Mental Health First Aid Training - Phynix Initiative
Image taken from phynixinitiative.com.au


In Australia, almost 1 in 5 Australians suffer from mental health disorder in a given year, and nearly half (45%) of the population will experience a mental illness at some point in their life. It is the third leading cause of disease burden in Australia, just behind cardiovascular disease and cancer.

In optometry practice, we will encounter patients and colleagues with mental health issues. Although we are not experts, it is still our duty of care to provide patients guidance through mental health first aid.

 What is mental health first aid?
Mental health first aid is defined as the help provided to a person developing or experiencing a worsening of their existing mental health problem. The first aid is given to the person as an early intervention until the crisis resolves or appropriate professional treatment is received.

Why do we need mental health first aid?
As there is a strong social stigma attached to mental illness, many people do not discuss their struggles nor seek help. About two thirds of people with mental disorders do not seek any treatment.
Vision impairment and blindness can affect all facets of patient's daily life, reducing functionality, social ability and subsequently their quality of life. Chou et al documented robust evidence that those with visual impairments are 2-3x more likely to suffer clinical depression. Clinicians usually already have some trust from patients and can therefore try to provide the early intervention necessary.

Understanding the signs of mental health disorders
The most common types of mental health disorders optometrists will encounter are clinical depression, anxiety and substance use disorder. Early warning signs may include:
  • Not turning up to appointments
  • Erratic behaviour observed in examination/waiting room
  • Feeling tired all the time
  • Disheveled appearance
  • Reduced participation, and withdrawn from others
  • Lack of concentration and/or loss of confidence

Examples of mental health disorders 
Clinical depression
 Anxiety
 Substance abuse disorder
Diagnosis requires at least one of the following: 
  • Depressed mood that doesn't go away 
  • Loss of interest/pleasure in activities 
  • Lack of energy and tiredness 
  • Feeling guilty when not at fault 
  • Thinking about death, wanting to die 
  • Becoming agitated and difficult to sleep 
  • Lack of interest in food 
  • Moving slowly


Many different types of disorder: e.g. social anxiety disorder, panic anxiety, general anxiety disorder etc 
All have set requirements

Note the duration of anxiousness is 6 months or more. 


Also called substance abuse, substance dependance or substance misuse.

Alcohol is the most common substance use disorder.

It is when someone loses control or there is a disturbance of mood due to physiological effects of substances.

Use the link below for early intervention:
www.checkyourdrinking.net
Criteria for the above conditions and more can be found here https://www.ncbi.nlm.nih.gov/books/NBK64063/#A92667


How to approach mental health first aid


Try to take a deep breath, face the patient with shoulder to shoulder at the same height, and if sitting, have your hands folded on your laps.
If you are unsure of how to begin the conversation with the patient, you might want to say something along the lines of:
“I’m really concerned about “x’s/your” behaviour. Have you talked about this with your family or GP? Have you done anything about it? Or would it be okay if I share this with the GP?”



Click here to visit a page on where to find professional help and resources. 



 References

1. Mental health first aid (self care) Webinar by Teresa Coffey and Simon Hanna 
2. Chou, K. L. (2008). Combined effect of vision and hearing impairment on depression in older adults: evidence from the English Longitudinal Study of Ageing. J Affect Disord, 106(1-2), 191-196. doi:10.1016/j.jad.2007.05.028
3. Center for Substance Abuse Treatment. Managing Depressive Symptoms in Substance Abuse Clients During Early Recovery. Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2008. (Treatment Improvement Protocol (TIP) Series, No. 48.) Appendix D—DSM-IV-TR Mood Disorders. Available from: https://www.ncbi.nlm.nih.gov/books/NBK64063/