Kate Roberts, Ph.D., a certified school psychologist who has practices in two Massachusetts towns, has spent more than 25 years in schools and with families helping them navigate difficult behavioral problems. So when she learned that two senators from New Hampshire helped sponsor the Mental Health First Aid Act of 2013, a bill that expands mental health care training, Roberts was both relieved and cautious.
“For training to be the most useful, it needs to target the specific populations to have the most impact,” she says. “It needs to address stigmatization regarding emotional well being and highlight from the beginning the benefits of the training. In other words, what are the goals and are they measurable?”
The goals, according to U.S. Senators Kelly Ayotte (R-NH) and Jeanne Shaheen (D-NH) who introduced the bill in January, are to increase effectiveness for mental health care across the country. With a designated $20 million in aid, the legislation – which has received bipartisan support – goes toward training programs that address crisis situations and call for timely referrals for available mental health services.
That focus would be key, says Roberts. “If this training helps us recognize signs sooner, all the better. But if the goal is earlier identification with the expectation they’ll be getting services, then the people responsible for providing the services and their funding sources (insurance companies) should be factored into the equation.”
The bill’s focus, however, is on equipping individuals such as first responders, school administrators, police officers and others to recognize warning signs and risk factors for mental disorders like panic attacks and anxiety disorders as well as schizophrenia and clinical depression. It emphasizes crisis de-escalation techniques and action plans for connecting individuals in psychiatric crisis to mental health professionals.
“By helping the public better identify and understand the signs of mental health crisis situations, the Mental Health First Aid Act takes an important first step toward strengthening our mental health system,” Ayotte says in an email.
Bryan Gibb, director of public education for the National Council for Community Behavioral Healthcare (NCCBH), says that existing mental health first aid training already addresses common signs, symptoms and risk factors for depression and mood disorders. Since 2007, the NCCBH has provided mental health first aid training for 2,500 instructors in 50 states, training more than 100,000 participants.
“The sooner someone’s illness is recognized and treated, the more likely they are to have a positive outcome and avoid a crisis,” Gibb says. “That said, the training does not teach people how to diagnose or treat illness any more than first aid training (from the Red Cross) would prepare you to treat a physical illness.”
The point of such training, he adds, is to help people know what mental illness might look like and how to provide comfort or defuse a crisis while referring them to professionals. As of September 2012, Gibb says 75 instructors had trained more than 2,500 people throughout New England, though he expected to see an increase of requests because of the December 2012 school shooting in Newtown, Conn.
“If this bill passes, it could go a long way toward reducing the stigma around mental illnesses and addictions and getting people connected to professional resources,” Gibb says. “We want to reduce any (economic) barriers so that anyone who wants to can get the training.”
For school psychologists like Roberts, it’s a wait and see situation.
“There’s always a need for purposeful training, especially if those who attend have a desire to be there,” she says. “There just needs to be a lot of clarity about outcomes and whether they’re measurable because if you’re going to introduce broader training, you should be able to assess its effectiveness.”
By Jo Kadlecek