Bill Schubart: It’s Time for Mental Health First Aid

May is Mental Health Awareness Month and in our world today there are many reasons to want to be aware.

Vermont has decided, as a policy if not in practice, that physical and mental health deserve and should receive equal health care commitment and investment. But our measures of mental health well-being, particularly among our young and older populations, show that we are failing to deliver physical and mental health equity. However, there are some positive changes in the works.

The mental health system has been allowed to deteriorate for years. What was left of the Vermont State Hospital in Waterbury closed permanently in 2011 after severe damage from Tropical Storm Irene and has never been replaced. His existence was an acknowledgment that mental illness required treatment, but he provided care that ran the gamut from inspiring (the pig barn and his innate understanding of the healing power of caring for animals) to inhumane (the cells in the basement where the mentally defective . basically imprisoned).

In 1915 the Brandon Training School opened. Originally named the Vermont State School for Handicapped Children, no doubt in response to the growing enthusiasm for eugenics at UVM, it further reflected our poor knowledge of the science and epigenetics of mental health and was closed for good in 1993.

We have learned a lot in the past years. We now understand the critical role that trauma plays in the breakdown of mental and physical health. In the 1950s, when I was a child, no one had ever heard of or imagined what we now understand as adverse childhood experiences. That’s not to say they didn’t exist, but some sort of family code of honor meant one kept them to themselves. Whether it’s sexual abuse, physical abuse, pregnancy out of wedlock, family suicide, an incarcerated family member, alcoholism, or drug addiction (yes, pharmaceutical drug addiction was common since World War I. It ran in my family.) , these facts were silent. The good news about mental health today is that we accept these issues more freely. This has opened up new pathways to treatment, such as trauma-informed awareness, counseling and healing.

The newer approach in recent science is questioning the very existence of mental illness as we have understood it, while clearly acknowledging the existence of symptoms of mental illness. New research at Harvard Medical School and McLean Hospital, presented in the book Brain Energy by Christopher Palmer, MD, director of the department of graduate and continuing education at McLean Hospital and assistant professor of psychiatry at Harvard Medical School, focuses on metabolic dysfunction as evidenced in an analysis of human mitochondria showing a link with symptoms of mental disorders.

Patients with symptoms such as anxiety disorder, depression and even bipolar disorder have seen recovery when their diet is changed, hinting at a link between what is conventionally called mental illness and the widespread use of chemical soil amendments for supported an industrial supply of processed food. . This research has created the science of psycho-nutrition.

Ironically, here in his home state of Vermont, Governor Scott has just vetoed a bill designed to limit the use of neonicotinoids, a major toxin that is systematically applied to our lands and washed into our waterways.

But for now, a practical response is based on the time-honored tradition of volunteer fire brigades and emergency medical services teams in communities around the state. These dedicated first responders and emergency medical technicians are well trained in diagnosis and first aid treatments. They respond to calls for help, whether at the scene of an accident resulting in traumatic injury or at home emergencies, such as a cardiac arrest or diabetic coma.

Medical advances and first aid training have migrated some emergency care to ambulances, so emergency care begins with the EMT in the ambulance in radio contact with the medical staff at the hospital so that the emergency room personnel are aware and ready for a incoming patient.

A promising new model of health care has emerged in the last decade that parallels our community EMS services. It focuses on emergency mental health crises and is called Mental Health First Aid. As of 2023, more than 3 million people in the US have received Mental Health First Aid training, including former first lady Michelle Obama, from nearly 1,500 certified instructors.

What is the size of the problem? Vermont’s senior population is our fastest growing age group. If trends continue, by 2030 one in three of us will be over 60 and older people will have high rates of late-onset mental health challenges such as anxiety and depressive disorders, often caused by loneliness or lack of regular human connection. Men over 75 have a higher suicide rate than any other population group. Mental Health First Aid for adults can be a protective factor for our family members, neighbors, colleagues and friends.

When we think about Mental Health First Aid, we must also make an assessment of the increasing rate of mental distress in our young people. Mental illness does not differentiate by age. It is increasing in our older and younger populations.

Nationally, the suicide rate among our youth is rising. Many of our emergency rooms are filled with young people suffering from suicidal ideation or attempted suicide, self-harm, depression, anxiety, addiction, and eating disorders, and we have little or no care facilities for them. And these manifestations of mental health are increasing in our schools which struggle to find and fund resources to deal with them.

The case for addressing mental health crises among our younger and older populations is urgent, and training in Mental Health First Aid is a critical step in the right direction.

For example, you come home after work to find your grandfather depressed and talking to himself about ending his life. You know there’s a gun in the house. Or maybe your teenage son has disappeared from family events and meals, lives on his cell phone and no longer responds to questions about his well-being. A person trained in MHFA will be able to identify and respond to symptoms like these.

We will also need trained MHFA trained people available in our hospitals, nursing homes, colleges and schools. Mental Health First Aid is similar to cardiopulmonary resuscitation. We can always use more people who know how to administer CPR, and the more people trained in CPR, the safer we all are.

If you need urgent mental health care or know someone who does, you can get in touch here for help. Locally, United Way is offering free training in June.

Physical and mental well-being are inextricably linked, and we are finally developing the resources to care for both in an emergency. This is progress in health care.

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