Stories about first aid
Table presents three stories that are focused mainly around problems that took place within the intimate social network of friends and family, while Table presents three that examine issues that arose in the work setting (broadly defined).
Stories of providing first aid that involve the intimate network
Stories of providing first aid that involve the work setting.
In Table , Story 1 shows how the course helped someone cope with a challenge, reacting constructively to a partner with a mental disorder. The story is not one with a conventional happy ending – they did not in fact "live happily ever after" – but it does illustrate how the respondent was able to act constructively and make sense for himself about what happened.
Story 2 is somewhat similar in that it centres on dealing with a person with a mental disorder in an intimate, family relationship. Again there is a benefit with regard to increased understanding and self-knowledge. Here, however, we also see that it enabled the respondent to take actions that preserved a relationship that otherwise was in serious jeopardy.
Story 3 is slightly less intimate, but concerns the way a person responded to a friend who was experiencing mental health issues. The main benefits here are focused around the short term – it helped to get the man concerned to get counselling – and in palliating the emotional impact of the challenge. While the respondent does not see that having been at the course solved the problem, clearly he finds the short term and palliative effects valuable.
The three workplace stories (Table ) are quite different in context, even though they share some themes: the first comes from a person who works directly in a helping profession, the second from someone who works in a context where clients have ancillary problems, while the last example comes from someone who was carrying out work experience.
In Story 4, the respondent clearly identifies benefits for him and for a client with whom he was working who experienced mental health issues. While he does not feel he fully solved anything, he is clearly able to show how deploying the skills he had acquired led to a positive set of developments and small wins.
In Story 5, a person who works with socially disadvantaged clients mentions that he sees many people with mental health issues. Choosing one recent case as an example, he shows how increased understanding and awareness led to taking positive steps that benefited the client.
Story 6 introduces a quite different aspect. Here we see that while the intervention the respondent took was positive for a client, and also increased the respondent's self-awareness and positive feelings, a major benefit is that the knowledge acquired on the course positively role modelled something for co-workers and helped them meet a challenge.
Analysis of themes in open-ended questions
In this section, each open ended-question is presented and the results analysed and illustrated with examples.
Could you tell us something about the situation(s) and the problems you believed the person(s) was experiencing?
As the following illustrations show, some people took the course because of existing problems with friends and family in their life, others because voluntary work brought them into contact with people experiencing mental health problems and there were also quite a few people with professional health care positions who sought to receive additional training. Problems also varied in character from the more serious (schizophrenia) to somewhat less serious (panic attacks) and from the chronic to the episodic.
My son has for many years experienced depression and more recently possibly some kind of psychosis. He admitted himself into a mental health hospital and received help from psychologists on release. He is currently taking anti-depression medication, but I was not sure he would continue to take the drugs.
I was with a friend who had an anxiety attack which included difficulty in breathing, racing heart, chest pains, cold clammy skin and obvious distress.
As I am a trained nurse and work in a Day Room. We have quite a lot of patients with problems. I found the course very informative as my training 40 years ago lacked in psychiatry. My knowledge comes from life and reading and nowadays I can recognise panic attacks, depression and look after these much better.
The large majority of respondents felt they were able to be helpful with the situation faced. Those who could not help were asked "What was the reason(s) that you were not able to help that person(s)?" The three responses to this question referred to the fact that the person was already getting help or did not want help.
Can you give us any examples of something you did?
There was a wide variety of response here. While each response is unique, several broad themes emerged. The foremost theme, especially common for problems with family and friends, was calming the distressed person and listening to them. A sub-theme concerned listening and also actively referring for more specialist assistance.
I helped calm the person, kept them safe with supportive doctor and family members. I also supported without agreeing with their delusions and thoughts.
Listened. Identified that I could understand somewhat of how they saw things. Encouraged to consult a doctor or psychologist.
Two other major themes ran a roughly equal second place. One concerned referral to specialist help, which was more obvious among respondents where the contact was through a professional, workplace situation.
Persuade the person to seek counselling. Tried to listen and advise, also gave essential financial assistance.
The other main theme concerned giving concrete support and practical help and information/advice.
Offered non-discriminatory, non-judgmental support. Made gentle suggestions about ways she might get child to school, helped her get a Christmas tree up (for the kids) which alleviated her guilt around not feeling like having a Christmas.
What do you think were the effects on that person/s of what you did?
A few people responded to this question with general, positive statements such as "helpful" or "excellent" effects. The largest group, however, described immediate impacts, which involved calming, comforting or emotional support.
A calm and relaxed atmosphere brought the client a reassurance that I was not a threat to him, so calmed the client down so he could talk and get what was in his mind out and not be prejudged.
The second largest group overall described long term changes. These included getting the person on medication, giving practical help and establishing better relationships.
Kept him alive during the first severe stages of his illness (about one month), reassurance, gave him the time and space to recover himself, cut to a small degree the despair of "utter aloneness", did a lot of simple things (phone calls, tax, Centrelink, bills, forms etc) that for the duration of the illness were impossible for him but helped keep his "life on track".
