Mental health challenges and encouraging help seeking behaviours among rural residents

Lakshmi Mahadevan, Associate Professor and Extension Specialist at Special Populations, looks toward helping rural residents seek appropriate and timely help for mental health challenges

Beginning March 2020, Texas A&M AgriLife Extension Service (AgriLife Extension) launched the “Reducing Opioid Use and Misuse through Mental Health First Aid in Rural Texas” (MHFA_RTX) project funded through a Rural Health and Safety Education grant awarded by the United States Department of Agriculture (USDA).

MHFA_RTX seeks to teach people to identify and address mental health challenges, or substance use disorder among fellow rural citizens by implementing ALGEE safely and responsibly.

How do Mental Health First Aiders help tackle mental health challenges?

• Assess for risk of suicide or harm.
• Listen nonjudgmentally.
• Give reassurance and information.
• Encourage appropriate professional help.
• Encourage self-help and other support strategies.

MHFA for adults takes the fear and hesitation out of starting conversations about mental health and substance use problems by giving individuals experiencing mental health challenges their sense of autonomy and decision-making power back.

This is accomplished by training Mental Health First Aiders to apply a nonjudgmental approach throughout the duration of the MHFA interaction.

Mental Health First Aiders’ nonjudgmental approach

1. Allowing individuals to say “I don’t want to talk with you about this” or “I don’t want to talk right now” or “Can I contact you later?” or “I would like to talk but not with you.”
2. Refraining from advising individuals about undertaking a specific course of action.
3. Not making decisions or taking action that amount to seeking active treatment for the individuals unless it is a medical emergency.
4. Exercising patience with individuals who are indecisive, delay getting treatment or refuse to seek appropriate professional or self-care.
5. Knowing that the MHFA “ALGEE” framework is non-linear and will require starting over, repetition of steps, and consistent follow-up.
6. Giving individuals a variety of care options that they can choose to utilize in real time or in the future.
7. Encouraging individuals to choose the care options that are most appropriate.
8. Reminding individuals that they can choose to discontinue or choose alternate means of care as needed.
9. Using universal language that transcends cultural barriers such as “You are not alone…”; “I am concerned about you because I have noticed…” and, “It is natural to feel this way and I am here if you want to talk about it.”.
10. Noticing signs and symptoms of substance use and non-suicidal self-injury and stating observations objectively without overreacting or heightened emotion.
11. Disclosing personal lived experiences emphasising recovery, optimism and strategies that worked without making the conversation all about oneself.

As of 2022, MHFA_RTX grant has trained over 240 Texans to be Mental Health First Aiders. Of those trained, 90% indicated that their knowledge of mental health challenges, signs, and symptoms has improved. 85% of participants reported appreciation for the MHFA action plan and the potential for preventing, intervening and recovery for fellow rural citizens experiencing mental health challenges.

Additionally, 80% of participants indicated that they were highly likely to have a supportive conversation with an adult experiencing signs and symptom(s) of a mental health or substance use challenge or crisis.

Participant testimonials

The most helpful part of the course was,

1. “Learning how to provide aid that will lead to encouraging a person to seek help”.
2. “Approaching the awkward conversations for me would be difficult. The scenarios were very good demonstrating how to start the conversations in a variety of settings”.
3. “Understanding how to approach a situation with purpose. Before, I had great advice, but failed to adequately listen in order to understand the actual struggles behind the situation”.

The USDA-NIFA funded, “Reducing Opioid Use and Misuse through Mental Health First Aid in Rural Texas” grant is focused on and has been effectively working to offset barriers posed by ruralized culture, stigma and judgment to beginning difficult conversations about mental health.

Additionally, by encouraging independent decision making, and creating avenues for individuals to regain a sense of autonomy and control, Mental Health First Aiders are helping more rural Texas adult residents to seek appropriate help without delay thus increasing the likelihood of getting on a path to quicker recovery.

 

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