This guide provides a framework for offering initial support to individuals experiencing mental health challenges during crisis situations. It emphasizes practical steps that can be taken until professional help is available or the crisis is resolved. Remember, mental health first aid is not a substitute for professional treatment but rather a bridge to it. Staying calm is crucial, as is remembering that your role is to provide support, not to diagnose or solve problems. If the person is an immediate danger to themselves or others, contact emergency services in your region immediately.

I. The ALGEE Action Plan:

The Mental Health First Aid (MHFA) action plan, often remembered by the acronym ALGEE [3], provides a flexible, step-by-step approach to offering support:

• A – Approach, Assess, and Assist in a Crisis: Approach the person in a calm and non-threatening manner. Assess the situation for any immediate dangers, and determine the person’s mental state, behaviors, and any risks involved. Offer initial support.
• L – Listen Non-judgmentally: Actively listen to the person’s concerns without judgment. Allow them to express their feelings and experiences [2].
• G – Give Support and Information: Offer reassurance and support. Provide information about mental health problems and available resources [2].
• E – Encourage the Person to Get Appropriate Professional Help: Encourage the person to seek professional help from mental health professionals, counselors, or other qualified providers [2]. Help them identify local resources.
• E – Encourage Self-help and Other Support Strategies: Encourage the person to engage in self-help strategies and seek support from family, friends, or community resources [2].

II. Managing Stress in Crisis Situations:

Crisis situations can trigger significant stress responses. Here’s how to manage stress effectively, both for yourself and others:

• Recognize the Signs of Stress: Be aware of physical, emotional, and behavioral signs of stress, such as fatigue, irritability, difficulty concentrating, changes in sleep or appetite, and social withdrawal.
• Promote a Sense of Safety and Calm: Create a safe and calming environment. Speak in a reassuring tone and avoid sudden movements or loud noises.
• Define Roles and Provide Clear Information: Clearly define individual roles and provide briefings on the current situation, safety procedures, and available resources.
• Encourage Breaks and Self-Care: Encourage regular breaks, relaxation techniques (deep breathing, meditation, gentle stretching), nutritious meals, and sufficient sleep.
• Limit Media Exposure: Excessive exposure to media coverage of the crisis can increase stress. Encourage limiting exposure and focusing on factual updates.
• Promote Social Connection: Encourage sharing feelings with trusted loved ones and friends.
• Lead by Example: Leaders should manage their own stress effectively to maintain a positive and supportive environment.

III. Addressing Trauma in Crisis Situations:

Traumatic events can have lasting psychological effects. Here’s how to provide trauma-informed support:

• Recognize the Signs of Trauma: Be aware of signs of trauma, such as flashbacks, nightmares, anxiety, hypervigilance, emotional numbing, and avoidance behaviors.
• Prioritize Safety: Ensure the person feels safe and secure. Create a predictable and stable environment [2].
• Practice Trauma-Informed Care: Emphasize safety, trustworthiness, choice, collaboration, and empowerment throughout the intervention process [2].
• Acknowledge the Event and Reactions: Acknowledge the crisis event and the individual’s reactions to it without judgment.
• Facilitate Understanding and Normalization: Help the individual understand and normalize their reactions to the crisis.
• Encourage Effective Coping: Identify and reinforce the individual’s personal coping mechanisms. Discuss physical self-care practices and explore available social support.
• Connect to Trauma-Specific Resources: Connect the person to mental health professionals trained in trauma-informed care.

IV. Supporting Grief in Crisis Situations:

Loss and grief are common in crisis situations. Here’s how to support grieving individuals:

• Allow Expression of Grief: Allow the person to express their grief in their own way, without judgment or pressure to “move on.”
• Offer a Listening Ear: Provide a listening ear and validate their feelings.
• Normalize Grief Reactions: Explain that grief can manifest in many ways, including sadness, anger, guilt, and confusion.
• Offer Practical Support: Offer practical assistance with tasks such as making arrangements or providing childcare.
• Connect to Grief Resources: Connect the person to grief support groups, counselors, or other grief resources.

V. Managing Psychological Disorders in Crisis Situations:

Individuals with pre-existing psychological disorders may experience exacerbation of symptoms during crisis situations. Here’s how to provide support:

• Identify the Problem: Define the immediate concerns and understand the person’s mental state, behaviors, and any risks involved.
• Ensure Medication Adherence: Encourage the person to continue taking their prescribed medications, if applicable.
• Provide a Structured Environment: Provide a structured and predictable environment to reduce anxiety and confusion.
• Use De-escalation Techniques: Use de-escalation techniques to manage agitation or aggression. These techniques help break through emotional barriers by matching or redirecting the individual’s emotional and physical state, thereby facilitating a more controlled and supportive intervention.
• Connect to Crisis Services: Connect the person to crisis intervention teams, community mental health services, or other emergency mental health resources.
• Treatment: Treatment often involves a combination of medication, counseling/therapy, and practical help with living skills, as well as support for close family members.

VI. Self-Care for the Mental Health First Aider:

Providing mental health first aid can be emotionally taxing. It’s essential to prioritize self-care:

• Acknowledge Your Own Feelings: Recognize and acknowledge your own feelings of stress, anxiety, or sadness.
• Take Breaks: Take regular breaks to rest and recharge.
• Seek Support: Talk to trusted friends, family members, or colleagues about your experiences.
• Practice Relaxation Techniques: Engage in relaxation techniques such as deep breathing, meditation, or yoga.
• Limit Exposure to Traumatic Content: Limit your exposure to graphic or disturbing content related to the crisis.
• Seek Professional Help: If you are experiencing significant distress, seek professional help from a therapist or counselor.

VII. Mental Health First Aid Training

Consider enrolling in a Mental Health First Aid course. MHFA training for mental health have been developed in line with the successful guideline for First Aid with physical illness. The programme trains amateurs as Mental Health First Aiders within a limited time.
[4]
Apart from providing theoretical background information, the training also teaches practical first aid measures for mental health issues, both while still developing, but also while already causing an acute mental crisis.

VIII. Important Resources:

• Global Mental Health First Aid (MHFA) International: Visit MHFAInternational.org [1][5] for information about MHFA programs and Licensed Providers in various countries. This organization represents an international network delivering practical mental health first aid training and education.
• Crisis Helplines: Search online for crisis helplines and mental health resources specific to your region. Many countries have national suicide prevention hotlines and crisis text lines.
• General Crisis Support: If someone is in immediate danger to themselves or others, contact your local emergency services (police, fire, ambulance).
• Crisis Text Line: In some regions (e.g., the USA since at least 2023), you can text a crisis hotline. Check availability in your area.

Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider for any questions you may have regarding a medical condition.

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^{[1] https://mhfainternational.org/international-quality-principles/
[2] https://esf.com.au/wp-content/uploads/2018/05/2011-Kate-Riddell-AV.pdf
[3] https://pmc.ncbi.nlm.nih.gov/articles/PMC6235998/
[4] https://www.uni-jena.de/en/58751/first-aid-with-mental-health-problems-mhfa
[5] https://mhfainternational.org/guidelines/
[6] https://www.mentalhealthfirstaid.org/wp-content/uploads/2021/04/Tips-and-Tools-for-MHFAiders-April-8-2021.pdf
[7] https://www.corporatewellnessmagazine.com/article/best-practices-for-integrating-mental-health-first-aid-in-the-workplace
[8] https://www.mhfa.com.au/promoting-positive-mental-health-practices-in-the-workplace/}