July 2015

Behavioral Health Partners

Mental Health First Aid
by Denise Elsbree, LCSW

Here are the discouraging facts:

• During any given year, one in four adults in the United States, will experience a mental health or substance use disorder.
• The average length of time it takes someone to obtain professional help for a mental health disorder is 10 years.
• Recent events in the news perpetuate the belief that everyone experiencing a mental illness is dangerous.
• The stigma of mental illness can cause people to move away from someone experiencing pain rather than to reach out and offer assistance.

Those of us who have made behavioral health our business know how devastating a mental health disorder can be. We understand the hesitancy people have in seeking help and the difficulties someone may experience prior to making that first phone call to a counseling office. On the other hand, we also have the opportunity to walk with people in recovery and see the positive outcomes that people with mental illness can experience.

Friends, family members, and even community members are typically the first to observe a person in mental health crisis. Wouldn’t it be great if there were a program that helped to reduce the stigma of mental illness and taught skills that encouraged individuals to recognize signs and symptoms of mental health challenges and to support the individual in obtaining behavioral health treatment? Mental Health First Aid (MHFA) is that program.

Mental Health First Aid is a public education program, like CPR, that teaches people to recognize the signs and symptoms of common mental health disorders and, more importantly, teaches skills on how to interact effectively with someone developing a mental health disorder or experiencing a mental health crisis. Just like taking a CPR class does not make someone a medical professional, MHFA participants do not become clinicians. Rather, they learn how to reach out and support someone experiencing a mental health challenge or crisis.

The eight hour class introduces participants to an overview of the impact of mental health disorders compared to other medical conditions, information about specific mental health disorders and the action plan/skills that can be utilized to assist someone developing a mental health disorder or in a mental health crisis.

ALGEE is the acronym for the MHFA action plan: assess for risk of suicide or harm; listen nonjudgmentally; give reassurance and information; encourage appropriate professional help; and encourage self-help and other support strategies. The information and action skills are taught through lecture, video clips, role plays and other techniques that engage adult learners.

MHFA classes are typically taught in a one day format (eight course hours with a rest/meal break) or two day format (two sessions which are four course hours a piece). All participants receive a 100 plus page manual that provides additional information about mental health disorders, how to assist someone and well-researched resources. Mental Health First Aiders are certified for three years.

Developed in Australia in 2001 by two health educators, Mental Health First Aid USA got its start in this country in 2008 through a partnership between the National Council on Behavioral Health, the Maryland Department of Health and Mental Hygiene and the Missouri Department of Mental Health.

Since then, over 400,000 Mental Health First Aiders have been trained in the USA, and over 13,000 individuals have been trained in Illinois. Recently Michelle Obama and her staff participated in a MHFA class and MHFA is included in SAMSHA’s national registry of evidenced-based programs and practices.

Because of the interest in MHFA for specific groups of people, the National Council on Behavioral Health has developed curricula for targeted audiences. Youth Mental Health First Aid teaches adults who interact with adolescents about utilizing ALGEE skills with teens. The basic adult MHFA also has specific applications for law enforcement, veterans and military families, faith-based organizations, senior citizens and higher education.

Since 2010, Linden Oaks Behavioral Health has been offering Mental Health First Aid classes to a wide range of audiences through our consortium of about 70 Mental Health First Aid instructors from different community organizations. Over 5,300 people have been taught through the Linden Oaks Consortium, which represents about one-third of all Mental Health First Aiders in the state of Illinois.

The Linden Oaks Consortium members are clinicians, nurses, clergy members, teachers, law enforcement, librarians and everyday citizens. Linden Oaks MHFA classes are offered at the Edward-Elmhurst facilities and many other locations in the Chicago-land area: libraries, police departments, churches, businesses, schools and not-for-profit organizations.

To find out more information about Mental Health First Aid visit, Linden Oaks mental health first aid. A list of the classes that are open to the public is also available on the website. Or if you are interested in hosting a MHFA class for your organization, the consortium is currently looking for new venues. Contact mhfa@edward.org for additional information about scheduling a class.

