Practical Tools for Providing Mental Health First Aid
How can we help a person in emotional distress? Difficult events, particularly those that are perceived as life-threatening, can trigger unusual feelings and behaviors such as extreme anxiety, uncontrollable crying, frenzied behavior and tremendous restlessness or, alternatively, withdrawal and detachment from the environment. In most cases, these emotions and behaviors are considered a "normal but temporary and passing response to an abnormal situation”. Immediate assistance to a person in distress can be extremely effective in reestablishing balance and control.
How to help a person in distress after a difficult event
Anyone can help a person who is suffering from mental distress, particularly following exposure to traumatic events such as an attack or an accident. To help in this case, you can perform several simple steps based on what is known as the MAASEH Model. Developed by Dr. Moshe Farchi, the MAASEH model was adopted by the Ministry of Health as an effective and proven model for action that may be performed during personal and national crises. The main goal of the model is to help a person in immediate distress transition from feeling helpless to feeling capable, from irrational behavior controlled by emotion to efficient, functional, intelligent and active behavior.
Mental Health First Aid in Times of Distress
https://www.youtube.com/watch?v=kEJ353s1_U4?rel=0
Stages of help according to the FEAC (MAASEH) model
F - Focus and expression of commitment: relay commitment and tell the persons before you who need assistance that they are not alone and that you are not leaving them. To prevent a sense of isolation, try to replace it with a sense of belonging.
E - Encourage effective actions: to transition from a state of helplessness to a feeling of ability and desire to act, encourage those in distress to perform simple but effective actions. For example, suggest collecting equipment that has become scattered, for example, if the bag fell and its contents scattered. Clean up the environment, communicate with relatives, prepare equipment or walk to a safe site together.
A - Ask simple questions that require thought: in situations of distress, the person before you is experiencing a flood of emotions. To reduce the excitability and create effective communication, ask simple questions with few words. Avoid emotional questions. Focus on questions that encourage thinking and choices, for example: are you alone? Do you want to talk to someone? Where do you need to go? Or questions the responses to are very clear, such as: what street do you live on? What is the telephone number of your parents?
C - Constructing the sequence of events: when distressed, people experience feelings of confusion, detachment and lack of continuity. To help them organize their thoughts and understand that the threatening event is over, help them organize and arrange the sequence of events. Briefly describe in simple words the event that occurred and ended. Make sure to mention that they are now in a safe place.
Important to know
Important to know
In unusual cases, such as when the person is unable to absorb information, you should immediately seek help, for example a family physician or urgent care centers, if necessary. You can also contact one of the hotlines for immediate assistance.
What to say and not say to a person experiencing anxiety
The situation |
What to say and do |
What not to say and do |
| Apathy or despondency | Pay attention, initiate a conversation, be with the person, speak with the person, ask questions and instruct him or her to perform simple actions, for instance, offer a beverage: “let’s get something to drink”. In other words, try to get the person to talk and do things, not on an emotional level but on a practical level. |
Don't underestimate what the person is experiencing but also don't get into an emotional conversation that reflects their feelings. It is especially important not to underestimate the person’s feelings, get angry or pity them. |
| Acute physical reactions, panic and unrest |
Suggest that the person move to a more comfortable and quieter place that has less stimuli like noise. With simple and clear instructions, it is possible to direct the person to perform functional actions. You can help the person channel the restlessness into practical actions, for instance, by arranging together a sitting area. It is important to pay attention to your safety and the person's safety, especially if the person is extremely restless. In any case, it is important to consult a mental health professional. |
Do not hit, slap, pour water and do not give medicines without a medical prescription. Do not promise that "it will be fine" and do not force the person to sit or lie down, unless there is a medical indication that requires it. If the person feels more comfortable walking, allow them to walk and walk with them while talking. |
| Stuttering and convulsions | While consulting a mental health specialist, try to calm the person down, including by distracting him or her. Try to be attentive to the person, and if it is difficult for them to speak, do not ask questions or belittle the questions. Try to perform physical activity depending on where you are, such as going for a walk. Sometimes physical contact can help in grounding and returning to the "here and now" but this is not right for everyone. Touching, therefore, should be used with sensitivity while exercising discretion. |
Do not yell. It is unhelpful to say: "Stop immediately", or criticize or correct the stuttering or spasms (for example, don't say: "Now speak clearly"). Pay attention to what you say and especially avoid making jokes about the person. |