Providing help where it’s needed
By Scott HillFeatures Health Care Mental Health Commission of Canada (MHCC) Mental Health First Aid
Advice for security professionals who may encounter persons in distress or dealing with a mental health issue
Currently, one in five Canadians suffer from a mental health issue.
Given the nature of security work, the chances of encountering a person with a mental health issue is much higher than 20 per cent. In order to properly assist someone having a mental issue, it is important to understand what is happening and how you can best help.
In most provinces in Canada, in order to obtain a security licence, an individual is required to have a first-aid certificate. There is similar training for security practitioners that is offered by the Mental Health Commission of Canada (MHCC), which is called Mental Health First Aid.
One of the major obstacles people with mental health issues face is the reluctance to speak about what they are going through. As a society, we need to make it OK for people to discuss their issues and get the help that they need.
What is mental health?
The Public Health Agency of Canada defines positive mental health as: “The capacity of each and all of us to feel, think, and act in ways that enhance our ability to enjoy life and deal with the challenges we face. It is a positive sense of emotional and spiritual well-being that respects the importance of culture, equity, social justice, interconnections and personal dignity.”
They go on to differentiate between a mental health disorder (which is a major change in a person’s thinking, emotional state and behaviour) and a mental health problem. A mental health problem is a broader term that includes both mental health disorders and the symptoms of disorders that may not be severe or evident enough to warrant the diagnosis of a mental disorder.
Myths about mental health
In order to help, we must first dispense with some of the myths about mental health. Common ones include:
• People with mental health issues are violent
• People with mental health issues could make themselves better if they wanted
• Mental health issues are contagious • People with mental health issues are faking for sympathy, to get out of work, etc.
We will discuss first-aid for different disorders and how security personnel can render first-aid; however, the one common acronym that is used by MHCC is ALGEE.
As security professionals, we must always be cognizant of keeping our environment safe. If there is any sense of danger to yourself or the people around you, then the appropriate emergency response units (police, paramedics, etc.) should be called right away and without hesitation. Psychology should be, and must be, left to the professionals. This information is strictly a guide on how to assist in the moment and is not meant to be taken as professional advice or to replace/substitute for professional help.
The first stage of ALGEE is to (A) assess the risk of suicide or harm. With the information above in mind, it is encouraged to have a serious conversation about how they are feeling. Contrary to popular belief, discussing suicide with them will not make them suicidal. Ask them about their plans for suicide, inquire about past behaviour/ attempts, and about the support systems in place. Once you have had that conversation, work together to disable their plans of suicide. Instead, work with them on a plan for safety. This could be agreeing to meet or speak on the phone the next day. As always, ensure your personal safety.
The second stage of ALGEE, or the first if there is no risk present, is to (L) listen non-judgmentally. This can be more challenging than it seems, but it is important to engage in a conversation on how they are feeling. There are several actions that should NOT be taken when listening to a person. These actions include expressing frustration, being critical, or being confrontational. Also, one of the biggest pitfalls to avoid is offering glib advice like “pull yourself together” or “cheer up.”
When moving to (G) giving reassurance and information, it is important to convey (and remember) that the person is suffering from a real medical condition, that it is common, and there are treatments available. Help the person understand that their mental issue is not a character defect or weakness and that there is light at the end of the tunnel. While issues can take a while to develop and time to resolve, they will get better with the right help.
The fourth stage is (E) encouraging the person to get the appropriate professional help (such as family doctors, counselors, mental health therapists, psychiatrists, hotlines, etc.).
The final stage is (E) encouraging other support systems that are recognized treatments that help with depression and other mental health issues. Examples of these treatments include exercise, light therapy, acupuncture, massage therapy, yoga breathing, etc.
Types of disorders and first-aid
Disorders include substance-related disorders (drugs, alcohol, etc.), mood related disorders, anxiety/trauma related disorders, and psychotic disorders. As always, ensure your own personal safety before attending to others.
For a substance-related disorder, first-aid is different depending on if the person is conscious or unconscious. If they are unconscious, place them in the recovery position and call emergency services. If possible, determine the substance that was taken and keep the person warm. If they are conscious, you should reassure them that help is on the way (emergency services). It is important to remember not to give them any food or water. This information should be provided to the emergency personnel when they arrive.
First-aid for mood related disorders consists of calming the person down and listening to what they are saying.
It is very important to realize that the symptoms of a heart attack are almost identical to those of a panic attack. When in doubt, call emergency services right away. First-aid is accomplished by moving the person to a quiet area and helping them to slow their breathing (usually guided breathing done in unison). Reassure them that they are having a panic attack, that it will pass, and that someone will stay with them and keep them safe until the attack stops or medical help arrives.
First-aid for trauma or anxiety consists of listening to what the person wants to say. Let the person tell the story if they want to, but do not force them to relive the trauma by telling you the story if they wish to avoid it. It is important to reassure them that their feelings are normal and that it may last days or weeks. Advise them to avoid using drugs or alcohol to cope with the trauma. If it lasts for more than a few weeks, they should be advised to seek professional help.
Psychotic disorders are mental health problems that cause a person to lose some touch with reality. Common signs or symptoms include changes in emotion, motivation, thinking/ perception, or behaviour. This can manifest in many different ways and some symptoms may include mood swings, irrational behaviour, intense suspicion of others, deterioration in hygiene, anger, fear, etc. As always, when rendering first-aid, ensure your own safety first. If necessary, call the police. It is important to create a calm, non-threatening environment.
If possible and appropriate, do not restrict the person’s movement and ensure that you both have easy access to an exit. Speak in a slow, quiet, and firm manner, but always remain polite. Do not respond to the person in a hostile or aggressive manner, but focus on a calm environment. It is possible that they may be experiencing delusions. If so, it is important not to dismiss, minimize or argue about their delusions.
That being said, it is equally important not to reinforce the delusions by pretending that they are real. Keep the person calm and safe until help arrives.
With the growing number of Canadians that are experiencing mental health problems, it is important that a security professional be able to render help openly and honestly. As stated above, this is best done by listening empathically (rather than sympathetically) and by letting the person experiencing the issue know that it is perfectly alright to talk about it.
The more attention that is called to this important issue, the sooner people will get the help they need.
Scott Hill is the owner of 3D Security Services, a Registered Condominium Manager with the Association of Condominium Managers of Ontario, a Physical Security Professional (PSP) with ASIS, and a Certified Security Project Manager (CSPM) with the Security Industry Association.
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