MHFA embraces the belief in recovery and wellness. A goal of the program is to offer hope and support through the process of recovery.

“Mental illness is nothing to be ashamed of, but stigma and bias shame us all.”
-Former President Bill Clinton.

MHFA is a powerful community strategy that can positively impact our clients, their families and our own circles of support.

Denise Elsbree, LCSW
Denise is the Community Liaison for Mental Health First Aid at Linden Oaks Behavioral Health. Previous work experiences include: Program Director at Communities In Schools of Aurora, a drop-out prevention organization; creating the Social Work Services Unit at the Aurora Police Department, and counseling youth as part of the Kane County Regional Office of Education in the Truancy Prevention Program. Denise supervised social work interns for 19 years and taught courses in the Aurora University Social Work Department. Denise is a graduate of Wheaton College and the Jane Addams College of Social Work at the University of Illinois at Chicago.

The Armor That We Wear as Clinicians and Professionals: How Mental Health First Aid Training Can Benefit Everyone
by Barry Groesch

There are several different types of armor that humans wear.

The first type that comes to mind when discussing armor is protective armor. My background includes 30 years in law enforcement so the protective armor I am most familiar with is the bullet proof vest. Throughout my career, I would get a lot of questions about the bulletproof vest. People were curious about what it was like to sport this attire for so many years. For the record, you get used to it and, yes, it’s heavy and bulky, but well worth the insurance that it entails you.

After my retirement from law enforcement, I moved into another career in behavioral health as a Mental Health First Aid (MHFA) Coordinator. Now I now teach MHFA to educators, medical professionals, first responders, police/fire/paramedic representatives, behavioral health professionals members of faith communities, human resource departments and concerned community members. The training is an eight-hour class that gives the participant a better understanding of mental health issues and how to appropriately help family, friends, coworkers, and/or members of the general public who may be in crisis.

I have personally learned so much from the MHFA curriculum and from other instructors, who include first responders, behavioral health therapists/counselors, clergy and other professionals who help and interact with individuals with mental health disorders. This experience has helped me gain perspective on what mental illness is, what it feels like and how it touches all of us.

During this journey of teaching and learning, I have also recognized that in our personal and professional lives we as individuals all put on an invisible protective armor of sorts in certain circumstances.

In my career as a police officer, I forged an emotional barrier in difficult situations in order to complete what was acquired of me, most of the time not realizing that these layers of protective armor were being applied. Slowly after each incident- a horrific car accident, a brutal domestic dispute, and a violent mugging- you realize the toll that witnessing these never-ending situations have on you.

There are different ways, both healthy and unhealthy, of dealing with this human frailty, some use humor, sarcasm, or even self-medication to calm themselves. It can be automatic response like that of “fight or flight response”, an emotional armor that is applied innocently enough to help us to deal with the next dilemma.

I recognized this and tried to keep it at bay by not totally submerging myself in the law enforcement culture. However, through my career as a MHFA instructor and working alongside many other types of professionals, I have learned that this is not just a law enforcement phenomenon. I have observed this armor in several different professionals, including nursing, behavioral health and even clergy. When discussing emotional armor with these individuals, they all readily agree that this happens and they have also observed the different forms of self-help that are employed to deal with the emotional trauma of difficult professional or even personal situations.

On the surface, the Mental Health First Aid curriculum, including a look at anxiety, depression, chemical dependency, and psychosis in a human form and the management of individuals in crisis, may seem unnecessary to people who interact with mental illness on a regular basis. However, MHFA training really helps professionals look at what our own views are as individuals (not just as professionals) and some of the stigmas that we still carry with us from the media and/or myths we have heard.

MHFA training also helps to examine the attitude that it’s “those” people that have problems, not us. As we learn in MHFA, one out of four of us in any given year is struggling with a mental health issues and so it’s important for professionals, especially behavioral health professionals, to remember that stripping off the armor in certain situations can be advantageous. MHFA reminds us that we are all living together, we have ebbs and flows of problems, and how to help our fellow man in an appropriate, compassionate and non-judgmental way.

