In an effort to raise awareness and to remove some of the stigma associated with mental illness, especially depression, Tony Warren, Superintendent of Schools in Turner, Montana, applied for and received a School Safety Grant from the Montana Office of Public Instruction (OPI). In fulfilling the terms of the grant, Dr. Curtis Smeby and Dr. Darlene Sellers from MSU-Northern will teach the first session of a Youth Mental Health First Aid class on Thursday, January 30, and will return again on Thursday, February 6 from 4:00-8:00 p.m. at Turner Public School for the second session in a two-part series.

With a focus on children and young people, Youth Mental Health First Aid (YMHFA) is an eight-hour in-person training designed for anyone wanting to learn about mental illnesses and addictions, including risk factors and warning signs. Similar to CPR, participants encounter a five-step action plan to help young people who are developing a mental health problem or who are in crisis.

The course was created in Australia in 2001 by Betty Kitchener, a nurse specializing in health education, and Tony Jorm, a mental health literacy professor. In 2008, Mental Health First Aid was brought to the United States and is operated by the National Council for Behavioral Health in partnership with the Missouri Department of Mental Health.

Warren applied for the OPI grant because suicide rates are significantly higher in rural America, particularly in rural Montana. In fact, research suggests that the suicide rate in rural America is 45% greater than that in large urban areas. Social isolation, lack of access to mental health care, and small community living where internal struggles become tightly held secrets are all explanations for that statistic. The independent, “cowboy-up” mentality that a lot of people in agricultural communities wear like a badge of honor and the stigma of depression being seen as a weakness are additional factors.

“Unfortunately, communities throughout Blaine County have all recently experienced suicides of our youth. I believe that we have a moral obligation to increase awareness of this issue in an attempt to breakdown some of the stigma associated with mental illness. Turner Public School has extended an invitation to our community members and other community partners throughout Blaine County for this valuable training. Even if you can only make one of the dates, I still feel you will walk away with valuable information,” Warren stated.

Because the district secured a School Safety Grant from OPI, there is no cost associated with these trainings. Warren outlined the following goals and hopes for the sessions:

• Inform the community about common mental health concerns with youth

• Reduce stigma

• Teach individuals how to recognize signs of mental health issues with youth

• Learn the difference between typical adolescent behavior and warning signs of mental illness

• Provide participants with skills to apply a five-step action plan to assist any youth who may be experiencing a mental health problem or crisis

• Encourage an ongoing open dialogue about mental health in rural communities.

In the 66th Legislative Session, Montana’s Legislature passed House Bill 601 to provide funds to school districts to support school safety professional development. The bill, sponsored by John Fuller, Representative of House District 8, requested a transfer of funds within OPI for distribution to schools for professional development grants. Acceptable uses for the school safety professional development grants include but are not limited to individual training of school employees, improvement of facilities, and programs that promote the protection of students from violence, theft, bullying, harassment, exposure to weapons, and the sale or use of illegal substances on school grounds and during school-related activities

The first, four-hour session of the YMHFA training will see participants engaging with instructional segments accompanied by slides and activities for each segment. After an ice breaker activity, the group will receive an overview of the course, its manual, and a description of the role a bystander might play. Participants will also take a Mental Health Opinions Quiz and acquire some strategies for helping the community with YMHFA.

Next, trainees will receive an overview of youth mental health challenges in the United States and the prevalence of mental disorders and how everyone would likely have a label if they asked the right professional. The group will engage with the activity “Find Your Match” to identity their personal mental health issues, illnesses, and disorders.

Following that activity, attendees will discuss how the term normal is subjective and how there are as many different definitions for normal as there are people on this planet. Essentially, the activity and discussion will suggest that people are no less or more of a human for having depression than they would be for having cancer or cardiovascular disease or injuries from a car accident.

