Mental health first aid and social support cannot replace professional help – but can supplement it

Across cultures, we intuitively understand our role as family members, partners and friends in supporting someone with a physical illness or injury. Yet, we often leave people facing mental health issues or illnesses alone or abandon them in care asylums. This stems from a limited understanding of mental health and the role of social support for mental health. We still, rather conveniently, see mental health only as a domain of experts.

Experts are undoubtedly important in dealing with such issues, but social support is equally important, especially in a country like India where there is an acute shortage of mental health professionals. Moreover, given the impact of the Covid-19 crisis and the lockdown on mental health, families and communities have to step up to provide first response and continued social support.

Starting a dialogue

We stigmatise these issues because we see mental and emotional vulnerabilities as weaknesses – something to be embarrassed or ashamed of. The stigma is only compounded by myths that people with mental health illnesses are abnormal, manipulative, or violent, or completely dependent. These myths influence our behaviour towards them and reduce our ability to help them.

So how do we address our limitations? We can begin by educating ourselves through free online resources, conversations with people facing mental health issues and illnesses, and consulting mental health professionals.

Mental health exists on a spectrum, ranging from issues like occasional anxiety and burnout to illnesses like clinical depression, bipolar disorder, anxiety disorder, schizophrenia, that can seriously impair functioning.

Not all of us suffer from mental illnesses, but we all experience mental health issues and need social support, albeit to varying degrees. Episodes like violent outbursts or psychotic breaks would undoubtedly require medical attention right away. However, for panic attacks or feelings of anxiety or depression, we can provide social support alongside therapeutic support.

What we can do

We must start by understanding the emotional needs of persons who requires support. Someone with a mental health issue or illness needs to be cared for with patience, kindness, respect and empathy. We need to communicate with the person about their social support needs and our abilities to provide such support.

Different people would have different needs and triggers. For instance, some people with mental illnesses may require friends or family to remind them to take their medications. While some require physical contact to calm them down, others are triggered by physical contact.

It is necessary to listen without invalidating them. If a loved one tells us they are suffering from depression we should not say, “just lighten up”. Telling a depressed person to cheer up trivialises their condition. It is as helpful as telling a diabetic person to will themselves to produce more insulin. It does not work.

What works, then?

We need to do for our loved ones struggling with depression what we would have done for a loved one with diabetes – encourage them to get professional help and make lifestyle changes, and let them know that we are here for them.

It is also crucial to familiarise ourselves with mental health first aid, so it comes as naturally to us as performing physical health first aid. We can reach out to mental health helplines for information on this or if our loved one is consulting a mental health professional, ask them what we can do to provide mental health first aid.

For instance, if a person is having a panic attack, we can help them calm down by getting them to breathe slower. Once they are calm, we can get them the therapeutic attention they need either online through therapy or mental health helplines. We do not need to be experts to get somebody to breathe slower, just present and patient.

Systemic changes

It is critical while providing support to others to also take care of our mental and physical health, set healthy boundaries, and reach out for the therapeutic and social support we need. Mental health professionals can counsel patients’ families on coping strategies and strategies for self-care as well. If we have someone within our circle who is suffering, we should recommend this to them.

Importantly, our efforts need to be backed by the government. The government needs to launch public awareness campaigns to educate the public on mental health issues and social support, including mental health first aid. It needs to provide basic mental health first aid training for health workers and health professionals. Where patients with mental illness require caregivers, it also needs to provide robust social, economic and psychological support for caregivers. It further needs to mandate that insurers provide coverage for mental health illnesses to ease the financial burden on families and patients.

To be human is to be vulnerable. Nobody is immune to mental health issues. But we can choose to be immune to prejudice, stigma and judgment. We can choose to show up for a fellow human going through a dark night of the mind with the words we have all needed to hear at some point: “You are not alone”.

Ashna Ashesh is a public health advocate working with Survivors Against TB, a lawyer and an MDR-TB survivor who struggled with depression.