What kind of emotional armor have you been forging in your life? Is it heavy and bulky? If I asked you, who you are today- would you solely identify yourself as your profession? I invite you to attend one of our classes and to learn more about MHFA and how you can benefit from the curriculum. Contact us at mhfa@edward.org.

Barry Groesch, BA
Barry Groesch started his law enforcement career in 1981 as a deputy at the Kendall County Sheriff’s Department. He likes to jokingly say that he was on the 36-year plan at Northern Illinois University where he completed his bachelors of arts degree in 2009. In 2011, he retired from the Yorkville Police Department as a patrol sergeant. Shortly after retiring from law enforcement, Barry joined Linden Oaks Behavioral Health as the coordinator of the Linden Oaks Mental Health First Aid program. He helped to grow the program to where is is today with over 30 participating organizations and 5,300 plus certificate holders. Barry retired from his full time position at Linden Oaks in 2014 to spend his winters in Punta Gorda, Florida. However, he is still a part time consultant.

Primary Care Behavioral Health Integration
by Amit Thaker

The correlation between a person’s mental health and physical health is indisputable. Nearly 70 percent of primary care visits stem from psychosocial issues. That is, patients will present with a physical health complaint, but underlying mental health or substance abuse issues are often triggering these visits (Kessler).

Primary care physicians and staff often feel ill-equipped with both time and knowledge to fully address the wide range of mental health concerns that patients may present with in their offices. That predicament has long burdened primary care practices.

Two growing trends are making a positive impact on this problem. Improvements in the screening and treatment of mental health problems in primary care settings and the improvement of individual medical care in behavioral health settings, are developing areas of practice and research. Generally, the combination of this care is called integration or collaboration.

The idea of combining behavioral health with primary care is not new. In fact, there are eight current models of implementation being piloted across the country. One of the more prominent models involves the basic premise of providing mental health services on site in the primary care setting.

Having access to mental health services through a primary care physician is not only more convenient for patients and their families and eases the pressure on the primary care physician; it also significantly reduces the stigma patients often encounter when seeking out mental health services.

Providing psychiatric services as part of a larger primary care practice is the hallmark model of behavioral health integration but success heavily hinges on organization wide support. To make integration successful, connecting with clinicians is just as important as understanding the financial and operational impact system wide.

For years this hasn’t been possible, until now. The environment around us is changing. Healthcare is rapidly shifting and this next step of evolution allows for unprecedented collaboration and integration between primary care and behavioral health.

Interest in integrated care is growing and many organizations have begun to pilot different models to provide higher quality, comprehensive and coordinated care across the continuum. Linden Oaks Behavioral Health is expanding its own pilot primary care behavioral health integration project and is currently recruiting qualified therapists to work in a behavioral health integration role. For more information on behavioral health integration clinician positions, CLICK HERE.

References

• Kessler, R., W. Chiu, O. Demler, and E. Walters. 2005. Prevalence, Severity, and Comorbidity of Twelve-Month DSM-IV Disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry 62(6):617–27. Available at http://archpsyc.ama-assn.org/cgi/reprint/62/6/617.
• Robinson, P. 2005. Adapting Empirically Supported Treatments to the Primary Care Setting: A Template for Success. In Behavioral Integrative Care: Treatments That Work in the Primary Care Setting, edited by W. O’Donohue, M., Byrd, N. Cummings, and D. Henderson, pp. 53–71. New York: Brunner-Routledge. Available at http://www.amazon.com/Behavioral-Integrative-Care-TreatmentsPrimary/dp/0415949467.

Amit Thaker, MBA, MPH
Amit currently serves as the Director of Business Development and Marketing for Linden Oaks Behavioral Health. He plays a crucial role in strategic initiatives including primary care integration, community relations, and administrative planning. Prior to his tenure at Edward-Elmhurst, he served as a management consultant, focusing on referral development, operational efficiencies, marketing, and community benefit.