005, it was operating across Australia and in Scotland and Hong Kong, and has since spread to more than 20 other countries. Over 200,000 people in Australia alone – more than 1% of the population – have now received the training.

This rapid growth should not be surprising, given the prevalence of mental-health problems worldwide. In Australia, roughly one in five adults is affected by a diagnosable mental-health problem each year, but many of these people receive no professional help. The statistics are similar in other developed countries. This means that everyone will either be personally affected by a mental-health problem or have close contact with someone who is. Indeed, most people will have contact, whether they are aware of it or not, with someone who is suicidal.

Research shows that whether or not a person obtains professional help is strongly influenced by the encouragement and attitudes of those close to them. People with strong support networks have a significantly better chance of recovery than those whose problems go undetected or are ignored or minimized. Given this, ensuring awareness and acceptance in communities, while enhancing people’s ability to identify potential mental-health problems in others and to provide help, is vitally important.

This need is particularly pressing for those – such as parents, teachers, youth workers, and sports coaches – who are in regular contact with young people. Mental-health problems tend to arise early in life, with the first episode occurring during adolescence or early adulthood – a critical phase of development, when people are completing their education, joining the work force, building key relationships, and forming health habits. Without a strong support system, mental-health problems can disrupt these developments, damaging the future prospects of those whom they affect.

While the Mental Health First Aid course’s rapid expansion has helped to improve the situation in many communities, there is much left to do. In the short term, all developed countries should aim to achieve 1% participation rates in mental-health first-aid courses, as Australia has.

In the longer term, countries should aim to match participation rates in conventional first-aid courses. In the last three years, 11% of Australia’s population has completed such a course, partly owing to requirements that people in certain positions, such as child-care workers, have a first-aid certificate. Requiring that people in particular occupations – including high-school teachers, nurses, and police officers – acquire a mental-health first-aid certificate would significantly enhance participation, thereby strengthening support for those who are struggling with mental-health problems.

Such certifications are even more important in the developing world, given the limited availability of mental-health professionals. Pilot work in rural India shows that the mental-health first-aid approach can be successfully adapted to the needs of communities with limited resources.

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In developed and developing countries alike, the scope of the problem is too large to be left exclusively to mental-health professionals. Every member of the community must be empowered to protect and improve their own mental health, and that of those around them.

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