It cannot be ascertained for certain, but one sensible interpretation of the contrast between these two groups is that more focus was placed on the immediate effects when the respondent was less heavily involved with the person experiencing the mental health problem and/or the problem was less severe. Where the problem was more severe, and especially when the respondent was more closely involved (e.g. friend or family member) more detailed answers, with a longer time frame, were supplied.
Can you give us any examples of how your relations with that person/s, or your feelings towards them, have changed?
The overwhelming trend in the data here was in the direction of very positive answers, with a relative trickle of answers that were either mixed or negative. Within the positive trend, two sub-trends could be identified, reflecting the double- barrelled character of the question. In the first, the respondent concentrated mainly upon how the relationship improved:
Our relationship has improved. Communication is better and violent mood swings are not as frequent.
The second theme, of course, focused more on positive improvement in the way the respondent felt or thought.
More tolerant – I'm less inclined to get "cross" about my time being "wasted".
A few respondents gave a negative response, although none of these suggested that the course was in any way deficient or that the things they learned failed to work.
Not a lot. Perhaps they are more willing to communicate their feelings.
Clearly, the experience of the course had positive effects for the large majority of people, either in improving their relationship with someone experiencing a mental health problem or in their feelings towards and ideas about that person, or both.
Importantly, here and elsewhere in the analysis, no hint emerged that the course led people into an unrealistic position. For example, no one told a story that suggested they became over-confident and hence made a mess of a situation.
Do you think this change had any effect on the person/s, either good or bad?
The overwhelming response here was that effects had been positive. In a number of cases the respondent simply said "good", or "positive", but many others elaborated.
I believe the change has had a good effect, she is gradually moving forward to make things better in her life with the support of services, GP, etc.
This change has been very positive on both of us. I have seen first hand the benefits of being a good listener and friend and giving helpful advice. My friend states that she is more patient and understanding of others.
Very few overall gave negative responses. Clearly, the dominant response to this question was that the knowledge and skills assisted people to take a constructive and positive response which led to desirable and welcome outcomes.
How (if at all) has doing the MHFA course changed how you relate to or feel about the person(s) suffering from that mental health problem?
Two main themes emerged in the answers here – competence and empathy – both with sub-themes. The largest single group of answers concerned professional competence. A substantial number of people who did the course worked with people in the broad area of health or the helping professions. For these respondents, the course clearly delivered a greatly increased sense of comfort and confidence.
It has opened my eyes to the wide range of mental health problems people may suffer. In my work I deal with unemployed people who may be suffering from mental health problem as a result of unemployment or it may be affecting their ability to hold down employment.
While professional competence was important, a linked but smaller theme was personal competence, that is, the capacity to deal confidently with something that had previously been an on-going challenge.
The course provided me the gateway to education about mental health issues, it has made me more self aware and prepared me better for the experiences that I have had thus far especially as it was emotionally hard for me to accept that a close family member was ill.
The second large theme in response to this question centred upon having developed empathy and understanding. As with competence, this theme sub-divided, in this case almost equally, into two themes: generalised empathy towards people with a mental illness and specific empathy towards someone with whom there had previously been tensions and strain.
I have deeper understanding on what these people actually going through. I have become more empathetic towards them.
Made me much more aware of his problem and to question how much of his earlier behaviour (he is now 48) may have been a result of his mental condition.
A third and minor theme was that the course refreshed or reinforced existing knowledge, skills and attitudes.
It was really a "filling in" and affirmation, and "refresher" of all I had learned and experienced in the past when working with people with cerebral palsy, head injuries, and autism. I learned a little more about other mental health problems.
Again, the responses showed that people did the course with a variety of expectations and needs, yet despite this variety, it succeeded across the board in meeting those varied needs and expectations.
Is there anything else you would like to say about the MHFA course and its value for you?
This question generated a particularly rich vein of data. The central trend that informed the vast bulk of comments was an extremely positive view of the program. Indeed, only one or two negative comments were received of any kind. Nonetheless, some themes could be discerned. First, within those who were directly positive, some were rather non-specific, while others gave detailed examples. These included gaining knowledge of how to help, greater confidence in providing help, breaking down barriers to dealing with mental health problems, and making contact with other people with similar concerns about mental health issues.
This was some of the best information I've had for years and wish I had done a course this good 30 years ago.
I found the course quite confronting. The insight gained on my personal situation was appreciated. The value of the course to me was high. I would encourage everyone to attend. I think the handbook is an excellent tool. I learnt a lot from the course.
Extremely valuable from point of view of year Advisor at a large rural high school. Provided information and avenues where to get help or refer young people to. Also valuable as a legal studies teacher (an added benefit).
Another group were very enthusiastic about the course and wanted to see it extended, either by follow on courses or by linking to new audiences.
I think it should run regularly as the population needs to learn how to deal with the situations and it creates an awareness and perhaps takes away the fear of the unknown.
This course was exceptional in its presentation and content. A more in-depth and extensive follow up program would be beneficial and valuable.
Finally, another group offered criticism. This was almost always constructive and linked to positive evaluation.
I found it very interesting, but would have liked a little more in-depth treatment of some conditions, with some various "case histories." That would have been very helpful. There seems to be a bit of a gap between how community and mental health departments are portrayed, and what they actually deliver, or take responsibility for.