Other topics in Session One will include adolescent development, youth resilience, a discussion of the risk factors for developing a mental health disorder, protective factors, and the spectrum of interventions when someone observes signs and symptoms of suicide in another. Participants will also watch clips from the film Suicide: The Ripple Effect. The film highlights the journey of Kevin Hines, who at age 19, attempted to take his life by jumping from the Golden Gate Bridge.

In the film, developed for YMHFA, Hines shares his struggle with mental illness and substance use. In his junior year of high school, he was diagnosed with bipolar disorder. Although Hines attempted suicide by jumping off the Golden Gate Bridge in September 2000, he survived the 220-foot plunge. Now he travels the world as an inspirational speaker sharing his story of hope, healing, and recovery. Hines not only recounts how he won the battle for mental health but describes the people who helped him along the way. Participants in the YMHFA course watch Hines’ story to learn strategies to help young people who may be experiencing a mental health challenge or are in crisis.

This first session will conclude with the development of a YMHFA Action Plan and a review of the Five Actions involved: ALGEE. ALGEE is an acronym utilized as a mnemonic device to remember the Actions:

• Action A = Approach the Youth and Assess for Risk of Suicide or Harm

• Action L = Listen Nonjudgmentally

• Action G = Give Reassurance and Information

• Action E = Encourage Appropriate Professional Help

• Action E = Encourage Self-Help and Other Support Strategies

On Day Two, trainees will take a deep dive with these Five-Actions. Each of the steps will be accompanied by scenarios, activities, additional clips from the Kevin Hines film, and information on useful supports for youth with symptoms of a mental health disorder.

Those gathered will examine various crisis situations and practice ALGEE, assessing for risk of suicide or harm in various types of crises and determining fact, fiction, or somewhere in between in reading the signs that might suggest suicide ideation. Furthermore, they will perform panic attack role plays and discuss the importance of self-care, or taking care of the one providing first aid. These crisis intervention role plays give the first aider practice in developing and polishing the ALGEE intervention skills with different scenarios and groups.

To close the course, those attending will take the YMHFA Exam and then receive certificates for their attendance and achievement.

Besides workshops and films, websites, social media, and books can further contribute to our information-base on mental health. Like nearly one in five people, author Matt Haig suffers from depression, and he is very outspoken about mental health. He once wrote the Tweet: “Suicide is not selfish. Suicide is, normally, death caused by the illness of depression. It is the final symptom. A final collapse under unbearable weight. Suicide is a tragedy. If you have never been close to that edge, try not to judge what you can’t understand.”

Not only a presence on Twitter, Haig has also written blogs and is the author of Reasons to Stay Alive (Penguin Books, 2015), which is a resource for individuals who feel like they can no longer live with anxiety and depression.

In this memoir, Haig explains that everyone’s life is touched by mental illness. If we do not suffer from it ourselves, then we have a friend or loved one who does. Haig’s candor about his experiences is both inspiring to those who feel daunted by depression and illuminating to those who are mystified by it. Above all, his humor and encouragement never allow readers to lose sight of hope. Speaking as his present self to his former self in the depths of depression, Haig reminds himself and his readers that there are always reasons to stay alive, that one day we will experience joy that matches the pain of depression.

Comparing depression to a hurricane, Haig also outlines how a mind has its own weather system and points out that even hurricanes run out of energy eventually. He further reminds us not to worry about labels and to ignore stigma. At one time, for example, polio was thought to be an illness unique to poor people. According to Haig, “prejudice often comes before information. Depression is not a weakness or a personality failure. It’s an illness. We must not give depression power because depression lies. Everybody has a story about depression yet, for decades, we have been silent about it.”

A moving, funny, and joyous exploration of how to live better and to feel more alive, books like Reasons to Stay Alive, films like Suicide: The Ripple Effect, organizations like the National Council for Behavioral Health, and workshops like the one held in Turner can open the conversation about suicide and mental illness. After all, more conversations may lead to less stigma and to a reduction in the incidence of suicide and self-medicating with alcohol or drugs for conditions such as anxiety or depression.